scholarly journals Surgical treatment of mid-shaft clavicle fractures by minimally invasive internal fixation facilitated by intra-operative external fixation: A preliminary study

2019 ◽  
Vol 105 (5) ◽  
pp. 847-852
Author(s):  
Jean-Gabriel Delvaque ◽  
Thierry Bégué ◽  
Benoit Villain ◽  
Nasser Mebtouche ◽  
Jean-Charles Aurégan
BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e052966
Author(s):  
Adriano Fernando Mendes Jr. ◽  
Rodrigo Fleury Curado ◽  
Jair Moreira Dias Jr. ◽  
José Da Mota Neto ◽  
Oreste Lemos Carrazzone ◽  
...  

IntroductionFractures of the diaphysis of the clavicle are common; however, treatment guidelines for this condition are lacking. Surgery is associated with a lower risk of non-union and better functional outcomes but a higher risk of complications. Open reduction and internal fixation with plates and screws are the most commonly performed techniques, but they are associated with paraesthesia in the areas of incisions, extensive surgical exposure and high rates of implant removal. Minimally invasive techniques for treating these fractures have a lower rate of complications. The aim of this study is to evaluate which surgical treatment option (minimally invasive osteosynthesis or open reduction and internal fixation) has better prognosis in terms of complications and reoperations.Methods and analysisThe study proposed is a multicentric, pragmatic, randomised, open-label, superiority clinical trial between minimally invasive osteosynthesis and open reduction and internal fixation for surgical treatment of patients with displaced fractures of the clavicle shaft. In the proposed study, 190 individuals with displaced midshaft clavicle fractures, who require surgery as treatment, will be randomised. The assessment will occur at 2, 6, 12, 24 and 48 weeks, respectively. The primary outcome of the study will be the number of complications and reoperations. For sample size calculation, a moderate effective size between the techniques was considered in a two-tailed test, with 95% confidence and 90% power. Complications include cases of infection, hypertrophic scarring, non-union, refracture, implant failure, hypoesthesia, skin irritation and shoulder pain. Reoperations are defined as the number of surgeries for pseudoarthrosis, implant failure, infection and elective removal of the implant.Ethics and disseminationStudy approved by the institutional ethics committee (number 34249120.9.0000.5505—V.3). The results will be disseminated by publications in peer-reviewed journals and presentations in medical meetings.Trial registration numberRBR-3czz68)/UTN U1111-1257-8953.


2003 ◽  
Vol 60 (6) ◽  
pp. 663-667 ◽  
Author(s):  
Sasa Milenkovic ◽  
Milorad Mitkovic ◽  
Mile Radenkovic ◽  
Desimir Mladenovic ◽  
Gordana Soldatovic ◽  
...  

Pertrochanteric fractures usually occur in patients over 65 years of age, with greater loss of skeletal mass (osteoporosis). Nonsurgical methods of treatment are accompanied by relatively high lethality rate. Moreover, they do not produce satisfactory anatomical and functional results. Surgical treatment by using dynamic implants represents a method of choice in the fixation of pertrochanteric fractures. This paper presents the treatment results of 110 patients, 61 with pertrochanteric fractures, who were surgically treated by the dynamic method of internal fixation, and 49 patients who were treated by the method of external fixation. Dynamical implants enabled both dynamization and compression of the fracture in the axis of the neck, as well as the diaphysis of the femur, which lowered the risk of mechanical complications, and, at the same time, provided effective healing of the fracture, early activation, and mobilization of the patients on whom the surgery was performed. In patients infected by various diseases, for whom surgical trauma represents a life threat, the external fixation is recommended as a method of choice.


2019 ◽  
Vol 11 (1) ◽  
pp. 42-51
Author(s):  
Hua-shui Liu ◽  
Sheng-jun Duan ◽  
Fu-zhen Xin ◽  
Zhen Zhang ◽  
Xue-guang Wang ◽  
...  

2020 ◽  
Author(s):  
Chenggong Wang ◽  
Can Xu ◽  
Mingqing Li ◽  
Hui Li ◽  
Han Xiao ◽  
...  

Abstract Background: Almost all of the traditional calcaneal fracture minimally invasive internal fixation (MIIF) require a lot of intraoperative fluoroscopy, moreover, the fracture recovery of many patients are not considered ideal. Therefore, we designed a new surgical procedure through the digital surgical simulation and made patient-specific instrument (PSI) for calcaneal fracture patients before surgery, and then we manage the operation through the assistance of PSI during the whole process. The purpose of this study is to verify whether the PSI assisted calcaneal fracture minimally invasive internal fixation is accurate and practical. Methods: We retrospectively analyzed the Sanders type III or IV fresh calcaneal fracture patients who had been performed MIIF assisted by the PSI in our hospital during January 2016 to December 2018. We collected and analyzed perioperative data including intraoperative fluoroscopy times, whether the internal fixation actual usage (IFAU) same as preoperative plan, surgical time and situation of complication; and collected and analyzed the data of preoperative actual measurement, preoperative-plan and postoperative actual measurement from X-rays and CT, including Böhler angle, Gissane angle, subtalar joint width, calcaneus valgus angle and calcaneal volume overlapping ratio. All patients had been followed up and their AOFAS score had been recorded. Then we performed statistical analyses. Results: The intraoperative fluoroscopy times was 3.95±1.78, the condition of IFAU in 16 patients was the same as preoperative plan, the surgery time was 28.16±10.70 min, no patients developed complications. The preoperative plan Böhler angle, Gissane angle, subtalar joint width and calcaneus valgus angle were not significant different from the postoperative; the preoperative Böhler angle, Gissane angle, subtalar joint width and calcaneus valgus angle were all significant different from the postoperative. The calcaneal volume overlapping ratio with preoperative design was 91.2±2.3%. The AOFAS score of all patients gradually increased as time goes on, and difference of the AOFAS scores between all time-points were significant. Conclusions: The new PSI can indeed carry out the preoperative plan accurately and quickly, and the PSI assisted calcaneal fracture minimally invasive internal fixation is accurate and practical.


Hand Surgery ◽  
1996 ◽  
Vol 01 (01) ◽  
pp. 31-35 ◽  
Author(s):  
Ueli Büchler

A method is presented for open reduction, bone grafting, minimal internal fixation and ancillary dynamic external fixation of unstable impacted fracture-dislocations of the proximal interphalangeal joint of the finger involving more than 40% of the surface of the joint plateau.


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