Bennett’s Fracture

1990 ◽  
Vol 15 (1) ◽  
pp. 58-61
Author(s):  
K. KJÆR-PETERSEN ◽  
O. LANGHOFF ◽  
K. ANDERSEN

The relationship between the quality of redaction and the occurrence of arthritic changes, symptoms and disability was studied in 41 Bennett’s fractures. Excellent position was obtained in five of nine fractures treated by closed reduction and plaster immobilisation, in four of six fractures treated by percutaneous K wire fixation and in 18 of 26 fractures treated by open reduction. After a median interval of 7.3 years, 15 of 18 reviewed patients with fractures healed in excellent position were free of symptoms, but this was so in only six of 13 fractures with residual displacement. The remainder had intermittent slight pain. Radiographic signs of arthritis was found in ten of 24 patients: three of 14 patients with excellent reduction and seven of ten patients with residual displacement.

1991 ◽  
Vol 16 (4) ◽  
pp. 454-459 ◽  
Author(s):  
O. LANGHOFF ◽  
K. ANDERSEN ◽  
K. KJÆR-PETERSEN

The relationship between methods of treatment, quality of reduction and the occurrence of late disability and osteo-arthritic changes was studied in 17 Rolando’s fractures. Three were undisplaced, 14 were displaced: of these excellent reduction was achieved in five of 11 treated by open reduction and in none of the three treated by percutaneous K wire fixation. After a median interval of 5.8 years, six of 16 reviewed patients had minor symptoms, while nine had no symptoms. Radiographic examination of 11 patients showed signs of osteoarthritis in six. We did not establish a relationship between the quality of reduction and the occurrence of late symptoms and osteoarthritis.


1994 ◽  
Vol 19 (3) ◽  
pp. 373-377 ◽  
Author(s):  
E. J. F. TIMMENGA ◽  
T. J. BLOKHUIS ◽  
M. MAAS ◽  
E. L. F. B. RAAIJMAKERS

18 patients with Bennett’s fracture were evaluated after a mean follow-up period of 10.7 years. Treatment consisted of closed reduction and K-wire fixation in seven cases and open reduction with osteosynthesis in 11 cases. Overall, symptoms were few and restricted mobility of the thumb could not be demonstrated. The strength of the affected hand was decreased in all patients regardless of the type of treatment. Osteoarthritis was found to correlate with the quality of reduction of the fracture, but had developed in almost all cases even after exact reduction. Exact reduction, either by the open or closed method, should be the aim of treatment of Bennett’s fracture.


2020 ◽  
Vol 22 (6) ◽  
pp. 427-436
Author(s):  
Piotr Zając ◽  
Piotr Zając

Background. The paper presents a treatment algorithm for supracondylar humeral fractures in children, involving temporary use of skeletal traction following failure of primary closed reduction and percutaneous fixation (CRPF) and introducing closed reduction after management by skeletal traction. The aim of this study was to assess the outcomes of supracondylar humerus fracture treatment performed according to the algorithm. Material and methods. The treatment was performed in 149 children (70 girls, 79 boys) with extension-type supracondylar humeral fractures. The study group was assessed with regard to a modified Gartland classification, neurological complications (12 children, 8%) and vascular complications (8 children, 5.4%). A total of 124 (83.2%) patients underwent emergency CRPF and 24 children (16.1%) received skeletal traction after a failed CRPF. After 2-6 days, an elective repeat CRPF procedure was attempted, which was successful in 17 children. The attempt failed in the other 7 children, who received traction and underwent open reduction under a single anesthesia. One child (0.7%) with a white and pulseless hand was treated by emergency open reduction and percutaneous fixation. Results. The study used the Flynn criteria modified by the author. After 6 months, the results in the group treated with CRPF (both primary and following skeletal traction) were good in 90.8% of patients, satisfactory in 8.5%, and poor in 0.7%, whereas in the open reduction and percutaneous fixation group, the results were good in 87.5% of cases and satisfactory in 12.5%. Conclusions. 1. X-ray-guided closed reduction and percutaneous K wire fixation is a method of choice in the treatment of displaced supracondylar humeral fractures in children. If closed reduction fails, the surgeon is faced with a choice between primary open reduction and the use of direct traction through the olecranon. 2. The use of skeletal traction following failure of primary emergency CRPF results in local improvement in the fracture region and allows for scheduling an elective repeat delayed closed reduction and percutaneous K wire fixation procedure. 3. The algorithm used in clinical practice, based on literature reports and the author’s experience, helps achieve good treatment outcomes.


2002 ◽  
Vol 34 (1) ◽  
pp. 41-48 ◽  
Author(s):  
M. Lutz ◽  
P. Angermann ◽  
R. Sailer ◽  
A. Kathrein ◽  
M. Gabl ◽  
...  

2021 ◽  
pp. 107110072199000
Author(s):  
Al-Walid Hamam ◽  
Moaz Bin Yunus Chohan ◽  
Christina Tieszer ◽  
Abdel-Rahman Lawendy ◽  
Christopher Del Balso ◽  
...  

Background: The goal of the study was to compare radiographic and functional outcomes between conventional closed syndesmotic reduction and screw fixation with open reduction, direct repair of the anterior inferior tibiofibular ligament (AiTFL) and screw fixation. We hypothesized that open reduction with restoration of the AiTFL would provide an improved reduction with better radiographic and functional outcomes. Methods: Fifty consecutive patients with OTA 44-C ankle fractures were enrolled. Treatment was nonrandomized and based on surgeon preference. Patients were treated with either open reduction, suture-anchor AiTFL repair, and screw fixation (ART group), or conventional closed reduction of the syndesmosis followed by screw fixation (CR group). The primary outcome measure was anteroposterior (AP) displacement of the fibula on CT scan at 3 months postoperatively. Secondary outcome measures included the Maryland Foot Score, the American Orthopaedic Foot & Ankle Society (AOFAS) Ankle Hindfoot Score, and the Foot and Ankle Outcome Score (FAOS). Results: Mean AP difference between injured and noninjured ankles was decreased in the ART group compared with the CR group (0.7 ± 0.3 mm vs 1.5 ± 0.3 mm, P = .008). No differences were observed between groups in overall scores for secondary outcome measures. The ART group displayed a significant difference in Maryland Foot Shoe subscore at 12 months (ART = 9.5 vs CR = 8.3, P = .03) and FAOS Quality of Life subscore at 12 months (64.1 compared to 38.3, P = .04). Conclusions: Open anatomic syndesmotic repair resulted in improved radiographic outcomes compared with closed reduction. Cosmesis was worse at 6 weeks compared to the CR group; however, quality of life and shoewear were improved in the ART group at 1 year postoperatively. Level of Evidence: Level II, prospective comparative study.


2016 ◽  
Vol 144 (1-2) ◽  
pp. 46-51 ◽  
Author(s):  
Sinisa Ducic ◽  
Marko Bumbasirevic ◽  
Vladimir Radlovic ◽  
Petar Nikic ◽  
Zoran Bukumiric ◽  
...  

Introduction. Closed reduction and percutaneous pinning are the most widely used treatment options for displaced supracondylar humerus fractures in children, but there is still no consensus concerning the most preferred technique in injuries of the extension type. Objective. The aim of this study was to compare three common orthopaedic procedures in the treatment of displaced extension type supracondylar humerus fractures in children. Methods. Total of 93 consecutive patients (66 boys and 27 girls) referred to our hospital with Gartland type II or III extension supracondylar humeral fractures were prospectively included in the study over a six-year period. At initial presentation 48 patients were classified as Gartland type II and 45 as Gartland type III fractures. The patients were subdivided into three groups based on the following treatment modality: closed reduction with percutaneous pinning, open reduction with Kirschner wires (K-wires) fixation, and closed reduction with cast immobilisation. The treatment outcome and clinical characteristics were compared among groups, as well as evaluated using Flynn?s criteria. Results. Excellent clinical outcome was reported in 70.3% of patients treated with closed reduction with percutaneous pinning and in 64.7% of patients treated with open reduction with K-wire fixation. The outcome was significantly worse in children treated with closed reduction and cast immobilisation alone, as excellent outcome is achieved in just 36.4% of cases (p=0.011). Conclusion. Closed reduction with percutaneous pinning is the method of choice in the treatment of displaced pediatric supracondylar humeral fracture, while open reduction with K-wire fixation is as a good alternative in cases with clear indications.


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