scholarly journals (A130) Advantages of Apparatus of External Fixation in Severe Injuries of Extremities in Children

2011 ◽  
Vol 26 (S1) ◽  
pp. s36-s37
Author(s):  
A. Karabenyuk ◽  
A. Levitskiy
Keyword(s):  
External Fixation ◽  
Soft Tissues ◽  
Bone Fractures ◽  
Shock Therapy ◽  
Long Bone ◽  
Late Period ◽  
Severe Injuries ◽  
Acute Period ◽  
Restorative Treatment ◽  
Treatment Indications

PurposeTo study advantages of external fixation in severe injuries of extremities in children.Material and Method305 children at the age from 3 to 17 years with polytrauma (ISS > 18) were studied. From them skeletal injuries took place in 198 patients, cranioskeletal trauma - 125, multiple bone fractures - 56, bone fractures + visceral trauma - 24. 44 children had open bone fractures or fractures accompained with vast defects of soft tissues. Operative interventions in polytrauma are divided into urgent, elective and delayded. Urgent intervention (according to vital indications) are conducted together with anti-shock therapy in massive blood losses (injury of spleen, liver), crushing of lungs, cardiac tamponade, intracranial compression. Elective interventions are prformed after stabilization of patient's state and after bringing him out of shock.ResultsSets for external fixation were used in acute period of trauma, in early and late posttraumatic period. Tipe of sets depended on character of injury and followed steps of treatment. Indications for external fixation in acute period and catabolic phase of traumatic disease were: 1. multiple fragmental fractures, 2. defects of bones, 3. vast defects of soft tissues, 4. long bone fractures accompained with severe brain trauma. Indications for external fixation in late period were mulunion, in postpond – ununion, deformations and shortening of extremities.ConclusionThe usage of external fixation was an effective approach in treatment of children with severe complicated injuries of extremities. Advantages of external fixation in conditions of polytrauma were undiscutable: management in force effects, absence of secondary dislocations, good conditions for debridment and follow restorative treatment, mobility of patients.

scholarly journals Results of Conversion Osteosynthesis in Treatment of Patients with Long Bone Fractures

2019 ◽  
Vol 23 (3) ◽  
pp. 257-270
Author(s):  
Ya. M. Alsmadi ◽  
N. V. Zagorodniy ◽  
E. I. Solod ◽  
A. F. Lazarev ◽  
M. A. Abdulkhabirov ◽  
...  
Keyword(s):  
External Fixation ◽  
Soft Tissues ◽  
Bone Fractures ◽  
Damage Control ◽  
Traumatic Shock ◽  
Long Bone ◽  
Optimal Time ◽  
Long Bones ◽  
Results Of Treatment ◽  
Post Traumatic

Аbctract. Treatment of long bones fractures of the extremities has a particular relevance in modern traumatology due to their high frequency, as well as a large number of deaths in patients with polytrauma. It is dangerous to perform an urgent final osteosynthesis in severe patients because of the possibility of shock and the deterioration of the condition of the injured. Therefore, the principle of Damage control with urgent fixation of damaged segments by external fixation and their subsequent replacement (converse) to intramedullary osteosynthesis had a particular relevance in the treatment of patients with long bones fractures. Purpose: Improving treatment outcomes for patients with long bones fractures. Materials and methods. In the present study, a retrospective analysis of using conversion osteosynthesis in the treatment of 120 patients with long bones extremities fractures in a multidisciplinary hospital was carried out. For a better analysis of the results of treatment, we divided the patients into two groups: The first group 44 patients with fractures of the long bones with polytrauma according to the ISS severity scale> 17. The second group consists of 76 patients with closed isolated unstable comminuted fractures of the long bones with severe post-traumatic edema, who have a high risk of significant trauma of soft tissues. Results. The most optimal time for conversion osteosynthesis to patients with polytrauma was 7-12 days, which prevented the occurrence of traumatic shock; and for patients with closed isolated unstable fractures of long bones with significant of post-traumatic edema for conversion osteosynthesis, the optimal time was 3-7 days after injury, which prevented the occurrence of inflammatory complications in the postoperative period. Conclusion. The study confirmed the feasibility of conversion osteosynthesis in the treatment of patients with diaphyseal fractures. The use of the technique of transferring the fixation of fragments by the external fixation device to the internal osteosynthesis (conversion) contributed to a reduction in the duration of inpatient treatment of patients with fractures of the long bones.

SECONDARY INTRAMEDULLARY NAILING OF OPEN LOWER EXTREMITY LONG BONE FRACTURES AFTER EXTERNAL FIXATION

1993 ◽  
Vol 86 (Supplement) ◽  
pp. 80
Author(s):  
Thomas Calton ◽  
Stephen L. Henry ◽  
Zack Stearns ◽  
David Seligson
Keyword(s):  
Lower Extremity ◽  
External Fixation ◽  
Intramedullary Nailing ◽  
Bone Fractures ◽  
Long Bone ◽  
Long Bone Fractures

External Fixation of Long Bone Fractures in Children

1994 ◽  
Vol 29 (6) ◽  
pp. 1525
Author(s):  
Se Hyun Cho ◽  
Hae Ryong Song ◽  
Kyung Hoi Koo ◽  
Young Sik Min ◽  
Yeun Chun Jung ◽  
...  
Keyword(s):  
External Fixation ◽  
Bone Fractures ◽  
Long Bone ◽  
Long Bone Fractures ◽  
Fractures In Children

Urgent diagnostics of musculoskeletal injury: the value of ultrasonography

2021 ◽  
Vol 19 (3) ◽  
pp. 81-86
Author(s):  
A. M. SHCHIKOTA ◽  
◽  
I. V. POGONCHENKOVA ◽  
S. A. GUMENYUK ◽  
◽  
...  
Keyword(s):  
Soft Tissues ◽  
Bone Fractures ◽  
Musculoskeletal Injury ◽  
Ease Of Use ◽  
Long Bone ◽  
Emergency Ultrasonography ◽  
Highly Sensitive ◽  
Ultrasound Diagnostics ◽  
Surgical Manipulations ◽  
Ultrasonic Navigation

The article presents a review of literature on the value of ultrasonography in acute musculoskeletal injury diagnostics. The main objectives of emergency ultrasonography are outlined: detection of fractures, large hematomas, injuries of tendons, muscles and nerves, detection of foreign bodies of soft tissues, ultrasonic navigation of surgical manipulations and reposition of fractures. The ultrasound method is highly sensitive цand specific in the detection of long-bone fractures, muscles and tendons rupture, which can make an impact on therapeutic tactic and patient’s routing. Ultrasound diagnostics has become useful for pediatric patients due to its ease of use, mobility and non-ionizing qualities. Ultrasonography of acute musculoskeletal injury will probably be increasingly important for orthopedic surgeons and emergency physicians.

Tactics of Operative Treatment for Closed Long Bone Fractures in Patients with Polytrauma in Early Period

2003 ◽  
Vol 10 (3) ◽  
pp. 3-9
Author(s):  
V A Sokolov ◽  
E I Byalik ◽  
V A Sokolov ◽  
E I Byalik
Keyword(s):  
Soft Tissues ◽  
Bone Fractures ◽  
Plate Osteosynthesis ◽  
Early Period ◽  
Functional Results ◽  
Fat Embolism ◽  
Long Bone ◽  
Long Bone Fractures ◽  
Embolism Syndrome ◽  
Urgent Operation

Results of the treatment of 218 victims with polytrauma were analyzed during the period from 1998 to 2202. There were 127 patients with one and 91 patients with several closed fractures. Authors consider osteosynthesis for closed long bone fractures to be an urgent operation of third term. Osteosynthesis is absolutely indicated to the patients with psychomotor excitation, in cases of the threat for skin perforation by bone fragments and in patients requiring intensive nursing for their life rescue. The choice of operative method depends on polytrauma severity and fracture type. When osteosynthesis is performed by urgent indications in patients with polytrauma the requirements to osteosynthesis stiffness are higher than in isolate injuries, as the rotation displacement, migration and fixator deformity frequently take place in unconscious patients who need constant intensive nursing. In patients with concomitant thorax injury urgent intramedullar osteosynthesis by nail is contraindicated due to the possibility of fat embolism syndrome development. In these patients plate osteosynthesis is preferred. If there are no absolute indications to urgent osteosynthesis this operation could be performed on 3-10 days after trauma using lightly traumatic and invasive methods not waiting for the complete normalization of homeostasis parameters and restoration of soft tissues in the fracture zone. In closed long bone fractures tactics of early osteosynthesis allows to decrease the rate of hypostatic complications and mortality by more than 10% and achieve good functional results.

Comparison of Screw Quantity and Placement of Metacarpal Fracture Fixation: A Biomechanical Study

Hand ◽  
2020 ◽  
pp. 155894472097411
Author(s):  
Stephen P. Canton ◽  
Srujan Dadi ◽  
Austin Anthony ◽  
Michael Clancy ◽  
John R. Fowler
Keyword(s):  
Soft Tissues ◽  
Bone Fractures ◽  
Plate Fixation ◽  
Study Groups ◽  
Bending Stiffness ◽  
Biomechanical Study ◽  
Long Bone ◽  
Metacarpal Fractures ◽  
Loading Mode ◽  
Bending Load

Background It is recommended to have 6 bicortical screws for plate fixation of long bone fractures; however, many metacarpal fractures do not allow 6 screws due to size limitations and proximity of crucial anatomical structures. The purpose of this biomechanical study was to determine whether the mechanical properties of a 4-screw nonlocking construct are noninferior to those of a 6-screw nonlocking construct. Methods Metacarpal sawbones were used to simulate a midshaft, transverse fracture. Nonlocking bicortical screws were placed in the 6-hole plate, and the metacarpals were randomly assigned to 2 equal study groups: (1) 4 screws, 2 on either side of the fracture (4S); and (2) 6 screws, 3 on either side of the fracture (6S). The metacarpals were tested in a cyclic loading mode and load to failure in a cantilever bending mode. Results Maximum deflection was significantly higher for 4S compared with 6S. Cyclic root mean square (RMS) was also significantly greater for 4S at 70 and 100 N. There were no statistically significant differences observed between the 2 constructs for maximum bending load, bending stiffness, and cyclic RMS at 40 N. The maximum bending load in 4S and 6S was 245.6 ± 37.9 N and 230.8 ± 41.9 N, respectively; 4S was noninferior and not superior to 6S. Noninferiority testing was inconclusive for bending stiffness. Conclusions A 4-screw bicortical nonlocking construct is noninferior to a 6-screw bicortical nonlocking construct for fixation of metacarpal fractures, which may be advantageous to minimize disruption of soft tissues while maintaining sufficient construct stability.

External fixation for primary and definitive management of open long bone fractures: the Syrian war experience

2019 ◽  
Vol 43 (12) ◽  
pp. 2661-2670 ◽  
Author(s):  
Abduljabbar Alhammoud ◽  
Bakry Maaz ◽  
Ghalib Ahmed Alhaneedi ◽  
Mason Alnouri
Keyword(s):  
External Fixation ◽  
Bone Fractures ◽  
Long Bone ◽  
Long Bone Fractures ◽  
War Experience ◽  
Definitive Management
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