scholarly journals Modified two-tension-band for patellar fractures

2019 ◽  
Vol 48 (4) ◽  
pp. 030006051989349
Author(s):  
Chong Zhang ◽  
Yong Zhao ◽  
Kai Deng
Keyword(s):  
Complication Rate ◽  
Early Mobilization ◽  
Tension Band ◽  
Bony Union ◽  
Complication Rates ◽  
Lower Complication ◽  
Band Group ◽  
Group 2 ◽  
Patellar Fractures ◽  
Group 1

Objective To compare a modified two-tension-band (MTTB) technique with the AO tension band in treating patellar fractures. Methods This retrospective study included patients treated with AO tension band (group 1) or MTTB (group 2). Data obtained during serial follow-up evaluations of time to bony union, range of motion (ROM), Hospital for Special Surgery (HSS) score and complication rates, were analysed. Results Fractures healed in all 51 patients included in the study (group 1, n = 28; group 2, n = 23), with no statistically significant between-group difference in time to bony union. Regarding function results, group 2 had better HSS scores at 3 and 6 months postoperatively; however, at 1 year postoperatively, both groups had similar HSS scores and achieved acceptable flexion and ROM. The overall complication rate was significantly lower in group 2, but average costs were higher in group 2 versus group 1. Conclusion MTTB provides secure fixation and improved knee function at 3 and 6 months postoperatively, and has a lower complication rate with early mobilization, compared with the AO tension-band technique.

scholarly journals Fixation of Ankle Fractures

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0008
Author(s):  
Andrew Molloy ◽  
Samantha Whitehouse ◽  
Lyndon Mason
Keyword(s):  
Complication Rate ◽  
Major Complication ◽  
Ankle Fractures ◽  
Complication Rates ◽  
Junior Staff ◽  
System Changes ◽  
Major Complication Rate ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Category: Trauma Introduction/Purpose: Ankle fractures are one of the most common fractures. Historically these have been frequently treated by non-specialists and junior staff. In 2011 we presented high malunion rates, which have been mirrored in other departments work. We present the results of system changes to improve the results of ankle fracture fixation Methods: Image intensifier films were reviewed on PACS and scored based on the criteria published by Pettrone et al. At least two blinded assessors assigned scores independently. Patients clinical data was collected from medical records. In 2011 we presented the results of fixation in 94 consecutive patients (Group 1) from 2009. Following this there was period of education in the department to allow change. 68 patients (Group 2) were then reviewed from a 7 month period in 2014 Multiple system changes were introduced in the department including; new treatment algorithms, dedicated foot and ankle trauma lists and clinics, and next day review of all intra-operative radiographs by independent attending. Prospective data was collected on 205 consecutive cases (Group 3) from 01/01/15 – 09/30/16 Results: Patients in group 1 had a malreduction rate of 33%. The major complication rate in this group was 8.5% (8 patients); with only one of these occurred in a correctly reduced fracture. These complications included 4 revision fixations, 2 deep infections and 1 amputation. Following the period of re-education, in Group 2, the mal-reduction rate deteriorated to 43.8%. In this group the major complication rate was 10.9%; including 6 revision fixations and 1 ankle fusion. In Group 3, following overall system changes, the malreduction rate was 2.4%. This result is statistically significant. The major complication rate fell to 0.98%; 1deep infection and 1 amputation (in a polytrauma patient with vascular injury). This result is again statistically significant. Conclusion: Our initial results show that very poor results are a consequence when sufficient attention is not given to what are frequently considered to be ‘simple’ fractures. In group 2 we demonstrated that soft educational changes (eg presentations, emails) are ineffective in improving results. We have demonstrated that hard (institutional system) changes in our department provided statistically significant improvements. These changes allowed the correct surgeon for the fracture in both determining the treatment plan and operating. With these changes, malreduction rates fell from 43.8% to 2.4% and major complication rates from 10.9% to 0.98%

COMPARISON OF FUNCTIONAL OUTCOME OF MODIFIED TBW VERSUS MODIFIED TBW AUGMENTED WITH CIRCUMFERENTIAL CERCLAGE WIRING IN TRANSVERSE FRACTURE OF PATELLA

2021 ◽  
pp. 47-48
Author(s):  
Satendra Kumar Sinha ◽  
Angwsa Hazowary
Keyword(s):  
Deep Infection ◽  
Tension Band ◽  
Tension Band Wiring ◽  
P Value ◽  
Complication Rates ◽  
Transverse Fracture ◽  
Group 2 ◽  
Displaced Fracture ◽  
Group 1

Background: The most common fracture of patella is transverse fracture of body. The gold standard treatment for displaced fracture is by tension band wiring (TBW) technique, augmentation with circumferential cerclage ss wiring has been suggested to improve the strength of the xation. Methods: The study was conducted at Nalanda Medical College, Patna during the period 2018-2020, by treating 28 patients. Group 1 (n=15) treated with modied tension band wiring (TBW) alone while as Group 2 (n=13) treated by modied TBW along with augmented circumferential cerclage ss wiring. Outcome was studied, graded and compared using the Modied Bostman Scale, union rates, and complication rates. Results: The results at nal follow up in group 1 were excellent in 10( 66.67%), good in 4(27.67%) and unsatisfactory in 1(6.67%). In group 2 the results were excellent in 8(61.54%), good in 5(38.46%) and no unsatisfactory results. Both groups have similar outcomes based on the scoring system used. The results were tested using t test and found to be different but not statistically signicant( p value- 0.469). In group one, 1(6.67%) developed deep infection and 1(6.67%) developed supercial infection. In group 2 2(15.38%) developed supercial infection, however these results are not statistically signicant (p value-0.432). Hardware irritation was seen in 3(20%) of group 1 and 3(23.07%) of group 2(p value>.05). 2(13.33%) of group 1 had implant removal during the course of follow up where as 2(15.38) in group 2 had hardware removal done. Conclusions: Modied tensioned band wiring for displaced transverse fracture of patella is an inexpensive and excellent method of treatment and the use of circumferential cerclage ss wiring along with tension band wiring for displaced transverse fractures of patella seems to have no added advantage over xation with tension band wiring alone.

scholarly journals Comparison of penile prosthesis types' complications: A retrospective analysis of single center

2020 ◽  
Vol 92 (4) ◽  
Author(s):  
Erdem Kisa ◽  
Mehmet Zeynel Keskin ◽  
Cem Yucel ◽  
Murat Ucar ◽  
Okan Yalbuzdag ◽  
...  
Keyword(s):  
Postoperative Complication ◽  
Penile Prosthesis ◽  
Diabetes Type 2 ◽  
Pelvic Surgery ◽  
Complication Rates ◽  
Initial Surgery ◽  
Significant Difference ◽  
Lower Complication ◽  
Group 2 ◽  
Group 1

Objectives: The aim of this study was to compare clinical outcomes and complication rates associated with semirigid (malleable) and inflatable penile prostheses (PPs) and investigate the factors that influence these complications. Material and methods: The records of 131 patients who had undergone penile prosthesis implantation (PPI) in our clinic due to erectile dysfunction (ED) between January 2010 and March 2019 were retrospectively reviewed. The initial surgery included 116 primary implants and 15 men had two revision operations. Patients were assigned to two groups as semirigid (malleable) PPI (group 1) and inflatable PPI (group 2) patients, and obtained data were compared across these two groups. Results: Group 1 included 93 patients, while Group 2 included 38 patients. Postoperative complication rates of Group 1 were 8.6% (n = 8), and Group 2 were 21% (n = 8), and the comparison of postoperative complication rates revealed a statistically significant difference between the two groups (p = 0.025). The majority of these complications (50%) was constituted by mechanical failure associated with inflatable PPs. When patients were further segregated as those with and without diabetes type 2 (DM) and those who had and had not undergone radical pelvic surgery (RPS), the comparison of complication rates across these subgroups did not yield any significant difference. Conclusions: We determined in this study that semirigid (malleable) PPs were associated with lower complication rates compared to the inflatable group, particularly with regard to mechanic failure, and that DM and history of RPS did not make a difference in complication rates in patients planned to undergo PPI.

Complications Related to Implant Fixation of Patellar Fractures: Comparison of Ring Pins versus Bent K-Wires

2016 ◽  
Vol 30 (06) ◽  
pp. 560-564 ◽  
Author(s):  
Min Kyung ◽  
Seung Lee ◽  
Min Kim
Keyword(s):  
Tension Band ◽  
Implant Removal ◽  
Tension Band Wiring ◽  
The Novel ◽  
Implant Migration ◽  
Group 2 ◽  
K Wires ◽  
Patellar Fractures ◽  
Ring Pin ◽  
Group 1

AbstractPatellar fractures are characterized by injuries to the extensor and typically require surgical fixation. Among the methods used for fixation, the most common is the modified AO tension-band wiring technique. However, using this technique, implant migration occurs due to the lack of connections between the K-wires and the tension-band wire, which causes irritation and reduces fracture stability. Recently, new methods for tension-band wiring have been developed in which tension bands lock the K-wires through an attached “ring” to prevent migration. The purpose of this study was to compare the clinical outcomes when either the conventional or novel technique was used for tension-band wiring. This was a retrospective study involving 48 patients who underwent tension-band wiring to correct a patellar fracture. Patients in group 1 (n = 23) were treated between December 2010 and February 2012 using conventional tension-band wiring, while patients in group 2 (n = 25) were treated between March 2012 and May 2014 using the novel ring pin method. Different surgeons performed the operations in the two groups, while all other conditions were consistent. The surgical outcomes were assessed according to the level of implant migration, irritation, and implant removal procedures. All patients in group 2 achieved a union of the patella, while two patients in group 1 did not. These two patients underwent partial patellectomy within 1 year of the initial surgery. Implant migration and removal were significantly more common among patients in group 1 (p = 0.0038 and 0.011, respectively), with the implant removal period being significantly shorter as well (p = 0.005). The novel ring pin method was superior to the conventional method in terms of preventing implant migration, removal, or other secondary operations for the correction of complications.

scholarly journals Outcome of Transverse Patella Fractures Fixed With Cannulated Screws and Stainless Steel Tension Band Wiring

2021 ◽  
Author(s):  
Haytham Abdel-Moneim Abdel-Moneim ◽  
Mohammed Ahmed Moussa
Keyword(s):  
Stainless Steel ◽  
Fracture Healing ◽  
Skin Irritation ◽  
Early Mobilization ◽  
Healing Time ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Complication Rates ◽  
Cannulated Screws ◽  
Patellar Fractures

Abstract Background: Tension band supplemented by K-wires has long been the definitive technique for patellar fractures fixation. However, it is not without drawbacks. The stainless streel cable-cannulated screw tension band technique, may shorten healing time, decrease the complications and provide early range of knee motion. Herein, the current study evaluates the clinical and radiological outcome of this surgical modality. Methods: This prospective study was conducted on 21 patients (13 males and 8 females) with transverse fracture patella from June 2017 to April 2021. The surgical fixation consisted of two 4.0-mm parallel partially threaded cannulated cancellous screws with a figure-of-eight stainless steel tension band wiring. Follow-up was at least 10 months. Assessment criteria included the Lysholm score for knee function, ROM, VAS for pain, fracture reduction, fracture healing time, and complication rates. After 3 postoperative weeks, slab was removed and immediate rehabilitation were commenced.Results: The average Lysholm scores were 82.9 ± 4.4 SD, 87.8 ± 5.3 SD, and 92.7 ± 3.6 SD after 3, 6, and 10 months, respectively. VAS scores for pain were 2.6 ± 3.0 SD, 1.4 ± 2.6 SD, and 0.5 ± 2.3 SD at 3, 6 and 10-month, respectively. The patients had gained total ROM after 3, 6 and 10 months. The mean fracture healing time was 2.1 months (range, 1.5 - 3.1 months). Two patients experienced skin irritation by wire tails.Conclusion: The stainless steel cannulated screws and tension band construct provides a good alternative in treatment of transverse patellar fractures. It could yield stable fixation, low complication rate while providing early mobilization and accelerated rehabilitation.

scholarly journals Age-Independent Clinical Outcome in Proximal Humeral Fractures: 2-Year Results Using the Example of a Precontoured Locking Plate

2022 ◽  
Vol 11 (2) ◽  
pp. 408
Author(s):  
Rony-Orijit Dey Hazra ◽  
Johanna Illner ◽  
Karol Szewczyk ◽  
Mara Warnhoff ◽  
Alexander Ellwein ◽  
...  
Keyword(s):  
Treatment Strategy ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Fracture Reduction ◽  
Complication Rates ◽  
Locking Plate Osteosynthesis ◽  
Group 2 ◽  
Group 1

Introduction: The optimal treatment strategy for the proximal humeral fracture (PHF) remains controversial. The debate is centered around the correct treatment strategy in the elderly patient population. The present study investigated whether age predicts the functional outcome of locking plate osteosynthesis for this fracture entity. Methods: A consecutive series of patients with surgically treated displaced PHF between 01/2017 and 01/2018 was retrospectively analyzed. Patients were treated by locking plate osteosynthesis. The cohort was divided into two groups: Group 1 (≥65 years) and Group 2 (<65 years). At the follow-up examination, the SSV, CMS, ASES, and Oxford Shoulder Score (OS), as well as a radiological follow-up, was obtained. The quality of fracture reduction is evaluated according to Schnetzke et al. Results: Of the 95 patients, 79 were followed up (83.1%). Group 1 consists of 42 patients (age range: 65–89 years, FU: 25 months) and Group 2 of 37 patients (28–64 years, FU: 24 months). The clinical results showed no significant differences between both groups: SSV 73.4 ± 23.4% (Group 1) vs. 80.5 ± 189% (Group 2). CMS: 79.4 ± 21 vs. 81.9 ± 16, ASES: 77.2 ± 20.4 vs. 77.5 ± 23.1, OS: 39.5 ± 9.1 vs. 40.8 ± 8.2; OS: 39.5 ± 9.1 vs. 40.8 ± 8.2. In the radiological follow-up, fractures healed in all cases. Furthermore, the quality of fracture reduction in both groups is comparable without significant differences. The revision rate was 9.5% in Group 1 vs. 16.2% in Group 2. Discussion: Both age groups show comparable functional outcomes and complication rates. Thus, the locking plate osteosynthesis can be used irrespective of patient age; the treatment decision should instead be based on fracture morphology and individual patient factors.

Thromboembolic Complications of Elective Coil Embolization of Unruptured Aneurysms

Neurosurgery ◽  
2010 ◽  
Vol 67 (3) ◽  
pp. 743-748 ◽  
Author(s):  
Gyojun Hwang ◽  
Chulkyu Jung ◽  
Sukh Que Park ◽  
Hyun Sung Kang ◽  
Sang Hyung Lee ◽  
...  
Keyword(s):  
Complication Rate ◽  
Coil Embolization ◽  
Single Agent ◽  
Thromboembolic Complication ◽  
Thromboembolic Complications ◽  
Unruptured Aneurysms ◽  
Complication Risk ◽  
Group 2 ◽  
Risk Of Hemorrhage ◽  
Group 1

Abstract OBJECTIVE We retrospectively evaluated whether antiplatelet preparation lowered the thromboembolic complication rate during the perioperative period. METHODS We reviewed 328 elective coil embolization procedures in which only microcatheters were used for coiling. No antiplatelet medication was prescribed before the procedure in 95 cases (29%, group 1), whereas antiplatelet therapy was used in 233 cases (71%, group 2; 61 [18.6%] with a single agent [aspirin or clopidogrel] and 172 [52.4%] with both agents). Antiplatelet agents were not given after coiling unless atherosclerosis, severe coil protrusion, or a thromboembolic complication occurred during the procedure. A thromboembolic complication was defined as a procedural thromboembolic event or transient ischemic attack or stroke occurring within 2 days of embolization. RESULTS Thromboembolic complications occurred in 11 cases (3.4%): 6 (6.3%) in group 1 and 5 (2.1%) in group 2 (P = .085). In 195 cases (59.5%) treated by the single microcatheter technique, the risk of thromboembolic complications was low and not affected by antiplatelet preparation (1.8% [no preparation] vs 2.2% [preparation]; P = 1.000). However, in 133 cases (40.5%) treated by the multiple microcatheter technique, antiplatelet preparation significantly reduced the thromboembolic complication risk by 85.2% (12.8% [no preparation] vs 2.1% [preparation]; odds ratio, 0.148; 95% confidence interval, 0.027–0.798; P = .023). The aneurysms treated by the multiple microcatheter technique had more complex configurations for coiling (P &lt; .001). The risk of hemorrhage was not increased by antiplatelet preparation (P = .171). CONCLUSION Antiplatelet preparation lowered the periprocedural thromboembolic complication rate in unruptured aneurysms treated by the multiple microcatheter technique and did not increase the risk of hemorrhage. Therefore, antiplatelet preparation can help to reduce complications in patients in whom technical difficulties are expected without the risk of hemorrhage.

Does the sequential addition of accelerometer-based navigation and sensor-guided ligament balancing improve outcomes in TKA?

2020 ◽  
Vol 102-B (6_Supple_A) ◽  
pp. 24-30
Author(s):  
Andrew T. Livermore ◽  
Jill A. Erickson ◽  
Brenna Blackburn ◽  
Christopher L. Peters
Keyword(s):  
Patient Reported Outcomes ◽  
Control Group ◽  
Complication Rates ◽  
Ligament Balancing ◽  
Patient Reported ◽  
Distal Femoral Resection ◽  
Sequential Addition ◽  
Group 2 ◽  
Femoral Resection ◽  
Group 1

Aims A significant percentage of patients remain dissatisfied after total knee arthroplasty (TKA). The aim of this study was to determine whether the sequential addition of accelerometer-based navigation for femoral component preparation and sensor-guided ligament balancing improved complication rates, radiological alignment, or patient-reported outcomes (PROMs) compared with a historical control group using conventional instrumentation. Methods This retrospective cohort study included 371 TKAs performed by a single surgeon sequentially. A historical control group, with the use of intramedullary guides for distal femoral resection and surgeon-guided ligament balancing, was compared with a group using accelerometer-based navigation for distal femoral resection and surgeon-guided balancing (group 1), and one using navigated femoral resection and sensor-guided balancing (group 2). Primary outcome measures were Patient-Reported Outcomes Measurement Information System (PROMIS) and Knee injury and Osteoarthritis Outcome (KOOS) scores measured preoperatively and at six weeks and 12 months postoperatively. The position of the components and the mechanical axis of the limb were measured postoperatively. The postoperative range of motion (ROM), haematocrit change, and complications were also recorded. Results There were 194 patients in the control group, 103 in group 1, and 74 in group 2. There were no significant differences in baseline demographics between the groups. Patients in group 2 had significantly higher baseline mental health subscores than control and group 1 patients (53.2 vs 50.2 vs 50.2, p = 0.041). There were no significant differences in any PROMs at six weeks or 12 months postoperatively (p > 0.05). There was no difference in the rate of manipulation under anaesthesia (MUA), complication rates, postoperative ROM, or blood loss. There were fewer mechanical axis outliers in groups 1 and 2 (25.2%, 14.9% respectively) versus control (28.4%), but this was not statistically significant (p = 0.10). Conclusion The sequential addition of navigation of the distal femoral cut and sensor-guided ligament balancing did not improve short-term PROMs, radiological outcomes, or complication rates compared with conventional techniques. The costs of these added technologies may not be justified. Cite this article: Bone Joint J 2020;102-B(6 Supple A):24–30.

Perioperative Outcomes and Quality of Life after Repair of Recurrent Hiatal Hernia are Compromised Compared with Primary Repair

2019 ◽  
Vol 85 (5) ◽  
pp. 556-560 ◽  
Author(s):  
Andrew M. Brown ◽  
Ramzy Nagle ◽  
Michael J. Pucci ◽  
Karen Chojnacki ◽  
Ernest L. Rosato ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Recurrent Hernia ◽  
Perioperative Outcomes ◽  
Complication Rates ◽  
Conversion Rates ◽  
Quality Of Life Index ◽  
Group 2 ◽  
Gastrointestinal Quality Of Life ◽  
Group 1

Paraesophageal hernia repair (PEHR) is burdened by high recurrence rates that frequently lead to redo PEHR. Revisional surgery, because of higher complexity, higher risk of injury, and the intrinsic risk of recurrence, has increased likelihood of higher complication rates and decreased quality of life (QOL) postoperatively. We aimed to compare perioperative outcomes and QOL after revisional and primary PEHR. A retrospective review of all patients who underwent PEHR for a recurrent hernia between January 2011 and July 2016 was completed. These were matched with a contemporary cohort of patients who underwent primary PEHR by age, gender, and BMI. Perioperative measures were compared. The patients were invited to complete the Gastrointestinal Quality of Life Index (GIQLI) to assess response to surgical intervention. There were 24 patients (group 1) who underwent revisional PEHR, and they were matched to 48 patients (group 2) who had a primary hernia repair. Thirteen patients in group 1 responded to the survey (54%), whereas 21 patients’ responses were received from group 2 (44%). Conversion rates, LOS, and mean Gastrointestinal Quality of Life Index scores were significantly different between the two groups. Reoperative procedures for paraesophageal and hiatal hernias are burdened by higher conversion rates and length of stay, with similar overall complication rates. Patients who are undergoing repair of a recurrent hernia should be preoperatively counseled, and should have realistic expectations of their GI QOL after surgery.

scholarly journals The effects of previous open renal stone surgery types on PNL outcomes

2016 ◽  
Vol 10 (7-8) ◽  
pp. 246 ◽  
Author(s):  
Faruk Ozgor ◽  
Onur Kucuktopcu ◽  
Burak Ucpinar ◽  
Omer Sarilar ◽  
Akif Erbin ◽  
...  
Keyword(s):  
Renal Stone ◽  
Complication Rates ◽  
Success Rates ◽  
Anesthetic Agents ◽  
History Of ◽  
Renal Stone Surgery ◽  
Retrospective Nature ◽  
Group 2 ◽  
Free Status ◽  
Group 1

<p><strong>Introduction:</strong> Our aim was to demonstrate the effect of insicion of renal parenchyma during open renal stone surgery (ORSS) on percutaneous nephrolithotomy (PNL) outcomes.</p><p><strong>Methods:</strong> Patients with history of ORSS who underwent PNL operation between June 2005 and June 2015 were analyzed retrospectively. Patients were divided into two groups according to their type of previous ORSS. Patients who had a history of ORSS with parenchymal insicion, such as radial nephrotomies, anatrophic nephrolithotomy, lower pole resection, and partial nephrectomy, were included in Group 1. Other patients with a history of open pyelolithotomy were enrolled in Group 2. Preoperative characteristics, perioperative data, stone-free status, and complications were compared between the groups. Stone-free status was defined as complete clearance of stone(s) or presence of residual fragments smaller than 4 mm. The retrospective nature of our study, different experience level of surgeons, and lack of the evaluation of anesthetic agents and cost of procedures were limitations of our study.</p><p><strong>Results:</strong> 123 and 111 patients were enrolled in Groups 1 and 2, respectively. Preoperative characteristics were similar between groups. In Group 1, the mean operative time was statistically longer than in Group 2 (p=0.013). Stone-free status was significantly higher in Group 2 than in Group 1 (p=0.027). Complication rates were similar between groups. Hemorrhage requiring blood transfusion was the most common complication in both groups (10.5% vs. 9.9%).</p><p><strong>Conclusions:</strong> Our study demonstrated that a history of previous ORSS with parenchymal insicion significantly reduces the success rates of PNL procedure.</p>

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