Case 5: Adolescent Unstable Tibial Fracture Treated Initially with Closed Reduction and Plaster Cast Immobilization Converted to TL-Hex External Fixation due to Residual Displacement

2015 ◽  
pp. 29-35 ◽  
Author(s):  
Haim Shtarker ◽  
Mikhail Samchukov
Keyword(s):  
External Fixation ◽  
Closed Reduction ◽  
Tibial Fracture ◽  
Plaster Cast ◽  
Cast Immobilization ◽  
Residual Displacement

scholarly journals Closed Reduction and Percutaneous Kirschner Wire Fixation Combined with Plaster Cast versus Conventional Plaster Cast immobilization in the Treatment of Colles' Fracture – A Prospective Randomized Comparative Study

1970 ◽  
Vol 17 (2) ◽  
pp. 98-105 ◽  
Author(s):  
KS Uzzaman ◽  
KA Awal ◽  
MK Alam
Keyword(s):  
Comparative Study ◽  
Closed Reduction ◽  
Kirschner Wire ◽  
Plaster Cast ◽  
Cast Immobilization ◽  
Fixation Group ◽  
Wire Fixation ◽  
Colles Fracture ◽  
End Results

Purpo'e: To evaluate functional & anatomical results of the Colles’ fracture treated by two methods- i) Closed reduction & precutaneous kirschner wire (K- wire) fixation combined with plaster cast & ii) Conventional plaster cast immobilization after closed reduction.Methods: A randomized prospective comparative study was done from July 2003 to June 2005 on 52 patient with Colles' fracture in NITOR, Dhaka. 12 patients lost from follow up. Twenty patient (20) in each group were finally available for evaluation. The group treated by closed reduction & percutaneous K-wire fixation combined with plaster cast- designated as "Arm A" & another group treated conventionally by plaster cast only designated by "Arm-B". Male Female ratio was 1:3, Age range was 35 to 70 years (Mean age 52.5 years) Distribution of limbs side involvement almost equal. Mode of injuries were domestic fall & RTA (4:1) According to AO classification fracture were in both groups- A2 = 13, A3 = 10, C1 = 6, C2 = 8 & C3 = 3 (Total- 40). Follow up period was 6-14 months (mean = 6 month)Results: Union time for most of the fractures was 6-8 weeks. At final follow up Satisfactory Anatomical end results of percutuneous fixation group (Arm-A) were 80% and in conventional plaster cast group (Arm-B) were 35%. (P<0.01). Satisfactory functional end results in Arm-A group were 70% and in Arm-B group were 30% (P<0.01) Complications seen much more in conventional group (Arm-B) than percutaneous K-wire fixation group (Arm-B). Sarmiento & Latta’s criteria was used to evaluate the progress.Conclusion: The coventional plaster cast method for treatment of colles’ fracture usually can't maintain radial length & angulation in many instances and results significant anatomical difficultly and functional disability. On the other hand after close reduction additional fixation in the form of percutaneous crossed K-wire can maintain the reduction till bony union & prevent late collapse at fracture site & provides better result. Key Words: Colles' fracture; closed reduction; Plaster cast & Kirschner wire (K-wire) fixationDOI: 10.3329/jdmc.v17i2.6591J Dhaka Med Coll. 2008; 17(2) : 98-105

scholarly journals Epidemiology of tibial shaft fractures

2002 ◽  
Vol 10 (4) ◽  
pp. 10-17 ◽  
Author(s):  
Marco Aurélio Sertório Grecco ◽  
Idyllio do Prado Junior ◽  
Murilo Antonio Rocha ◽  
José Wagner de Barros
Keyword(s):  
External Fixation ◽  
Road Traffic ◽  
Plaster Cast ◽  
Epidemiological Studies ◽  
Open Fractures ◽  
Tibial Shaft ◽  
Cast Immobilization ◽  
Epidemiological Analysis ◽  
Shaft Fractures ◽  
Tibial Shaft Fractures

In this work an epidemiological analysis on tibial shaft fractures was performed. During four years, our service treated 179 fractures, 132 in male, 47 in female, aged 14 to 83 years. The 21 to 30-year-old patiens were the more injured. Of these, 120 were open and 59 close fractures of which prevailing cause was road traffic accident. The study based on patients promptuaries analyses and radiographs. The fractures occurred 97 times in the middle third (54.18%); 102 times (56.98%) presented simple fragments, and 57 (31.38%) oblique lines. We treated close and open fractures, respectively, 48 and 38 cases with plaster cast immobilization; 3 and 67 with external fixation after plaster cast immobilization; 5 and 12 with osteosynthesis by means of plate and screws, and 2 and 3 with external fixation only. In both close and open fractures, respectively, 7 and 20 cases of pseudarthrosis and 1 and 11 of infections have occurred. With the data obtained we verified an actual validity of the epidemiological studies as a contribution for better identifying lesions features and their treatment and complications. This allows proceedings and apprenticeship refinement.

scholarly journals Comparative study on the functional outcome of ligamentotaxis in comminuted fractures of the distal end of radius and with that of conservative means of closed reduction and casting

2017 ◽  
Vol 3 (3) ◽  
pp. 614
Author(s):  
Urampath Sudheer ◽  
Chundarathil Jayaprakash
Keyword(s):  
External Fixator ◽  
Closed Reduction ◽  
Functional Results ◽  
Plaster Cast ◽  
X Rays ◽  
Cast Immobilization ◽  
Score System ◽  
Articular Fractures ◽  
Comminuted Fractures ◽  
Group 2

<p><strong>Background</strong>: Comminuted fractures of lower end of radius most often bring out unsatisfactory outcome, if treated by conservative means of closed reduction and casting. This study was aimed to compare the results of ligamentotaxis in comminuted fractures of the distal end of radius and with that of closed manipulative reduction and plaster cast immobilization.</p><p><strong>Methods</strong>: Patients with comminuted fracture lower end of radius treated by ligamentotaxis or the conservative methods were included in the prospective study. Patients in group l treated by external fixator and in group 2 treated by conservative line of management. Postoperative check X-rays were taken. All the patients were evaluated on 3rd, 6th, 12th and 18th months after surgery. Functional results were assessed by Gartlands point score system and subjected to statistical analysis.</p><p><strong>Results: </strong>Total fifty patients were included in the study. Twenty five were treated by external fixator and the remaining was treated by conservative line of management. Patients underwent ligamentotaxis had 88% excellent results whereas 52% of patients on conservative care had similar results. When the conservative methods gave poor results for severely comminuted fractures, ligamentotaxis could bring out excellent re-orientation of fragments back to near normal alignment.</p><p><strong>Conclusions</strong>: Ligamentotaxis using a distracter is a better method to treat comminuted fractures of lower end of radius. Even though the initial reductions were excellent in a plaster cast, re-displacement rates are very high in a plaster cast. Fractures without intra articular extension always yielded far better results than intra articular fractures.</p>

scholarly journals Isolated dislocation of the pisiform bone in a 10-year-old boy

2019 ◽  
Vol 147 (3-4) ◽  
pp. 223-225
Author(s):  
Sinisa Ducic ◽  
Nikola Bojovic ◽  
Vladimir Radlovic ◽  
Goran Djuricic ◽  
Bojan Bukva
Keyword(s):  
Closed Reduction ◽  
Pediatric Population ◽  
Rare Condition ◽  
Plaster Cast ◽  
Clinical Findings ◽  
Carpal Bone ◽  
Cast Immobilization ◽  
Rare Injury ◽  
Volar Aspect ◽  
Pisiform Bone

Introduction. Isolated dislocation of the pisiform bone is a very rare condition due to robust ligamentous attachments that stabilize the pisiform to the carpus. This type of injury is usually a result of direct trauma to the ulnar and volar aspect of the wrist. Case outline. We present an isolated dislocation of the pisiform, with no other carpal bone injuries, treated successfully with closed reduction. Diagnosis was based on clinical findings, plain radiographs, and computer tomography examination of the wrist. Elongation and partial rupture of the pisometacarpal ligament was found on magnetic resonance imaging. Conclusion. Fracture and dislocation of the pisiform is an extremely rare injury in children, which could be easily neglected or misdiagnosed. Closed reduction with plaster cast immobilization should always be considered as the first method of treatment in the pediatric population, since the conservative approach provides excellent results.

Plaster immobilization versus anterior plating for dorsally displaced distal radial fractures in elderly patients in Pakistan

2021 ◽  
pp. 175319342097778
Author(s):  
Muhammad Tahir ◽  
Faridullah Khan Zimri ◽  
Nadeem Ahmed ◽  
Allah Rakhio Jamali ◽  
Ghulam Mehboob ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Randomized Trial ◽  
Closed Reduction ◽  
Primary Outcome ◽  
Locking Plate ◽  
Cast Immobilization ◽  
Distal Radial Fractures ◽  
Level Of Evidence ◽  
Anterior Plating ◽  
Plaster Immobilization

This prospective, multi-centred, randomized trial examined outcomes of 3- and 12-month follow-ups of 159 elderly participants aged more than 75 years with isolated distal radial fractures, treated by anterior locking plate or closed reduction and cast immobilization. The primary outcome was the patient-rated wrist evaluation (PRWE) score. The PRWE score at 12 months was not significantly different between the two groups; however, the radiological outcomes and complications rates were worse in the casting group. Level of evidence: III

scholarly journals Reamed intramedullary nailing versus circular frame external fixation for segmental tibial fractures (STIFF-F): a mixed methods feasibility study

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Caroline B. Hing ◽  
Elizabeth Tutton ◽  
Toby O. Smith ◽  
Molly Glaze ◽  
Jamie R. Stokes ◽  
...  
Keyword(s):  
Mixed Methods ◽  
External Fixation ◽  
Intramedullary Nailing ◽  
Feasibility Study ◽  
Online Survey ◽  
Tibial Fracture ◽  
Tibial Fractures ◽  
Circular Frame ◽  
Pilot Rct ◽  
Randomised Controlled

Abstract Background Segmental tibial fractures are fractures in two or more areas of the tibial diaphysis resulting in a separate intercalary segment of the bone. Surgical fixation is recommended for patients with segmental tibial fractures as non-operative treatment outcomes are poor. The most common surgical interventions are intramedullary nailing (IMN) and circular frame external fixation (CFEF), but evidence about which is better is of poor quality. An adequately powered randomised controlled trial (RCT) to determine optimum treatment is required. STIFF-F aimed to assess the feasibility of a multicentre RCT comparing IMN with CFEF for segmental tibial fracture. Methods STIFF-F was a mixed-methods feasibility study comprising a pilot RCT conducted at six UK Major Trauma Centres, qualitative interviews drawing on Phenomenology and an online survey of rehabilitation. The primary outcome was recruitment rate. Patients, 16 years and over, with a segmental tibial fracture (open or closed) deemed suitable for IMN or CFEF were eligible to participate. Randomisation was stratified by site using random permuted blocks of varying sizes. Participant or assessor blinding was not possible. Interviews were undertaken with patients about their experience of injury, treatment, recovery and participation. Staff were interviewed to identify contextual factors affecting trial processes, their experience of recruitment and the treatment pathway. An online survey was developed to understand the rehabilitation context of the treatments. Results Eleven patients were screened and three recruited to the pilot RCT. Nineteen staff and four patients participated in interviews, and 11 physiotherapists responded to the survey. This study found the following: (i) segmental tibial fractures were rarer than anticipated, (ii) the complexity of the injury, study setup times and surgeon treatment preferences impeded recruitment, (iii) recovery from a segmental tibial fracture is challenging, and rehabilitation protocols are inconsistent and (iv) despite the difficulty recruiting, staff valued this research question and strived to find a way forward. Conclusion The proposed multicentre RCT comparing IMN with CFEF is not feasible. This study highlighted the difficulty of recruiting patients to an RCT of a complex rare injury over a short time period. Trial registration The study was registered with the International Standard Randomised Controlled Trials Number Registry: ISRCTN11229660

scholarly journals Fracture of Proximal Humerus & Shaft Managed With Closed Reduction & External Fixation by Joshi External Stabilisation System (Jess) – A Case Report

2018 ◽  
Vol 5 (1) ◽  
pp. 54-58
Author(s):  
Prakriti Raj Kandel ◽  
Rajiv Baral ◽  
Abhishek Kumar Thakur ◽  
Gyaneshwar Prasad Singh ◽  
Laxmi Pathak
Keyword(s):  
External Fixation ◽  
Closed Reduction ◽  
Proximal Humerus ◽  
Road Traffic ◽  
Skin Grafting ◽  
Shaft Fracture ◽  
Left Shoulder ◽  
Medical Sciences ◽  
Lacerated Wound ◽  
Fracture Of Proximal Humerus

We are presenting a case of proximal humerus& shaft fracture in a 50 year old female. She sustained injury on her left upper limb in a road traffic accident. It was managed with closed reduction & external fixation by Joshi External Stabilisation System (JESS). Lacerated wound over her left shoulder & arm region was managed with skin grafting. The post-operative period was uneventful. Journal of Universal College of Medical Sciences (2017) Vol.05 No.01 Issue 15, Page: 54-58

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