Internal fixation of an unstable open fracture of a distal phalanx with a Herbert screw

1988 ◽  
Vol 13 (3) ◽  
pp. 428-432 ◽  
Author(s):  
Robin R. Richards ◽  
Ghassan Khoury ◽  
M. Christine Young
Keyword(s):  
Internal Fixation ◽  
Open Fracture ◽  
Distal Phalanx ◽  
Herbert Screw

scholarly journals Efficacy of Antibiotic Laden Collagen Sponge In Treating Open Fracture

2018 ◽  
Vol 17 (1) ◽  
Author(s):  
Kularaj Subramaniam ◽  
Aminuddin Che Ahmad
Keyword(s):  
Internal Fixation ◽  
Open Fracture ◽  
Female Gender ◽  
Blood Parameters ◽  
Collagen Sponge ◽  
Open Fractures ◽  
Predisposing Factor ◽  
Observational Cohort ◽  
Grade 3

Introduction: Open fractures are known as a major predisposing factor for a higher incidence of infection. The aim of this study was to assess the efficacy of antibiotic impregnated collagen sponge in reducing the risk of infection in open fractures Grade 3. Materials and Methods: This was an observational cohort study, evaluating the incidence of infection in open fractures of the femur Grade 3A/3B following insertion of gentamicin impregnated collagen sponge (Collatamp®) during definitive fracture fixation. Eryhtrocyte Sedimentation Rate (ESR) and total white count (TWC) were used as blood parameters to observe for the possibility of infection from pre-operatively up to follow up visits at the clinic. Results: A total number of 36 patients, whom had sustained open fracture of the femur Grade 3A/B, underwent internal fixation with antibiotic impregnated collagen sponge insertion. Overall, ESR and TWC in both male and female gender were downgoing trend, with p values of <0.001, and clinically there was no evidence of infection. No infection was identified in 97.2% of patients, following the internal fixation and antibiotic impregnated collagen sponge insertion. There was only one patient (2.8%) who developed infection following the definitive internal fixation and antibiotics impregnated collagen sponge insertion. Conclusion: The use of antibiotic impregnated collagen sponge in open fractures reduced the occurrence of infection. Furthermore, this allows for an uncomplicated union of the bone following definitive fixation.

Distal phalanx fracture in adults: Seymour-type fracture

2013 ◽  
Vol 39 (3) ◽  
pp. 237-241 ◽  
Author(s):  
M. Ugurlar ◽  
G. Saka ◽  
N. Saglam ◽  
A. Milcan ◽  
T. Kurtulmus ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Open Fracture ◽  
Extensor Tendon ◽  
Distal Phalanx ◽  
Mallet Finger ◽  
Surgical Methods ◽  
Type Fracture ◽  
K Wires ◽  
Type Of Fracture ◽  
Metaphyseal Region

Seymour’s fracture is an extra-articular, transverse, physeal, and juxta-epiphyseal open fracture of the distal phalanx seen in childhood. In this study, we present 10 adult cases of fractures localized to the metaphyseal region, 1–2 mm distal to the insertion of the extensor tendon. Mean age was 38 years. Four patients were treated conservatively with a mallet finger splint. Closed reduction and osteosynthesis with Kirschner wires (K-wires) was performed in three of the patients. Three of the patients had open fractures in whom closed reduction could not be performed. They underwent open reduction and osteosynthesis with K-wires. We recommend that extra-articular distal phalanx fractures mimicking mallet finger in adults are called Seymour-type fracture to establish a common language among clinicians to define this type of fracture. These fractures generally occur by hyperflexion of the distal phalanx and can be treated by conservative or surgical methods. The outcomes of conservative and surgical management of Seymour-type fractures depend on the appropriate reduction as well as efficient physical therapy.

Scaphoid fracture in the young athlete – therapeutic outcome of internal fixation using the Herbert screw

2002 ◽  
Vol 122 (9) ◽  
pp. 510-513 ◽  
Author(s):  
Keiichi Muramatsu ◽  
Kazuteru Doi ◽  
Noriyuki Kuwata ◽  
Fujio Kawakami ◽  
Koichiro Ihara ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Scaphoid Fracture ◽  
Young Athlete ◽  
Therapeutic Outcome ◽  
Herbert Screw

scholarly journals Combined Dorsal and Ulnarward Carpometacarpal Dislocation Associated with Open Fracture of the Base of First Metacarpal and Severe Degloving Injury

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Ali J. Electricwala ◽  
Jaffer T. Electricwala
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Closed Reduction ◽  
Rare Case ◽  
Open Fracture ◽  
Kirschner Wires ◽  
Degloving Injury ◽  
The Right ◽  
High Index Of Suspicion

We report a rare case of dislocation of second to fourth carpometacarpal (CMC) joints of the right hand with combined dorsal and ulnarward displacement of the second to fourth digits and fracture of the shaft of the first metacarpal associated with degloving injury. These injuries were diagnosed early and treated successfully with closed reduction and internal fixation using Kirschner wires. The functional outcome was good at follow-up at 5 years. A high index of suspicion is required to successfully diagnose and treat this condition.

The use of Prophylactic Flucloxacillin in Treatment of Open Fractures of the Distal Phalanx within an Accident and Emergency Department: A Double-Blind Randomized Placebo-Controlled Trial

2003 ◽  
Vol 28 (5) ◽  
pp. 388-394 ◽  
Author(s):  
J. STEVENSON ◽  
G. MCNAUGHTON ◽  
J. RILEY
Keyword(s):  
Emergency Department ◽  
Open Fracture ◽  
Controlled Trial ◽  
Distal Phalanx ◽  
Open Fractures ◽  
Controlled Study ◽  
Double Blind ◽  
Accident And Emergency ◽  
Significant Difference ◽  
Accident And Emergency Department

Open fractures of the distal phalanx commonly present to the Accident and Emergency Department. Controversy surrounds the use of prophylactic antibiotics in treating this injury. A double-blind, prospective, randomized placebo-controlled study was undertaken comparing the use of prophylactic flucloxacillin to placebo in addition to meticulous wound toilet. One hundred and ninety-three adult patients with an open fracture of the distal phalanx were studied. Seven patients developed superficial infections, an overall infection rate of 4%. No patient developed osteitis or a deep wound infection. There were three cases of infection in the 98 patients (3%) in the antibiotic group and four cases of infection in the 95 patients (4%) in the placebo group. A difference of proportion test confirmed no significant difference. It is concluded that the addition of prophylactic flucloxacillin to thorough wound toilet and careful soft-tissue repair of open fracture of the distal phalanx confers no benefit.

scholarly journals A clinical study of surgical management of paediatric humeral supracondylar fracture

2019 ◽  
Vol 5 (6) ◽  
pp. 1088
Author(s):  
Ajay Kumar ◽  
Karthik Padmanabhan
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Open Fracture ◽  
Supracondylar Fracture ◽  
Cubitus Varus ◽  
Inexpensive Method ◽  
Follow Up Study ◽  
Elbow Injuries ◽  
K Wires

<p class="abstract"><strong>Background:</strong> Injury to the supracondylar region of the humerus and complete displacement of the fragments occurs in many of the cases when children usually fall while playing. This is most common fracture seen in children, makes up to 60% of all elbow injuries. Early intervention results in excellent reduction and avoids complications. Concomitant vascular and nerve damages may occur. Open reduction and internal fixation is a helpful option for the treatment of supracondylar facture of humerus in children.</p><p class="abstract"><strong>Methods:</strong> Forty children who presented with displaced supracondylar fracture of the humerus were treated with open reduction and internal fixation with Kirschner (K) wires after thorough pre-operative investigation during the course of the study. Children below the age of 13 were selected irrespective of the sex.<strong></strong></p><p class="abstract"><strong>Results:</strong> Good results were obtained in 60% of the patients, fair in 30% and poor in 10%. The poor results were due to the open fracture and in two cases the patient presented very late to the hospital. Complications such as nerve injuries, vascular injuries, infections were noticed in the study. Four patients had cubitus varus and twelve patients had flexion loss on follow-up study.</p><p class="abstract"><strong>Conclusions:</strong> Open reduction and internal fixation with K wire is an easy, simple, inexpensive method, which has good outcome.</p>

Outcome of Open Long Bone Fractures in Dogs Stabilized with Linear External Skeletal Fixator

2021 ◽  
Author(s):  
Tejpal Singh ◽  
Ashwani Kumar ◽  
Rahul Kumar Udehiya ◽  
Kirandeep Kaur Gill ◽  
Tejinder Singh Rai ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Fracture ◽  
Bone Fractures ◽  
Open Fractures ◽  
Long Bone ◽  
Type I ◽  
Group Iii ◽  
Long Bone Fractures ◽  
Group I ◽  
Tract Infections

Background: External skeletal fixator (ESF) has been recommended as biological method to stabilize open fracture as it does not involves the wound site, besides protecting adjacent soft tissue structures. Considering the advantages of ESF, this study was envisaged with an objective to study the outcome of open fractures of radius-ulna and tibia-fibula stabilized with linear ESF in dogs.Methods: This study included 17 dogs suffering from open long bone fractures of radius-ulna and tibia-fibula, divided into three groups; linear ESF type I or II (group I, n=8) and type III (group II, n=3). In group III (n=6), open fractures were initially treated using conservative methods i.e management of open wound till complete healing followed by delayed internal fixation using intramedullary pin or bone plating.Result: Majority of the open fractures of radius-ulna and tibia-fibula were transverse (64.71%), involving distal third diaphysis (47.06%) in heavy weight (54.55%), 1-3 year old (64.71%), non-descript (35.29%), male (88.23%) dogs due to automobile accidents (58.82%). Neutrophilic (81.47±4.45%) leukocytosis (24610±2461.88 per cumm) and elevated levels of alkaline phosphatase and creatine kinase were observed. Staphylococcus spp. was the common isolated bacteria sensitive to Gentamicin, Cefotaxime, Tobramycin, Amikacin and Neomycin. High per cent fractures (83.33%) in group III had acceptable functional outcome as compared to fractures treated with linear ESF (55.55%) in groups I and II. Osteomyelitis due to pin tract infections was the major complication (8/11; 72.7%) recorded in ESF groups (Group I and II) that lead to delayed and/or nonunion. Weight bearing score improved markedly after removal of the ESF frame. In conclusions, immediate fixation of the long bone fracture using linear ESF in the presence of open contaminated / infected wounds leads to unacceptable outcome. Poor animal compliance, pin tract discharge, osteomyelitis, delayed union and nonunion are major complications associated with linear ESF. Conservative management of the open fracture wound using standard treatment for 2-3 weeks till complete wound healing followed by internal fixation with intramedullary pin or bone plate is recommended for open long bone fractures in dogs.

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