scholarly journals A Staged Surgical Treatment Outcome of Type 3 Open Tibial Fractures

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ahmet Aslan ◽  
Emin Uysal ◽  
Ahmet Özmeriç
Keyword(s):  
Elective Surgery ◽  
Treatment Protocol ◽  
Case Series ◽  
Good Method ◽  
High Energy ◽  
Tibial Fractures ◽  
Open Tibial Fractures ◽  
One Year ◽  
Staged Treatment ◽  
Type 3

Aim. In these case series which are about type 3 open tibial fractures formed with three different high energy trauma etiologies in different parts of tibia. We aimed to assess our three-stage treatment approach and discuss final results of our elective surgery management with three different fixation methods. Patients and Methods. We assessed 19 patients with type 3 open tibial fractures between 2009 and 2012. Our treatment protocol consisted of three stages. Early intervention in operating room, which including vascular repairs or soft tissue closure, was done if necessary. Definitive surgery was performed using internal or external fixation in the first 15 days. Patients were followed up for at least one year. Last conditions of all our cases were evaluated according to modified Johner and Wruhs criteria. Results. Nine cases were type 3A, seven cases were type 3B, and three cases were type 3C in terms of fracture typing. All patients were followed up for at least one year and mean follow up time was 15 months. In terms of functional and clinical outcome, six cases were evaluated as excellent, eight cases as good, two cases as fair, and three cases as poor. Discussion. Staged treatment option in type 3 open tibial fractures seems to be a good method in reducing complication and achieving the best result. We think that definitive staged treatment protocol including internal fixation with plating or intramedullary nailing (IMN) of the fractures is a reliable method, especially to avoid complications as a result of external fixator and to provide patient rapport.

One‐year results of a nonsurgical treatment protocol for peri‐implantitis. A retrospective case series

2019 ◽  
Vol 30 (7) ◽  
pp. 702-712 ◽  
Author(s):  
Ruth Estefanía‐Fresco ◽  
Ana M. García‐de‐la‐Fuente ◽  
Aitor Egaña‐Fernández‐Valderrama ◽  
Manuel Bravo ◽  
Luis Antonio Aguirre‐Zorzano
Keyword(s):  
Treatment Protocol ◽  
Case Series ◽  
Nonsurgical Treatment ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
One Year

scholarly journals Sinonasal Polyps: A Diagnostic Challenge

2019 ◽  
Vol 27 (3) ◽  
pp. 243-250
Author(s):  
Sucharita Sarkar ◽  
Rama Saha ◽  
Mou Das ◽  
Samares Sardar
Keyword(s):  
Treatment Protocol ◽  
Case Series ◽  
Olfactory Neuroblastoma ◽  
Mass Lesion ◽  
Diagnostic Challenge ◽  
Basal Cell Adenocarcinoma ◽  
Adenoid Cystic ◽  
Malignant Lesions ◽  
One Year ◽  
Gross Examination

Introduction Sinonasal polyps, presenting as mass lesion of nose and paranasal sinuses ranges pathologic entity including infective diseases to malignant lesions. 80% are non-neoplastic lesions and less than 1% are malignant. They all present with symptoms of nasal stuffiness or obstruction and mass lesion, producing significant diagnostic challenges as they possess extremely varied clinical behaviour, etiopathogenesis, treatment protocol as well as prognosis.   Case Series During period of one year (March 2017 to February 2018), we had six patients presenting with nasal polyp having special features that need attention. After proper investigation each case was operated and gross examination followed by histopathology was done. They   revealed six different diagnoses e.g., Olfactory neuroblastoma, Adenoid Cystic Carcinoma, Basal Cell Adenocarcinoma, Sinonasal Mucosal Melanoma, Primitive Neuroectodermal Tumour (PNET) and Aspergilloma. Discussion Clinicians’ attention is drawn to the fact that, similar presentation may have varied differential diagnoses, some of which may be very rare and histopathology is essential for coming to definitive diagnosis.

Clainical Study of External Fixation for Type 3 Open Tibial Fractures

1991 ◽  
Vol 26 (6) ◽  
pp. 1667
Author(s):  
Chong Il Yoo ◽  
Hui Taeg Kim ◽  
Weon Wook Park
Keyword(s):  
External Fixation ◽  
Tibial Fractures ◽  
Open Tibial Fractures ◽  
Type 3

One-Year Clinical and Imaging Follow-up After Exercise-Based Treatment for Acute Complete Adductor Longus Tendon Avulsions in Athletes: A Prospective Case Series

2021 ◽  
pp. 036354652110159
Author(s):  
Andreas Serner ◽  
Per Hölmich ◽  
Javier Arnaiz ◽  
Johannes L. Tol ◽  
Kristian Thorborg ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Treatment Protocol ◽  
Case Series ◽  
Return To Sport ◽  
Long Term Results ◽  
Research Centre ◽  
Longus Tendon ◽  
One Year ◽  
Adductor Longus

Background: Complete avulsions of the adductor longus tendon are serious injuries, yet we have few data to inform clinical decisions on management. Previous studies are limited by a lack of detailed follow-up. Purpose: To describe detailed clinical and imaging measures 1 year after complete proximal adductor longus avulsion injuries in athletes who received exercise-based treatment. Study Design: Case series; Level of evidence, 4. Methods: A total of 16 adult male competitive athletes were included in this study <7 days after an acute adductor longus tendon avulsion injury. All athletes were advised to complete a supervised standardized criterion-based rehabilitation protocol. Standardized clinical examination, a modified Copenhagen Hip and Groin Outcome Score (HAGOS), the Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC-O), and detailed magnetic resonance imaging (MRI) assessment were performed after inclusion, on the day of completion of the treatment protocol (return to sport), and at 1-year follow-up after injury. Results: One player was lost to follow-up. Median return-to-sport time was 69 days (interquartile range [IQR], 62-84). One player had an early reinjury and performed an additional rehabilitation period. One-year follow-up was completed a median from 405 days (IQR, 372-540) after injury. The median HAGOS score was 100 for all subscales (IQRs from 85-100 to 100-100), and the median OSTRC-O score was 0 (IQR, 0-0). The median range of motion symmetry was 100% (IQR, 97%-130%) for the bent-knee fall-out test and 102% (IQR, 99%-105%) for the side-lying abduction test. Side-lying eccentric adduction strength symmetry was 92% ± 13% (mean ± SD), and median supine eccentric adduction strength symmetry was 93% (IQR, 89%-105%). MRI results at 1-year follow-up showed that from the original complete discontinuity in all cases, 10 athletes (71%) had partial tendon continuity, and 4 (29%) had complete tendon continuity. Conclusion: Nonsurgically treated athletes with a complete acute adductor longus avulsion returned to sport in 2 to 3 months. At the 1-year follow-up after injury, athletes had high self-reported function, no performance limitations, normal adductor strength and range of motion, and signs of partial or full tendon continuity as shown on MRI. This indicates that the primary treatment for athletes with acute adductor longus tendon avulsions should be nonsurgical as the time to return to sport is short, there are good long-term results, and there is no risk of surgical complications.

scholarly journals TIBIAL PLATEAU FRACTURES

2018 ◽  
Vol 25 (06) ◽  
pp. 810-814
Author(s):  
Saeed Ahmad ◽  
Tariq Mahmood ◽  
Muhammad Imran Haider
Keyword(s):  
External Fixator ◽  
Tibial Plateau ◽  
Case Series ◽  
High Energy ◽  
Tibial Plateau Fractures ◽  
Tibial Fractures ◽  
Female Ratio ◽  
Non Union ◽  
Hybrid External Fixator ◽  
Pin Track

Background: Tibial fractures is most common type of long bone fractures. Highspeed lifestyles with vehicles motorcycles as well as growing waves of violence, contributingincrease occurrence of tibial fractures. Tibial plateau fractures continues to be a challenge fororthopedic surgeon. Treatment of these fractures have been plagued by complications. Recentimprovements in the techniques and development of hybrid external fixator have revolutionizedthe treatment of such fractures. Objective: To evaluate the clinical outcomes of hybrid externalfixator in high energy Schatzkar V and VI tibial plateau fractures. Study Design: Descriptive,Case series. Period: 27 June 2013 to 26 June 2016. Setting: Nishtar Hospital, Multan. Materialand methods: A total of 125 patients with open and close tibial plateau fractures, 20 to 50 yearsof age of both genders were included in the study. Patients having history of pervious surgeryor intervention tibial plateau fractures, and h/o malignancy were excluded. All the patients wereoperated by a consultant orthopedic surgeon. Outcome was assessed at 16 weeks by serialradiological x-ray by formation of callus and noting any grade of pin track infection. Results; Ourstudy comprised of 125 patients having Schatzker V and Schatzker VI tibial plateau fractureswho met our inclusion criteria. Mean age of 38.925 ± 7.09 years. Majority of the patients 47(37.60%) were between 41 to 50 years of age. Mean duration since injury in our study was 13.18± 4.79 hours. Out of 125 patients, 102 (81.60%) were males and 23(18.40%) were females withmale to female ratio of 1.2:5.4. Fifty three (42.4%) patients presented with Schatzker V and 72(57.6%) had Schatzker VI type of tibial plateau fractures. In our study, non-union was seen in10cases (8.0%) and pin track infection was noted to be present in 19 (15.20%) patients. So, theacceptable outcome (achievement of union without non-union or pin track infection during 16weeks) was seen in 96(76.8%) patients. Conclusion: This study concluded that there is highrate of acceptable outcome (achievement of union without any non-union or pin track infectionduring 16 weeks) after hybrid external fixator of the open and closed fractures of tibial plateauamong the patients having schatzker-V and VI.

The Lymphatic Response to Injury with Soft-Tissue Reconstruction in High-Energy Open Tibial Fractures of the Lower Extremity

2017 ◽  
Vol 139 (2) ◽  
pp. 483-491 ◽  
Author(s):  
Malou C. van Zanten ◽  
Raakhi M. Mistry ◽  
Hiroo Suami ◽  
Andrew Campbell-Lloyd ◽  
James P. Finkemeyer ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Lower Extremity ◽  
High Energy ◽  
Tibial Fractures ◽  
Soft Tissue Reconstruction ◽  
Open Tibial Fractures ◽  
Tissue Reconstruction

Orthoplastic reconstruction of type IIIB open tibial fractures retaining debrided devitalized cortical segments

2019 ◽  
Vol 101-B (8) ◽  
pp. 1002-1008 ◽  
Author(s):  
K. Al-Hourani ◽  
M. Stoddart ◽  
U. Khan ◽  
A. Riddick ◽  
M. Kelly
Keyword(s):  
Infection Rate ◽  
Median Number ◽  
High Energy ◽  
Deep Infection ◽  
Trauma Centre ◽  
Tibial Fractures ◽  
Open Tibial Fractures ◽  
Type Iiib ◽  
Bone Fragments ◽  
Male Patients

AimsType IIIB open tibial fractures are devastating high-energy injuries. At initial debridement, the surgeon will often be faced with large bone fragments with tenuous, if any, soft-tissue attachments. Conventionally these are discarded to avoid infection. We aimed to determine if orthoplastic reconstruction using mechanically relevant devitalized bone (ORDB) was associated with an increased infection rate in type IIIB open tibial shaft fractures.Patient and MethodsThis was a consecutive cohort study of 113 patients, who had sustained type IIIB fractures of the tibia following blunt trauma, over a four-year period in a level 1 trauma centre. The median age was 44.3 years (interquartile range (IQR) 28.1 to 65.9) with a median follow-up of 1.7 years (IQR 1.2 to 2.1). There were 73 male patients and 40 female patients. The primary outcome measures were deep infection rate and number of operations. The secondary outcomes were nonunion and flap failure.ResultsIn all, 44 patients had ORDB as part of their reconstruction, with the remaining 69 not requiring it. Eight out of 113 patients (7.1%) developed a deep infection (ORDB 1/44, non-ORDB 7/69). The median number of operations was two. A total of 16/242 complication-related reoperations were undertaken (6.6%), with 2/16 (12.5%) occurring in the ORDB group.ConclusionIn the setting of an effective orthoplastic approach to type IIIB open diaphyseal tibial fractures, using mechanically relevant debrided devitalized bone fragments in the definitive reconstruction appears to be safe. Cite this article: Bone Joint J 2019;101-B:1002–1008.

scholarly journals Early complications of preoperative external traction fixation in staged treatment of tibial fractures: a 402 cases series study

2020 ◽  
Author(s):  
Jiazhao Yang ◽  
Wanbo Zhu ◽  
Qirong Dong
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
High Energy ◽  
Study Data ◽  
Fracture Site ◽  
Tibial Fractures ◽  
Early Complications ◽  
The Mean ◽  
Staged Treatment

Abstract Background and Objective: Different external skeletal fixators have been widely used in preoperative traction of high-energy tibial fractures prior to a definitive surgical treatment. However, early complications associated with this staged treatment for traction and soft tissue injury recovery have rarely been discussed. This study aimed to analyze the early complications associated with preoperative external traction fixation in the staged treatment of tibial fractures.Materials and Methods: A total of 402 patients with high-energy tibial fractures treated using preoperative external traction fixation at a level-1 trauma center from 2014 to 2018 were enrolled in this retrospective study. Data regarding the demographic information, Tscherne soft tissue injury, fracture site, entry point placement, and duration of traction were recorded. Procedure-related complications such as movement and sensation disorder, vessel injury, discharge, infection, loosening, and iatrogenic fracture were analyzed.Results: The mean patient age was 42.5 (18–71) years and the mean duration of traction was 7.5 (0–26) days. In total, 19 (4.7%) patients presented with procedure-related complications, including technique-associated complications in 6 patients and nursing-associated complications in 13. Differences in the incidence of complications with respect to sex, affected side, soft tissue injury classification, and fracture sites were not observed. However, the number of complications due to hammer insertions was significantly fewer than those due to drill insertions (2.9% vs. 7.4%).Conclusion: The application of preoperative external traction fixation had been proved to be an ideal alternative treatment for high energy tibial fractures. In this study, we found the incidence of early complications of the fixation is low, and it is not significantly associated with the severity of soft tissue injury and fracture site. Although relatively rough and more likely to cause pain, complications of hammer insertions were significantly fewer than drill insertions. The possible reason was higher probability of heat damage and loosening by drilling.

Sign in / Sign up

Export Citation Format

Share Document