Open Reduction and Screw Fixation of Mallet Fractures

2004 ◽  
Vol 29 (2) ◽  
pp. 135-138 ◽  
Author(s):  
S. C. KRONLAGE ◽  
D. FAUST
Keyword(s):  
Open Reduction ◽  
Screw Fixation ◽  
Articular Surface ◽  
Joint Space ◽  
Satisfactory Outcome ◽  
Loss Of Reduction ◽  
Secondary Procedures ◽  
Distal Interphalangeal ◽  
The Mean ◽  
Extensor Lag

Twelve patients with mallet fractures treated by open reduction and internal fixation with small screws were reviewed at an average of 31 months after surgery. The indication for surgery was a fracture involving more than one-third of the distal phalanx articular surface or with subluxation of the distal interphalangeal joint. Loss of reduction occurred in one patient and in another one screw loosened slightly without loss of reduction. There were no nail deformities, infections, or secondary procedures. The mean range of motion was from 6° (range, 0–30°) (extensor lag) to 70° (range, 60–90°) flexion. Ten patients had no evidence of degenerative changes, one had minor joint space narrowing and one had significant deformity. Open reduction and screw fixation with small screws can lead to satisfactory outcome in appropriate patients.

Joint replacement in 131 painful osteoarthritic and post-traumatic distal interphalangeal joints

2011 ◽  
Vol 37 (4) ◽  
pp. 304-309 ◽  
Author(s):  
A. Sierakowski ◽  
C. Zweifel ◽  
M. Sirotakova ◽  
S. Sauerland ◽  
D. Elliot
Keyword(s):  
Extensor Tendon ◽  
Range Of Movement ◽  
Lateral Instability ◽  
Ulnar Deviation ◽  
Distal Interphalangeal ◽  
Post Traumatic ◽  
The Mean ◽  
Ongoing Pain ◽  
Extensor Lag ◽  
Immediate Mobilization

This study reports the results of Swanson replacement of 131 DIP joints for painful osteoarthritis and two for ongoing pain after injury. Thirty-seven arthroplasties (28 patients) were carried out with extensor tendon division and repair, and postoperative immobilization for 8 weeks. Ninety-four (60 patients) were then carried out without tendon division, allowing immediate mobilization. At assessment after a mean period of 57 months, the mean postoperative range of movement was 39°, and the mean extensor lag was 11°, with significant improvement of both in both operative groups. The severity of pain improved significantly following surgery. All but one patient were satisfied with the cosmetic result of replacement. The overall complication rate was 7/131(5%). Three joints developed cellulitis and one developed osteomyelitis, requiring subsequent fusion. Two joints had subsequent fusions because of persistent lateral instability and marked ulnar deviation and one had a persistent mallet-type deformity, corrected by tendon shortening.

scholarly journals A single-stage posterior approach with open reduction and pedicle screw fixation in subaxial cervical facet dislocations

2015 ◽  
Vol 23 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Jin Hoon Park ◽  
Sung Woo Roh ◽  
Seung Chul Rhim
Keyword(s):  
Pedicle Screw ◽  
Disc Herniation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Posterior Approach ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Herniated Disc ◽  
The Mean ◽  
Cervical Facet

OBJECT The optimal treatment for cervical facet dislocations is controversial, but the generally accepted process recommends an initial closed reduction with the next step determined according to the success of the closed reduction and the presence of traumatic disc herniation. This study aimed to show the efficacy of a posterior approach performed with an open reduction and pedicle screw fixation with removal of disc particles, if required, in the management of subaxial cervical dislocations. METHODS Between March 2012 and September 2013, 21 consecutive patients with cervical facet dislocations were enrolled. The affected levels were as follows: 4 at C3–4; 2 at C4–5; 5 at C5–6; and 10 at the C6–7 level. Seven patients had traumatic disc herniations. Closed reduction was not attempted; a prompt posterior cervical surgery was performed instead. After open reduction, pedicle screw fixation was performed. In cases with traumatic disc herniation, herniated disc fragments were excised via a posterolateral approach and successful decompressions were determined by postoperative MRI studies. Clinical outcomes were assessed using the American Spinal Injury Association (ASIA) grading system. Radiological outcomes were assessed by comparing the degree of subluxation and the angle of segmental lordosis between pre- and postoperative CT scans. RESULTS All patients improved neurologically. The mean segmental angles improved from 7.3° ± 8.68° to −5.9° ± 4.85°. The mean subluxation improved from 23.4% ± 16.52% to 2.6% ± 7.19%. Disc fragments were successfully removed from the 7 patients with herniated discs, as shown on MRI. CONCLUSIONS Open reduction followed by pedicle screw fixation or posterolateral removal of herniated disc fragments is a good treatment option for cervical facet dislocations.

External Fixation for Surgical Treatment of a Mallet Finger

2003 ◽  
Vol 28 (3) ◽  
pp. 228-230 ◽  
Author(s):  
T. KALELI ◽  
C. OZTURK ◽  
S. ERSOZLU
Keyword(s):  
Surgical Treatment ◽  
Surgical Technique ◽  
Interphalangeal Joint ◽  
Mallet Finger ◽  
Distal Interphalangeal Joint ◽  
Distal Interphalangeal ◽  
The Mean ◽  
Extensor Lag ◽  
New Surgical Technique

A new surgical technique is described for the treatment of mallet finger deformity which involves the application of a mini external fixator across the distal interphalangeal joint and resection of a portion of the extensor mechanism. We reviewed 19 patients who were treated with this technique, at a mean follow-up period of 36 (range, 24–48) months. The mean extensor lag was 2° (range, −7° to 13°) and the mean flexion range was 70° (range, 20°–90°).

scholarly journals Nightstick Fractures, Outcomes of Operative and Non-Operative Treatment

2019 ◽  
Vol 62 (1) ◽  
pp. 19-23
Author(s):  
Mohammed Ali ◽  
D. I. Clark ◽  
Amole Tambe
Keyword(s):  
Internal Fixation ◽  
Functional Status ◽  
Operative Treatment ◽  
Open Reduction ◽  
Associated Injuries ◽  
Clinical Notes ◽  
Satisfactory Outcome ◽  
Isolated Fracture ◽  
The Mean

Introduction: A nightstick fracture is an isolated fracture of the ulnar shaft. Although operative and non-operative treatments have been commonly decided by the degree of displacement of the fracture, still there is a controversy specially in those moderately displaced. Herein we report our experience with nightstick fractures. Objective: To evaluate operative and non-operative treatment of nightstick fracture. Materials and methods: We retrospectively reviewed the clinical notes, physiotherapy letters and radiographs of 52 patients with isolated ulnar shaft fractures. Outcome Measurements included radiographic healing, post-operative range of motion and complications. Results: The study included 13 females and 39 males, with a mean age of 26 years [range, 18–93 years]. The mean Follow-up period was 32 months ranged from 12 to 54 months. Ten patients were treated non-operatively; forty-two patients had open reduction and internal fixation including six open fractures. The average wait for surgery was 2.5 days. Mobilisation was commenced immediately after the surgeries non-load bearing. 40 patients had no complications post-operatively with good outcome and average of four visits follow-up. In the non-operative group, five out ten failed and had a mean follow-up of nine visits. Conclusion: Satisfactory outcome is to be expected with open reduction and internal fixation. Fractures with less than 50% displacement should be treated on individual bases, considering; age, pre-morbid functional status, co-morbidities, compliance and associated injuries.

scholarly journals Evaluation of talus fractures treated with fixation- correlation of functional outcome with the fracture type and wound condition

2018 ◽  
Vol 4 (4) ◽  
pp. 647
Author(s):  
Neetin Pralhad Mahajan ◽  
Nikhil Dilip Palange ◽  
Eknath Pawar ◽  
Amit Supe ◽  
Prasannakumar G. S.
Keyword(s):  
Functional Outcome ◽  
Open Reduction ◽  
Articular Surface ◽  
Early Mobilization ◽  
Angular Deformity ◽  
Consecutive Series ◽  
Fracture Type ◽  
Type Iv ◽  
Early Motion ◽  
Satisfactory Outcome

<p class="abstract"><strong>Background:</strong> Fractures of talus are one of the most difficult ones to treat owing to the problems of complicated fracture patterns, wound problems, risk of osteonecrosis etc. This study aims to evaluate the relation of the fracture type and wound with the functional outcome after open reduction and fixation.</p><p class="abstract"><strong>Methods:</strong> The study was conducted in Sir J. J. Group of Hospitals from June 2014 to March 2018. A consecutive series of 28 patients with displaced fractures of talus were selected after approval from ethical committee. All patients were operated and evaluated at average of 6 months after surgery.<strong></strong></p><p class="abstract"><strong>Results:</strong> The Hawkins score was used to evaluate the functional outcome. 60% of patients of type II gained good to very good score as compared to 40% of patients of type III and 30% of type IV. With increase in severity of the fracture, percentage of score decreased.</p><p><strong>Conclusions:</strong> Most precise method of restoring and maintaining the anatomy of talus fracture is open reduction and internal fixation to allow early motion. Surgery for displaced fractures consists of anatomically correct reconstruction to avoid articular surface incongruence and angular deformity as well as preservation and rapid restoration of talar blood supply. This will ensure early mobilization and satisfactory outcome. Open fractures have worse functional outcome than closed fractures owing to lower union rates, higher osteonecrosis rates and higher re-operation and infection rates. </p>

scholarly journals A novel dynamic distraction external fixator for proximal interphalangeal joint fracture dislocation

2019 ◽  
Vol 47 (4) ◽  
pp. 1628-1635 ◽  
Author(s):  
Hua-Zhu Wang ◽  
Jian-Yong Zhao ◽  
Zhi-Sheng Zhang
Keyword(s):  
Grip Strength ◽  
External Fixator ◽  
Articular Surface ◽  
Joint Space ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
X Rays ◽  
Joint Fracture ◽  
The Mean

Objective To evaluate the efficacy of a novel dynamic distraction external fixator for proximal interphalangeal joint (PIPJ) fracture-dislocation. Methods From March 2005 to March 2014, 20 patients with PIPJ fracture-dislocation were treated with our technique. Function scores according to the Michigan Hand Outcome Questionnaire (MHQ) score, union time, grip strength, and range of motion (ROM) were recorded before and after treatment. Results All patients completed a mean follow-up of 22 months (range, 12–60 months). All patients achieved fracture union and joint reduction. The mean union time was 3 months (range, 2–6 months). The mean postoperative MHQ score was 88.00 ± 3.42 (range, 84.00–92.00). Postoperative grip strength of the affected sides was 92% of the contralateral sides. X-rays showed that the fracture line disappeared completely with a good joint contour. The range of extension in the PIPJ was −5° (range, −10°–0°). The range of flexion in the PIPJ was 89.40° ± 9.79° (range, 75°–100°). Postoperatively, four patients had slight narrowing of the joint space and two had an uneven articular surface. Pin breakage, loosening, and tract infection were not observed. Conclusions The novel dynamic distraction external fixator is a promising option for PIPJ fracture-dislocation.

scholarly journals Comparison of Computed Tomography Articular Surface Geometry of Male Versus Female Thumb Carpometacarpal Joints

Hand ◽  
2017 ◽  
Vol 13 (1) ◽  
pp. 33-39
Author(s):  
Jessica G. Shih ◽  
James G. Mainprize ◽  
Paul A. Binhammer
Keyword(s):  
Sex Differences ◽  
Articular Surface ◽  
Joint Space ◽  
Joint Surface ◽  
Surface Geometry ◽  
Significant Difference ◽  
The Mean ◽  
Joint Congruence ◽  
Cmc Joint ◽  
Space Volume

Background: Given the predilection of first carpometacarpal (CMC) joint osteoarthritis in women compared with men, we aim to determine the differences in first CMC joint surface geometry and congruence between young healthy males and females. Methods: Wrist computed tomographic scan data of 11 men and 11 women aged 20 to 35 years were imported into 3-dimensional software programs. The first metacarpal and the trapezium were aligned in a standardized position according to landmarks at key points on Gaussian and maximum curvature maps. Measurements of joint congruence and surface geometry were analyzed, including joint space volume, distance between the bones at the articular surface edges, area of the joint space, and radii of curvature in the radial-ulnar and volar-dorsal planes. Results: The mean thumb CMC articular space volume was 104.02 ± 30.96 mm3 for females and 138.63 ± 50.36 mm3 for males. The mean first metacarpal articular surface area was 144.9 ± 10.9 mm2 for females and 175.4 ± 25.3 mm2 for males. After normalizing for size, the mean thumb CMC articular space volume was 119.4 ± 24.6 mm3 for females and 117.86 ± 28.5 mm3 for males. There was also no significant difference for the articular space volume, articular surface distances, articular space, and mean radii of curvatures. Conclusions: This study found that there are sex differences in the first CMC joint articular volume without normalizing for size; however, there are no sex differences in first CMC joint articular volume, curvature characteristics, or joint congruence of young, healthy patients after normalizing for joint size.

Delayed Single Kirschner Wire Compression Technique for Mallet Fracture

2005 ◽  
Vol 30 (2) ◽  
pp. 180-184 ◽  
Author(s):  
D. FRITZ ◽  
M. LUTZ ◽  
R. ARORA ◽  
M. GABL ◽  
M. WAMBACHER ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Kirschner Wire ◽  
Compression Technique ◽  
Active Range Of Motion ◽  
Mallet Fracture ◽  
Strenuous Work ◽  
Distal Interphalangeal ◽  
The Mean

Twenty-four mallet fractures which involved at least one third % of the articular surface of the distal interphalangeal joint were treated by open reduction and internal fixation using a single double-ended Kirschner wire at a mean of 9 days after injury (range 4–15). At a mean follow-up of 43 (range 12–18) months the active range of motion, pain and the Warren and Norris criteria were evaluated. The mean active range of motion was from −2° extension (range 0–10°) to 72° flexion (range 50–90°). Nineteen patients were pain free and five suffered from mild pain during strenuous work. The Warren and Norris results were successful in 22 and improved in two cases. Radiographs showed, that all the fractures united in a near-anatomic position but with joint narrowing in six digits.

scholarly journals Open reduction, triceps lengthening, and collateral ligaments reconstruction in neglected elbow dislocation: a case report

2020 ◽  
Vol 8 (12) ◽  
pp. 4488
Author(s):  
Henry Tirtosuharto ◽  
Made Bramantya Karna ◽  
Anak Agung Gde Yuda Asmara ◽  
Putu Feryawan Meregawa
Keyword(s):  
Open Reduction ◽  
Articular Surface ◽  
Elbow Dislocation ◽  
Tendon Graft ◽  
Fascia Lata ◽  
Collateral Ligaments ◽  
Range Of Movement ◽  
Left Elbow ◽  
Satisfactory Outcome ◽  
Elbow Contracture

Neglected elbow dislocations are common in developing countries. Neglected elbow dislocation leads to retraction of triceps muscles and collateral ligaments. This cause limitation of range of movement that is inadequate for the activities of daily living. A 48 years old man presented with stiffness on the left elbow. He fell down with arm in extension position 8 months prior to admission and was treated by a traditional bonesetter before seeking medical treatment. Active ROM of the left elbow was limited to 15ᵒ during flexion. The patient diagnosed as left elbow contracture due to neglected left elbow dislocation. Open reduction, MCL-LCL reconstruction and triceps lengthening was performed. Left elbow ROM was improved and MEPI score was good on 5 months evaluation. Open reduction surgery was done to avoid the risk of fracture or articular surface damage. The posterior approach provides good exposure to the retracted posterior structures and give easier access to perform V-Y plasty used for triceps lengthening. Collateral ligaments repair provides immediate stability and give better functional results. Docking technique was used for collateral ligaments repair using fascia lata tendon graft. Immobilization and physical rehabilitation are done to improve elbow joints range of movement. Open reduction surgery, triceps lengthening and collateral ligaments reconstruction using tendon graft from tensor fascia lata give satisfactory outcome for elbow contracture due to neglected left elbow dislocation.

scholarly journals Evaluation of the Outcome of Different Surgical Techniques in the Treatment of Distal Femur Intra-articular Fractures: A Retrospective Study

2021 ◽  
Vol 8 (1) ◽  
pp. 1-8
Author(s):  
Abolfazl Bagherifard ◽  
◽  
Shoeib Majdi ◽  
Paniz Motaghi ◽  
Mohamad Reza Heidarikhoo ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Distal Femur ◽  
Screw Fixation ◽  
Surgical Techniques ◽  
Type B ◽  
Articular Fractures ◽  
Satisfactory Outcome ◽  
The Mean ◽  
Fracture Types

Background: A preferred surgical approach to distal femur intra-articular fractures is still controversial. Objectives: In the current study, we assessed the outcome and complications of three different surgical techniques, including screw fixation, Retrograde Intramedullary Nailing (RIN), and Locking Compression Plate (LCP). Methods: A total of 63 patients with distal femur intra-articular fractures were included in this retrospective study. AO/OTA fracture and dislocation classification was used to categorize patients. Type B fractures were treated with screw fixation and type C fractures were treated using LCP and RIN. Outcome measures, including the knee range of motion (ROM) and pain level, were Results: The mean±SD age of patients was 36.7±15.7 years. The fracture types B and C were detected in 22 (32.4%) and 46 (67.6%) patients. The mean follow-up period was 27.2±15.9 months. Mild knee pain was the only complication of screw fixation that was observed in 21% of patients. LCP was associated with some complications, including pain (19.4%), infection (9.7%), limited ROM (47.4%), malunion (47.4%), and nonunion (6.5%). RIN was also associated with several complications, including pain (44.4%), infection (11.1%), limited ROM (33.3%), and malunion (41.2%). A comparison of the outcome in matched fracture types of LCP and RIN groups revealed no superiority of each technique. Conclusion: Screw fixation alone results in a satisfactory outcome in the treatment of type B distal femur intra-articular fractures. LCP and RIN are associated with a variety of complications with no superiority over each other.

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