Does mandibular condylar morphology after fracture healing predict functional outcomes in patients treated with closed reduction?

2021 ◽  
Author(s):  
Paminder Singh ◽  
Sujata Mohanty ◽  
Zainab Chaudhary ◽  
Pankaj Sharma ◽  
Jyoti Kumar ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Closed Reduction ◽  
Functional Outcomes ◽  
Condylar Morphology

Minimally Invasive Double-Button Fixation of Displaced Lateral Clavicular Fractures in Athletes

2016 ◽  
Vol 45 (2) ◽  
pp. 462-467 ◽  
Author(s):  
Maximiliano Ranalletta ◽  
Luciano A. Rossi ◽  
Hugo Barros ◽  
Francisco Nally ◽  
Ignacio Tanoira ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Closed Reduction ◽  
Functional Outcomes ◽  
Constant Score ◽  
Case Series ◽  
Return To Sport ◽  
Return To Play ◽  
Short Version ◽  
Level Of Evidence ◽  
The Mean

Background: Early union and a rapid return to prior function are the priorities for young athletes with lateral clavicular fractures. Furthermore, it is essential to avoid nonunion in this subgroup of patients, as this is frequently associated with persistent pain, restriction of movement, and loss of strength and endurance of the shoulder. Purpose: To analyze the time to return to sport, functional outcomes, and complications in a group of athletes with displaced lateral clavicular fractures treated using closed reduction and minimally invasive double-button fixation. Study Design: Case series; Level of evidence, 4. Methods: A total of 21 athletes with displaced lateral clavicular fractures were treated with closed reduction and minimally invasive double-button fixation between March 2008 and October 2013. Patients completed a questionnaire focused on the time to return to sport and treatment course. Functional outcomes were assessed with the Constant score and the short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) questionnaire. Pain was evaluated with the visual analog scale (VAS). Radiographs were reviewed to identify radiographic union, malunion, and nonunion. Results: Of the 21 study patients, 20 returned to sport after treatment; 100% returned to the same level. The mean time to return to play was 78 days (range, 41-120 days). Four patients (20%) returned to sport less than 6 weeks after surgery, 14 (70%) returned between 6 and 12 weeks after surgery, and 2 (10%) returned after 12 weeks. The mean Constant score was 89.1 ± 4.2 (range, 79-100), the mean QuickDASH score was 0.4 ± 2.6 (range, 0-7.1), and the mean VAS pain score was 0.4 ± 1.0 (range, 0-3) at final follow-up (mean, 41 months). The only complication was asymptomatic nonunion. Hardware removal was not necessary in any patient. Conclusion: Closed reduction and minimally invasive double-button fixation of displaced lateral clavicular fractures in athletes was successful in terms of returning to the previous level of athletic activity regardless of the type of sport, with excellent clinical results and a low rate of complications.

scholarly journals Comparison of suprapatellar versus infrapatellar approaches of intramedullary nailing for distal tibia fractures

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Yao Lu ◽  
Gen Wang ◽  
Bin Hu ◽  
Cheng Ren ◽  
Liang Sun ◽  
...  
Keyword(s):  
Blood Loss ◽  
Fracture Healing ◽  
Closed Reduction ◽  
Distal Tibia ◽  
Reduction Rate ◽  
Healing Time ◽  
Reduction Technique ◽  
Surgical Time ◽  
Tibia Fractures ◽  
Distal Tibia Fractures

Abstract Background This study aimed to analyze and compare the clinical and functional outcomes of distal tibia fractures treated with intramedullary nailing (IMN) using the suprapatellar (SP) and infrapatellar (IP) surgical approaches. Methods A retrospective analysis was performed in 63 patients with distal fractures that were treated with IMN between August 2014 and August 2018. A total of 27 and 36 patients underwent IMN using the SP and IP techniques, respectively. The surgical time, blood loss, closed reduction rate, rate of adjuvant reduction technique, fracture healing time, and complications were reviewed in this study. Anterior knee pain was assessed using the visual analog scale. The Lysholm Knee Scoring Scale and American Orthopaedic Foot and Ankle Society (AOFAS) scale were used as clinical measurements. Results A total of 63 patients, with a minimum follow-up of 12 months, were evaluated. The average surgical time, blood loss, rate of adjuvant reduction technique, closed reduction rate, fracture healing time, and Lysholm Knee Scoring Scale score were insignificantly different (P > 0.05) between the two groups. However, the SP approach was superior to the IP approach in terms of pain score, AOFAS score, and fracture deformity rate (P < 0.05). Conclusions In the treatment of distal tibia fractures, the SP IMN technique is associated with a significantly higher functional outcome, lower knee pain, and lower rate of fracture deformity than the IP IMN technique.

scholarly journals Anatomic Repair vs Closed Reduction of the Syndesmosis

2021 ◽  
pp. 107110072199000
Author(s):  
Al-Walid Hamam ◽  
Moaz Bin Yunus Chohan ◽  
Christina Tieszer ◽  
Abdel-Rahman Lawendy ◽  
Christopher Del Balso ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Outcome Measures ◽  
Closed Reduction ◽  
Functional Outcomes ◽  
Open Reduction ◽  
Screw Fixation ◽  
Secondary Outcome ◽  
Level Of Evidence ◽  
Significant Difference

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.

scholarly journals The Ilizarov technology for closed reduction of hip dislocation in children with developmental hip dysplasia

2021 ◽  
Vol 27 (3) ◽  
pp. 345-350
Author(s):  
M.P. Teplenky ◽  
◽  
E.V. Oleinikov ◽  
V.S. Bunov ◽  
◽  
...  
Keyword(s):  
Closed Reduction ◽  
Functional Outcomes ◽  
Hip Dysplasia ◽  
Hip Dislocation ◽  
Treatment Method ◽  
Long Term Results ◽  
Aseptic Necrosis ◽  
Developmental Hip Dysplasia

Introduction The possibility of gradual closed reduction of hip dislocation in children over 1.5 years old is considered doubtful. Purpose Analysis of long-term results of applying the Ilizarov technique of gradual closed reduction in combination with the reconstruction of the hip joint components. Methods The outcomes of treatment of 62 children (81 joints) with congenital hip dislocation in the follow-up period from 5 to 16 years were studied. The treatment method included closed reduction of the dislocation using the technology proposed by G.A. Ilizarov and subsequent reconstruction of the joint components. The patients are divided into two groups based on their age. The first group included 33 patients (43 joints) under the age of 5 years. The second group consisted of 29 patients (38 joints) aged 5–8 years. Results Closed reduction failed in five cases. The recurrence of dislocation after closed reduction was 5.3 %. The rate of aseptic necrosis after closed reduction was 9.7 %. Good functional outcomes were reported in 87.7 %. They were significantly better in the younger group. The proportion of good anatomical results did not depend on age and was 77 % in general. Poor results were obtained in 8.8 %. Conclusion The anatomical and functional outcomes and the number of complications by using the technique described were comparable to other methods of gradual closed reduction of hip dislocation. But the technique we have described expands the age restrictions for its use.

Early Versus Delayed Hip Reduction in Treating Femoral Head Fracture Combined With Posterior Hip Dislocation: A Comparative Study

2021 ◽  
Author(s):  
Shanxi Wang ◽  
Bohua Li ◽  
Zhengdong Zhang ◽  
Xiaojun Yu ◽  
Qin Li ◽  
...  
Keyword(s):  
Femoral Head ◽  
Fracture Healing ◽  
Functional Outcomes ◽  
Hip Dislocation ◽  
Healing Time ◽  
Early Group ◽  
Femoral Head Fracture ◽  
Hip Reduction ◽  
Delayed Group ◽  
Posterior Hip Dislocation

Abstract Background: Few studies focus on the treatment of femoral head fracture combined with posterior hip dislocation, and the the safe interval time between injury and reduction still remains controversial. The purpose of this study was to evaluate and compare the outcome of early and delayed hip reduction in treating femoral head fracture combined with posterior hip dislocation. Methods: A total of 71 patients were evaluated in this retrospective study. Based on the time to hip reduction, they were divided into early group (within 6 hours after injury) and delayed group (between 6 - 12 hours after injury). The two groups were compared in reference to hospital day, fracture healing time, the occurrence of complications and final functional outcome. The Thompson-Epstein criteria, modified merled’ Aubigne-Postel scores, visual analog scale (VAS) and Medical Outcomes Short Form 12-item questionnaire score (SF-12) were used for final functional evaluation.Results: The mean hospital day and fracture healing time in the early group were significantly lower than delayed group. The incidence of infection, post-traumatic osteoarthritis, and avascular necrosis of the femoral head (ANFH) in the delayed group were higher than early group. The early group had better functional outcomes in term of Thompson-Epstein criteria, modified merled’ Aubigne-Postel scores and physical component scale (PCS) than delayed group. Conclusions: For the treatment of femoral head fracture combined with posterior hip dislocation, the early and prompt hip reduction can effectively facilitate the fracture healing and patient recovery as well as obtain better functional outcomes.

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