Mini-open anterior approach focal cleaning combined with posterior internal fixation for thoracolumbar tuberculosis: Follow-up of 149 cases

UNSTRUCTURED The retrospective study of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures provides a theoretical basis for the application of this technology. The paper collected 28 patients with tibiofibular fractures from the Department of Orthopaedics in our hospital from March 2015 to June 2018. After the treatment, the follow-up evaluation of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures and concurrency the incidence of the disease, as well as the efficacy and occurrence of the internal fixation of the treatment of tibial fractures in our hospital. The results showed that Taylor's three-dimensional external fixator was superior to orthopaedics in the treatment of tibiofibular fractures in terms of efficacy and complications. To this end, the thesis research can be concluded as follows: Taylor three-dimensional external fixation in the treatment of tibiofibular fractures is more effective, and the incidence of occurrence is low, is a new technology for the treatment of tibiofibular fractures, it is worthy of clinical promotion.

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Staged Management of Severely Displaced Calcaneal Fractures With Transarticular Pinning: A Damage Control Strategy

Foot & Ankle International ◽

10.1177/10711007211013012 ◽

2021 ◽

pp. 107110072110130

Author(s):

Kyeong-Hyeon Park ◽

Chang-Wug Oh ◽

Joon-Woo Kim ◽

Hee-June Kim ◽

Dong-Hyun Kim ◽

...

Keyword(s):

Soft Tissue ◽

Internal Fixation ◽

Kirschner Wire ◽

Wound Complications ◽

Calcaneal Fractures ◽

Simple Method ◽

Wire Fixation ◽

The Mean ◽

Radiographic Union

Background: Severely displaced calcaneal fractures can result in considerable morphology derangement and may be accompanied by soft tissue compromise. Delayed operative restoration of the calcaneal morphology may result in acute retensioning of the damaged soft tissue with associated wound-related complications. In this study, we describe a staged treatment of displaced intra-articular calcaneal fractures that uses temporary transarticular Kirschner wire (K-wire) fixation and staged conversion to definite fixation. Methods: We identified all of the patients who were treated at our institution for calcaneal fractures between 2015 and 2019. A total of 17 patients with 20 calcaneal fractures were selectively treated with 2-stage management. Temporary transarticular K-wire fixation was performed 24 hours after the injury to restore calcaneal morphology and the surrounding soft tissue. After the soft tissue was considered safe, delayed open reduction and internal fixation was performed. The time to definite surgery, radiographic alignment, wound complications, time to radiographic union, and hindfoot American Orthopaedic Foot & Ankle Society (AOFAS) scores were recorded. Results: The average follow-up period was 17 months (range, 12-43). The average Böhler angle increased from a mean of −22 degrees (range, −109 to 25) to 25 degrees (range, 0 to 47) after temporary transarticular K-wire fixation. The mean time from temporary pinning to conversion to definite internal fixation was 20 (range, 10-32) days. There were no immediate postoperative complications. The average time to radiographic union was 13.7 (range, 10-16) weeks. The mean AOFAS score was 87 (range, 55-100). No infections or wound complications were reported during the follow-up period. Conclusion: Temporary transarticular pinning for staged calcaneal fracture treatment is safe and effective in restoring the calcaneal morphology. This novel and relatively simple method may facilitate delayed operation and decrease wound-related complications. Level of Evidence: Level IV, retrospective case series.

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Complex fractures of the distal humerus in the elderly: primary total elbow arthroplasty or open reduction and internal fixation? Mid-term follow-up

International Orthopaedics ◽

10.1007/s00264-021-05027-z ◽

2021 ◽

Author(s):

Yaiza Lopiz ◽

Daniel Garríguez-Pérez ◽

Carlos García-Fernández ◽

Laura del Baño ◽

María Galán-Olleros ◽

...

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

The Elderly ◽

Distal Humerus ◽

Total Elbow Arthroplasty ◽

Elbow Arthroplasty ◽

Complex Fractures

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Promising medium-term results of anterior approach with an anatomical short stem in primary hip arthroplasty

Journal of Orthopaedics and Traumatology ◽

10.1186/s10195-021-00567-x ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Fabrizio Rivera ◽

Alessandro Bardelli ◽

Andrea Giolitti

Keyword(s):

Operating Room ◽

Anterior Approach ◽

Direct Anterior Approach ◽

Short Stem ◽

Medium Term ◽

Operating Room Table ◽

Sf 36 ◽

Standard Operating ◽

The Mean

Abstract Background In the last decade, the increase in the use of the direct anterior approach to the hip has contributed to the diffusion of the use of short stems in orthopedic surgery. The aim of the study is to verify the medium-term clinical and radiographic results of a cementless anatomic short stem in the anterior approach to the hip. We also want to verify whether the use of the standard operating room table or the leg positioner can affect the incidence of pre- and postoperative complications. Materials and methods All total hip arthroplasty patients with a 1-year minimum follow-up who were operated using the MiniMAX stem between January 2010 and December 2019 were included in this study. Clinical evaluation included the Harris Hip Score (HHS), Western Ontario and McMaster Universities Hip Outcome Assessment (WOMAC) Score, and Short Form-36 (SF-36) questionnaires. Bone resorption and remodeling, radiolucency, osteolysis, and cortical hypertrophy were analyzed in the postoperative radiograph and were related to the final follow-up radiographic results. Complications due to the use of the standard operating room table or the leg positioner were evaluated. Results A total of 227 patients (238 hips) were included in the study. Average age at time of surgery was 62 years (range 38–77 years). Mean follow-up time was 67.7 months (range 12–120 months). Kaplan–Meier survivorship analysis after 10 years revealed 98.2% survival rate with revision for loosening as endpoint. The mean preoperative and postoperative HHS were 38.35 and 94.2, respectively. The mean preoperative and postoperative WOMAC Scores were 82.4 and 16.8, respectively. SF-36 physical and mental scores averaged 36.8 and 42.4, respectively, before surgery and 72.4 and 76.2, respectively, at final follow-up. The radiographic change around the stem showed bone hypertrophy in 55 cases (23%) at zone 3. In total, 183 surgeries were performed via the direct anterior approach (DAA) on a standard operating room table, and 44 surgeries were performed on the AMIS mobile leg positioner. Comparison between the two patient groups did not reveal significant differences. Conclusion In conclusion, a short, anatomic, cementless femoral stem provided stable metaphyseal fixation in younger patients. Our clinical and radiographic results support the use of this short stem in the direct anterior approach. Level of evidence IV.

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Nascent Malunion of an Isolated Intraarticular Fracture of the Ulnar Head

Journal of Wrist Surgery ◽

10.1055/s-0039-1698453 ◽

2019 ◽

Vol 09 (03) ◽

pp. 240-243

Author(s):

Frank Nienstedt ◽

Markus Mariacher ◽

Günther Stuflesser ◽

Wilhelm Berger

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

Excellent Result ◽

Corrective Osteotomy ◽

Fracture Dislocation ◽

Intraarticular Fracture ◽

Ulnar Head ◽

Ulnar Styloid Fracture ◽

Palmar Approach

Abstract Background Isolated fractures of the ulnar head are rare. Only few cases have been reported in literature. Case Description We report a case of a 16-year-old student who was treated for an ulnar styloid fracture conservatively. An associated displaced intraarticular fracture of the ulnar head has been overlooked. He presented late in our clinic with a symptomatic nascent malunion of the ulnar head fracture. A corrective osteotomy by a palmar approach was performed. Fixation by screws was used with an excellent result at 7-year follow-up. Literature Review The rare cases of isolated ulnar head fractures reported in literature were treated by open reduction and internal fixation only in case of fracture dislocation. Clinical Relevance The authors highlight the fact that even a nascent malunion of an isolated intraarticular fracture of the ulnar head may be treated successfully by open reduction and internal fixation.

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Cervical Perimedullary Arteriovenous Shunts

Neurosurgery ◽

10.1227/neu.0000000000000401 ◽

2014 ◽

Vol 75 (3) ◽

pp. 238-249 ◽

Cited By ~ 14

Author(s):

Toshiki Endo ◽

Hiroaki Shimizu ◽

Kenichi Sato ◽

Kuniyasu Niizuma ◽

Ryushi Kondo ◽

...

Keyword(s):

Spinal Cord ◽

Anterior Approach ◽

Open Surgery ◽

Treatment Strategies ◽

Good Recovery ◽

Intraoperative Angiography ◽

Indocyanine Green Videoangiography ◽

Arteriovenous Shunts ◽

Complete Obliteration

Abstract BACKGROUND: Reports of cervical perimedullary arteriovenous shunt (PMAVS) are limited, and treatment strategies have not been established. OBJECTIVE: To describe angioarchitecture and optimal treatment strategies for cervical PMAVS. METHODS: We treated 22 patients with cervical PMAVS between 2000 and 2012 (8 women and 14 men; age, 9-80 years). According to the classification, our patients included type IVa (4 patients), type IVb (16 patients), and type IVc (2 patients). Seventeen patients presented with subarachnoid hemorrhage. RESULTS: A total of 41 shunting points were localized in 22 patients, of which 34 points were located ventral or ventrolateral to the spinal cord. The anterior spinal artery (ASA) contributed to the shunts in 16 patients. Aneurysm formation was identified in 8 patients. Endovascular treatment was attempted in 3 patients, resulting in complete obliteration in 1 patient (type IVc). Overall, 21 patients underwent open surgery. An anterior approach with corpectomy was elected for 2 patients; the other 19 patients underwent the posterior approaches using indocyanine green videoangiography, intraoperative angiography, endoscopy (8 patients), and neuromonitoring. Twenty patients were rated as having a good recovery at 6 months after surgery. No recurrence was observed in any patients during the follow-up (mean, 59.7 months). CONCLUSION: Shunting points of the cervical PMAVS were predominantly located ventral or ventrolateral to the spinal cord and were often fed by the ASA. Even for ventral lesions, posterior exposure assisted with neuromonitoring and endoscopy, and intraoperative angiography provided a view sufficient to understand the relationships between the shunts and the ASA and contributed to good surgical outcomes.

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Results of Treatment of Chronic Dorsal Fracture-Dislocations of the Proximal Interphalangeal Joints of the Fingers

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(98)80101-0 ◽

1998 ◽

Vol 23 (6) ◽

pp. 798-801 ◽

Cited By ~ 11

Author(s):

O. ISHIDA ◽

Y. IKUTA

Keyword(s):

Articular Cartilage ◽

Internal Fixation ◽

Open Reduction ◽

Proximal Interphalangeal Joint ◽

Interphalangeal Joint ◽

Fracture Dislocation ◽

Results Of Treatment ◽

Palmar Plate ◽

Fracture Dislocations

We reviewed 20 cases of chronic dorsal fracture-dislocation of the proximal interphalangeal joint, with a mean follow-up period of 74 months. In patients without comminuted palmar fragments, open reduction and internal fixation or osteotomy of the malunited fragment provided good results. In treating patients with damaged articular cartilage or with comminuted palmar fragments by palmar plate arthroplasty, poor results were obtained because of secondary osteoarthritic changes.

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