Soft-Tissue Alterations Associated with Acute, Extended Open Reduction and Internal Fixation of Orbital Fractures

1992 ◽  
Vol 3 (3) ◽  
pp. 134-140 ◽  
Author(s):  
Michael J. Yaremchuk ◽  
Woo-kyung Kim
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Open Reduction ◽  
Orbital Fractures ◽  
Tissue Alterations

scholarly journals Delayed Peroneal Neuropathy After Bosworth Fracture Dislocation of the Ankle

2021 ◽  
Vol 111 (4) ◽  
Author(s):  
Sung Hoon Choi ◽  
Jeong Min Hur ◽  
Kyu-Tae Hwang
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Fracture Dislocation ◽  
Tibial Tubercle ◽  
Proximal Fragment ◽  
Rare Injury ◽  
Soft Tissue Swelling ◽  
Severe Soft Tissue

The Bosworth ankle fracture-dislocation is a rare injury and is often irreducible because of an entrapped proximal fragment of the fibula behind the posterior tibial tubercle. Repeated closed reduction or delayed open reduction may result in several complications. Thus, early open reduction and internal fixation enable a better outcome by minimizing soft-tissue damage. We report on a 27-year-old man who underwent open reduction and internal fixation after multiple attempts at failed closed reduction, complicated by severe soft-tissue swelling, rhabdomyolysis, and delayed peroneal nerve palsy around the ankle.

scholarly journals Open Reduction Internal Fixation versus External Fixation with Limited Internal Fixation for Displaced Comminuted Closed Pilon Fractures: A Randomised Prospective Study

2018 ◽  
Vol 24 (1) ◽  
pp. 84-89
Author(s):  
Rayan Ahmed ◽  
Kotb Ahmed ◽  
M. Elmoatasem Elhussein ◽  
Samir Shady ◽  
Tamer A. El-Sobky ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Prospective Study ◽  
Internal Fixation ◽  
External Fixation ◽  
Functional Outcomes ◽  
Open Reduction ◽  
Articular Surface ◽  
High Energy ◽  
Complication Rates ◽  
Pilon Fractures

Background Pilon fractures involve the dome of the distal tibial articular surface. The optimal treatment for high-energy pilon fractures remains controversial. Some authors advocate the use of open reduction and internal fixation (ORIF) to avoid articular incongruence. Others advocate the use of bridging external fixation with limited internal fixation (EFLIF) to reduce soft tissue complications. Literature reports of prospective studies comparing the radioclinical outcomes of ORIF and EFLIF in high-energy fractures are scarce. Retrospective studies have their limitations because of insufficient randomisation. The objective of this randomised prospective study is to compare the clinical, radiologic and functional outcomes of displaced and comminuted closed pilon fractures, Rüedi and Allgöwer type II and III, treated by either ORIF or EFLIF. Materials and Methods Forty-two patients were selected for the study. Twenty-two patients were subjected to ORIF and 20 patients were subjected to EFLIF. We used the American Orthopaedic Foot and Ankle Society score as a standard method of reporting clinical status of the ankle. Patients were followed-up clinically and radiologically for over 2 years after the surgical treatment. Results The results of ORIF and EFLIF in treatment of high-energy pilon fractures are equally effective in terms of functional outcomes and complication rates on the short term. Conclusion Soft tissue integrity and fracture comminution seem to have a significant influence on outcomes of intervention. A prospective multicentre study with a larger sample size that controls for other associated variables and comorbidities is warranted. Level of evidence Level II.

scholarly journals External Fixation versus Primary Open Reduction and Internal Fixation (ORIF) of Intra-articular Calcaneus Fractures

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0002
Author(s):  
Rishin Kadakia ◽  
Catphuong Vu ◽  
Jason Bariteau ◽  
Rahul Rege ◽  
Mara Schenker
Keyword(s):  
Soft Tissue ◽  
Postoperative Complications ◽  
Internal Fixation ◽  
External Fixation ◽  
Open Reduction ◽  
Wound Dehiscence ◽  
Complication Rates ◽  
Soft Tissue Envelope ◽  
Calcaneus Fractures

Category: Hindfoot, Trauma Introduction/Purpose: Calcaneus fractures are common injuries of the foot and account for approximately sixty percent of all tarsal bone fractures. Anatomic reduction of the articular surface is associated with good long-term outcomes. Unfortunately, there is a high rate of complications following surgical fixation due to the fragile soft tissue envelope surrounding these injuries. External fixation of joint depression calcaneus fractures allows for restoration of morphology and preservation of soft tissues. The purpose of this work is to determine if acute external fixation in the management of joint depression calcaneus fractures leads to decreased postoperative complications and better outcomes. Methods: Patients were identified using the appropriate procedure codes over a ten year span at a level one trauma center. Those under the age of eighteen and underwent nonoperative treatment were excluded. Electronic medical records were reviewed to obtain, basic demographic data, comorbidities, and injury specifics. Calcaneus fractures were classified as open or closed and using the Essex-Lopresti classification system. Operative reports were reviewed to determine which patients initially underwent external fixation versus open reduction internal fixation (ORIF), furthermore any staged operative interventions were also noted. Electronic records were also reviewed to determine the length of follow up and incidence of postoperative complications. Bivariate analysis was used to identify an association between collected variables and postoperative complications (wound dehiscence, hardware failure, infection, nonunion). Multivariate logistic regression analysis was used to determine if patients treated with acute external fixation were associated with lower postoperative complication rates. Results: 152 calcaneus fractures were identified and included for analysis. The average age was thirty-eight and the majority of patients were male (111/152 = 73%). Average follow up was approximately five months. Seventeen percent (26/152) were open fractures. Twenty-six (17%) were treated initially with external fixation and eleven of these were a staged ORIF. The overall complication rate was 11% (17/152) with the most common complication being wound dehiscence. Only one complication occurred in the group initially managed with external fixation. Statistical analysis revealed that open fractures were associated with increased postoperative complication rates in a bivariate and multivariate model. Conclusion: External fixation of joint depression calcaneus fractures restores height and preserves the soft tissue envelope. Although there was only one complication in the external fixation group, the difference in complication rates was not statistically significant based on initial treatment. The low number of patients treated with external fixation initially and the short follow up are limitations of this study. Further work is needed with a larger patient cohort in a prospective setting. Acute external fixation may prove to be a useful tool to help prevent postoperative complications following joint depression calcaneus fractures.

scholarly journals Reoperation in Zygomatico-orbital Trauma: A Review of Patients With Suboptimal Outcomes Following Initial Repair

2020 ◽  
Vol 13 (3) ◽  
pp. 205-210
Author(s):  
Richard Taylor ◽  
Deepshikha Kumar ◽  
Jai Ghelani ◽  
Iain Varley
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Preoperative Imaging ◽  
Surgical Approaches ◽  
Orbital Fractures ◽  
Orbital Trauma ◽  
Factors Affecting ◽  
Intraoral Approach ◽  
Increased Risk ◽  
Operative Notes

Introduction: Treatment to restore anatomy, function, and aesthetics after trauma should involve as little surgical insult as possible. As such, repeated procedures may suggest failed initial management. To date, no predictive factors for failure of primary surgery have been identified. Objectives: The aim of this review was to identify factors affecting the requirement for reoperation following treatment of zygomatico-orbital injuries. Study Design and Methods: A retrospective review of patients undergoing surgery for zygomatico-orbital fractures between 2011 and 2019 in a single UK major trauma center was undertaken. All operative notes and imaging were reviewed independently by 2 authors to classify the fracture patterns for both zygomatic and orbital components of the injury. For all cases, the mode of preoperative imaging the grade of operating surgeon, materials used for fixation, and the surgical approaches were recorded. Results: Coding data identified 432 patients who underwent surgery for zygomatico-orbital fractures. In total, 116 cases were treated with closed reduction and 316 with open reduction and internal fixation; 20 cases required reoperation. There were no significant differences identified between cases requiring reoperation and those who did not. Conclusions: A need for repeated surgery is rare. However, this review identified an increased risk of infection of fixation when an intraoral approach was used and highlights the potential benefits that can be achieved by open reduction and internal fixation when more conservative approaches fail to achieve the desired outcome.

scholarly journals Arthroscopic Reduction with Endobutton Fixation for Glenoid Fracture

Joints ◽  
2017 ◽  
Vol 05 (02) ◽  
pp. 127-130 ◽  
Author(s):  
Ettore Taverna ◽  
Vincenzo Guarrella ◽  
Michael Freehill ◽  
Guido Garavaglia
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Open Reduction ◽  
Soft Tissue Injuries ◽  
Glenoid Fracture ◽  
Arthroscopic Reduction ◽  
Clinical And Radiological Results ◽  
Persistent Instability ◽  
Glenohumeral Dislocation

AbstractGlenoid rim fractures, accompanied by acute glenohumeral dislocation or subluxation usually results in persistent instability. Traditionally open reduction and internal fixation has been recommended in displaced intra-articular glenoid fractures. However, open reduction is difficult, and it may not be possible to address the associated intra-articular soft-tissue injuries. A few reports of arthroscopic-assisted fixation of these fractures have been recently published. The most anatomic method for addressing an acute glenoid rim lesion is a reduction (either open or arthroscopic) and internal fixation. We are reporting a case of arthroscopic reduction and fixation of a glenoid fracture utilizing Endobuttons with clinical and radiological results at 18 months follow-up.

scholarly journals Open Reduction with Internal Fixation (ORIF) versus Hybrid Circular External Fixator (HCEF) as the Treatment of Choice for Bicondylar Tibial Plateau Fractures : A Systematic Review and Meta-Analysis

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0004
Author(s):  
I Made Arya Susila ◽  
Sherly Desnita Savio ◽  
Cokorda Gde Oka Dharmayuda
Keyword(s):  
Systematic Review ◽  
Soft Tissue ◽  
Blood Loss ◽  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Meta Analysis ◽  
Operation Time ◽  
Cochrane Library ◽  
Similar Operation

Bicondylar Tibial Plateu Fractures (BTPF) present a challenge in management due to the involvement of articular surface, resulting in high complication rate. This study aims to compare two treatments, Open Reduction with Internal Fixation (ORIF) and Hybrid Circular External Fixation (HCEF) as the choice of surgical procedure for BTPF that still controversial until now. Discussion: BTPF is a complex and challenging injury associated with severe bone and soft tissue damage which may result in severe morbidity and chronic complications. The minimally invasive procedure offered by HCEF preserves soft tissue and offers lower rate of deep infection. Furthermore, HCEF should be more considered as the treatment of choice for BTPF due to its shorter hospital LoS which may minimalize nosocomial infection risks and costs. Materials and Methods: A systematic review using Cochrane Library, PubMed, and Google Scholar was conducted based on PRISMA guideline. Inclusion criteria were studies comparing HCEF and ORIF of BTPF. Studies of only one surgical technique modality, Schatzker types I-IV Tibial Plateu Fractures, and case reports were excluded, resulting in six included studies. For the meta-analysis of hospital length of stay (LoS), random effect model was used for continuous outcomes using Review Manager 5.3. Results: Most common complications are nerve injuries, infection, and non/delayed union. Blood loss was higher in ORIF group, while both procedures have similar operation time and functional outcome. The mean hospital LoS for ORIF (n = 60) was 18.45, as for HCEF (n =63) was 8.325. There was significant difference in terms of hospital LoS between ORIF and HCEF (P =0.003). Conclusion: ORIF and HCEF carry similar operation time, functional outcome, union rate, and complication, though HCEF is more beneficial in terms of blood loss and hospital LoS.

scholarly journals Dual plate osteosynthesis in bicondylar tibial plateau fractures-case series

2021 ◽  
Vol 7 (4) ◽  
pp. 848
Author(s):  
Shreekantha Koteshwara Surendra Rao ◽  
Mahammad Aseem Mahammadgous Mulla ◽  
Deepak Malik ◽  
Mohammed Usman
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Open Reduction ◽  
Tibial Plateau ◽  
Plate Osteosynthesis ◽  
Tibial Plateau Fractures ◽  
Radiological Outcome ◽  
Articular Fractures ◽  
Dual Plating ◽  
Dual Plate

<p>Tibial plateau fractures accounts for about 1% of injuries. Various mechanisms have been described, resulting in milder form to serious injuries depending upon force of impact.  High velocity injuries resulted from valgus or varus impacted forces combined with axial loading such as in Schatzker type 6. The ideal method of treatment for these fractures is always a matter of debate. As all intra-articular fractures necessitate anatomic reduction of the articular surface, restoration of axial alignment, and stable fixation, which can be achieved very well by open reduction and internal fixation (ORIF) with dual plating. To study the functional and radiological outcome of Tibial plateau fractures treated surgically with dual plate osteosynthesis. 15 patients in the age group 18-60 were included. Rasmussens criteria was used to assess the functional and radiological outcomes with follow up period of 1 year prospectively. The outcome assessment using Rasmussens score concluded good results. The average duration for union was ­6 months. ROM achieved in these patients were to be at least 124 degrees. The infection rate in this study was accounted as 13.3%. Open reduction and internal fixation of tibial plateau fractures, by dual plating has good functional and radiological outcome. This is an effective method of treatment even with moderate soft tissue injury if meticulous surgical technique, appropriate soft tissue handling and adequate healing period given. All these have shown to decrease the postoperative complications such as infection.</p>

Sign in / Sign up

Export Citation Format

Share Document