Successful Treatment of a 15-Year-Old Nonunion of a Midshaft Clavicle Fracture Causing Brachial Plexus Compression

A 49-year-old man with a 15-year-old nonunion of a midshaft clavicle fracture suffered from progressive tingling in his entire arm and fingers for two years, due to irritation of the brachial plexus in the costoclavicular space, especially upon elevation of the arm. After open reduction and internal plate fixation, all symptoms were resolved and complete consolidation of the fracture was achieved at one-year follow-up. This case demonstrates two things: brachial plexus compression can occur even many years after a nonunion of a clavicle fracture and union can be still achieved, even in a longstanding nonunion.

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Can Only Fix Sternoclavicular Joint to Treat Bipolar Clavicle Injury?

10.21203/rs.3.rs-533358/v1 ◽

2021 ◽

Author(s):

Dongxu Feng ◽

Yong Liu ◽

Zijun Li ◽

Jie Huang ◽

Mei Fan ◽

...

Keyword(s):

Plate Fixation ◽

Clavicle Fracture ◽

Early Mobilization ◽

Recurrent Dislocation ◽

Sternoclavicular Joint ◽

Dash Score ◽

Distal Clavicle Fracture ◽

The Mean ◽

Internal Plate Fixation

Abstract Background: Owing to the rarity of bipolar clavicle injury, treatment remains controversial. The purpose of this study is to report treatment of bipolar clavicle injury with internal plate fixation.Methods: We present our experience of clavicle hook plating for sternoclavicular joint dislocation and anatomical plating for distal clavicle fracture for the treatment of three consecutive bipolar clavicle injuries with different injury patterns. At follow up, radiographs were assessed for joint congruity, fracture union, and implant failure. Clinical evaluation included Disability of the Arm, Shoulder, and Hand (DASH), Constant and Murley Score, Visual Analog Scale (VAS), and complications.Results：All patients had a minimum follow-up of six months. Each fracture had solid union, and each dislocation showed no sign of recurrent dislocation, the mean shoulder forward flexion was 153.3°±10.4°, the mean DASH score was 13.9±9.2 points. The mean Constant and Murley score was 82.3±12.3 points, and, the mean VAS score was 2.2±2.0 point. No complications were encountered, and each patient was highly satisfied with their treatments.Conclusion: Our experience of using internal plating for bipolar clavicle injury is positive, as it allows early mobilization and resulted in good joint function. Also, only sternoclavicular joint fixation might be sufficient for some part of bipolar clavicle injury, acromioclavicular joint fixation is not necessary unless residual instability existence.

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A COMPREHENSIVE PELVIC AND FEMORAL OSTEOTOMY REVISION TO TREAT A FAILED PELVIC AND FEMORAL OSTEOTOMY: A CASE REPORT

Journal of Musculoskeletal Research ◽

10.1142/s0218957721500226 ◽

2021 ◽

pp. 2150022

Author(s):

Panos K. Megremis ◽

Orestis P. Megremis

Keyword(s):

Surgical Procedure ◽

Open Reduction ◽

Pelvic Osteotomy ◽

Femoral Osteotomy ◽

Salter Osteotomy ◽

Shortening Osteotomy ◽

Innominate Osteotomy ◽

Walking Age ◽

One Year

Hip’s open reduction combined with Salter innominate osteotomy and femoral osteotomy is the treatment of choice when treating Developmental Dislocation of the Hip (DDH) at walking age. We report a case of a five-year-old girl who underwent a failed surgical procedure of hip’s open reduction, Salter innominate osteotomy, and the femoral osteotomy. One year later, one-stage surgical procedure of hip’s open reduction, Dega pelvic osteotomy, and femoral de-rotation varus shortening osteotomy was performed. During the five-year follow-up, the clinical outcome was evaluated as excellent. The Dega pelvic osteotomy is an effective pelvic osteotomy for DDH, in a case of a failed Salter osteotomy.

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Efficacy of anterior cervical decompression and fusion procedures for monomelic amyotrophy treatment: a prospective randomized controlled trial

Journal of Neurosurgery Spine ◽

10.3171/2013.4.spine12575 ◽

2013 ◽

Vol 19 (4) ◽

pp. 412-419 ◽

Cited By ~ 19

Author(s):

Feizhou Lu ◽

Hongli Wang ◽

Jianyuan Jiang ◽

Wenjun Chen ◽

Xin Ma ◽

...

Keyword(s):

Bone Grafting ◽

Iliac Crest ◽

Plate Fixation ◽

Cervical Collar ◽

Therapeutic Effects ◽

Iliac Crest Bone Grafting ◽

Anterior Cervical Decompression ◽

Significant Difference ◽

Internal Plate Fixation

Object Monomelic amyotrophy (MMA) is a benign, self-limiting lower motor neuron disease. Optimal surgical strategies—discectomy decompression and fusion (DDF) or corpectomy decompression and fusion (CDF)—for patients with aggravated symptoms (within 6 months of presentation) are controversial, particularly in those who are ineligible for conventional treatment. These 2 methods of anterior cervical decompression and fusion for MMA in patients unwilling or unable to wear a conventional cervical collar long term were evaluated. Methods Anterior cervical decompression and fusion were performed in 48 male patients with MMA between September 2007 and September 2010. Patients were randomly treated with anterior cervical discectomy decompression with autologous iliac crest bone grafting and internal plate fixation (DDF group: 24 patients) or anterior cervical corpectomy, posterior longitudinal ligament resection, autologous iliac crest bone grafting, and internal plate fixation (CDF group: 24 patients). Subjective symptom assessments and electromyography (EMG) examinations were conducted both preoperatively and postoperatively. Results Subjective assessments and EMG studies (mean follow-up duration 25.9 months) indicated improvement in 64.6% and 60% of patients, respectively. No significant correlations between the effectiveness of surgery and age at symptom onset, preoperative symptom duration, or postoperative follow-up time were found. Conclusions The lack of a significant difference in effectiveness between DDF and CDF favors DDF as more clinically applicable because of its lower procedural risks. As a second-line alternative to cervical collar treatment, surgical anterior cervical decompression and fusion via DDF or CDF may prevent further deterioration and produce good short-term therapeutic effects in patients with MMA; however, cervical collar treatment is recommended for eligible patients because of its lower associated risks.

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Amebic abscess: Sonographic follow-up of persistent hepatic defects in two patients one year after successful treatment for amebiasis of the liver

Journal of Clinical Ultrasound ◽

10.1002/jcu.1870090809 ◽

1981 ◽

Vol 9 (8) ◽

pp. 451-452 ◽

Cited By ~ 8

Author(s):

Gretchen A. W. Gooding

Keyword(s):

Successful Treatment ◽

Amebic Abscess ◽

One Year

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The comparison of Nice knots and traditional methods as an auxiliary reduction-fixation technique in pre-contoured locking plate fixation for comminuted Robinson type 2B clavicle fracture: a retrospective study

10.21203/rs.3.rs-33348/v1 ◽

2020 ◽

Author(s):

Shengkun Hong ◽

Wei Wang ◽

Jinku Guo ◽

Feixiong He ◽

Cong Wang

Keyword(s):

Locking Plate ◽

Plate Fixation ◽

Clavicle Fracture ◽

Operation Time ◽

Locking Plate Fixation ◽

Traditional Methods ◽

Traditional Group ◽

Lag Screw ◽

Clavicle Fractures

Abstract Background: Open reduction and pre-contoured locking plate fixation is a popular treatment option for displaced midshaft clavicle fracture. Lag screw and cerclage are two main intraoperative techniques to reduce and fix fragments. However, both lag screw and metallic cerclage have disadvantages. The doubled-suture Nice knot has been reported in many areas of orthopedic surgery for its effectiveness. This study aims to compare the outcomes of comminuted mid-shaft clavicle fractures reduced by Nice knots versus traditional techniques (lag screw or/and metallic cerclage) when bridged with pre-contoured locking plates.Methods: We retrospectively reviewed 101 patients (65 females and 36 males) diagnosed with midshaft clavicle fractures with at least one wedge fragment reduced by either Nice knots or traditional methods and bridged with pre-contoured locking plates between December 2016 and April 2019. Operation time, functional outcomes, pain, patient satisfaction, fracture healing and complications were assessed at a follow-up of 12 to 40 months.Results: The mean age of all the patients was 50.8 years. There were 52 and 49 patients in Nice knot group and traditional group respectively, and no differences between two groups was found in general patient characteristics, fracture type, follow up and injury-to-surgery duration. The Nice knot group had significant less operation time (p < 0.01) than the traditional group (mean and standard deviation [SD], 78.6±19.0 compared with 94.4±29.9 minutes, respectively). For healing time, functional score, pain, satisfaction and complications, there was no significant differences between groups, despite the Nice knot group had slightly better results.Conclusions: Both Nice knots and traditional methods treated for comminuted Robinson type 2B clavicle fractures were effective and safe. And the Nice knots seemed to be superior with significant less operation time.

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Successful treatment of a patient with Turcot syndrome

Colorectal Oncology ◽

10.17650/2220-3478-2018-8-3-46-50 ◽

2018 ◽

Vol 8 (3) ◽

pp. 46-50

Author(s):

V. A. Aliev ◽

Z. Z. Mamedli ◽

A. I. Ovchinnikova ◽

O. A. Rakhimov ◽

L. N. Lyubchenko ◽

...

Keyword(s):

Successful Treatment ◽

Malignant Tumors ◽

Social Activity ◽

Previous Treatment ◽

Disease Stage ◽

Turcot Syndrome ◽

Accelerated Rehabilitation ◽

One Year ◽

Mechanical Anastomosis

We report a case of successful treatment of a 15-year-old female patient (body mass index 16) diagnosed with Turcot syndrome (familial adenomatous polyposis of the colon) combined with multiple primary malignant tumors, including anaplastic astrocytoma (received combination therapy in 2007), metachronous cecal cancer (underwent subtotal colectomy and 12 courses of polychemotherapy in 2016–2017), and metachronous stage III pT3N1M0 rectal cancer at 8 cm. The patient underwent laparoscopic low resection with extirpation of the ileosigmoid anastomosis, creation of a reservoir-rectal anastomosis, and preventive ileostomy. The patient had minimal intraoperative blood loss and uneventful postoperative period (with an accelerated rehabilitation protocol). She was discharged from a hospital on day 9. Considering previous treatment episodes and the disease stage, we also included into the treatment regimen adjuvant FOLFOX polychemotherapy in a reduced dose for 6 months. During one-year follow up, there was no evidence of disease progression. Later, the patient underwent ileostomy closure with forming a side-to-side mechanical anastomosis. The patient is fully rehabilitated in term of her social activity.

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Functional outcome after open reduction and internal fixation for traumatic diastasis of the pubic symphysis a one year follow-up study

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20163548 ◽

2016 ◽

Vol 2 (4) ◽

pp. 256

Author(s):

B. L. S. Kumar Babu ◽

Biju Ravindran

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

High Energy ◽

Walking Distance ◽

Early Weight Bearing ◽

Dual Plating ◽

Pubic Diastasis ◽

One Year

Background: Pubic diastasis often results in anteroposterior compression (APC) injuries based on Young and Burgess classification. It is caused due to high-energy trauma and of much clinical importance is given when coexists with urogenital and neurological complications with hemodynamic instability. Open reduction and internal fixation with plating facilitates early mobilisation with better results and is the preferable mode of stabilisation. We evaluated the clinical and functional outcome of such patients in a one-year follow-up period.Methods: In our study, we included 20 patients with APC II injuries who underwent an open reduction by single or dual plating technique by the Pfannenstiel approach, were followed for one year.Results: Among 20 patients, 14 patients (70%) were operated with single superior plating, six patients (30%) were performed with dual plating, i.e., both superior and anterior plating. Among 20 patients, two patients (10%) were operated for primary arthrodesis with double plating. Only one among 20 (5%) had implant failure due to early weight bearing and were re-operated with primary arthrodesis with plating. Results were analysed based on a scoring system which includes five criteria such as anterior pelvic pain, dyspareunia and sexual dysfunction, ability to sit, gait abnormalities and walking distance. Among 20 patients ten patients (50%) had excellent results, six patients (30%) had good results, two patients (10%) had fair results, two patients (10%) had poor results.Conclusions: Open reduction and internal fixation of traumatic pubic diastasis in type II APC injuries with single or dual plating had given better results and early functional recovery.

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Outcome of Closed Reduction of Developmental Dysplasia of Hip Before First Year of Age, A Retrospective Cohort Study, Saudi Arabia

10.21203/rs.3.rs-109277/v1 ◽

2020 ◽

Author(s):

Fahad AlShayhan ◽

Abdulmonem Alsiddiky ◽

Raghad Barri

Keyword(s):

Closed Reduction ◽

Open Reduction ◽

Medical Center ◽

Developmental Dysplasia ◽

First Year ◽

Developmental Dysplasia Of Hip ◽

Class 1 ◽

One Year ◽

Skin Traction

Abstract Background: Developmental dysplasia of hip (DDH) management is challenging hence there is no fixed rules or radiographic criteria to assess and manage DDH. There are many treating modalities including closed reduction, open reduction, skin traction, hip Spica and many others. This study is to assess the outcome of closed reduction in patients below 12 months of ages.Method: A retrospective study among patients with DDH who underwent closed reduction before the first year of age in a major referral medical center. The study included 100 patients and 168 hips. Average of follow up period was 5.97 years (±3.01). Couple of variables were measured in AP x ray of pelvis to assess the outcome of closed reduction. Results: Most of the hips were grade 1 and 2 according to the IHDI (International hip dysplasia institution) classification. Significant improvement in the acetabular index post closed reduction. In addition to the normalizing of CE angel's values. Also, majority of hips were severin's class 1 and 2 which were associated with good outcome.Conclusion: Safe closed reduction in patients with DDH below one year of age had a great outcome, less AVN, less growth complications and decrease the need of future open reduction.

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Treatment of midshaft clavicle fracture with anatomical contoured clavicular locking plate

Asian Journal of Medical Sciences ◽

10.3126/ajms.v10i1.21329 ◽

2018 ◽

Vol 10 (1) ◽

pp. 92-96

Author(s):

Pratyenta Raj Onta ◽

Krishna Sapkota ◽

Krishna Wahegaonkar ◽

Niraj Ranjeet ◽

Pabin Thapa ◽

...

Keyword(s):

Shoulder Joint ◽

Open Reduction ◽

Locking Plate ◽

Plate Osteosynthesis ◽

Plate Fixation ◽

Clavicle Fracture ◽

Shaft Fracture ◽

Free Movement ◽

Early Return ◽

The Mean

Background: Fracture clavicle is a common fracture around the shoulder joint accounting about 2.6% of all fracture and 44% in shoulder region. Mid shaft clavicle fracture accounts about 81% of total clavicle fracture. Open reduction and plate fixation is a good treatment method for displaced mid shaft clavicle fracture with benefit of early pain free movement of shoulder joint and early return to work. The anatomical contoured clavicular plate maintains mechanical strength and has less soft tissue complications. Aims and Objective: The aim of the study was to evaluate the clinical and radiological outcome, time for fracture union and complications in midshaft clavicle fracture managed with anatomical contoured clavicularlocking plate. Material and Methods: This study was done in Manipal Teaching Hospital, Pokhara, Nepal.There were a total of 30 patients (19 male and 11 female) who had displaced mid shaft fracture. All patients underwent plate osteosynthesis with anatomical contoured locking plate. The patients were followed up at 3 weeks, 6 weeks, 3 month and 6 months’ time. Results: There were 30 patients among whom; one patient had bilateral clavicle fracture. The mean age of the patient was 37.19 (11.96) years. The mean time for clinical and radiological union was 8.77 (1.17) weeks and 17.03 (3.06) weeks. All patients in our study had union of fracture with only one patient having superficial surgical site infection. Conclusion: Open reduction and plate fixation is a good option for displaced mid shaft clavicle fracture which help the patient for early pain-free movement of shoulder. Use of anatomical contoured clavicle plate provides fixation of clavicle to its normal contour and provides better fixation and stability.

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