Clinical Results of Intraarticular Fractures of the Base of the Fifth Metacarpal Treated by Closed Reduction and Cast Immobilization

2000 ◽  
Vol 25 (3) ◽  
pp. 258-261 ◽  
Author(s):  
J. M. LUNDEEN ◽  
A. Y. SHIN
Keyword(s):  
Retrospective Study ◽  
Closed Reduction ◽  
Clinical Results ◽  
Fracture Type ◽  
Carpometacarpal Joint ◽  
Cast Immobilization ◽  
Intraarticular Fractures

This retrospective study evaluated the results of closed reduction and cast immobilization for isolated intraarticular fractures of the base of the fifth metacarpal. Twenty-two of 37 such fractures were available for follow-up at an average of 43 months, and these had all healed at an average of 5 weeks without any cast complications. Twenty patients reported excellent or good results, and two reported fair or poor results. At follow-up, 13 had no arthrosis and nine had mild arthrosis of the carpometacarpal joint. However, outcome was not influenced by fracture type, the degree of subluxation or articular step off, or the presence of arthrosis. We conclude that isolated fractures of the base of the fifth metacarpal can be reliably treated with closed reduction and cast immobilization.

Treatment of Phalangeal Fractures by Tension Band Wiring

2001 ◽  
Vol 26 (1) ◽  
pp. 50-52 ◽  
Author(s):  
Y. SAFOURY
Keyword(s):  
Retrospective Study ◽  
Open Reduction ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Range Of Movement ◽  
Intraarticular Fractures ◽  
Phalangeal Fractures

This retrospective study assessed the outcomes of 30 patients with phalangeal fractures which were treated by open reduction and tension band wiring. Oblique, transverse and comminuted extraarticular fractures, as well as intraarticular fractures, were treated with this technique and they all united in about 8 weeks. There were no significant complications. At a mean follow-up period of 2.3 years, the active range of movement of the involved fingers was excellent in 17, and good in 13 instances. There were no fair or poor results.

scholarly journals Closed Reduction and Percutaneous Kirschner Wire Fixation Combined with Plaster Cast versus Conventional Plaster Cast immobilization in the Treatment of Colles' Fracture – A Prospective Randomized Comparative Study

1970 ◽  
Vol 17 (2) ◽  
pp. 98-105 ◽  
Author(s):  
KS Uzzaman ◽  
KA Awal ◽  
MK Alam
Keyword(s):  
Comparative Study ◽  
Closed Reduction ◽  
Kirschner Wire ◽  
Plaster Cast ◽  
Cast Immobilization ◽  
Fixation Group ◽  
Wire Fixation ◽  
Colles Fracture ◽  
End Results

Purpo'e: To evaluate functional & anatomical results of the Colles’ fracture treated by two methods- i) Closed reduction & precutaneous kirschner wire (K- wire) fixation combined with plaster cast & ii) Conventional plaster cast immobilization after closed reduction.Methods: A randomized prospective comparative study was done from July 2003 to June 2005 on 52 patient with Colles' fracture in NITOR, Dhaka. 12 patients lost from follow up. Twenty patient (20) in each group were finally available for evaluation. The group treated by closed reduction & percutaneous K-wire fixation combined with plaster cast- designated as "Arm A" & another group treated conventionally by plaster cast only designated by "Arm-B". Male Female ratio was 1:3, Age range was 35 to 70 years (Mean age 52.5 years) Distribution of limbs side involvement almost equal. Mode of injuries were domestic fall & RTA (4:1) According to AO classification fracture were in both groups- A2 = 13, A3 = 10, C1 = 6, C2 = 8 & C3 = 3 (Total- 40). Follow up period was 6-14 months (mean = 6 month)Results: Union time for most of the fractures was 6-8 weeks. At final follow up Satisfactory Anatomical end results of percutuneous fixation group (Arm-A) were 80% and in conventional plaster cast group (Arm-B) were 35%. (P<0.01). Satisfactory functional end results in Arm-A group were 70% and in Arm-B group were 30% (P<0.01) Complications seen much more in conventional group (Arm-B) than percutaneous K-wire fixation group (Arm-B). Sarmiento & Latta’s criteria was used to evaluate the progress.Conclusion: The coventional plaster cast method for treatment of colles’ fracture usually can't maintain radial length & angulation in many instances and results significant anatomical difficultly and functional disability. On the other hand after close reduction additional fixation in the form of percutaneous crossed K-wire can maintain the reduction till bony union & prevent late collapse at fracture site & provides better result. Key Words: Colles' fracture; closed reduction; Plaster cast & Kirschner wire (K-wire) fixationDOI: 10.3329/jdmc.v17i2.6591J Dhaka Med Coll. 2008; 17(2) : 98-105

Results of 115 Rubis II reverse thumb carpometacarpal joint prostheses with a mean follow-up of 10 years

2017 ◽  
Vol 42 (6) ◽  
pp. 592-598 ◽  
Author(s):  
M. Dehl ◽  
M. Chelli ◽  
S. Lippmann ◽  
S. Benaissa ◽  
V. Rotari ◽  
...  
Keyword(s):  
Clinical Results ◽  
Carpometacarpal Joint ◽  
Level Of Evidence ◽  
Thumb Carpometacarpal Joint ◽  
The Mean ◽  
Thumb Carpometacarpal ◽  
Joint Prostheses ◽  
Clinical And Radiological Results

The aim of this study was to assess the clinical and radiological results of the Rubis II thumb carpometacarpal joint reverse prosthesis, at a mean follow-up of 10 years. Between 1997 and 2008, 253 prostheses were implanted in 199 patients; 115 were reviewed. The survival after a mean of 10 years was 89%. At the last follow-up, 70% of prostheses were painless; the others reported moderate or intermittent pain. The satisfaction rate was 98%. The mean opposition was 9 on the Kapandji scale; the mean QuickDASH score was 30. Wrist, key and tip pinch strengths were comparable with the non-operated side. Of the 115 implants, one was radiologically loose (1%) and 15 had suffered dislocations (13%), 12 of which were caused by an injury. Eleven thumbs had revision surgery. This study confirms that the good clinical results of the Rubis II prosthesis are maintained in the medium and long term, and represents a useful alternative to trapeziectomy for selected patients. Level of evidence: IV

Arthroscopically-Assisted Reduction of Intra-Articular Fractures of the Distal Radius

1998 ◽  
Vol 23 (3) ◽  
pp. 391-395 ◽  
Author(s):  
L. ADOLFSSON ◽  
P. JÖRGSHOLM
Keyword(s):  
Distal Radius ◽  
Closed Reduction ◽  
Joint Surface ◽  
Percutaneous Fixation ◽  
Articular Fractures ◽  
Intraarticular Fractures ◽  
Arthroscopically Assisted ◽  
Arthroscopically Assisted Reduction

Twenty-seven patients with intraarticular fractures of the distal radius with a step of more than 1 mm in the joint surface after attempted closed reduction, were treated by reduction under arthroscopic control and percutaneous fixation. All fractures healed without measurable incongruity of the joint surface and at follow-up 3 to 38 months after surgery 19 patients had excellent and eight patients good results according to the Mayo modified wrist score.

scholarly journals Operative treatment improves patient function in recalcitrant medial epicondylitis

2013 ◽  
Vol 95 (7) ◽  
pp. 486-488 ◽  
Author(s):  
M Shahid ◽  
F Wu ◽  
SC Deshmukh
Keyword(s):  
Retrospective Study ◽  
Return To Work ◽  
Grip Strength ◽  
Operative Treatment ◽  
Conservative Management ◽  
Open Surgery ◽  
Clinical Results ◽  
Medial Epicondylitis

The purpose of this retrospective study was to assess the outcome of open surgery for patients with recalcitrant medial epicondylitis following failed conservative management. The clinical results are presented for 15 patients (17 elbows) who were reviewed at a mean follow-up of 66 months. Operative treatment improved patient function significantly with a mean increase in grip strength of 10kg and a mean decrease (improvement) in DASH (Disabilities of the Arm, Shoulder and Hand) score of 25.7. All but one patient experienced little or no residual elbow discomfort and had excellent Mayo elbow performance scores postoperatively. Eleven of the twelve patients who were previously in employment were able to return to work within eight weeks of surgery. This study demonstrates that operative treatment for recalcitrant medial epicondylitis is effective in restoring patient function and strength.

scholarly journals Efficacy of percutaneous short segment fixation on the treatment of Magerl A3 thoracolumbar fractures: a retrospective study

2020 ◽  
Author(s):  
hongheng lin ◽  
Xiaoting Ou ◽  
Wenchao Li ◽  
Minyuan Chen ◽  
Caijun Liu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Blood Loss ◽  
Operation Time ◽  
Clinical Results ◽  
Radiographic Evaluation ◽  
Correction Loss ◽  
Short Segment ◽  
Significant Correction ◽  
Short Segment Fixation

Abstract BackgroundThis is a retrospective study to evaluate the efficacy of percutaneous short segment fixation (PSSF) with or without intermediate screws in Magerl A3 thoracolumbar (TL) fractures accompanied with low bone mineral density (BMD).Methods From January 2017 to December 2018, 30 patients diagnosed with Magerl A3 TL fractures having a BMD between 0.5/cm2 and 1g/cm2 in the lumbar vertebrae with intact neurological functions and a history of major trauma who underwent PSSF with or without intermediate screws were enrolled in this study. The patients were divided into two groups of those with intermediate screws (group F) or without (group S). The operation time and intra-operation blood loss were recorded. Oswestry disability index (ODI) questionnaire and visual analogue scale (VAS) were employed as clinical assessments and quantified. Radiographic follow-up assessed according to the Cobb angle (CA), Vertebral wedge angle (VWA), and anterior vertebral body height (AVBH).ResultsLoose screws were observed in 4 of the 30 enrolled patients. Significant differences were observed in operation time and intra-operative blood loss between the two groups. The enrolled patients’ clinical results (VAS and ODI scores) were good, however, no significant differences during all follow-up periods were present between the two groups. Radiographic evaluation (CA, VWA and AVBH) improved immediately after surgery, but significant correction loss was observed in the follow-up periods, especially in the first month. Radiographic evaluation demonstrated no significant differences between the two groups.Conclusion Although the patients’ clinical results were satisfactory, PSSF could not resist the correction loss in Magerl A3 TL fractures accompanied with BMD below 1g/cm2. Accordingly, the use of intermediate pedicle screws may be unnecessary due to their limited ability in resisting correction loss and increasing operation time as well as intra-operation blood loss.

scholarly journals Redisplacement of paediatric distal radius fractures: what is the problem?

2021 ◽  
pp. 1-8
Author(s):  
Diogo M.C. Constantino ◽  
Luis Machado ◽  
Marcos Carvalho ◽  
João Cabral ◽  
Pedro Sá Cardoso ◽  
...  
Keyword(s):  
Risk Factor ◽  
Distal Radius ◽  
Closed Reduction ◽  
Significant Risk ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Cast Immobilization ◽  
Significant Difference

Purpose Distal radius fractures represent one of the most common fractures in children. Our purpose is to analyze risk factors for redisplacement in children with distal radius fractures treated by means of closed reduction and plaster cast immobilization. Methods Retrospective study, including children under the age of 17 years, who underwent closed manipulation and cast immobilization for a distal third radius fracture, between 2012 and 2015. Preoperative radiographs were reviewed for initial translation, angulation and shortening, distance of the fracture from the physis, degree of fracture obliquity and the presence of an ulna fracture. Postoperative radiographs were analyzed for translation, angulation and shortening, as well as the quality of closed reduction. Cast index, gap index and three-point index, were measured on the postoperative radiographs. Redisplacement and re-intervention during follow-up were registered. Results A total of 26 patients were included in this study. Comparison between post-reduction and immediate post-cast removal radiographs did not show any statistically significant difference between translation or shortening. Coronal (p = 0.002) and sagittal (p = 0.002) angulation showed a statistically significant difference, but both median values remained below cut-off values for redisplacement. Redisplacement was observed in four patients. Only one patient underwent remanipulation. All four had full remodelling and proper radiological alignment at final follow-up. Quality of reduction was found to be a statistically significant risk factor for redisplacement (p = 0.013). Conclusion Closed reduction and cast immobilization under general anaesthesia yields good results in the treatment of distal forearm fractures in paediatric patients. Quality of reduction was the only risk factor that we found to be predictive of redisplacement. Level of Evidence: Level III – Retrospective comparative study

Can Condylar Fracture Still Be Treated with Conservative Approach?? – A Retrospective Study

2021 ◽  
Vol 13 (3) ◽  
pp. 169-175
Author(s):  
Arunima Awasthy ◽  
Pramod Krishna B ◽  
Rajdeep Singh ◽  
Heena Mazhar ◽  
Durgesh Kumbhare ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Closed Reduction ◽  
Clinical Results ◽  
Conservative Approach ◽  
Male Predominance ◽  
Maxillofacial Fractures ◽  
Difference Of Opinion ◽  
To Come ◽  
Condylar Fractures ◽  
Larger Sample

Background: Ideal management of mandibular condylar fractures remains controversial in maxillofacial trauma. Traditionally, conservative approach was implemented but recently ORIF (Open Reduction with Internal Fixation) has become prevalent. A difference of opinion has been acknowledged in the review of literature concerning the results achieved by open/closed reduction of fractures of the condyle in mandible. Research Objectives: To assess the preference of treatment for fractures of condyle and their indications, advantages, disadvantages and complications for open/closed reduction of fractures of condyle. Methodology: A 13-year retrospective study involving 56 patients who reported with fractures of condylar region were selected from 264 patients who experienced maxillofacial fractures. Out of them, seven were treated with ORIF, while 49 underwent closed reduction. Every patient was critically evaluated for identifying their indications, advantages, disadvantages, their effectiveness and complications of chosen interventions used in the management of condylar fractures. Findings: A male predominance was observed. Closed reduction with concomitant active physical therapy after inter-maxillary fixation gave similar results to that of open method. Conclusion: This study manifested that an appropriately followed conservative treatment provided similar clinical results when compared to ORIF for the management of condylar fractures. In cases with severe loss of height of mandible, surgical intervention is to be preferred to restore it. Further prospective randomized controlled trials with larger sample size are required to come to a decisive conclusion.

scholarly journals Bone Loss in Distal Radial Fractures Treated with A Composite Xenohybrid Bone Substitute: A Two Years Follow-Up Retrospective Study

Materials ◽  
2020 ◽  
Vol 13 (18) ◽  
pp. 4040
Author(s):  
Riccardo Ferracini ◽  
Alessandro Bistolfi ◽  
Claudio Guidotti ◽  
Stefano Artiaco ◽  
Agnese Battista ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Bone Loss ◽  
Bone Graft ◽  
Distal Radius ◽  
Bone Grafting ◽  
Clinical Results ◽  
Distal Radius Fractures ◽  
Dash Score ◽  
Radius Fractures

(1) Background: Recently, surgical treatment of distal radius fractures has increased exponentially. Many locking plates’ fixation systems have been developed allowing a more stable reduction and early mobilization. Sometimes, open reduction and fixation of distal radius fractures may leave a residual bone loss requiring grafting. This retrospective study reports clinical and radiologic outcomes of distal radius fractures treated with xenohybrid bone grafting in order to assess (i) the safety of the investigated bone graft; (ii) its radiological integration and biomechanical performances, and (iii) clinical outcomes of the patients; (2) Methods: We performed a retrospective study on a cohort of 19 patients. Preoperative X-ray and CT scan were performed. The mean clinical and radiographical follow-up was two years. Safety of the xenohybrid bone graft was constantly evaluated. Clinical results were assessed through the DASH score and Mayo wrist score; (3) Results: No adverse reactions, infections, and local or general complication were related to the use of xenohybrid bone graft. The radiolucency of the xenografts suggested progressive osteointegration. No evidence of bone graft resorption was detected. All the patients reached consolidation with good to excellent clinical results; and (4) Conclusions: Clinical and radiological data demonstrated that xenohybrid bone grafting promotes new bone formation and healing in osteopenic areas caused by fracture reduction.

scholarly journals Long-term outcomes of the modified Nirschl technique for lateral Epicondylitis: a retrospective study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Soonchul Lee ◽  
In-Tae Hong ◽  
Soohyun Lee ◽  
Tae-sup Kim ◽  
Kyunghun Jung ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Lateral Epicondylitis ◽  
Clinical Results ◽  
Long Term Results ◽  
Outcome Variable ◽  
Wrist Extension ◽  
Vas Score ◽  
The Mean

Abstract Background Although the Nirschl technique was introduced approximately 40 years ago, only limited information is available about the long-term results, especially concerning extensor power changes after surgery. The purpose of this study was to investigate long-term clinical results of surgical treatment of lateral epicondylitis using the modified Nirschl technique. The main outcome variable was muscle strength for wrist extension because the extensor origin was not reattached after removal of the degenerative extensor tendon. Methods Data from 99 patients who underwent surgical lateral epicondylitis treatment between 2007 to 2012 were included in the study. The mean follow-up period was 8.5 years (5 to 10, ± 1.1 years) and the mean age at surgery was 44.8 years (32 to 70, ± 9.8 years). The surgeries were performed using the modified Nirschl method and did not include extensor origin reattachment. Outcome measurements included the Visual Analogue Scale (VAS) score, Disabilities of the Arm, Shoulder and Hand (DASH) score, the MAYO elbow performance score, and Nirschl and Pettrone’s grades. Wrist extension and grip strength were analyzed using a digital handgrip dynamometer (microFET2TM system) and JAMA hand dynamometer. Results Mean time required to return to work was 2.4 months after surgery. At the last follow-up after surgery, the mean VAS score had significantly improved, from 4.9 to 1.1. Mean MAYO elbow performance scores significantly improved, from 64 to 90, and mean DASH scores improved from 50 to 13. The Nirschl and Pettrone’s grades were 80% rated as ‘excellent’ and 16% rated as ‘good’. After adjusting for power differences between the dominant and non-dominant arms, the difference between wrist extensor power of the operated elbow and the non-operated opposite elbow at the final follow-up was not statistically significant. No patients complained about wrist extension weakness. Conclusion Although reattachment of the extensor origin was not performed during the modified Nirschl surgical technique, there was no significant weakness in wrist extension power and the long-term follow-up revealed favorable clinical results. Level of evidence Level IV (case series). Retrospective study.

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