Surgical treatment of midclavicular fractures: a prospective comparison of Knowles pinning and plate fixation

Abstract Background Transoral atlantoaxial reduction plate (TARP) fixation or occipitocervical fixation (OF) is an effective treatment for basilar invagination (BI) with irreducible atlantoaxial dislocation (IAAD). But, all current clinical studies involved a single surgical procedure. The clinical effects of TARP and OF operation for BI with IAAD have yet to be compared. We therefore present this report to compare the treatment of TARP and OF procedure for BI with IAAD. Methods Fifty-six patients with BI with IAAD who underwent TARP or OF operation from June 2011 to June 2017 were retrospectively analyzed. Among these, 35 patients underwent TARP operation (TARP group), and 21 patients underwent OF operation (OF group). We compared the difference of clinical, radiological, and surgical outcomes between the TARP and OF groups postoperatively. Results Compared with OF group, the operative time and blood loss in TARP group were lower. There was no statistical difference in the atlantodental interval (ADI), clivus canal angle (CCA), cervicomedullary angle (CMA), distance between the top of the odontoid process and the Chamberlain line (CL) and Japanese Orthopaedic Association (JOA) score between the TARP and OF groups preoperatively, but the improvements of these parameters in the TARP group were superior to those in the OF group postoperatively. The fusion rates were higher in the TARP group than those in the OF group at the early stage postoperatively. Conclusions TARP and OF operations are effective surgical treatment for BI with IAAD, but the performance of reduction and decompression and earlier bone fusion rates of TARP procedure are superior to those of OF.

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SURGICAL TREATMENT OF CLAVICULAR FRACTURES IN SPORT

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118s00047 ◽

2018 ◽

Vol 6 (6_suppl3) ◽

pp. 2325967118S0004

Author(s):

E Gastaldi Orquin ◽

GM Gastaldi Llorens

Keyword(s):

Surgical Treatment ◽

Internal Fixation ◽

Open Reduction ◽

Plate Osteosynthesis ◽

Platelet Rich Plasma ◽

Plate Fixation ◽

Activity Level ◽

Contact Sports ◽

Sport Practice ◽

Shoulder Range Of Motion

Clavicular fractures are common in sport practice, they are easily diagnosed and have a relative good forecast. Nevertheless there is no consensus among orthopedic surgeons regarding treatment for displaced midle-third clavicular fractures (Robinson’s classification 2B2) and lateral-third fractures. The tendency toward operative treatment is increasing due to the earlier sport recovery. Objectives: The aim of the paper is to present the results of treatment of 98 clavicular fractures in the Clinic Gastaldi of Traumatology during the period from 1997 to 2016, analyzing the radiologic and clinical results. Methods: The serie consists of 89 patients, 80 males and 9 females, average age 32.2 years. From them, 89 were agude fractures and 9 nonunion (after conservative treatment). According to the Thomsom classification there were 82 middle-third and 16 lateral-third. Motorbike sport trauma was the cause of 49 patients (55%), bike trauma in 18 (20%), 18 (20%) fractures occurred due to contact sports and 3 other causes. All patients were surgically treated. We used an antero-superior approach, open reduction and internal fixation with antero-superior plate osteosynthesis. In case of nonunion we decorticated the fracture callus, adding intramedullary reaming and graft bone. PRP (Platelet Rich-Plasma) was used in 8/9 patients. Postoperatively, the patients were placed in a sling. After that they began a rehabilitation program that consists of isometrics, pendular and active movements until 45° during 3 weeks. From 4th to 6th week, active movements until 90°. The patients began free movements after the 6th week. Results: Fracture healing mean was 10 weeks. Bikes and motorbikes were able to ride again between 10 to 21 days after surgery (once removed stitches). All patients retrieved full shoulder range of motion and returned to their previous activity level. Complications: we had no nonunion rates after surgical treatment, neither infections. 1 case of insufficient plate fixation and 4 re-fractures which required surgical treatment. Conclusion: We suggest surgical treatment for clavicular fractures in adult patients, contact sports with IIB and IIIB fractures, re-fractures and painful nonunion. Surgical treatment with open reduction and internal fixation (ORIF) of displaced middle-third clavicular fractures achieved shorter time to complete return to sport and earlier bone union.

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Letter to the editor: Surgical treatment of vertically unstable lateral clavicle fractures (Neer 2b) with locked plate fixation and coracoclavicular ligament reconstruction

Archives of Orthopaedic and Trauma Surgery ◽

10.1007/s00402-013-1855-x ◽

2013 ◽

Vol 133 (12) ◽

pp. 1697-1698

Author(s):

Natascha Kraus ◽

Markus Scheibel

Keyword(s):

Surgical Treatment ◽

Ligament Reconstruction ◽

Plate Fixation ◽

Coracoclavicular Ligament ◽

Locked Plate ◽

Letter To The Editor ◽

Lateral Clavicle ◽

Coracoclavicular Ligament Reconstruction ◽

Clavicle Fractures

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Surgical treatment of unstable fractures of the distal clavicle: A comparative study of Kirschner wire and clavicular hook plate fixation

Acta Orthopaedica Scandinavica ◽

10.1080/000164702317281404 ◽

2002 ◽

Vol 73 (1) ◽

pp. 50-53 ◽

Cited By ~ 137

Author(s):

Tapio Flinkkilä ◽

Jukka Ristiniemi ◽

Pekka Hyvönen ◽

Martti Hämäläinen

Keyword(s):

Surgical Treatment ◽

Comparative Study ◽

Plate Fixation ◽

Kirschner Wire ◽

Hook Plate ◽

Distal Clavicle ◽

Clavicular Hook Plate ◽

Unstable Fractures

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Surgical treatment of avulsion fracture around joints of extremities using hook plate fixation

BMC Musculoskeletal Disorders ◽

10.1186/s12891-019-2585-1 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 2

Author(s):

Qudong Yin ◽

Yongjun Rui ◽

Yongwei Wu ◽

Jun Liu ◽

Yunhong Ma ◽

...

Keyword(s):

Surgical Treatment ◽

Avulsion Fracture ◽

Plate Fixation ◽

Hook Plate

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PLATE FIXATION OF ODONTOID FRACTURES WITHOUT C1–C2 ARTHRODESIS

Neurosurgery ◽

10.1227/01.neu.0000339117.60613.8c ◽

2009 ◽

Vol 64 (4) ◽

pp. 726-733 ◽

Cited By ~ 7

Author(s):

Patrick Platzer ◽

Gerhild Thalhammer ◽

Anna Krumboeck ◽

Rupert Schuster ◽

Florian Kutscha-Lissberg ◽

...

Keyword(s):

Surgical Treatment ◽

Plate Fixation ◽

Activity Level ◽

Rigid Fixation ◽

Atlantoaxial Joint ◽

Anterior Plate ◽

Odontoid Fractures ◽

Patient Reported ◽

Pain Symptoms ◽

Fracture Compression

Abstract OBJECTIVE Surgical treatment of odontoid fractures that do not allow interfragmentary fracture compression involves either posterior atlantoaxial arthrodesis or additional anterior stabilization using a plate construct. The purpose of this study was to determine the clinical and radiographic outcome after anterior plate fixation of odontoid fractures that were not suitable for anterior screw fixation. METHODS We reviewed the clinical and radiographic records of 9 patients with an average age of 54 years at the time of surgery who had undergone anterior plate fixation of an odontoid fracture. Indications for using a plate construct were odontoid fractures with anterior oblique fracture lines, fractures with comminution or major displacement, and pathological fractures. RESULTS Eight patients returned to their preinjury activity level and were satisfied with their treatment. One patient reported chronic pain symptoms and a notable decrease in cervical spine motion. Using the Smiley-Webster Scale to quantify their clinical outcome, we achieved an overall outcome score of 1.6. Bony fusion was achieved in all patients. Reduction or fixation failed in 2 patients. Reoperation for technical failures was not necessary in any of the patients. CONCLUSION We had promising results using anterior plate fixation for surgical treatment of odontoid fractures that did not allow interfragmentary fracture compression. Because this method avoids the rigid fixation of the atlantoaxial joint in contrast to techniques of posterior cervical arthrodesis, it seems to be a practical option for the management of fracture types that require additional stabilization of the odontoid.

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Comparison of Radiographic Outcomes of Surgical Treatment in Patients with Distal Radial Fractures

Ortopedia Traumatologia Rehabilitacja ◽

10.5604/01.3001.0012.8395 ◽

2018 ◽

Vol 20 (6) ◽

pp. 461-470

Author(s):

Jakub Florek ◽

Ireneusz Kotela ◽

Filip Georgiew ◽

Witold Zieńczuk ◽

Tomasz Rzeszutek

Keyword(s):

Surgical Treatment ◽

Open Reduction ◽

Locking Plate ◽

Plate Fixation ◽

Kirschner Wire ◽

Treatment Method ◽

Kirschner Wires ◽

Distal Radial Fractures ◽

Efficient Treatment ◽

Radiographic Outcomes

Background. Unstable and comminuted distal radial fractures require surgical treatment by percutaneous insertion of Kirschner wires, open reduction, and fixation with a non-locking or locking plate or with an external device. Choosing a surgical method that produces “better” outcomes may help select the most efficient treatment method. Material and methods. The study group included 100 patients after surgical treatment by closed reduction and simple fixation with Kirschner wires and by open reduction and LCP locking plate fixation. Radiographic assessment was based on images obtained before the surgery, immediately after fracture reduction, and at 6 weeks, 6 months, and 12 months after the procedure. Results. A comparison of the volar tilt angle in patients after fixation with Kirschner wires and LCP plates did not show any statistically significant differences before the surgery or at 6 weeks. A difference in the outcomes was found at 6 and 12 months and it turned out to be highly statistically significant. A comparison of the inclination angle and radial height in patients after Kirschner wire and LCP plate fixation showed statistically significant differences at 6 weeks, 6 months, and 12 months. A comparison of the radiographic outcomes using the Sarmiento classification in patients after Kirschner wire and LCP plate fixation revealed statistically significant differences at all follow-up time points. Conclusions. The radiographic parameters were superior in patients treated by open reduction and LCP plate fixation. The difference was seen with regard to all the parameters studied.

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