Failure of dual plating in a complex open distal femur fracture as the result of major trauma

2021 ◽  
Vol 14 (12) ◽  
pp. e245362
Author(s):  
Thomas Robert William Ward ◽  
Kanai Garala ◽  
Bryan Riemer
Keyword(s):  
Callus Formation ◽  
Case Reports ◽  
Open Reduction Internal Fixation ◽  
Fixation Method ◽  
Dual Plating ◽  
Metaphyseal Bone ◽  
Polytrauma Patient ◽  
High Degree ◽  
Technique Failure ◽  
Massive Bone

A 61-year-old polytrauma patient was admitted with a right distal comminuted metaphyseal femoral fracture with intra-articular extension (Orthopaedic Trauma Association 33C2.3 classification) among other injuries. Due to the high degree of comminution and massive bone loss, this was initially managed with a dual plating open reduction internal fixation. Dual plating has shown to be a superior fixation method than single variable angle locking compression plate (VA-LCP) plating providing greater fixation in metaphyseal bone. Our case reports the failure of dual plating which required removal of metalwork and subsequent fixation using intramedullary nail and plate technique. Failure of dual plating is not well documented in the literature. The most recent radiographs taken 15 months postrevision surgery show that the bone has started to heal with evidence of callus formation.

scholarly journals Congenital pseudoarthrosis of the clavicle: Should we reconsider timing and fixation method?

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901879953 ◽  
Author(s):  
Uriel Giwnewer ◽  
Guy Rubin ◽  
Eithan Dohovni ◽  
Nimrod Rozen ◽  
Noam Bor
Keyword(s):  
Literature Review ◽  
Bone Graft ◽  
Callus Formation ◽  
Skin Irritation ◽  
Autologous Bone Graft ◽  
Fixation Method ◽  
Clinical Difference ◽  
Compression Plate ◽  
Different Ages ◽  
Autologous Bone

Background: Congenital pseudoarthrosis of the clavicle (CPC) is rare and may require treatment, usually because of an unacceptable appearance or occasionally because of pain in an adolescent patient. Spontaneous union is unknown, and consequently any desired union requires open reduction and bone grafting. Many authors recommend performing the operation at the age of 3–5 years and using different fixation methods. We present our experience with three cases and literature review in an attempt to further elucidate the appropriate timing of the procedure and the fixation method. Methods: This was a retrospective review of three cases presenting with pseudoarthrosis of the clavicle. All cases were treated by curettage of the pseudoarthrosis, with the void filled using full-thickness ileac crest autologous bone graft and bridging plate—one compression and two anatomical, at different ages. We performed a literature review with emphasis on timing of the procedure, fixation method and complications. Results: All patients healed with good callus formation. One patient (5-year-old female treated using a compression plate) experienced overlying skin irritation and underwent removal of the plate. There were no restriction of movement, pain or any other complaint on the final follow-up. We did not find any difference in the operating complexity at different ages, but when a compression plate was used, it had to be removed later due to bulging of the plate. Discussion: No clinical difference was observed between earlier and late operation. Therefore, we suggest performing a curettage of the pseudoarthrosis, gapping the void using autologous bone graft, and using an anatomical bridging plate.

Self-extrication and selective spinal immobilisation in a polytrauma patient with spinal injuries

Trauma ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 229-232
Author(s):  
Aidan Brown ◽  
Adam Low
Keyword(s):  
Randomised Controlled Trials ◽  
Case Reports ◽  
Evidence Base ◽  
Spinal Injuries ◽  
Controlled Trials ◽  
Safe Practice ◽  
Spinal Immobilisation ◽  
Multi Level ◽  
Randomised Controlled ◽  
Polytrauma Patient

Methods of extrication and spinal immobilisation following trauma remains controversial. There is a consensus shift towards encouraging patients to self-extricate from vehicles after collisions and reduced use of hard cervical collars. Difficulties in conducting randomised controlled trials in this area means that case reports are important in adding to the existing evidence base. This case of an 81-year-old female polytrauma patient suggests that self-extrication, and not using hard cervical collars is safe practice, even in the context of significant multi-level spinal injuries.

scholarly journals FatalAcinetobacter baumaniiNecrotizing Fasciitis following Open Reduction Internal Fixation in a Polytrauma Patient

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Alexandre Nehme ◽  
Nabih I. Joukhadar ◽  
Elias Saidy ◽  
Mohammad Darwiche ◽  
Dany K. Aouad ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Necrotizing Fasciitis ◽  
Open Reduction ◽  
Open Reduction Internal Fixation ◽  
Surrounding Tissue ◽  
Tissue Destruction ◽  
Multiple Fractures ◽  
Optimal Care ◽  
Fast Progression ◽  
Polytrauma Patient

Necrotizing fasciitis is an uncommon and potentially fatal infection that can affect the epidermis, dermis, and more commonly the subcutaneous, fascia, and muscle layers. NF is usually caused by toxin-producing bacteria with a relatively fast progression associated with severe surrounding tissue destruction. Early diagnosis and management are crucial factors for survival. Broad-spectrum antibiotics along with surgical debridement, sometimes multiple, are needed in order to stop or slow down the progression of NF. Despite optimal care, necrotizing fasciitis remains a highly morbid condition with a high mortality rate. We present a case of a 28-year-old male patient with rapidly developing fatalA. baumanniiassociated with necrotizing fasciitis, after open reduction and internal fixation (ORIF) of multiple fractures after polytrauma.

scholarly journals Fixation of Light Weight Polypropylene Mesh with n-Butyl-2-cyanocrylate in Pelvic Floor Surgery: Experimental Design Approach in Sheep for Effectiveness Evaluation

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Sandra Barbosa ◽  
Tania Nieves ◽  
Félix García ◽  
Eva Cepeda ◽  
Xavier Moll ◽  
...  
Keyword(s):  
Animal Model ◽  
Experimental Design ◽  
Mesh Size ◽  
Synthetic Mesh ◽  
Fixation Method ◽  
Light Weight ◽  
Pilot Studies ◽  
Fixation Methods ◽  
Post Surgery ◽  
High Degree

Objective. The aim of this study was to find a proper experimental design and to evaluate n-butyl-2-cyanoacrylate (Histoacryl) as a fixation method for a light-weight and large pore PP mesh (Synthetic PP Mesh-1) using the sheep as an animal model.Methods. Posterior vaginal implantation by means of episiotomy was used to implant 8 ewes which were evaluated macroscopically and histologically at 3 months (n=4) and 6 months (n=4) post-surgery. In previous pilot studies anterior vaginal implantation was evaluated, as well as different synthetic mesh materials, sizes and fixation methods (n=1to 3) during three weeks. In all cases a clinical evaluation of the animal was performed.Results. A reduction in the mesh size (Synthetic PP Mesh-1) together with precise application of the surgical glue Histoacryl to fix the mesh yielded significantly better histocompatibility results (P<0.01) compared to larger size or other fixation methods.Conclusion. The combination ofSynthetic PP Mesh-1with Histoacryl offered a high degree of graft integration without vaginal ulceration and a minimal foreign body reaction, being the sheep a proper animal model to test these types of medical devices.

scholarly journals Management of Sternal Segment Dislocation in a Child with Closed Reduction

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Omer Soysal ◽  
Osman Cemil Akdemir ◽  
Sedat Ziyade ◽  
Murat Ugurlucan
Keyword(s):  
Surgical Treatment ◽  
Closed Reduction ◽  
Callus Formation ◽  
Case Reports ◽  
Review Of The Literature ◽  
Body Segment ◽  
Sternal Fracture ◽  
Fractures In Children ◽  
Traumatic Dislocation ◽  
Sternal Fractures

Trauma may lead to sternal fracture or dislocation. Dislocation of a sternal segment in the childhood period is very rare as for sternal fractures in children. There are only six case reports regarding the issue in the literature. Additionally, there is not an established consensus for the treatment of the pathology. In this paper we present traumatic dislocation of a sternal body segment in a 10-year-old child who was successfully managed conservatively by closed reduction together with the review of the literature. Surgical treatment is not necessary especially in acute cases. Pathology may be treated with closed reduction. Callus formation usually supports the dislocated part of the sternum in time.

scholarly journals How Do Pilon Fractures Heal? An Analysis of Dual Plating, Biomechanically Matched Fixation, and Callus Formation

2019 ◽  
Author(s):  
Sean T Campbell ◽  
L. Henry Goodnough ◽  
Brett Salazar ◽  
Justin F. Lucas ◽  
Julius Bishop ◽  
...  
Keyword(s):  
Callus Formation ◽  
Dual Plating ◽  
Pilon Fractures

scholarly journals Pharmacokinetic Interactions between Cardiovascular Medicines and Plant Products

2019 ◽  
Vol 2019 ◽  
pp. 1-19 ◽  
Author(s):  
Irina-Iuliana Costache ◽  
Anca Miron ◽  
Monica Hăncianu ◽  
Viviana Aursulesei ◽  
Alexandru Dan Costache ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Pharmacological Activity ◽  
Case Reports ◽  
Herbal Products ◽  
Plant Products ◽  
Pharmacokinetic Interactions ◽  
Cardiovascular Pharmacotherapy ◽  
High Degree ◽  
Potential Interactions

The growing use of plant products among patients with cardiovascular pharmacotherapy raises the concerns about their potential interactions with conventional cardiovascular medicines. Plant products can influence pharmacokinetics or/and pharmacological activity of coadministered drugs and some of these interactions may lead to unexpected clinical outcomes. Numerous studies and case reports showed various pharmacokinetic interactions that are characterized by a high degree of unpredictability. This review highlights the pharmacokinetic clinically relevant interactions between major conventional cardiovascular medicines and plant products with an emphasis on their putative mechanisms, drawbacks of herbal products use, and the perspectives for further well-designed studies.

Carbon Nanofiber Surface Roughness Increases Osteoblast Adhesion

2003 ◽  
Vol 774 ◽  
Author(s):  
Karen S. Ellison ◽  
Rachel L. Price ◽  
Karen M. Haberstroh ◽  
Thomas J. Webster
Keyword(s):  
Surface Roughness ◽  
Carbon Fiber ◽  
Carbon Nanofibers ◽  
Carbon Fibers ◽  
Carbon Nanofiber ◽  
Callus Formation ◽  
Study Results ◽  
Osteoblast Adhesion ◽  
High Degree

AbstractThe present study demonstrated for the first time desirable cytocompatibility properties of carbon nanofibers pertinent for bone prosthetic applications. Specifically, osteoblast (boneforming cells), fibroblast (cells contributing to callus formation and fibrous encapsulation events that result in implant loosening), chondrocyte (cartilage-forming cells), and smooth muscle cell (for comparison purposes) adhesion were determined on carbon nanofibers in the present in vitro study. Results provided evidence that nanometer dimension carbon fibers promoted select osteoblast adhesion, in contrast to the performance of conventional carbon fibers. Moreover, adhesion of other cells was not influenced by carbon fiber dimensions. To determine properties that selectively enhanced osteoblast adhesion, similar cell adhesion assays were performed on poly-lactic-co-glycolic (PLGA) casts of carbon fiber compacts previously tested. Compared to PLGA casts of conventional carbon fibers, results provided the first evidence of enhanced select osteoblast adhesion on PLGA casts of nanophase carbon fibers. The summation of these results demonstrate that due to a high degree of nanometer surface roughness, carbon fibers and PLGA with nanometer surface dimensions may be optimal materials to selectively increase osteoblast adhesion necessary for successful orthopedic implant applications.

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

2017 ◽  
Vol 27 (6) ◽  
pp. 578-583 ◽  
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.

Intra-articular Distal Humerus Fractures: Parallel Versus Orthogonal Plating

2021 ◽  
pp. 155633162110098
Author(s):  
Jack M. Haglin ◽  
David N. Kugelman ◽  
Ariana Lott ◽  
Rebekah Belayneh ◽  
Sanjit R. Konda ◽  
...  
Keyword(s):  
Distal Humerus ◽  
Open Reduction Internal Fixation ◽  
Fracture Repair ◽  
Chi Square ◽  
Locking Compression Plates ◽  
Dual Plating ◽  
Dual Plate ◽  
Humerus Fractures ◽  
Distal Humerus Fractures

Background: Dual-plating osteosynthesis is the standard treatment for Orthopedic Trauma Association (OTA)-type 13-C distal humerus fractures. However, optimal plate position is debated. Purpose: The purpose of this study was to evaluate dual-plate positioning following intra-articular distal humerus fracture repair by comparing outcomes between patients plated in parallel and those plated orthogonally following open-reduction, internal-fixation (ORIF) of intra-articular distal humerus fractures. Methods: All OTA-type 13-C intra-articular distal humerus fractures treated operatively at our institution over a 10-year period were reviewed. Clinical outcomes and complications were compared between those plated in parallel and those plated orthogonally. Data were analyzed using independent-samples t-tests, Mann-Whitney U tests, chi-square tests, and Fisher’s exact tests. Results: A total of 69 patients met inclusion criteria. Mean follow-up among this cohort was 19.3 months; 45 (64.8%) patients had orthogonal dual plating, and 24 (35.2%) had parallel plating. Groups did not differ with respect to demographics or duration of follow-up. Clinically, there were no significant differences in time to union, elbow arc of motion at any time point, or patient Mayo Elbow Performance Index (MEPI) scores at final follow-up. Furthermore, there were no differences in complications. Conclusion: Parallel and orthogonal plating following ORIF of distal humerus fractures with modern, contoured locking compression plates had similar outcomes in this study. This study represents the largest comparative series in the literature at the time of its writing. Both techniques may be considered when deciding on dual-plating technique for treating intra-articular distal humerus fractures.

Sign in / Sign up

Export Citation Format

Share Document