Dorsal Spanning Plate for Perilunate Dislocations

Abstract Purpose The purpose of this study was to compare radiographic outcomes in patients treated with the traditional method of open reduction, internal fixation (ORIF) and casting as compared with those treated with ORIF and dorsal spanning plate (DSP) fixation. We hypothesized that the application of a DSP to augment the repair of perilunate dislocations would maintain carpal stability while also allowing early loadbearing through the carpus. Materials and Methods This is a retrospective radiographic review of patients with a perilunate dislocation, who were treated with ORIF and casting or ORIF with a dorsal spanning plate between 2012–2018. Scapholunate (SL) and lunotriquetral (LT) intervals were measured immediately after the index surgery and after scheduled hardware removal. A total of 28 patients met inclusion criteria, including 13 cases with traditional treatment and 15 cases with dorsal spanning plate fixation. Results Comparison of the change in SL interval and LT interval between the 13 patients in the traditional treatment group and the 15 patients in the DSP group did not yield any clinically relevant variation after statistical analysis. Both groups demonstrated minimal change in the radiographic markers of carpal stability from postoperative radiographs obtained immediately after the index repair and after the removal of hardware. Conclusion DSP fixation placed at the index surgery with early loadbearing for the treatment of perilunate dislocation is not inferior to the current mainstay of treatment consisting of cast immobilization without loadbearing and does not confer any increased carpal instability in comparison to ORIF and casting.

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Failed Latarjet procedure: a systematic review of surgery revision options

Journal of Orthopaedics and Traumatology ◽

10.1186/s10195-021-00587-7 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Matteo Buda ◽

Riccardo D’Ambrosi ◽

Enrico Bellato ◽

Davide Blonna ◽

Alessandro Cappellari ◽

...

Keyword(s):

Systematic Review ◽

Case Series ◽

Review Of The Literature ◽

Inclusion Criteria ◽

Latarjet Procedure ◽

Shoulder Stabilization ◽

Recurrent Instability ◽

Level Of Evidence ◽

Radiographic Outcomes

Abstract Background Revision surgery after the Latarjet procedure is a rare and challenging surgical problem, and various bony or capsular procedures have been proposed. This systematic review examines clinical and radiographic outcomes of different procedures for treating persistent pain or recurrent instability after a Latarjet procedure. Methods A systematic review of the literature was performed using the Medline, Cochrane, EMBASE, Google Scholar and Ovid databases with the combined keywords “failed”, “failure”, “revision”, “Latarjet”, “shoulder stabilization” and “shoulder instability” to identify articles published in English that deal with failed Latarjet procedures. Results A total of 11 studies (five retrospective and six case series investigations), all published between 2008 and 2020, fulfilled our inclusion criteria. For the study, 253 patients (254 shoulders, 79.8% male) with a mean age of 29.6 years (range: 16–54 years) were reviewed at an average follow-up of 51.5 months (range: 24–208 months). Conclusions Eden–Hybinette and arthroscopic capsuloplasty are the most popular and safe procedures to treat recurrent instability after a failed Latarjet procedure, and yield reasonable clinical outcomes. A bone graft procedure and capsuloplasty were proposed but there was no clear consensus on their efficacy and indication. Level of evidence Level IV Trial registration PROSPERO 2020 CRD42020185090—www.crd.york.ac.uk/prospero/

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Cementless Ceramic-on-Ceramic Total Hip Replacement in Children and Adolescents

Children ◽

10.3390/children8100858 ◽

2021 ◽

Vol 8 (10) ◽

pp. 858

Author(s):

Giovanni Trisolino ◽

Stefano Stallone ◽

Francesco Castagnini ◽

Barbara Bordini ◽

Monica Cosentino ◽

...

Keyword(s):

Survival Rate ◽

Children And Adolescents ◽

Total Hip Replacement ◽

Hip Replacement ◽

Inclusion Criteria ◽

Single Institution ◽

Radiographic Outcomes ◽

Implant Survivorship ◽

Ceramic On Ceramic

Background: total hip replacement (THR) is a rare surgical option in children and adolescents with disabling hip diseases. The aim of this study is to report results from a retrospective cohort of patients aged 18 years or less who underwent cementless Ceramic-on-Ceramic (CoC) THR at a single institution, investigating clinical and radiographic outcomes, survival rates, and reasons for revision of the implants. Materials and methods: we queried the Registry of Prosthetic Orthopedic Implants (RIPO) to identify all children and adolescents undergoing THR between 2000 and 2019 at a single Institution. Inclusion criteria were patients undergoing cementless CoC THR, aged less than 18 years at surgery, followed for at least 2 years. Sixty-eight patients (74 hips) matched all the inclusion criteria and were enrolled in the study. We assessed the clinical and radiographic outcomes, the rate of complications, the survival rate, and reasons for revision of the implants. Results: The mean follow-up was 6.6 ± 4.4 years (range 2–20). The most frequent reason for THR was post-traumatic or chemotherapy-induced avascular necrosis (38%). The overall survival rate of the cohort was 97.6% (95% CI: 84.9–99.7%) at 5 years of follow-up, 94.4% (95% CI: 79.8–98.6%) at 10 years and 15 years of follow-up. Two THR in two patients (2.7%) required revision. With the numbers available, Cox regression analysis could not detect any significant interaction between preoperative or intraoperative variables and implant survivorship (p-value 0.242 to 0.989).” The average HOOS was 85 ± 14.3 (range 30.6–100). Overall, 23 patients (48%) reported excellent HOOS scores (>90 points), 21 patients (44%) reported acceptable HOOS scores (60–90 points) while 4 patients (8%) reported poor outcomes (<60 points). Twenty-one patients (43%) were regularly involved into moderate- to high-intensity sport activities (UCLA ≥ 6). Conclusions: Cementless CoC THR is a successful procedure in children and teenagers, having demonstrated high implant survivorship and low rates of complications and failure. A meticulous preoperative planning and implant selection is mandatory, to avoid implant malposition, which is the main reason of failure and revision in these cases. Further studies are needed to assess the impact of the THR on the psychosocial wellbeing of teenagers, as well as risks and benefits and cost-effectiveness in comparison to the hip preserving surgical procedures.

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Stifle arthrodesis using a locking plate system in six dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.3415/vcot-14-08-0124 ◽

2015 ◽

Vol 28 (04) ◽

pp. 288-293 ◽

Cited By ~ 5

Author(s):

T. Nicetto ◽

M. Petazzoni

Keyword(s):

Body Weight ◽

Medical Records ◽

Tibial Fracture ◽

Locking Plate ◽

Sagittal Plane ◽

Inclusion Criteria ◽

Radiographic Outcomes ◽

Locking Plate System ◽

Plate System

SummaryObjectives: To describe the use of the Fixin locking plate system for stifle arthrodesis in dogs and to retrospectively report the clinical and radiographic outcomes in six cases.[uni2028]Materials and methods: Medical records of dogs that had arthrodesis with the Fixin locking plate system were reviewed. For each patient, data pertaining to signalment and implant used were recorded. Plate series and thickness, number of screws placed, number of cortices engaged, and screw diameters were also recorded. The outcome was determined from clinical and radiographic followups. Radiographic outcomes assessed included the measurement of the postoperative femoral-tibial angle in the sagittal plane.Results: Six dogs met the inclusion criteria for the study. Mean body weight was 13 kg (range: 3 - 34 kg). Radiographic follow-up (mean: 32 weeks, range: 3 - 52 weeks) was available for all dogs. In one case, an intra-operative complication occurred. In another case, a tibial fracture occurred 20 days after surgery. All arthrodeses healed and no implant complication was detected although all cases had mechanical lameness.Clinical significance: Stifle arthrodesis can be performed successfully using a Fixin locking plate system.

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Chiropractic rehabilitation for adolescent idiopathic scoliosis: end-of-growth and skeletal maturity results

Clinics and Practice ◽

10.4081/cp.2017.911 ◽

2017 ◽

Vol 7 (1) ◽

Cited By ~ 1

Author(s):

Mark W. Morningstar ◽

Brian Dovorany ◽

Clayton J. Stitzel ◽

Aatif Siddiqui

Keyword(s):

Adolescent Idiopathic Scoliosis ◽

Idiopathic Scoliosis ◽

Skeletal Maturity ◽

Exercise Program ◽

Inclusion Criteria ◽

Specific Exercise ◽

Curve Correction ◽

Total Correction ◽

Radiographic Outcomes ◽

Angle Measurements

The aim of this study was to evaluate the radiographic outcomes obtained in a sample of patients treated with a chiropractic scoliosis-specific exercise program for patients with adolescent idiopathic scoliosis. Patients were treated and subsequently followed through skeletal maturity, and their results were reported in accordance with the SOSORT Consensus Guidelines. A total of 60 patient charts were consecutively selected when they met inclusion criteria. Cobb angle measurements and Risser staging were collected on all images. Using SOSORT criteria, 51.7% of patients achieved curve correction and 38.3% achieved stabilization. In the curve correction group, average total correction was 12.75°. A small number of sampled patients’ curves progressed, with a 13% failure rate based upon patients who dropped out before skeletal maturity combined with those who had progressed at skeletal maturity. Future studies are needed to corroborate these observations.

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COMPARISON BETWEEN CAST IMMOBILIZATION VERSUS VOLAR LOCKING PLATE FIXATION OF DISTAL RADIUS FRACTURES IN ACTIVE ELDERLY PATIENTS, THE ASIAN PERSPECTIVE

Hand Surgery ◽

10.1142/s021881041450004x ◽

2014 ◽

Vol 19 (01) ◽

pp. 19-23 ◽

Cited By ~ 19

Author(s):

Ying-Ho Chan ◽

Tun-Lin Foo ◽

Chong-Jin Yeo ◽

Winston Yoon-Chong Chew

Keyword(s):

Elderly Patients ◽

Internal Fixation ◽

Distal Radius ◽

Locking Plate ◽

Plate Fixation ◽

Distal Radius Fractures ◽

Current Evidence ◽

Volar Locking Plate ◽

Radius Fractures ◽

Cast Immobilization

Displaced distal radius fractures in active elderly patients with high functional demand present a clinical dilemma because current evidence is equivocal in the recommendation of treatment. Internal fixation is an increasingly popular option with proposed superior results. Our study aims to evaluate the results among a population of active elderly patients with displaced fractures managed with either cast immobilization or internal fixation with volar locking plate. Seventy-five patients (35 cast immobilization and 40 internal fixation) with mean age of 74 ± 7.5 years with minimum of 12 months follow-up were studied. The radiological and clinical parameters were assessed at three, six, and 12 months. Functional outcomes (DASH, Green-O'Brien) were assessed at 12 months. Patients who underwent surgery regain wrist motion and grip strength earlier, but this was not statistically significant after six months.

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Comparative analysis between locking compression plate and Joshi's external stabilization system in the management of proximal tibial fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20205560 ◽

2020 ◽

Vol 7 (1) ◽

pp. 56

Author(s):

Amit Dwivedi ◽

Anupinder Sharma ◽

Vaibhav Ashta ◽

Robium Nairobi ◽

Sunandan Nandi

Keyword(s):

Plate Osteosynthesis ◽

Plate Fixation ◽

Deep Infection ◽

Open Reduction Internal Fixation ◽

Tibial Fractures ◽

Stabilization System ◽

Superficial Infection ◽

Bone Consolidation ◽

Proximal Tibial Fractures ◽

External Stabilization

Background: Proximal tibial fractures present with a variety of patterns. They are mostly treated using plate osteosynthesis or Joshi's external stabilization system (JESS) depending upon the injury configuration and surgeon preference. We have compared the efficacy of plate fixation to JESS in the treatment of complex proximal tibial fractures.Methods: 36 patients of proximal tibial fractures with a mean age of 47 years were included in the study, 20 were treated using plate osteosynthesis while the other 16 were treated using JESS, they were followed up at regular intervals till 24 weeks and the progress was recorded in accordance with the knee society score (KSS) parametersResults: 20 patients were treated using plate osteosynthesis, 18 of them had excellent KSS scores, 2 patients recorded good scores, average range of flexion was 126o, no incidences of superficial or deep infections were seen in any of them. Bone consolidation was achieved around 12 weeks in plate fixation group of the16 patients treated using JESS, 12 had excellent scores, 4 recorded a good score, average range of flexion was 118o, superficial infection was seen in 2 patients, with no incidence of deep infection. Bone consolidation was achieved around 16 weeks in JESS group.Conclusions: Both open reduction internal fixation (ORIF) with plating and JESS appear to be adequate fixation methods for complex proximal tibial fractures, but as per our study plate fixation resulted in earlier bone consolidation and gave a slightly better functional outcome compared to JESS.

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Is coracoclavicular reconstruction necessary in hook plate fixation for acute unstable acromioclavicular dislocation?

10.21203/rs.3.rs-50026/v3 ◽

2020 ◽

Author(s):

Yu-Ta Chen ◽

Kuan-Ting Wu ◽

Shun-Wun Jhan ◽

Shan-Ling Hsu ◽

Hao-Chen Liu ◽

...

Keyword(s):

Los Angeles ◽

Plate Fixation ◽

Demographic Data ◽

Shoulder Function ◽

Hook Plate ◽

Shoulder Injury ◽

Invasive Approach ◽

Radiographic Outcomes ◽

Ucla Score ◽

Rockwood Type Iii

Abstract Background: Acromioclavicular joint (ACJ) dislocation is a relatively common shoulder injury. For the treatment of cases of severe ACJ dislocation (Rockwood type III–V), hook plate fixation is a neasy-to-master and minimally-invasive approach to surgical intervention. Over stress on the acromion following hook plate fixation often leads to acromial complications such as osteolysis and loss of reduction. We hypothesized that suspensory reconstruction a longside hook plate fixation might provide a superior stability and reduce complications as compared with hook plate fixation alone. The purpose of the study was to assess the clinical and radiographic outcomes of these two surgical modalities.Methods: We retrospectively enrolled 49 patients with acute ACJ dislocation from May 2010 to December 2018. Among them, nineteen patients received hook plate fixation only (HP group), and 19 underwent concomitant hook plate fixation and loop suspension fixation with two mersilene sutures (HM group). The demographic data of the patients were recorded and analyzed. All patients underwent a shoulder x-ray initially, immediately postoperatively, and at 1, 3, 6 and12 months to measure the relative coracoclavicular distance (rCCD). Clinical assessment of shoulder function outcome was conducted using the Constant Murley Score (CMS); the University of California at Los Angeles (UCLA) Shoulder Score was also measured at the latest follow-up.Results: There were no significant differences in the demographic data between the two groups. With regards to the CMS and the UCLA score, the HM group and HP group both had excellent outcomes, and no significant differences in scores were observed between groups (CMS: 93.90±6.16 versus 94.47±7.26, p=0.47; UCLA score: 32.84±2.91 versus 34.32±1.16, p=0.07). However, the HM group demonstrated substantial superiority in terms of maintenance of the rCCD over the HP group (91.47±27.47 versus 100.75±48.70, p=0.015). In addition, there was less subacromial osteolysis in the HM group than the HP group (52.6% versus 15.8%, p=0.038).Conclusion: Both fixations yielded excellent functional outcomes. However, concomitant hook plate fixation with loop suspensory reconstruction demonstrated the fewer acromion complications and statistical differences in reduction maintenance with less clinical significance.

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Splinting after Distal Radius Fracture Fixation: A Prospective Cohort Analysis of Postoperative Plaster Splint versus Soft Dressing

Journal of Wrist Surgery ◽

10.1055/s-0039-1688946 ◽

2019 ◽

Vol 08 (06) ◽

pp. 452-455

Author(s):

Spencer Poiset ◽

Jack Abboudi ◽

Gregory Gallant ◽

Christopher Jones ◽

William Kirkpatrick ◽

...

Keyword(s):

Distal Radius Fracture ◽

Distal Radius ◽

Prospective Cohort ◽

Cohort Analysis ◽

Outcome Data ◽

Open Reduction Internal Fixation ◽

Radius Fracture ◽

Hardware Failure ◽

Radiographic Outcomes ◽

Pain Scores

Abstract Background The effect of postoperative dressing and splinting after distal radius fracture (DRF) open reduction internal fixation (ORIF) is not well understood. A prospective cohort analysis was performed to assess differences in functional and radiographic outcomes with the use of plaster splinting or soft dressing following DRF ORIF. Methods All patients undergoing DRF ORIF with locking volar plates were consecutively enrolled. Preoperative demographic and postoperative radiographic and functional outcome data were collected at 2 weeks and 3 months postoperatively. Functional data included range of motion (ROM), pain on visual analog scale (VAS), Patient-Rated Wrist Evaluation (PRWE), and quick Disabilities of the Arm, Shoulder and Hand (DASH) scores. Radiographic data included loss of fracture reduction. Results A total of 139 patients were enrolled (79 plaster splinting, 60 soft dressing). By the first postoperative visit (POV), there was one case of loss of reduction with plaster splinting and one case with soft dressing with no hardware failure or revision surgery in either group, and no difference in DASH, PRWE, or VAS pain scores. By the final POV, the soft dressing group showed greater ROM in extension by 9.6, flexion by 10.9, and supination by 4.8 degrees over plaster splinting. Additionally, the soft dressing group demonstrated statistically significant improvement in PRWE and DASH scores, as well as VAS pain scores as compared with plaster splinting. Conclusions Applying only soft dressing following DRF ORIF demonstrated improvements in ROM, VAS, and functional outcomes by final follow-up, with no significant differences in radiographic outcomes. No benefit of applying a plaster splint was identified.

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Primary Ankle Arthrodesis vs ORIF for Severely Comminuted Pilon Fractures

Foot & Ankle Orthopaedics ◽

10.1177/2473011418780437 ◽

2018 ◽

Vol 3 (3) ◽

pp. 247301141878043

Author(s):

Colin H. Beckwitt ◽

Spencer J. Monaco ◽

Gary S. Gruen

Keyword(s):

Functional Outcomes ◽

Retrospective Cohort ◽

Short Form ◽

Ankle Arthrodesis ◽

Open Reduction Internal Fixation ◽

Posttraumatic Arthritis ◽

Inclusion Criteria ◽

Level Of Evidence ◽

Severe Injuries ◽

Pilon Fractures

Background: The treatment for highly comminuted pilon fractures remains controversial. The goal of this retrospective cohort study was to compare functional outcomes of primary arthrodesis of the tibiotalar joint (fusion) and open reduction internal fixation (ORIF). Methods: Patients who underwent primary ORIF or fusion for pilon fractures at our institution since 2000 were identified by Current Procedural Terminology ( CPT) code. Inclusion criteria for the ORIF cohort were patients with an AO/Orthopaedic Trauma Association type C3 pilon fracture. Additional inclusion criteria for the fusion cohort were patients whose fractures were deemed non-reconstructable by the treating surgeon. Outcome assessment was determined by the Foot and Ankle Outcome Score (FAOS) and Short Form 36-item health survey (SF-36), time to radiographic union or fusion, and wound-healing complications at a minimum of 2 years after their surgery. Results: Nineteen ORIF and 16 fusion patients completed the study’s outcome assessments. A higher rate of nonunion was observed in patients treated by primary ORIF than primary fusion (5/19 vs 1/16). Posttraumatic arthritis was observed in 11 of 19 primary ORIF patients. Primary fusion patients exhibited increased symptoms, pain, and physical role limits but were equivalent to primary ORIF patients on all other functional metrics examined. Conclusions: Primary ankle arthrodesis achieves a lower rate of nonunion and comparable functional outcomes to ORIF in patients with severely comminuted pilon fractures. The higher rate of nonunion observed in the primary ORIF group suggests that primary fusion should be considered an effective procedure for severe injuries to decrease the need for further operative intervention. Level of Evidence: Therapeutic Level III, retrospective cohort.

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