Long-term results of open reduction of condylar head fractures of the mandible: 5 years follow up of small fragment screw based osteosynthesis

Etiology and outcome of 155 patients with midfoot fractures between 1972 and 1997 were analyzed to create a basis for treatment optimization. Cause of injuries were traffic accidents (72.2%), falls (11.6%), blunt injuries (7.7%) and others (5.8%). Isolated midfoot fractures (I) were found in 55 (35.5%) cases, Lisfranc fracture dislocations (L) in 49 (31.2%), Chopart-Lisfranc fracture dislocations (CL) in 26 (16.8%) and Chopart fracture dislocations (C) in 25 (16%). One hundred and forty eight (95%) of the midfoot fractures were treated operatively; 30 with closed reduction, 115 with open reduction, 3 patients had a primary amputation. Seven (5%) patients were treated non-operatively. Ninety seven (63%) patients had follow-up at an average of 9 (1.3–25, median 8.5) years. The average scores of the entire follow-up group were as follows: AOFAS – sum of all four sections (AOFAS-ET): 296, AOFAS-Midfoot (AOFAS-M): 71, Hannover Scoring System (HSS): 65, and Hannover Questionnaire (Q): 63. Regarding age, gender, cause, time from injury to treatment and method of treatment no score differences were noted (t-test: p > 0.05). L, C or I showed similar scores and CL significantly lower scores (AOFAS-ET, AOFAS-M, HSS, Q). The highest scores in all groups were achieved in those fractures treated with early open reduction and operative fixation. Midfoot fractures, particularly fracture dislocation injuries, effect the function of the entire foot in the long-term outcome. But even in these complex injuries, an early anatomic (open) reduction and stable (internal) fixation can minimize the percentage of long-term impairment.

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Lesión compleja del codo pediátrico: fractura de cóndilo externo asociada a luxación posteromedial de codo.

Revista Española de Cirugía Osteoarticular ◽

10.37315/sotocav20202825556 ◽

2020 ◽

pp. 56-60

Author(s):

A DARAS-BALLESTER ◽

NADIA JOVER-JORGE ◽

PEDRO DOMENECH-FERNANDEZ

Keyword(s):

Open Reduction ◽

Elbow Dislocation ◽

Complex Case ◽

Long Term Results ◽

K Wires ◽

Condyle Fracture ◽

Clinical And Radiological Results ◽

Humeral Condyle

Background and aim: External humeral condyle fracture associated with a posteromedial elbow dislocation is a very rare entity, of which there are very few cases published. Our objective is to present a complex case treated in our Hospital, the diagnosis, the treatment we chose, and the follow-up at 9 weeks after the intervention. Clinical case: 5-year-old boy with a posteromedial elbow dislocation associated with an external humeral condyle fracture, which was diagnosed by CT and treated surgically using an anterior approach over the elbow, open reduction, and osteosynthesis with K-wires. Results: clinical and radiological results 9 weeks after the intervention were excellent, presenting a Radiographic consolidation of the fracture and an excellent range of joint mobility. Conclusion: early diagnosis and surgical treatment through open reduction and osteosynthesis of the external condyle is the gold standard on treatment for these injuries, since a bad reduction leads to poor long-term results.

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A method of surgical treatment of unstable severe forms of juvenile femoral head epiphysiolysis

Kazan medical journal ◽

10.17816/kmj1801 ◽

2013 ◽

Vol 94 (6) ◽

pp. 838-843

Author(s):

A R Pulatov ◽

V V Mineev

Keyword(s):

Surgical Treatment ◽

Femoral Head ◽

Open Reduction ◽

Slipped Capital Femoral Epiphysis ◽

Late Results ◽

Biomechanical Study ◽

Long Term Results ◽

Slip Angle

Aim. To analyze the long-term results of the designed method for the open epiphysis reduction in patients with severe unstable forms of juvenile femoral head epiphysiolysis. Methods. The article describes the method of surgical treatment of severe forms of unstable juvenile femoral head epiphysiolysis and long-term outcomes in 21 patients. The indications for the method were the unstable form of juvenile femoral head epiphysiolysis and slipped capital femoral epiphysis with a slip angle of more than 40 degrees. The age of patients at time of treatment ranged from 11 to 16 years, follow-up period - from 2 to 15 years. Five patients underwent a comprehensive biomechanical study within one year after surgery. Results. The early and late results of the femoral head epiphysis open reduction were analyzed. Positive results were obtained in 19 cases (good results in 17, satisfactory in 2). The complication rate was 14.3% and included 3 cases of avascular femoral head necrosis, no cases of chondrolysis were revealed. According to biomechanical examination data performed in five patients 1 year after the surgery, almost complete functional recovery of the musculoskeletal system was revealed. Conclusion. Analysis of the results showed that being properly executed the open reduction of the femoral head with a corrective femoral neck osteotomy allowed to restore normal anatomic proportions and function of the affected joint, positive result was maintained for the entire follow-up period.

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Minimal bone resorption after open treatment of mandibular condylar head fractures

10.21203/rs.3.rs-958849/v1 ◽

2021 ◽

Author(s):

Michael-Tobias Neuhaus ◽

Nils-Claudius Gellrich ◽

Alexander-Nicolai Zeller ◽

Alexander Karl-Heinz Bartella ◽

Anna Katharina Sander ◽

...

Keyword(s):

Computed Tomography ◽

Bone Resorption ◽

Open Reduction ◽

Cone Beam ◽

Clinical Parameters ◽

Osteosynthesis Material ◽

Open Treatment ◽

Condylar Head

Abstract Open treatment of condylar base and neck fractures is widely recommended, whereas treatment of condylar head fractures is still controversial and just is removal of osteosynthesis material. In this study, bone resorption and remodelling after open treatment of condylar head fractures were three-dimensionally (3D) assessed and correlated with clinical parameters in a medium follow-up. Of 18 patients with 25 condylar head fractures who underwent open reduction and internal fixation, clinical data and cone beam computed tomography (CBCT) datasets were analysed. Condylar processes were segmented in the postoperative and follow-up CBCT scans. Volumetric and linear changes were measured using a sophisticated 3D-algorithm. In the course after surgery, patients function and pain improved significantly. Low rates of postoperative complications were observed. All 3D measurements showed no significant bone resorption during the follow-up period. Open reduction of condylar head fractures leads to good patients outcomes and low rates of long-term complications. This study underlines the feasibility and importance of open treatment of condylar head fractures and may help to spread its acceptance as the preferred treatment option.

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Prognostic factors for long-term results after condylar head fractures: A comparative study of non-surgical treatment versus open reduction and osteosynthesis

Journal of Cranio-Maxillofacial Surgery ◽

10.1016/j.jcms.2020.10.001 ◽

2020 ◽

Vol 48 (12) ◽

pp. 1138-1145

Author(s):

Andreas Kolk ◽

Lisa-Marie Scheunemann ◽

Florian Grill ◽

Herbert Stimmer ◽

Klaus-Dietrich Wolff ◽

...

Keyword(s):

Prognostic Factors ◽

Surgical Treatment ◽

Comparative Study ◽

Open Reduction ◽

Long Term Results ◽

Condylar Head ◽

Non Surgical Treatment

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Surgical reconstruction for unilateral iliac artery lesions in patients younger than 50 years

VASA ◽

10.1024/0301-1526/a000151 ◽

2011 ◽

Vol 40 (6) ◽

pp. 474-481 ◽

Cited By ~ 1

Author(s):

Radak ◽

Babic ◽

Ilijevski ◽

Jocic ◽

Aleksic ◽

...

Keyword(s):

Diabetes Mellitus ◽

Limb Salvage ◽

Iliac Artery ◽

Graft Patency ◽

Long Term Results ◽

Surgical Reconstruction ◽

Safe Procedure ◽

Term Survival

Background: To evaluate safety, short and long-term graft patency, clinical success rates, and factors associated with patency, limb salvage and mortality after surgical reconstruction in patients younger than 50 years of age who had undergone unilateral iliac artery bypass surgery. Patients and methods: From January 2000 to January 2010, 65 consecutive reconstructive vascular operations were performed in 22 women and 43 men of age < 50 years with unilateral iliac atherosclerotic lesions and claudication or chronic limb ischemia. All patients were followed at 1, 3, 6, and 12 months after surgery and every 6 months thereafter. Results: There was in-hospital vascular graft thrombosis in four (6.1 %) patients. No in-hospital deaths occurred. Median follow-up was 49.6 ± 33 months. Primary patency rates at 1-, 3-, 5-, and 10-year were 92.2 %, 85.6 %, 73.6 %, and 56.5 %, respectively. Seven patients passed away during follow-up of which four patients due to coronary artery disease, two patients due to cerebrovascular disease and one patient due to malignancy. Limb salvage rate after 1-, 3-, 5-, and 10-year follow-up was 100 %, 100 %, 96.3 %, and 91.2 %, respectively. Cox regression analysis including age, sex, risk factors for vascular disease, indication for treatment, preoperative ABI, lesion length, graft diameter and type of pre-procedural lesion (stenosis/occlusion), showed that only age (beta - 0.281, expected beta 0.755, p = 0.007) and presence of diabetes mellitus during index surgery (beta - 1.292, expected beta 0.275, p = 0.026) were found to be significant predictors of diminishing graft patency during the follow-up. Presence of diabetes mellitus during index surgery (beta - 1.246, expected beta 0.291, p = 0.034) was the only variable predicting mortality. Conclusions: Surgical treatment for unilateral iliac lesions in patients with premature atherosclerosis is a safe procedure with a low operative risk and acceptable long-term results. Diabetes mellitus and age at index surgery are predictive for low graft patency. Presence of diabetes is associated with decreased long-term survival.

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Short- and Long-Term Results of Total vs Subtotal Thyroid- ectomies in the Surgical Treatment of Graves' Disease

Swiss Surgery ◽

10.1024/1023-9332.7.1.20 ◽

2001 ◽

Vol 7 (1) ◽

pp. 20-24 ◽

Cited By ~ 14

Author(s):

Robert ◽

Mariéthoz ◽

Pache ◽

Bertin ◽

Caulfield ◽

...

Keyword(s):

Recurrent Laryngeal Nerve ◽

Nerve Palsy ◽

Recurrent Laryngeal Nerve Palsy ◽

Laryngeal Nerve ◽

Long Term Results ◽

Graves Disease ◽

Laryngeal Nerve Palsy ◽

Short And Long Term

Objective: Approximately one out of five patients with Graves' disease (GD) undergoes a thyroidectomy after a mean period of 18 months of medical treatment. This retrospective and non-randomized study from a teaching hospital compares short- and long-term results of total (TT) and subtotal thyroidectomies (ST) for this disease. Methods: From 1987 to 1997, 94 patients were operated for GD. Thirty-three patients underwent a TT (mostly since 1993) and 61 a ST (keeping 4 to 8 grams of thyroid tissue - mean 6 g). All patients had received propylthiouracil and/or neo-mercazole and were in a euthyroid state at the time of surgery; they also took potassium iodide (lugol) for ten days before surgery. Results: There were no deaths. Transient hypocalcemia (< 3 months) occurred in 32 patients (15 TT and 17 ST) and persistent hypocalcemia in 8 having had TT. Two patients developed transient recurrent laryngeal nerve palsy after ST (< 3 months). After a median follow-up period of seven years (1-15) with five patients lost to follow-up, 41 patients having had a ST are in a hypothyroid state (73%), thirteen are euthyroid (23%), and two suffered recurrent hyperthyroidism, requiring completion of thyroidectomy. All 33 patients having had TT - with follow-ups averaging two years (0.5-8) - are receiving thyroxin substitution. Conclusions: There were no instances of persistent recurrent laryngeal nerve palsy in either group, but persistent hypoparathyroidism occurred more frequently after TT. Long after ST, hypothyroidism developed in nearly three of four cases, whereas euthyroidy was maintained in only one-fourth; recurrent hyperthyroidy was rare.

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