New modified internal fixation method of transconjunctival lower blepharoplasty

Background: Fractures of the distal tibia are among the most difficult fractures to treat. The short distal segment presents difficulty in choosing the appropriate fixation method. The greatest challenge lies in the relatively tight soft tissue around the ankle. As a result, it has been a recent interest in treating these fractures with external fixation and limited internal fixation. The external stable fixation methods used are tubular or ring fixators, with or without immobilising the ankle. This minimally invasive nature of the surgery can avoid catastrophic wound complications like dehiscence, implant exposure and infection.Methods: 18 patients with extra-articular distal tibial fractures (AO Type 43A) were treated with the technique of ankle spanning external fixation. Lag screws or K-wires were supplemented for limited internal fixation when required. Fibula was stabilised in all cases. Intra- articular and Compound fractures were excluded. In addition to union at fracture site, ankle pain and motion was noted in each follow-up.Results: The mean follow-up was 25 months. Of the 18 patients included all but one fractures united with an average healing time of 16 to 18 weeks. Ankle pain and motion was graded according to Mazur modified by Teeny and Wiss clinical scoring system. 15 of them had excellent or good results, 2 had fair results. One patient had poor result. Five pin tract infections occurred. 17 patients had no evidence of osteoarthritis after completing follow up of at least 2 years.Conclusions: Distal tibial fractures are complex injuries, not only regarding the bony component, but also in terms of the management of the soft tissue problem. Ankle Spanning External Fixator with Limited Internal fixation is a relatively simple and cost-effective method for treating these fractures, achieving union and also maintaining ankle function.

Download Full-text

Distal tibial pilon fractures (AO/OTA type B, and C) treated with the external skeletal and minimal internal fixation method

Vojnosanitetski pregled ◽

10.2298/vsp1309836m ◽

2013 ◽

Vol 70 (9) ◽

pp. 836-841 ◽

Cited By ~ 3

Author(s):

Sasa Milenkovic ◽

Milorad Mitkovic ◽

Ivan Micic ◽

Desimir Mladenovic ◽

Stevo Najman ◽

...

Keyword(s):

Internal Fixation ◽

Ankle Joint ◽

Fixation Method ◽

Universal Method ◽

Type B ◽

Tibial Pilon ◽

Post Surgery ◽

Articular Fractures ◽

Type C ◽

Pilon Fractures

Background/Aim. Distal tibial pilon fractures include extra-articular fractures of the tibial metaphysis and the more severe intra-articular tibial pilon fractures. There is no universal method for treating distal tibial pilon fractures. These fractures are treated by means of open reduction, internal fixation (ORIF) and external skeletal fixation. The high rate of soft-tissue complications associated with primary ORIF of pilon fractures led to the use of external skeletal fixation, with limited internal fixation as an alternative technique for definitive management. The aim of this study was to estimate efficacy of distal tibial pilon fratures treatment using the external skeletal and minimal internal fixation method. Methods. We presented a series of 31 operated patients with tibial pilon fractures. The patients were operated on using the method of external skeletal fixation with a minimal internal fixation. According to the AO/OTA classification, 17 patients had type B fracture and 14 patients type C fractures. The rigid external skeletal fixation was transformed into a dynamic external skeletal fixation 6 weeks post-surgery. Results. This retrospective study involved 31 patients with tibial pilon fractures, average age 41.81 (from 21 to 60) years. The average follow-up was 21.86 (from 12 to 48) months. The percentage of union was 90.32%, nonunion 3.22% and malunion 6.45%. The mean to fracture union was 14 (range 12-20) weeks. There were 4 (12.19%) infections around the pins of the external skeletal fixator and one (3.22%) deep infections. The ankle joint arthrosis as a late complication appeared in 4 (12.90%) patients. All arthroses appeared in patients who had type C fractures. The final functional results based on the AOFAS score were excellent in 51.61%, good in 32.25%, average in 12.90% and bad in 3.22% of the patients. Conclusion. External skeletal fixation and minimal internal fixation of distal tibial pilon fractures is a good method for treating all types of inta-articular pilon fractures. In fractures types B and C dynamic external skeletal fixation allows early mobility in the ankle joint.

Download Full-text

Selection of internal fixation method for femoral intertrochanteric fractures using a finite element method

World Journal of Clinical Cases ◽

10.12998/wjcc.v9.i22.6343 ◽

2021 ◽

Vol 9 (22) ◽

pp. 6343-6356

Author(s):

Jia-Xuan Mu ◽

Shi-Yang Xiang ◽

Qing-Yu Ma ◽

Hai-Lun Gu

Keyword(s):

Finite Element Method ◽

Finite Element ◽

Internal Fixation ◽

Fixation Method ◽

Intertrochanteric Fractures ◽

Selection Of ◽

Element Method

Download Full-text

Internal Fixation Method Using EZ-Tcon for Transconjunctival Fat Repositioning: Clinical Outcomes and Efficacy

Aesthetic Plastic Surgery ◽

10.1007/s00266-020-01873-1 ◽

2020 ◽

Vol 44 (5) ◽

pp. 1-12

Author(s):

Cheol Ho Chang ◽

Juyoung Bae ◽

Myung Kyu Cha ◽

Sa Ik Bang ◽

Kyeong-Tae Lee

Keyword(s):

Internal Fixation ◽

Fixation Method ◽

Full Description ◽

Complication Rates ◽

Level Of Evidence ◽

Advantages And Disadvantages ◽

Tear Trough ◽

Tear Trough Deformity ◽

If Technique ◽

Fat Repositioning

Abstract Background Transconjunctival fat repositioning is the gold standard for the correction of tear trough deformity. For fixation of fat pedicle, the internal fixation (IF) and externalized percutaneous suture (EPS) techniques are used, which have their own advantages and disadvantages. The present study aimed to introduce a new IF technique using a devised needle (EZ-Tcon) and to compare its outcomes with those of the conventional EPS technique. Methods Patients with primary tear trough deformity who underwent transconjunctival fat repositioning were reviewed and categorized into two cohorts according to the fixation technique: cohort 1 consisted of patients treated using the conventional EPS technique and cohort 2 consisted of those in whom the new IF technique using EZ-Tcon was adopted. Post-operative complications and aesthetic outcomes were assessed using a four-scale grading system. Results A total of 545 patients, 211 from cohort 1 and 344 from cohort 2 were evaluated with a median follow-up of 70 days. Compared to cohort 1, cohort 2 showed significantly lower rates of long-standing conspicuous scars on lower eyelid, re-operation and overall complications. In the analysis of aesthetic outcomes, 88.9 percent of cohort 2 showed grade 0 (no deformity) or I (mild deformity) post-operatively. The rate of excellent outcomes (improvements of ≥ two grades) was significantly higher in cohort 2 than in cohort 1 (p-value < 0.001). Conclusion Our technique using EZ-Tcon could possess advantages of the conventional IF and EPS techniques, showing lower complication rates and aesthetically satisfactory outcomes, and could be a safe and reliable method of transconjunctival fat repositioning. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Download Full-text

Outcomes of Open Reduction and Internal Fixation of Bilateral Fractures of the Distal Radius

Journal of Hand and Microsurgery ◽

10.1055/s-0039-1688512 ◽

2019 ◽

Vol 11 (02) ◽

pp. 117-120

Author(s):

Jack G. Graham ◽

Sreeram Penna ◽

Daniel Fletcher ◽

Moody Kwok ◽

Daren J. Aita ◽

...

Keyword(s):

Postoperative Complications ◽

Internal Fixation ◽

Distal Radius ◽

Open Reduction ◽

Fixation Method ◽

X Rays ◽

Volar Approach ◽

Patient Demographics ◽

Radiographic Measurements

Abstract Background Bilateral distal radius fracture (DRF) is an uncommon injury. We described the outcomes of 10 consecutive cases of bilateral DRF treated with open reduction and internal fixation (ORIF) at our institution. Materials and Methods We retrospectively searched our electronic medical records data for all patients 18 years of age or older treated surgically for bilateral DRF over a 6-year period (2011–2016). Patient demographics, fracture classification, fixation method, postoperative complications, QuickDASH (Quick Disabilities of the Arm, Shoulder and Hand) questionnaire scores, wrist range of motion (ROM), and radiographic measurements of X-rays at final follow-up were collected and analyzed. Results Ten patients (8 women; 2 men; mean age: 63 years) with 20 fractures were assessed. A volar approach for ORIF was used in 90% of cases. Six of 20 (30%) wrists experienced postoperative complications and required hardware removal. Mean QuickDASH score was 24.8 at final follow-up. On average, ROM reached 58-degree extension, 52-degree flexion, 75-degree pronation, and 75-degree supination. Mean measurements of radial shortening, radial inclination, and volar tilt taken from final postoperative radiographs were 1.3 mm, 21.2 degrees, and 7.8 degrees, respectively. Conclusion In bilateral DRF treated with concomitant ORIF, functional outcomes, recovery of wrist ROM, and restoration of radiographic parameters are comparable to those seen in patients with ipsilateral DRF.

Download Full-text

Orthogonal Plating of Vancouver B1 and C-Type Periprosthetic Femur Fracture Nonunions

Hip International ◽

10.5301/hipint.5000500 ◽

2017 ◽

Vol 27 (6) ◽

pp. 578-583 ◽

Cited By ~ 4

Author(s):

Christopher E. Birch ◽

Michael Blankstein ◽

Jesse D. Chlebeck ◽

Craig S. Bartlett 3rd

Keyword(s):

Internal Fixation ◽

Open Reduction ◽

Femur Fracture ◽

Plate Osteosynthesis ◽

Perioperative Complications ◽

Femoral Shaft ◽

Open Reduction Internal Fixation ◽

Fixation Method ◽

Periprosthetic Femur Fracture ◽

Fracture Nonunions

Background Periprosthetic femoral shaft fractures are a significant complication after total hip arthroplasty (THA). Plate osteosynthesis has been the mainstay of treatment around well-fixed stems. Nonunions are a rare and challenging complication of this fixation method. We report the outcomes of a novel orthogonal plating surgical technique for Vancouver B1 and C-type periprosthetic fractures that previously failed open reduction internal fixation (ORIF). Methods A retrospective review identified all patients with Vancouver B1/C THA periprosthetic femoral nonunions from 2010 to 2015. Exclusion criteria included open fractures and periprosthetic infections. The technique utilised a mechanobiologic strategy of atraumatic exposure, resection of necrotic tissue, bone grafting with adjuvant bone morphogenetic protein (BMP) and revision open reduction internal fixation with orthogonal plate osteosynthesis. Results 6 Vancouver B1/C periprosthetic femoral nonunions were treated. 5 patients were female with an average age of 80.3 years (range 72-91 years). The fractures occurred at a mean of 5.8 years (range 1-10 years) from their initial arthroplasty procedure. No patients underwent further revision surgery; there were no perioperative complications. All patients had a minimum of 11 months follow-up (mean 18.6, range 11-36 months). All fractures achieved osseous union, defined as solid bridging callus over at least 2 cortices and pain free, independent ambulation, at an average of 24.4 weeks (range 6.1-39.7 weeks). Conclusions This is the 1st series describing orthogonal locked compression plating using modern implants for periprosthetic femoral nonunions. This technique should be considered in periprosthetic femur fracture nonunions around a well-fixed stem.

Download Full-text

"Net cage" technique in the treatment of inferior pole patella fracture: a novel patella internal fixation technique

10.21203/rs.3.rs-995136/v1 ◽

2021 ◽

Author(s):

Ming Li ◽

Hongfei Qi ◽

Teng Ma ◽

Zhong Li ◽

Cheng Ren ◽

...

Keyword(s):

Soft Tissue ◽

Knee Joint ◽

Internal Fixation ◽

Fracture Healing ◽

Healing Time ◽

Fixation Method ◽

Inferior Pole ◽

Functional Exercise ◽

Net Cage

Abstract Objective Fractures of the inferior pole of the patella can cause the knee joint extensor mechanism disorder. The fracture fragments are usually small and comminuted. Therefore, there are certain difficulties in fixation. The purpose of this study is to observe the effect of the "Net cage" technique in the treatment of the inferior pole of the patella. Methods This is a retrospective study that included 16 cases of inferior patella fractures (AO/OTA 34-A1) who underwent the "Net cage" technique from March 2017 to June 2020. Collecting their medical records and follow-up results, measuring indicators include the surgical complications of the fixation method, knee joint function, the number of fluoroscopies, fracture healing, and the incidence of soft tissue stimulation. Results The fractures of all patients healed smoothly, and there were no complications such as failure of internal fixation and fracture of implants. The average number of intraoperative fluoroscopy was 5.56 times (range: 4-10 times); the average fracture healing time was 10.5 weeks (range: 8-14 weeks) ). No patients reported internal fixation-related soft tissue irritation. At the last follow-up, the knee function showed that the average ROM was 133.75° (range: 120°~140°); The average Bostman score was 27.94 points (range: 24-30 points). Conclusion "Net cage" technology for the treatment of inferior pole fractures of the patella has the advantages of reduced fluoroscopy, fixation and stability, early functional exercise, and better knee joints after surgery.

Download Full-text