scholarly journals Treatment of Stifle Joint Luxation in a Cat Using a Temporary Trans-Articular Locking Plate

VCOT Open ◽  
2021 ◽  
Vol 04 (01) ◽  
pp. e20-e23
Author(s):  
Chadi Eid ◽  
Filippo Lusetti ◽  
Andrea Bonardi ◽  
Filippo Maria Martini
Keyword(s):  
Surgical Treatment ◽  
Range Of Motion ◽  
Locking Plate ◽  
Single Case ◽  
Locking Plates ◽  
Stifle Joint ◽  
Joint Luxation

AbstractThe aim of this study was to report the surgical treatment of stifle joint luxation through temporary immobilization of the joint with locking plates in a cat. Stifle joint was immobilized using a temporary trans-articular locking plate applied medially. Return to function was assessed by physical and radiographic follow-up examinations. The cat had good return to function despite a reduction in range of motion. Moderate chronic gonarthritis developed, as seen radiographically. Under the limitation of this single case, temporary trans-articular plating may be considered as useful method for the treatment of long-standing, severely displaced stifle joint luxations in cats.

scholarly journals A Novel All-Inside Arthroscopic Technique for Radial-Sided Triangular Fibrocartilage Complex Tears: A Case Report and Review of Literature

Hand ◽  
2017 ◽  
Vol 12 (5) ◽  
pp. NP166-NP169 ◽  
Author(s):  
Michael T. Edgerton ◽  
Robert C. Kollmorgen
Keyword(s):  
Case Report ◽  
Range Of Motion ◽  
Single Case ◽  
Excellent Result ◽  
Full Range ◽  
Triangular Fibrocartilage Complex ◽  
Wrist Arthroscopy ◽  
Single Case Report ◽  
Triangular Fibrocartilage

Background: Triangular fibrocartilage complex (TFCC) injuries are a known cause of ulnar-sided wrist pain. Wrist arthroscopy is the gold standard for diagnosis of these lesions and is becoming a more frequent method of treatment. Isolated radial-sided tears are uncommon and treatment of these lesions is controversial. There are few reports on repair techniques. Here we report on a novel arthroscopic, all-inside technique for traumatic radial-sided TFCC tears that resulted in full range of motion, significant improvement in pain, and ultimately return to sport. Methods: This is a single case report describing an all-inside, arthroscopic repair of a radial-sided TFCC tear. The techniques and postoperative protocol are discussed. Clinical outcomes were reported at final follow-up of 3.5 months. Results: At final follow-up, our patient had full wrist range of motion, 95% strength, occasional 1/10 pain, and returned to sport at her previous level of play. There were no complications. Conclusion: Although just a single case report, our patient had an excellent result based on modified Mayo wrist score. When comparing our result and the previous literature, this technique seems to be a valid method for addressing radial-sided TFCC tears.

Procedure-Specific Hardware Removal After Evans Osteotomy

2020 ◽  
Vol 110 (2) ◽  
Author(s):  
Patrick A. DeHeer ◽  
Shrunjay Patel ◽  
Sarah N. Standish
Keyword(s):  
Pain Relief ◽  
Locking Plate ◽  
Hardware Removal ◽  
Significant Finding ◽  
Locking Plates ◽  
Inclusion Criteria ◽  
Low Profile ◽  
Flexible Flatfoot ◽  
Pain Patients

Background The Evans osteotomy is a widely used procedure for the correction of adult and pediatric flexible flatfoot deformity. Locking plates are commonly used to stabilize the osteotomy and the allograft. However, there have been incidences of soft-tissue irritation caused by the hardware, requiring subsequent hardware removal. Therefore, we sought to review whether age, sex, or laterality of the procedure had any correlation with the rate of hardware removal. Methods A retrospective review was performed of 47 consecutive patients who underwent an Evans calcaneal osteotomy between October 1, 2013, and October 1, 2016. Data were collected and analyzed based on age, sex, laterality, and the need for hardware removal. Results All of the 47 patients met the inclusion criteria. Seventy procedures were performed, and hardware removal was required in 16 patients and 21 feet (30%). The only statistically significant finding was that 11 females and only five males required either unilateral or bilateral hardware removal (P = .039). All 16 patients reported complete pain relief after hardware removal. Conclusions Females are twice as likely as males to develop symptoms after locking plate application over an Evans osteotomy and may require hardware removal. Despite the low-profile nature of the locking plate to fixate the Evans osteotomy, the hardware can be a source of significant pain. Patients, especially females, should be cautioned about potential hardware-related pain and a possible follow-up procedure to remove the hardware.

scholarly journals Cervical laminoplasty developments and trends, 2003–2013: a systematic review

2015 ◽  
Vol 23 (1) ◽  
pp. 24-34 ◽  
Author(s):  
Stephan Duetzmann ◽  
Tyler Cole ◽  
John K. Ratliff
Keyword(s):  
Neck Pain ◽  
Range Of Motion ◽  
Single Case ◽  
Japanese Orthopaedic Association ◽  
Case Series ◽  
Visual Analog Scale Score ◽  
Open Side ◽  
The Mean ◽  
Axial Neck Pain

OBJECT Despite extensive clinical experience with laminoplasty, the efficacy of the procedure and its advantages over laminectomy remain unclear. Specific clinical elements, such as incidence or progression of kyphosis, incidence of axial neck pain, postoperative cervical range of motion, and incidence of postoperative C-5 palsies, are of concern. The authors sought to comprehensively review the laminoplasty literature over the past 10 years while focusing on these clinical elements. METHODS The authors conducted a literature search of articles in the Medline database published between 2003 and 2013, in which the terms “laminoplasty,” “laminectomy,” and “posterior cervical spine procedures” were used as key words. Included was every single case series in which patient outcomes after a laminoplasty procedure were reported. Excluded were studies that did not report on at least one of the above-mentioned items. RESULTS A total of 103 studies, the results of which contained at least 1 of the prespecified outcome variables, were identified. These studies reported 130 patient groups comprising 8949 patients. There were 3 prospective randomized studies, 1 prospective nonrandomized alternating study, 15 prospective nonrandomized data collections, and 84 retrospective reviews. The review revealed a trend for the use of miniplates or hydroxyapatite spacers on the open side in Hirabayashi-type laminoplasty or on the open side in a Kurokawa-type laminoplasty. Japanese Orthopaedic Association (JOA) scoring was reported most commonly; in the 4949 patients for whom a JOA score was reported, there was improvement from a mean (± SD) score of 9.91 (± 1.65) to a score of 13.68 (± 1.05) after a mean follow-up of 44.18 months (± 35.1 months). The mean preoperative and postoperative C2–7 angles (available for 2470 patients) remained stable from 14.17° (± 0.19°) to 13.98° (± 0.19°) of lordosis (average follow-up 39 months). The authors found significantly decreased kyphosis when muscle/posterior element–sparing techniques were used (p = 0.02). The use of hardware in the form of hydroxyapatite spacers or miniplates did not influence the progression of deformity (p = 0.889). An overall mean (calculated from 2390 patients) of 47.3% loss of range of motion was reported. For the studies that used a visual analog scale score (totaling 986 patients), the mean (cohort size–adjusted) postoperative pain level at a mean follow-up of 29 months was 2.78. For the studies that used percentages of patients who complained of postoperative axial neck pain (totaling 1249 patients), the mean patient number–adjusted percentage was 30% at a mean follow-up of 51 months. The authors found that 16% of the studies that were published in the last 10 years reported a C-5 palsy rate of more than 10% (534 patients), 41% of the studies reported a rate of 5%–10% (n = 1006), 23% of the studies reported a rate of 1%–5% (n = 857), and 12.5% reported a rate of 0% (n = 168). CONCLUSIONS Laminoplasty remains a valid option for decompression of the spinal cord. An understanding of the importance of the muscle-ligament complex, plus the introduction of hardware, has led to progress in this type of surgery. Reporting of outcome metrics remains variable, which makes comparisons among the techniques difficult.

scholarly journals Locking versus Non-locking Neutralization Plates with Limited Excision and Internal Fixation for Treatment of Extra-articular Type a Distal Tibial Fractures

2017 ◽  
Vol 11 (1) ◽  
pp. 57-63
Author(s):  
Kai-hua Zhou ◽  
Nong Chen
Keyword(s):  
Locking Plate ◽  
Type A ◽  
Tibial Fractures ◽  
Locking Plates ◽  
Superficial Infection ◽  
Distal Tibial Fractures ◽  
Radiographic Outcomes ◽  
Plate Group ◽  
The Cost

Purpose: This study aimed to compare the clinical, radiologic, and cost-effectiveness results between locking and non-locking plates for the treatment of extra-articular type A distal tibial fractures. Methods: We performed a retrospective review of AO/OTA 42-A1, A2 distal tibial fractures treated by plates from January 2011 to June 2013. Patients were divided to the locking plate group or the non-locking plate group. Clinical outcomes, radiographic outcomes, and hospitalization fee were compared between the two plates groups. Results: 28 patients were treated with a locking plate and 23 patients were treated with a non-locking plate. The mean follow-up was 18.8 months (12-23 months). There were no significant differences between the groups in surgical time, bleeding, bone union time, or AOFAS scores. The cost of the locking plate was ¥24,648.41 ± 6,812.95 and the cost of the non-locking plate was ¥11,642 ± 3,162.57, p < 0.001. Each group had one patient that experienced superficial infection these wounds were readily healed by oral antibiotics and dressing changes. To date, five patients in the locking group and ten patients in the non-locking group had sensations of metal stimulation or other discomfort (X2 = 3.99, p < 0.05) Until the last follow-up, 14 patients in the locking plate group and 18 patients in the non-locking plate group had their plates removed or wanted to remove their plates (X2 = 4.31, p < 0.05). Conclusion: The use of locking or non-locking plates provides a similar outcome in the treatment of distal fractures. However the locking plate is much more expensive than the non-locking plate.

Dual Plating Technique for Volar Rim Fracture of the Distal Radius Using DePuy-Synthes 2.0 m and 2.4 mm Locking Plates

2017 ◽  
Vol 22 (04) ◽  
pp. 423-428 ◽  
Author(s):  
Yoshihiro Abe ◽  
Masahiro Suzuki ◽  
Hiromasa Wakita
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Distal Radius ◽  
Distal Radius Fractures ◽  
Ulnar Variance ◽  
Locking Plates ◽  
Radius Fractures ◽  
Radial Inclination ◽  
The Mean

Background: To assess the surgical results of distal radius fractures with the involvement of a volar rim fragment using the DePuy-Synthes 2.0 mm and 2.4 mm locking plates.Methods: Subjects were six women and one man of average age 57 years (range, 31–83 y) and a mean follow-up period of 9 months (range, 5–19 mo) with AO B3 (volar shearing) distal radius fractures. Time of the procedure, physical examination of wrist range of motion, grip strength compared with the contralateral healthy wrist, and radiographic evaluation (volar tilt, radial inclination, and ulnar variance) were evaluated. The Visual Analog Scale (VAS: 0 points represents no pain, 100 points represents the worst pain possible) and the Quick Disability of the Arm, Shoulder, and Hand questionnaire (QuickDASH, 0 = no disability, 100 = extreme disability) were completed by patients at the final follow-up.Results: The average time of the procedure was 74 min. There were no perioperative complications. Average radiographic measures were: volar tilt, 8°; radial inclination, 23°, and ulnar variance, 0 mm. Wrist range of motion averaged 63° in wrist extension (range, 55–80°) and 55° in wrist flexion (range, 45–65°). Grip strength averaged 81% of the contralateral side at final evaluation (range, 67–100%). The mean QuickDASH score was 3.0 points (range, 0–9.1 points) and the mean VAS for pain was 9.3 at final follow-up.Conclusions: Open reduction internal fixation with the DePuy-Synthes 2.0 mm and 2.4 mm locking plates is an effective means of fixing a distal radius fracture that includes a volar rim fragment without interfering with flexor tendon gliding.

Surgical Treatment of Congenital Metacarpal Synostosis of the Ring and Little Fingers

1998 ◽  
Vol 23 (5) ◽  
pp. 691-694 ◽  
Author(s):  
E. HORII ◽  
T. MIURA ◽  
R. NAKAMURA ◽  
E. NAKAO ◽  
H. KATO
Keyword(s):  
Surgical Treatment ◽  
Range Of Motion ◽  
Average Length ◽  
Metacarpophalangeal Joint ◽  
Block Method ◽  
Active Flexion ◽  
Distraction Device ◽  
Little Finger

Fifteen hands with congenital metacarpal fusions were treated operatively by osteotomy combined either with the use of a silicone block or a distraction device. The aim of the silicone block was to separate the fused metacarpals, but it was buried in the metacarpals at follow-up, with recurrence of fusion. By the distraction technique, 13 mm of lengthening was obtained. The average length of the little metacarpal was 88% of that of the long finger metacarpal. Both methods were effective in correcting the abduction deformity of the little finger by a mean of 34°, and increasing the range of motion of the metacarpophalangeal joint to 28° of active flexion. Although the distraction method took longer than the silicone block method, the final appearance of the hand was better.

Fixation of fifth metacarpal neck fractures: a comparison of medial locking plates with intramedullary K-wires

2020 ◽  
Vol 45 (6) ◽  
pp. 567-573 ◽  
Author(s):  
Kuan-Jung Chen ◽  
Jung-Pan Wang ◽  
Cheng-Yu Yin ◽  
Hui-Kuang Huang ◽  
Ming-Chau Chang ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Surgical Treatment ◽  
Operative Time ◽  
Locking Plates ◽  
Level Of Evidence ◽  
Plate Group ◽  
Motion Time ◽  
Wire Fixation ◽  
K Wires

Surgical treatment for metacarpal neck fractures may be indicated for malrotation, palmar angulation exceeding 30° or metacarpal shortening exceeding 3 mm, although these thresholds have not been firmly established. In a retrospective study, we compared the clinical and radiographic results of 54 patients with displaced fifth metacarpal neck fractures who were treated with either medial locking plates (14 patients) or retrograde intramedullary K-wires (40 patients). At a mean follow-up of 26 months (range 12 to 62), metacarpal shortening and angulation were 2 mm greater and 4° greater, respectively, in the K-wire group. The plate group had an earlier return to work and greater aesthetic satisfaction, but operative time and complication incidence were higher. Range of motion, time to union, grip strength and Quick Disability of the Arm, Shoulder and Hand scores were similar. We conclude that medial plating offers no clear advantage over K-wire fixation in treating metacarpal neck fractures. Level of evidence: III

Comparative study of treatment for distal radius fractures with two different palmar locking plates

2016 ◽  
Vol 41 (5) ◽  
pp. 536-542 ◽  
Author(s):  
H. Tanaka ◽  
T. Hatta ◽  
K. Sasajima ◽  
E. Itoi ◽  
T. Aizawa
Keyword(s):  
Distal Radius ◽  
Randomized Trials ◽  
Locking Plate ◽  
Locking Plates ◽  
Group V ◽  
Minimal Loss ◽  
Loss Of Reduction ◽  
Significant Difference ◽  
Group A

Few randomized trials have shown how the placement of a palmar locking plate affects outcomes. The purpose of this study was to compare clinical and radiological outcomes of fixation using locking plates with different concepts for placement relative to the watershed line in a prospective randomized trial. Sixty-four patients with a displaced distal radius fracture were divided into two groups according to the plates used for fixation: distal-type (AcuLocTM, Group A) and proximal-type (VariAxTM, Group V). Wrist function including the range of motion and grip strength was compared at 1, 2, 3 and 6 months postoperatively. Loss of reduction was assessed radiologically. Both groups demonstrated overall satisfactory function at 6 months with no significant difference found between the groups. Minimal loss of reduction was demonstrated in both groups. Internal fixation using the palmar locking plates with two different placements provided satisfactory outcomes at 6-month follow-up, but our results indicate that plates placed distal to the watershed line may delay recovery of wrist motion.

scholarly journals EXPERIENCE IN ARTHROSCOPIC TREATMENT OF ACUTE ACROMIOCLAVICULAR JOINT INJURIES

2018 ◽  
pp. 42-46
Author(s):  
I. V. Grigor’ev ◽  
N. V. Zagorodniy ◽  
F. L. Lazko ◽  
A. P. Prizov ◽  
E. A. Belyak ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Range Of Motion ◽  
Acromioclavicular Joint ◽  
Shoulder Arthroscopy ◽  
Constant Score ◽  
Early Postoperative Period ◽  
Arthroscopic Treatment ◽  
Brachial Plexopathy ◽  
Joint Injuries

Purpose of study: to evaluate surgical treatment results in patients with closed dislocation of the acromial end of the clavicle.Patients and methods. Eighteen patients, aged 23-54 years, with acute acromioclavicular joint injuries of IIIIV type by Rockwood were operated on during 2015 – 2018. Surgical treatment was performed at terms up to 2 weeks after injury. Reduction of the acromial end of the clavicle, arthroscopic fixation and stabilization of acromioclavicular joint by TightRope system was performed. Postoperative follow-up was cjnducted in 4 and 6 weeks, 3 months and subsequently every 6 months after surgical intervention. To evaluate the results the Constant Score and radiographs were used.Results.Follow-up period made up 1 year. Functional result, i.e. range of motion and quality of life, by Constant Score was good already on day 14 after surgery and excellent (89.6±2.9 points) at the end of treatment course (2 months after intervention). Brachial plexopathy (reduction of the thumb and 2nd finger sensitivity and muscular force in the early postoperative period) was observed in 1 case. Six months conservative treatment resulted in positive effect. In 6 months range of motion in the operated joint was equal to that in a healthy one.Conclusion.Arthroscopic treatment of acromioclavicular joint injuries by TightRope system is a highly effective and minimum invasive method but requires experience and practical skills in shoulder arthroscopy.

scholarly journals Volar Locking Plate for Distal Radius Fractures: Functional Outcomes and Complication Rates with a Minimum of One Year Follow-Up

2021 ◽  
Vol 6 (05) ◽  
pp. 358-365
Author(s):  
Kastanis G ◽  
Pantouvaki A ◽  
Kapsetakis P ◽  
Spyrantis M ◽  
Magarakis G ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Grip Strength ◽  
Distal Radius ◽  
Locking Plate ◽  
Distal Radius Fractures ◽  
Volar Locking Plate ◽  
Radius Fractures ◽  
One Year ◽  
Quick Dash

Distal radius fractures (DRF) are the most common type of fractures of the upper extremities with an incidence of 44% of all types of forearm and hand fractures. In unstable DRF, the aim of surgical treatment is to restore a functional wrist. Volar locking plate is supported in literature as a promising surgical method in treatment of these fractures. The aim of this study is to analyze the type and complication rate with applied volar locking plate, the percentage of revision surgery and the functional outcomes in a minimum of one year follow up. Material &Methods: 104 fractures in 98 patients with a mean range of 48,5 years-old age underwent for unstable distal radius fractures with volar locking plate. The main cause was simple fall to an outstretched hand. In ten cases the fracture was open while in 28 cases the DRF was accompanied with ulnar styloid. All fractures classified by AO/OTA in A2-3 27 cases, B1-3 in 45 and C1-3 in 32 cases. The majority of patients were operated within 48-72 hours after injury. In all cases an extended flexor carpi radialis approach was performed and a volar locking plate was applied in all DRF’s. In sixteen cases with base of ulnar styloid fractures, low profile locking plates were applied, while in the rest of patients Kirschner wires were used. Postoperatively all patients followed a standard protocol rehabilitation program with passive and active motion of fingers and wrist. Results: Patients were evaluated according to complication (type and rate), time to fracture union, range of motion, Visual analogue pain scale, Quick Dash Score and patients-rated wrist evaluation score. Complications were distinguished in major and minor. Patients under 60 years-old with type fracture A2-3 and B1-3 showed better range of motion and grip strength than patients over 65 years old. In cases with type fractures C1-3 and age over 65 years old, ROM and grip strength decreased compared with the unilateral side. The percentage of complication and reoperation appeared more increased in type C1-3 related to the other two types of fractures. Finally the mean Quick DASH was 11,1±12,8, RPWE was 9.8±13,6 and the range of motion was in extension 75,2±7,3, in flexion 74±8,9, in pronation 85,6±1,9, in supination 88,5±2,4 in radial deviation 9,8±1,2 and in ulnar deviation 41,1±4,6 and grip strength was an average of 84,7% of uninjured hand. Conclusion: Unstable fractures required operative treatment with volar locking plate to be the gold standard in recently years. Unfortunately VPL presents postoperative complications related with plate and screw position with comminuted fracture or soft tissue damage which cannot be ignored, and for these reasons may be inadequate for all types of distal radius fractures.

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