Functional Outcomes of Patella Fractures Treated With Anterior Plate Osteosynthesis at One Year

2021 ◽  
Vol 35 (1) ◽  
pp. e1-e6
Author(s):  
Stephen J. Shymon ◽  
Hayley Jansson ◽  
Brian A. Schneiderman ◽  
Alexander Nazareth ◽  
Christopher Max Hoshino ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Plate Osteosynthesis ◽  
Anterior Plate ◽  
Patella Fractures ◽  
One Year

Outcomes Following Low-Profile Mesh Plate Osteosynthesis of Patella Fractures

2018 ◽  
Vol 31 (09) ◽  
pp. 919-926 ◽  
Author(s):  
Matthew Siljander ◽  
Denise Koueiter ◽  
Sapan Gandhi ◽  
Brett Wiater ◽  
Patrick Wiater
Keyword(s):  
Functional Outcomes ◽  
Plate Osteosynthesis ◽  
Fixation Method ◽  
Bony Union ◽  
Locked Plate ◽  
Component Score ◽  
Patella Fractures ◽  
Sf 36 ◽  
The Mean

AbstractTreatment of patella fractures is fraught with complications and historically poor functional outcomes. A fixation method that allows for early mobilization and decreases symptomatic hardware rates will improve knee range of motion, postoperative functional status, and reoperation rates. The purpose of this study was to evaluate the functional outcomes after locked plate osteosynthesis of patella fractures at a Level 1 trauma center. A retrospective case series was conducted of patients who underwent open reduction internal fixation (ORIF) of a patella fracture using a locked mesh plating technique coupled with neutralization of forces on the distal pole of the patella. Twelve patients were evaluated at a mean follow-up of 19 months (range, 6–30) with physical exam, functional outcomes, and radiographs. There were 9 women and 3 men with an average age of 66.1 years (range, 53–75). Radiographic bony union was achieved in all patients by 3-month follow-up. Visual Analog Pain Score averaged 1.7 (median, 1.0; range, 0–8), the mean Knee Outcome Score – Activities of Daily Living Scale was 83.9 (median, 92.1; range, 45.7–100.0), the mean Short Form Musculoskeletal Function Assessment (SMFA) Function Index was 9.9 (median, 3.7; range, 0.7–41.2), and the mean SMFA Bother Index was 11.1 (median, 3.1; range, 0–62.5). The SF-36 Physical Component Score mean was 48.4 ± 8.5 and the SF-36 Mental Component Score mean was 54.1 ± 9.6. No complications developed and there were no reoperations for nonunion, infection, or symptomatic hardware. This study demonstrates that locked plate osteosynthesis for operative patella fractures can reliably achieve bony union with potentially superior functional outcomes as compared with traditional methods. Further studies are needed to evaluate plate fixation for patella fractures, but early results are promising.

scholarly journals Comparison of One-Year Functional Outcomes and Quality of Life between Posterior Pelvic Ring Fixation and Combined Anterior-Posterior Pelvic Ring Fixation after Lateral Compression (B2 Type) Pelvic Fracture

Medicina ◽  
2021 ◽  
Vol 57 (3) ◽  
pp. 204
Author(s):  
Giedrius Petryla ◽  
Valentinas Uvarovas ◽  
Rokas Bobina ◽  
Jaunius Kurtinaitis ◽  
Roma Puronaitė ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pelvic Fracture ◽  
Functional Outcomes ◽  
Pelvic Ring ◽  
Pelvic Fractures ◽  
Posterior Pelvic Ring ◽  
Sf 36 ◽  
One Year ◽  
Anterior Posterior

Background and Objectives: The treatment algorithm of lateral compression B2 type pelvic fractures are still under debate. Some authors advocate conservative treatment, while others recommend surgical approach. The clear indications for isolated anterior or posterior ring fixation or combined anterior-posterior pelvic ring fixation of B2 type fractures remain unclear. The aim of this study was to compare the functional outcomes and quality of life after isolated posterior pelvic ring fixation and combined anterior-posterior pelvic ring fixation for the treatment of B2 pelvic fractures. Materials and Methods: Patients aged 18 to 65 years with B2 type pelvic fracture hospitalized in a single trauma centre over a period of 3 years were included in the research. Based on the attending surgeon’s preference, patients were treated with isolated posterior or combined anterior-posterior pelvic fixation. The quality of life and pelvic function were assessed using SF-36 and Majeed questionnaires, respectively. Patients filled in the questionnaires twice: during the first hospitalization (concerning their pre-trauma state—timepoint I) and one-year after the injury (timepoint II). Results: A cohort of 32 patients with B2 type pelvic fracture was enrolled in the analysis: 23 (72%) were female and 9 (28%) were male. The mean age was 35.3 ± 11.9 years. In this cohort 13 (41%) patients underwent isolated posterior pelvic ring fixation (group I) and 19 (59%) patients underwent combined anterior-posterior pelvic ring fixation (group II). No statistically significant differences were observed between the groups in both timepoints concerning Majeed, SF-36 PCS and MCS scores. However, in both groups Majeed and SF-36 PCS scores were statistically significantly lower one year after pelvic fracture compared with pre-trauma state, while SF-36 MCS scores did not differ. Conclusions: No differences were found in quality of life and functional outcomes between isolated posterior pelvic ring fixation and combined anterior-posterior fixation for the treatment of B2 type pelvic fractures.

657 ROUTINE ESOPHAGRAMS FOLLOWING HIATUS HERNIA REPAIR MINIMISES REOPERATIVE MORBIDITY: A MULTICENTER COMPARATIVE COHORT STUDY

2021 ◽  
Vol 34 (Supplement_1) ◽  
Author(s):  
David Liu ◽  
Melissa Wee ◽  
James Grantham ◽  
Bee Ong ◽  
Stephanie Ng ◽  
...  
Keyword(s):  
Hernia Repair ◽  
Hiatus Hernia ◽  
Functional Outcomes ◽  
Gastric Resection ◽  
Postoperative Morbidity ◽  
Early Complications ◽  
Esophageal Obstruction ◽  
Comparative Cohort Study ◽  
One Year

Abstract   Hiatus hernia repairs are common. Early complications such as re-herniation, esophageal obstruction and perforation, although infrequent, incur significant morbidity. Here, we determine whether routine postoperative esophagrams following hiatus hernia repair may expedite the surgical management of these complications, reduce reoperative morbidity, and improve functional outcomes. Methods Analysis of a prospectively-maintained database of 1829 hiatus hernia repairs undertaken in 14 hospitals from 1 January 2000 to 30 September 2020. 1571 (85.9%) patients underwent a postoperative esophagram which was reviewed. An early (<14 days) reoperation was performed in 44 (2.4%) patients. Results Compared to those without an esophagram, patients who received one prior to reoperation (n = 37) had a shorter time to diagnosis (2.4 vs. 3.9 days, p = 0.041) and treatment (2.4 vs. 4.3 days, p = 0.037) of their complications. This was associated with decreased open surgery (10.8% vs. 42.9%, p = 0.034), gastric resection (0.0% vs. 28.6%, p = 0.022), postoperative morbidity (13.5% vs. 85.7%, p < 0.001), ICU admission (16.2% vs. 85.7%, p < 0.001), and length-of-stay (7.3 vs. 18.3 days, p = 0.009). Furthermore, patients who underwent early reoperations for asymptomatic re-herniation had less complications and superior functional outcomes at one-year follow-up than those who needed surgery for symptomatic recurrences later on. Conclusion Postoperative esophagrams decreases the morbidity associated with early and late reoperations following hiatus hernia repair, and should be considered for routine use.

Perforator-Based Flap Reconstruction after Melanoma Resection: Evaluation of Oncological, Aesthetic, and Functional Outcomes

2021 ◽  
Author(s):  
Beniamino Brunetti ◽  
Rosa Salzillo ◽  
Stefania Tenna ◽  
Bruno Brunetti ◽  
Mario Alessandri Bonetti ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Locoregional Recurrence ◽  
Demographic Data ◽  
Exact Test ◽  
Significant Difference ◽  
Chi Squared ◽  
Group A ◽  
The Aesthetic ◽  
One Year ◽  
Group B

Abstract Background Evidence in literature about the best reconstructive approach after melanoma resection is controversial, with some authors advocating that tissue rearrangement flap techniques might hinder the early detection of local relapses. The aim of the present study is to evaluate oncological, aesthetic, and functional outcomes following melanoma reconstruction using pedicled perforator-based flaps. Methods The authors reviewed all patients affected by melanoma treated during a 6-year period. Demographic data, tumor characteristics, and operative variables were evaluated. Locoregional recurrence was assessed with clinical and radiological follow-up. One-year postoperatively patients rated on a 5-point Likert scale the aesthetic and functional outcomes of the procedure. Three blind observers examined preoperative and 1-year postoperative photographs and rated the aesthetic outcome of the reconstructive procedure. Results One-hundred sixty-five patients were treated with wide excision and delayed reconstruction, including pedicled perforator-based flaps in 70 patients (group A) and primary closure in 95 patients (group B). Mean Breslow thickness was 2.972 and 2.189 mm in group A and B, respectively. There was no statistically significant difference in locoregional recurrence (chi-squared test, p = 0.8333; Fisher's exact test, p > 0.9999) between the two groups. Group A reported a higher satisfaction with both the aesthetic (mean rating 4.390 in group A and 4.094 in group B) and functional (mean rating 4.732 in group A and 4.170 in group B) outcomes of the procedure, the latter being statistically significant (p = 0.0006). Conclusion This series suggests that pedicled perforator-based flaps provide optimal aesthetic and functional outcomes in melanoma reconstruction without impairing the locoregional control of the disease.

scholarly journals Initial Experience of Open Radical Retropubic Prostatecomy With 5 Cases

KYAMC Journal ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. 166-169
Author(s):  
Md Towhid Belal ◽  
Md Mostafizur Rahman ◽  
Tanvir Ahmed Chowdhury ◽  
Md. Shamim Hossain ◽  
Md Shafiqul Alam Chowdhury ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Surgical Margin ◽  
Radical Retropubic Prostatectomy ◽  
Surgical Team ◽  
Midline Incision ◽  
Perioperative Mortality ◽  
Retropubic Prostatectomy ◽  
Surgical Field ◽  
One Year ◽  
Age Range

Background: Radical prostatectomy is the best treatment option for clinically localized prostate cancer. But oncological as well as functional outcomes of this procedure including incontinence and erectile dysfunction are a big challenge for the surgeon. Objectives: This paper has focused on our initial experiences of oncological and functional outcomes of open radical retropubic prostatectomy. Materials and methods: Total five cases underwent open radical retropubic prostatectomy between January'2016 to October' 2017. All patients had clinically organ confined prostatic adenocarcinoma. Open radical retropubic prostatectomy with bilateral pelvic lymph node dissection was done through a lower midline incision. We observed the surgical experiences and assess the oncological and functional outcomes postoperatively. Results: The median age (range) of patients at diagnosis was 63 (56-72) years. The median Gleason sum (range) was 7 (6-9) and mean pretreatment PSA was 16.2±5.4 ng/ml. There was no perioperative mortality and no major complications in immediate postoperative period. Final pathological specimen shows negative surgical margin in all cases but one patient has positive unilateral lymph nodes. One patient achieved continence within 3 months; three patients achieved continence at 6 months, one patient after one year. Two patients had satisfactory erection at 6 months; onepatients are at 9 months, and two patients could not gain erection after one year. Conclusion: Though open radical retropubic prostatectomy is tough procedure due to its difficult access to the surgical field. Oncological and functional outcome is totally depending on the skill of the surgical team. KYAMC Journal Vol. 9, No.-4, January 2019, Page 166-169

scholarly journals Superior Capsular Reconstruction Patients Have High Rates of Return to Sports and Similar Functional Outcomes Compared to a Reverse Shoulder Arthroplasty Matched Cohort

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0027
Author(s):  
Brandon C. Cabarcas ◽  
Grant Hoerig Garcia ◽  
Joseph Liu ◽  
Gregory Louis Cvetanovich ◽  
Anirudh K. Gowd ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Return To Work ◽  
Functional Outcomes ◽  
Return To Sport ◽  
Postoperative Outcome ◽  
Rotator Cuff Tears ◽  
Return To Sports ◽  
Superior Capsular Reconstruction ◽  
One Year

Objectives: Superior capsular reconstruction (SCR) is a relatively new procedure to address irreparable rotator cuff tears and rotator cuff arthropathy. Biomechanical studies have produced favorable results on cadaveric models, but few studies have evaluated clinical outcomes, and none have addressed return to sport (RTS). The purpose of this study was to evaluate rates of RTS and functional outcomes after SCR compared to a reverse total shoulder arthroplasty (rTSA) matched cohort. Methods: A prospectively collected registry was queried retrospectively for consecutive patients who underwent SCR from 2015 to 2016. Inclusion criteria were ≥2 tendon irreparable rotator cuff tear by arthroscopic evaluation and minimum one-year follow up. All eligible SCR patients were matched by gender, age, handedness, and follow up time to patients that underwent rTSA with a similar preoperative diagnosis. All surgeries were performed by a single surgeon at one institution with consistent operative techniques. Patients were evaluated with the ASES questionnaire, VAS Pain Scale, as well as VR/SF-12 and VR6D. Patients were also administered a detailed outcomes survey regarding surgical history and return to sport and work activities. Results: Overall 75.0% of 32 eligible patients were available at follow up. Average age at surgery and follow up did not significantly differ between cohorts (p>0.500 both). Postoperative outcome scores for ASES, VAS, VR/SF-12, and VR6D did not differ (p>0.310 for all) between cohorts. Overall RTS rate was 77.8% for SCR and 87.5% for rTSA (p > 0.610). Average months to return to sports was significantly greater after SCR (7.3 ± 3.0) compared to rTSA (3.5 ± 2.2; p = 0.032). Patients in both cohorts participated in golf, weight-lifting, gym activity, basketball and cycling postoperatively. Direct RTS for these sports are displayed in Fig. 1. Return to work rate was 71.4% (10/14) SCR and 50.0% (4/8) rTSA (p = 0.326) at average 2.7 ± 2.8 and 1.9 ± 1.9 months, respectively (p = 0.591). Stratified by duty status, rates of return to work were sedentary (100% both SCR and rTSA), light (100% both SCR and rTSA), moderate (0% SCR and 66.67% rTSA), and heavy (0% both SCR and rTSA). Overall, 85.71% SCR patients and 90.0% rTSA patients were satisfied or very satisfied with their general postoperative outcome. Conclusion: At short-term follow-up, SCR patients had RTS rates comparable to rTSA patients with irreparable rotator cuff tears. However, time to RTS was more prolonged after SCR. Outcome scores did not significantly differ between the two cohorts, suggesting that SCR may achieve postoperative function and pain reduction similar to rTSA at one year. Return to work was also similar, although rates were not as high as return to sport. When stratified by duty status, return to more intense physical work demands was not consistent in either cohort. Despite this, over 85% of SCR and rTSA patients were satisfied postoperatively. The findings of this study demonstrate that SCR patients have high RTS levels, as well as similar functional outcomes and satisfaction compared to rTSA for irreparable rotator cuff tears. Clinicians can utilize this information for preoperative counseling, particularly with younger more athletic patients, considering SCR or rTSA for an irreparable rotator cuff tear.

scholarly journals Minimally invasive percutaneous plate osteosynthesis versus intramedullary nail fixation for distal tibial fractures: a systematic review and meta-analysis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Bo Wang ◽  
Yang Zhao ◽  
Qian Wang ◽  
Bin Hu ◽  
Liang Sun ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Functional Outcomes ◽  
Plate Osteosynthesis ◽  
Meta Analysis ◽  
Deep Infection ◽  
Tibial Fractures ◽  
Low Risk ◽  
Wound Complications ◽  
Distal Tibial Fractures ◽  
Randomized Controlled

Abstract Background The treatment for distal tibial fractures remains controversial to date. Minimally invasive percutaneous plate osteosynthesis (MIPPO) and intramedullary nailing (IMN) are well-accepted and effective methods for distal tibial fractures, but these methods were associated with complications. This study aimed to assess and compare the clinical and functional outcomes in patients with distal tibial fractures treated with MIPPO or IMN. Methods We systematically reviewed randomized controlled trials (RCTs) that compared MIPPO with IMN in patients with distal tibial fractures from inception till 15 August 2019. Also, quantitative summaries of time to reunion, rate of complications, and functional outcomes were evaluated. Results The pooled results suggested that patients in the MIPPO group had a longer time to reunion with a mean difference of 1.21 weeks [P = 0.02; 95% confidence interval (CI) 0.16–2.26)] than those in the IMN group. The overall union complications and deep infection between IMN and MIPPO were similar (P > 0.05). IMN had a significantly low risk of wound complications [risk ratio (RR) = 0.51, P = 0.00, 95% CI 0.34–0.77)]. The pooled functional outcomes of the two groups remained controversial by different evaluating scores. Conclusions Compared to MIPPO, IMN had a significantly low risk of wound complications and associated with limited time for reunion. Although the pooled functional outcomes of the two groups were controversial due to different evaluating scores, IMN was the preferred surgical technique than MIPPO for treating distal tibial fractures.

One-year functional outcomes of naturalistically treated patients with schizophrenia

2012 ◽  
Vol 198 (3) ◽  
pp. 378-385 ◽  
Author(s):  
Ilja Spellmann ◽  
Michael Riedel ◽  
Rebecca Schennach ◽  
Felix Seemüller ◽  
Michael Obermeier ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
One Year

Operative Management of Distal Tibial Extra-articular Fractures – Intramedullary Nail Versus Minimally Invasive Percutaneous Plate Osteosynthesis

2017 ◽  
Vol 19 (6) ◽  
pp. 537-541 ◽  
Author(s):  
Iftikhar H. Wani ◽  
Naseem ul Gani ◽  
Mohammad Yaseen ◽  
Adil Bashir ◽  
Mohammad Shahid Bhat ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Intramedullary Nailing ◽  
Callus Formation ◽  
Plate Osteosynthesis ◽  
Controlled Study ◽  
Articular Fractures ◽  
Foot Function Index ◽  
Function Index ◽  
Foot Function ◽  
One Year

Background. The ideal treatment of distal tibial extra articular fractures remains controversial. Minimally invasive percutaneous plate osteosynthesis and intramedullary nailing are the two most commonly used methods. We did a prospective randomized controlled study to assess the functional outcome of distal tibial extra articular tibial fractures by comparing these treatment methods. Materials and methods. Sixty patients with distal tibial extra articular fractures were randomly assigned to an IMN (intramedullary nailing) group and a MIPPO (minimally invasive percutaneous plate osteosynthesis) group. All patients were followed up for a period of one year. At final follow-up, clinical and radiological outcome was assessed by foot function index. Malunion, infection, implant removal, time to union and secondary interventions were compared between the two groups. The comparison of continuous variables was performed by using the Student t-test or Mann-Whitney U test in accordance with normality testing. A value of p less than 0.05 was considered statistically significant. Results. All patients were followed up for a period of one year. Time to callus formation was equal in both groups. There was no non-union in our series. Malunion was more common in the nailing group. The foot function index was similar in both groups. Conclusion. MIPPO and intramedullary nailing are effective treatment options in the management of distal tibial extra particular fractures, with comparable functional outcomes.

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