Anchor suture fixation of distal pole fractures of patella: twenty seven cases and comparison to partial patellectomy

Abstract Background Limited reference is available regarding surgical management in symptomatic ulnar styloid fractures with small bony avulsion. The study goal is to report the surgical outcomes using anchor suture fixation with comparison to traditional tension band wire fixation.Methods We retrospectively reviewed the medical records in patients who underwent surgical repair for unilateral ulnar styloid fractures with distal radioulnar instability between 2004 and 2017. A total of 31 patients were enrolled including two kinds of fixation methods. Anchor suture fixation plus distal radioulnar joint pinning was performed in ten patients with tiny avulsion bony fragments (group A); tension band wire fixation was performed in 21 patients with big styloid fracture fragments (group B). Patient characteristics and 2-year treatment outcomes were compared between two groups based on Mayo Modified Wrist Score (MMWS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), visual analog scale (VAS) and surgical complication. Descriptive statistics were used for calculation of key variables; a p-value of < 0.05 was considered statistically significant.Results Based on Gaulke classification, there were five subtypes in group A and three subtypes in group B. Incidence of concomitant distal radius fractures was significantly higher in group B; other patient characteristics including age, sex, injury side, and time to surgery showed no significant difference. Outcome assessment regarding MMWS, QuickDASH and VAS was comparable between two groups. Bone-related complications including nonunion, DRUJ subluxation and styloid resorption were analyzed; the difference was not significant. Incidence of implant-related complications including migration and secondary removal surgery was significantly higher in group B (p = 0.021).Conclusion Surgical fixation in symptomatic ulnar styloid fractures yields comparable treatment outcomes in both fracture patterns. Implant-related complication with secondary removal surgery is more common in tension band wire group. Anchor suture fixation is a feasible option for tiny styloid avulsion fragments with limited surgical complication.

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Single pulley double-strand anchor suture fixation of the coronoid process in terrible triad of the elbow injury

Journal of the Chinese Medical Association ◽

10.1097/jcma.0000000000000633 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Kai-Cheng Lin ◽

Wei-Yi Lai ◽

Yi-Ping Yang ◽

Yi-Yin Lin ◽

Tzu-Wei Lin ◽

...

Keyword(s):

Coronoid Process ◽

Suture Fixation ◽

Terrible Triad ◽

Elbow Injury ◽

Anchor Suture

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Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire

10.21203/rs.3.rs-32773/v2 ◽

2020 ◽

Author(s):

Alvin Chao-Yu Chen ◽

Yi-Hsuan Lin ◽

Chun-Jui Weng ◽

Chun-Ying Cheng

Keyword(s):

Surgical Complication ◽

Patient Characteristics ◽

Tension Band ◽

Suture Fixation ◽

Ulnar Styloid ◽

Tension Band Wire ◽

Wire Fixation ◽

Group A ◽

Group B ◽

Anchor Suture

Abstract Background Limited reference is available regarding surgical management in symptomatic ulnar styloid fractures with small bony avulsion. The study goal is to report the surgical outcomes using anchor suture fixation with comparison to traditional tension band wire fixation. Methods We retrospectively reviewed the medical records in patients who underwent surgical repair for unilateral ulnar styloid fractures with distal radioulnar instability between 2004 and 2017. A total of 31 patients were enrolled including two kinds of fixation methods. Anchor suture fixation plus distal radioulnar joint pinning was performed in ten patients with tiny avulsion bony fragments (group A); tension band wire fixation was performed in 21 patients with big styloid fracture fragments (group B). Patient characteristics and 2-year treatment outcomes were compared between two groups based on Mayo Modified Wrist Score (MMWS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), visual analog scale (VAS) and surgical complication. Descriptive statistics were used for calculation of key variables; a p-value of < 0.05 was considered statistically significant. Results Based on Gaulke classification, there were five subtypes in group A and three subtypes in group B. Incidence of concomitant distal radius fractures was significantly higher in group B; other patient characteristics including age, sex, injury side, and time to surgery showed no significant difference. Outcome assessment regarding MMWS, QuickDASH and VAS was comparable between two groups. Bone-related complications including nonunion, DRUJ subluxation and styloid resorption were analyzed; the difference was not significant. Incidence of implant-related complications including migration and secondary removal surgery was significantly higher in group B (p = 0.021). Conclusion Surgical fixation in symptomatic ulnar styloid fractures yields comparable treatment outcomes in both fracture patterns. Implant-related complication with secondary removal surgery is more common in tension band wire group. Anchor suture fixation is a feasible option for tiny styloid avulsion fragments with limited surgical complication.

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Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire

10.21203/rs.3.rs-32773/v3 ◽

2020 ◽

Author(s):

Alvin Chao-Yu Chen ◽

Yi-Hsuan Lin ◽

Chun-Jui Weng ◽

Chun-Ying Cheng

Keyword(s):

Treatment Outcomes ◽

Surgical Complication ◽

Patient Characteristics ◽

Tension Band ◽

Suture Fixation ◽

Ulnar Styloid ◽

Tension Band Wire ◽

Group A ◽

Group B ◽

Anchor Suture

Abstract Background: Limited reference is available regarding surgical management in symptomatic ulnar styloid fractures with small bony avulsion. The study goal is to report the surgical outcomes using anchor suture fixation with comparison to traditional tension band wire fixation.Methods: We retrospectively reviewed the medical records in patients who underwent surgical repair for unilateral ulnar styloid fractures with distal radioulnar instability between 2004 and 2017. A total of 31 patients were enrolled including two kinds of fixation methods. Anchor suture fixation plus distal radioulnar joint pinning was performed in ten patients with tiny avulsion bony fragments (group A); tension band wire fixation was performed in 21 patients with big styloid fracture fragments (group B). Patient characteristics and 2-year treatment outcomes were compared between two groups based on Mayo Modified Wrist Score (MMWS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), visual analog scale (VAS) and surgical complication. Descriptive statistics were used for calculation of key variables; a p-value of < 0.05 was considered statistically significant. Results: Based on Gaulke classification, there were five subtypes in group A and three subtypes in group B. Incidence of concomitant distal radius fractures was significantly higher in group B; other patient characteristics including age, sex, injury side, and time to surgery showed no significant difference. Outcome assessment regarding MMWS, QuickDASH and VAS was comparable between two groups. Bone-related complications including nonunion, DRUJ subluxation and styloid resorption were analyzed; the difference was not significant. Incidence of implant-related complications including migration and secondary removal surgery was significantly higher in group B (p = 0.021). Conclusion: Surgical fixation in symptomatic ulnar styloid fractures yields comparable treatment outcomes in both fracture patterns. Implant-related complication with secondary removal surgery is more common in tension band wire group. Anchor suture fixation is a feasible option for tiny styloid avulsion fragments with limited surgical complication.

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Lower pole of patella fractures treated with non-absorbable trans-osseous sutures: an effective surgical method to avoid implant related complications

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20211398 ◽

2021 ◽

Author(s):

Aniruddha Mondal ◽

Ayon Das

Keyword(s):

Tertiary Care ◽

Functional Results ◽

Absorbable Suture ◽

Patella Fracture ◽

Suture Fixation ◽

Inferior Pole ◽

Distal Pole ◽

Absorbable Sutures ◽

Patella Fractures

Background: The treatment option for inferior pole of patella fracture is still being debated. Although tension‑band wiring is the most widely used technique to treat patellar fractures, metal implant‑related complications such as implant failure, palpable hardware are very common and additional procedures are often necessary to treat the complications. The aim of the study was to evaluate the functional results in patients with inferior pole of patella fracture treated by trans-osseous non-absorbable suture fixation.Methods: Patients who underwent trans-osseous suture fixation by no. 5 Ethibond for post-traumatic distal pole patella fracture were included in the study. This was a prospective study conducted at a tertiary care Government Hospital in Kolkata, between December 2018 to May 2020. All patients were followed up at an interval of 2 weeks, 6 weeks, 12 weeks, 6 months and 9 months. Bostman score was used to assess the functional outcomes of the patients.Results: Outcome at final follow-up was assessed with Bostman scoring system. In a total of 11 patients, 8 (72.8%) patients showed excellent and 3 (27.2%) patients had good results during the final follow-up. None of the patients demonstrated unsatisfactory result. At the end of 9 months, the average Bostman score for 11 patients was 27.9.Conclusions: The trans-osseous suturing with non-absorbable sutures is a safe and effective fixation technique for the treatment of distal pole patella fractures. It allows for rapid recovery with minimal implant‑related complications. It also reduces the re-surgery rates significantly.

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Suture Anchor Versus Transosseous Tunnel Repair for Inferior Pole Patellar Fractures Treated With Partial Patellectomy and Tendon Advancement: A Biomechanical Study

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211022245 ◽

2021 ◽

Vol 9 (8) ◽

pp. 232596712110222

Author(s):

Ryan O’Donnell ◽

Nicholas J. Lemme ◽

Stephen Marcaccio ◽

Devin F. Walsh ◽

Kalpit N. Shah ◽

...

Keyword(s):

Patellar Tendon ◽

Suture Anchor ◽

Suture Anchors ◽

Inferior Pole ◽

Anchor Group ◽

Group 4 ◽

Distal Pole ◽

Load To Failure ◽

Partial Patellectomy ◽

Patellar Fractures

Background: Comminuted inferior pole patellar fractures can be treated in numerous ways. To date, there have been no studies comparing the biomechanical properties of transosseous tunnels versus suture anchor fixation for partial patellectomy and tendon advancement of inferior pole patellar fractures. Hypothesis: Suture anchor repair will result in less gapping at the repair site. We also hypothesize no difference in load to failure between the groups. Study Design: Controlled laboratory study. Methods: Ten cadaveric knee extensor mechanisms (5 matched pairs; patella and patellar tendon) were used to simulate a fracture of the extra-articular distal pole of the patella. The distal simulated fracture fragment was excised, and the patellar tendon was advanced and repaired with either transosseous bone tunnels through the patella or 2 single-loaded suture anchors preloaded with 1 suture per anchor. Load to failure and elongation from cycles 1 to 250 between 20 and 100 N of force were measured, and modes of failure were recorded. Statistical analysis was performed using a paired 2-tailed Student t test. Results: The suture anchor group had less gapping during cyclic loading as compared with the transosseous tunnel group (mean ± SD, 6.83 ± 2.23 vs 13.30 ± 5.74 mm; P = .047). There was no statistical difference in the load to failure between the groups. The most common mode of failure was at the suture-anchor interface in the suture anchor group (4 of 5) and at the knot proximally on the patella in the transosseous tunnel group (4 of 5). Conclusion: Suture anchors yielded similar strength profiles and less tendon gapping with cyclic loading when compared with transosseous tunnels in the treatment of comminuted distal pole of the patellar fractures managed with partial patellectomy and patellar tendon advancement. Clinical Relevance: Suture anchors may offer robust repair and earlier range of motion in the treatment of fractures of the distal pole of the patella. Clinical randomized controlled trials would help clinicians better understand the difference in repair techniques and confirm the translational efficacy in clinical practice.

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Method for suture fixation of a dislocated intraocular lens in the ciliary sulcus

Modern technologies in ophtalmology ◽

10.25276/2312-4911-2020-3-138-139 ◽

2020 ◽

pp. 138-139

Author(s):

D.M. Sultanova ◽

◽

N.M. Kislitsyna ◽

S.M. Dibirova ◽

E.S. Kurakina ◽

...

Keyword(s):

Intraocular Lens ◽

Suture Fixation

Актуальность. Имплантацию интраокулярных линз (ИОЛ) после проведенных операций факоэмульсификации катаракты выполняют в капсульный мешок хрусталика, фиксируя и центрируя их за счет гаптических элементов. Однако выделяют ряд осложненных случаев хирургии катаракты, когда появляется необходимость дополнительной шовной фиксации ИОЛ: при разрывах капсулы хрусталика, отсутствие капсульного мешка, слабости и несостоятельности связочно-капсулярного аппарата хрусталика, а также в случае дислокации ранее ИОЛ, не исключая частичной или полной люксации в стекловидное тело. Выбор конкретного способа фиксации в таком случае выполняется офтальмохирургом в зависимости от целого комплекса клинических факторов и модели ИОЛ. Существующие способы фиксации ИОЛ имеют ряд недостатков, ввиду чего разработка новых подходов для решения данной проблемы является актуальной. Цель. Предоставить способ репозиции ИОЛ с шовной фиксацией к склере в области цилиарной борозды. Материал и методы. Предложенный способ фиксации может быть эффективно применен для других видов ИОЛ. Представлен клинический случай дислокации ИОЛ модели Т-26. Описан методрепозиции ИОЛ с шовной фиксацией в цилиарную борозду. Этапы операции: данный способ шовной фиксации ИОЛ выполняется с применением двух игл, связанных нитью полипропилен 10-0 (manisutures polypropylene 10-0). Используя иглу –проводник 30G через парацентез на 6 часах проводятся иглы выше и ниже гаптического элемента ИОЛ. Образующаяся при этом петля нити фиксирует ИОЛ в проекции цилиарной борозды к склере. Результаты. Острота зрения в 1 день после операции составила 0,7, ВГД 19,0 мм рт.ст. При контрольном осмотре спустя 7 дней острота зрения 0,9без дополнительной коррекции, ВГД 18 мм рт.ст Выводы. Предложенный способ репозиции ИОЛ с шовной фиксацией в цилиарную борозду отличается атравматичностью, простотой выполнения и позволяет достичь хороших функциональных и анатомических результатов лечения пациентов.

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