Closed reduction: explicit substitutions without $\alpha$ -conversion

2005 ◽  
Vol 15 (2) ◽  
pp. 343-381 ◽  
Author(s):  
M. FERNÁNDEZ ◽  
I. MACKIE ◽  
F-R. SINOT
Keyword(s):  
Closed Reduction ◽  
Explicit Substitutions

Open Reduction for Dorsal Dislocation of Second to Fifth Carpometacarpal Joints: A Case Report

2020 ◽  
Author(s):  
Hiroo Kimura ◽  
Akira Toga ◽  
Taku Suzuki ◽  
Takuji Iwamoto
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Delayed Diagnosis ◽  
Preoperative Assessment ◽  
Radiographic Examination ◽  
Clinical Images ◽  
Left Hand ◽  
Carpometacarpal Joints ◽  
Joint Deformity ◽  
Poor Outcomes

Abstract Background Fracture-dislocations of all four ulnar (second to fifth) carpometacarpal (CMC) joints are rare hand injuries and frequently overlooked or missed. These injuries can be treated conservatively when closed reduction is successfully achieved, though they are sometimes irreducible and unstable. Case Description We report the case of a 17-year-old boy involved in a vehicular accident. Clinical images showed dorsal dislocation of all four ulnar CMC joints of the left hand associated with a fracture of the base of the fourth metacarpal. Although closed reduction was attempted immediately, the affected joints remained unstable and easily redislocated. Therefore, we performed open reduction and percutaneous fixation of all ulnar CMCs. He showed excellent recovery after 1 year postoperatively, reported no pain, and demonstrated complete grip strength and range of motion of the affected wrist and fingers. Literature Review Accurate clinical diagnosis of this lesion is difficult because of polytrauma, severe swelling masking the dislocated CMC joint deformity, and overlapping of adjacent metacarpals and carpal bones on radiographic examination. As for the treatment strategy, it has yet to obtain a consensus. Some reports value open reduction to guarantee anatomical reduction, and it is definitely needed in the patients with interposed tissues to be removed or with subacute and chronic injuries. Clinical Relevance Delayed diagnosis or treatment could lead to poor outcomes. Therefore, surgeons must be aware that precise preoperative assessment is critical, and anatomical open reduction of interposed bony fragments, like our case, may be required even in an acute phase.

COMPARATIVE ANALYSIS OF CLOSED REDUCTION AND EXPERT TIBIA NAILING WITH OPEN REDUCTION AND PLATE & SCREW FIXATION IN THE TREATMENT OF PROXIMAL TIBIA EXTRAARTICULAR FRACTURES

2018 ◽  
Author(s):  
Anil Pandey ◽  
Setul Shah ◽  
Deepak S Maravi ◽  
S Uikey
Keyword(s):  
Intramedullary Nailing ◽  
Closed Reduction ◽  
Proximal Tibia ◽  
Plate Fixation ◽  
Surgical Site Infections ◽  
Delayed Union ◽  
Large Sample Size ◽  
Multicentric Study ◽  
Group A ◽  
Group B

Introduction:- Extra-articular proximal tibial fractures account for 5–10 % of all tibial shaft fractures and it result from high-velocity trauma. Closed reduction with minimally invasive plating and locked intramedullary  nailing have been widely used for treatment of proximal tibia extraarticular fractures. Our pupose is to compare the pros and cons of these two methods. Materials and methods:- 22 patients were included in this study for a period of 2 years. Patients treated with IMN were kept in group A patients treated with percutaneus plating were kept in group B. Standard approach of nailing and plating were used and proper follow up were taken for next upcoming 1 year. Results:- Combined average age was 38years. Male were more commonly affected than female (13:8). Majority of fracture were of type A33. Operative time was < 2 hours in both groups. Less blood loss occurred during intramedullary nailing as compared to locking plate fixation. Surgical site infections (SSIs) were seen in two patients in the PTP group. Delayed union occurred in two patients in the IMN group. The average range of motion was 119.7(range 90-150, SD= 19.18) in group A and 115.2(range 80-150, SD = 17.28) in group B. Conclusion:- in treatment of proximal tibia extra articular fracture use of IMN and PTLCP gives comparable results. To validate this issue further a large sample size multicentric study is recommended   Key words: intramedullary nailing (IMN), Extraarticular tibialn fracture, Surgical site infection.

Plaster immobilization versus anterior plating for dorsally displaced distal radial fractures in elderly patients in Pakistan

2021 ◽  
pp. 175319342097778
Author(s):  
Muhammad Tahir ◽  
Faridullah Khan Zimri ◽  
Nadeem Ahmed ◽  
Allah Rakhio Jamali ◽  
Ghulam Mehboob ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Randomized Trial ◽  
Closed Reduction ◽  
Primary Outcome ◽  
Locking Plate ◽  
Cast Immobilization ◽  
Distal Radial Fractures ◽  
Level Of Evidence ◽  
Anterior Plating ◽  
Plaster Immobilization

This prospective, multi-centred, randomized trial examined outcomes of 3- and 12-month follow-ups of 159 elderly participants aged more than 75 years with isolated distal radial fractures, treated by anterior locking plate or closed reduction and cast immobilization. The primary outcome was the patient-rated wrist evaluation (PRWE) score. The PRWE score at 12 months was not significantly different between the two groups; however, the radiological outcomes and complications rates were worse in the casting group. Level of evidence: III

scholarly journals Plate Fixation for Irreducible Proximal Humeral Fractures in Children and Adolescents—A Single-Center Case Series of Six Patients

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 635
Author(s):  
Florian Freislederer ◽  
Susanne Bensler ◽  
Thomas Specht ◽  
Olaf Magerkurth ◽  
Karim Eid
Keyword(s):  
Closed Reduction ◽  
Biceps Tendon ◽  
Plate Fixation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Constant Murley Score ◽  
Fractures In Children ◽  
Initial Surgery ◽  
Conjoint Tendon

Background: Recommended treatment for severely displaced proximal humeral fractures in children is the closed reduction and percutaneous fixation by K-wires or intramedullary nailing. Methods: From January 2016 to January 2017 6, 21 children/adolescents (range 8 to 16 years) with proximal humeral fractures were treated surgically for severe displacement. In these six patients, several attempts of closed reduction were unsuccessful, and an open reduction was performed. The humeral head was fixed with a 3.5 mm T-plate without affecting the growth plate. Plate removal was performed at a mean interval of 132 days after initial surgery. Two years after initial surgery, the clinical outcome was assessed by the Constant–Murley score and QuickDASH score (including sport/music and work) and the shoulder joint was evaluated with a standardized sonographic examination for the rotator cuff and the conjoint tendon. Results: In all six patients, dorsal displacement of the fracture was irreducible due to the interposition of tendinous or osseous structures. Intraoperatively, the interposed structures were the long biceps tendon in two, periosteal tissue in two, a bony fragment in one, and the long biceps tendon together with the conjoint tendon in one case. At mean follow-up of 26 months (range 22 months to 29 months), patients showed very good clinical results with an excellent mean Constant–Murley score of 97.5 (range 91 to 100) and mean QuickDASH score (including sport/music and work) of 5.5 (range 0–20.8). An X-ray follow-up 6 weeks after surgery demonstrated early consolidation and correct alignment in all patients. A sonographic evaluation at 2 years post injury showed that the biceps and the conjoined tendon were intact in all patients. Conclusions: If a proximal humeral fracture is not reducible by closed means, a tissue entrapment (most likely biceps tendon) should be considered. Treatment with an open reduction and plate fixation yields very good clinical and radiological results and preserves interposed structures as the biceps and conjoint tendon.

scholarly journals Inferior Patella Dislocation due to Impaction in the Femoral Trochlea

2021 ◽  
pp. 89-92
Author(s):  
Ahmed Fadulelmola ◽  
Rob Gregory
Keyword(s):  
Closed Reduction ◽  
Early Mobilization ◽  
Patella Dislocation ◽  
Type Ii ◽  
Rare Presentation ◽  
Femoral Trochlea ◽  
Inferior Pole ◽  
Locked Knee ◽  
Inferior Dislocation ◽  
Superior Pole

Acute inferior dislocation of the patella is a rare presentation in trauma and orthopaedics. Type II is caused by direct upward force on the inferior pole of the patella when the knee is flexed impacting the superior pole osteophyte into the intercondylar notch. Impaction in the femoral trochlea is rarely reported. A 92-year-old lady presented with locked knee held in 85° of flexion with an abnormal knee contour. Radiographs demonstrated that the upper pole of the patella was impacted in the femoral trochlea with a fracture of a superior pole osteophyte. The extensor mechanism was intact. Closed reduction is achieved under strong opioid pain relief. The patient returned to her baseline knee function within 6 weeks. Closed reduction of an inferior patellar dislocation in elderly patients is aided by superior pole osteophyte fracture and facilitates early mobilization, and avoidance of general anaesthesia.

An Alternative Approach Using Circummandibular Wiring for Treatment of Dentoalveolar Fractures in Children: A Case Report

2021 ◽  
pp. 194338752199028
Author(s):  
José Henrique Santana Quinto ◽  
Andressa Bolognesi Bachesk ◽  
Lucas Costa Nogueira ◽  
Liogi Iwaki Filho
Keyword(s):  
Case Report ◽  
Surgical Technique ◽  
Bone Fracture ◽  
Closed Reduction ◽  
Alternative Methods ◽  
Alveolar Process ◽  
Fractures In Children ◽  
Alternative Approach ◽  
Open Treatment ◽  
Segmental Fractures

The prevalence of dentoalveolar injuries in children is approximately 25%, with falls from own height being one of the main etiologies. Diagnosis is based on the clinical evaluation associated with complementary imaging tests. The treatment of choice depends on the type of damage and structure affected. For alveolar process fractures, closed reduction and semi-rigid dental splinting for 4 to 6 weeks is generally satisfactory. However, some cases, such as severe segmental fractures, require open treatment to ensure adequate reduction and stabilization of the displaced alveolar segment, which is usually achieved by titanium miniplates and screws. Nevertheless, there are situations where this type of fixation is not possible, requiring alternative methods. Therefore, this article describes a surgical technique performed by open reduction, associating semi-rigid dental splint and circummandibular wiring in pediatric patient diagnosed with dentoalveolar fracture through clinical examination (with bone fracture displacement) and tomography. The technique promoted a good prognostic to the patient, proving to be a viable alternative for treating dentoalveolar fractures.

scholarly journals Effect of childhood overweight on distal metaphyseal radius fractures treated by closed reduction

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yu Liu ◽  
Chunjie Liu ◽  
Dongmei Guo ◽  
Ning Wang ◽  
Ying Zhao ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Conservative Treatment ◽  
Closed Reduction ◽  
Pediatric Population ◽  
Normal Weight ◽  
Medical Community ◽  
Overweight Children ◽  
Radius Fractures

Abstract Background The medical community has recognized overweight as an epidemic negatively affecting a large proportion of the pediatric population, but few studies have been performed to investigate the relationship between overweight and failure of conservative treatment for distal radius fractures (DRFs). This study was performed to investigate the effect of overweight on the outcome of conservative treatment for DRFs in children. Methods We performed a retrospective study of children with closed displaced distal metaphyseal radius fractures in our hospital from January 2015 to May 2020. Closed reduction was initially performed; if closed reduction failed, surgical treatment was performed. Patients were followed up regularly after treatment, and redisplacement was diagnosed on the basis of imaging findings. Potential risk factors for redisplacement were collected and analyzed. Results In total, 142 children were included in this study. The final reduction procedure failed in 21 patients, all of whom finally underwent surgical treatment. The incidences of failed final reduction and fair reduction were significantly higher in the overweight/obesity group than in the normal-weight group (P = 0.046 and P = 0.041, respectively). During follow-up, 32 (26.4%) patients developed redisplacement after closed reduction and cast immobilization. The three risk factors associated with the incidence of redisplacement were overweight/obesity [odds ratio (OR), 2.149; 95% confidence interval (CI), 1.320–3.498], an associated ulnar fracture (OR, 2.127; 95% CI, 1.169–3.870), and a three-point index of ≥ 0.40 (OR, 3.272; 95% CI, 1.975–5.421). Conclusions Overweight increases the risk of reduction failure and decreases the reduction effect. Overweight children were two times more likely to develop redisplacement than normal-weight children in the present study. Thus, overweight children may benefit from stricter clinical follow-up and perhaps a lower threshold for surgical intervention.

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