scholarly journals Clinical study of intramedullary nailing fixation for the treatment of Danis-Weber B in lateral malleolus fracture

2021 ◽  
Vol 49 (10) ◽  
pp. 030006052110473
Author(s):  
Hongfeng Chen ◽  
Zhen Li ◽  
Dongsong Yang ◽  
Pengru Wang ◽  
Junke Niu ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Functional Outcomes ◽  
Locking Plate ◽  
Operation Time ◽  
Healing Time ◽  
Lateral Malleolus ◽  
Intraoperative Blood Loss ◽  
Intramedullary Nails ◽  
Plate Group ◽  
Reduction Effect

Objective To compare the clinical effects between anatomical locking plates and interlocking intramedullary nails in patients with Danis-Weber B lateral malleolus fractures. Methods This retrospective study enrolled patients with Danis-Weber B fractures of the lateral malleolus. All the operations were completed by the same group of surgeons. The reduction effect, operation time, intraoperative blood loss, hospital stay, fracture healing time and ankle functional outcomes (Olerud-Molander Ankle Score [OMAS]) were compared. Postoperative complications, including incision infections, fixation discomfort and internal fixation loosening, were also compared. Results This study enrolled 73 patients that were treated with either an anatomical locking plate (locking plate group; n = 37) or an interlocking intramedullary nail (intramedullary nail group; n = 36). There was no significant difference between the two groups in terms of reduction effect, hospital stay and OMAS. The intramedullary nail group had significantly lower operation time, intraoperative blood loss and fracture healing time compared with the locking plate group. Postoperative complications in the intramedullary nail group were significantly lower compared with the locking plate group. Conclusion Using intramedullary nails resulted in more satisfactory functional outcomes compared with using locking plates in patients with Danis-Weber B fractures of the lateral malleolus.

scholarly journals Intramedullary nail versus locking plate for treatment of proximal humeral fractures: A meta-analysis based on 1384 individuals

2018 ◽  
Vol 46 (11) ◽  
pp. 4363-4376 ◽  
Author(s):  
Ming Li ◽  
Yanhua Wang ◽  
Yupeng Zhang ◽  
Ming Yang ◽  
Peixun Zhang ◽  
...  
Keyword(s):  
Intramedullary Nail ◽  
Locking Plate ◽  
Meta Analysis ◽  
Operation Time ◽  
Healing Time ◽  
Locking Plates ◽  
Intramedullary Nails ◽  
Incision Length ◽  
Operative Complications ◽  
Evidence Quality

Objective The optimal surgical intervention on the treatment for proximal humeral fractures (PHFs) remains uncertain. The aim of this study was to evaluate clinical outcomes following fixation of PHFs by intramedullary nails or locking plates Methods The Cochrane Library, PubMed, EMBASE, China Knowledge Resource Integrated (CNKI), Chongqing VIP and Wanfang databases were systematically searched for studies published between January 01, 1996 and December 31, 2016 that investigated intramedullary nail vs. locking plate in the surgical treatment of PHFs. A meta-analysis examined incision length, blood loss, operation time, fracture healing time, Constant scores and post-operative complications. The methodological and evidence quality were also assessed by MINORS and GRADE system. Results From the original 1024 references, 20 studies involving 1384 patients met the eligibility criteria. Analyses showed that intramedullary nails were superior to locking plates in incision length, peri-operative bleeding time, operation time and fracture healing time. However, there were no differences between treatments in Constant score or post-operative complications. Conclusion Although the evidence quality was poor, the results suggest that compared with locking plates, intramedullary nails may be a better choice for the repair of PHFs.

scholarly journals Study on the Effect of Removing the Slide Wire Screw on Locking Plate by Nail Groove Reconstruction Method

2021 ◽  
Author(s):  
Guanglei Zheng ◽  
Yingjie Qi
Keyword(s):  
Blood Loss ◽  
Locking Plate ◽  
Operation Time ◽  
Healing Time ◽  
Control Group ◽  
Reconstruction Method ◽  
Intraoperative Blood Loss ◽  
Limb Function ◽  
Experimental Group ◽  
Tungsten Steel

Abstract Background: This paper is to describe and evaluate the nail groove reconstruction method in removing slide wire screw on locking plate. Then compare the method with tungsten steel drilling nail method, to explore a new method of removing slide wire screw on locking plate.Method: A total of 1254 patients with removal fracture internal fixation devices were collected from the Affiliated Hospital of Hangzhou Normal University from July 2015 to September 2021, of which 62 cases met the inclusion and exclusion criteria. All patients were randomly divided into the experimental group and the control group. 31 people per group. There were 19 males and 12 females in the experimental group, the age of patients was 35.68±11.70years; while 18 males and 13 females in the control group, the age of patients was 36.27±10.37years. Nail groove reconstruction method was used in the experimental group, and the tungsten steel drilling nail method was used in the control group. Collect and count surgical-related indicators, the data of two groups were compared and analyzed from four aspects: intraoperative blood loss, operation time, incision healing time and limb function recovery time.Result: All slide wire screws were removed successfully, and all patients had no serious postoperative complications such as internal fixation retention and neurovascular injury. The experimental group was better than the control group in the following three aspects: the amount of intraoperative blood loss, the operative time, the recovery time of limb function, and the differences were statistically significant(p < 0.05). There was no significant difference in incision healing time between the two groups.Conclusion: The nail groove reconstruction method has less damage to the bone and soft tissue, less intraoperative blood loss, shorter operation time, and faster postoperative recovery of limb function. The nail groove reconstruction method is a simple and effective method, it has obvious advantages compared with the traditional method.

scholarly journals Analysis of the Effect of Dynamic Hip Screw and Anatomical Locking Plate

2015 ◽  
Vol 4 (4) ◽  
pp. 11
Author(s):  
Rong Ren ◽  
Ying Ren ◽  
Junhua Ji
Keyword(s):  
Locking Plate ◽  
Operation Time ◽  
The Elderly ◽  
Healing Time ◽  
Dynamic Hip Screw ◽  
Intertrochanteric Fractures ◽  
Successful Operation ◽  
Postoperative Drainage ◽  
Hip Screw ◽  
Intertrochanteric Femur Fracture

<p><strong>Objective: </strong>To analyze the effects of dynamic hip screw (DHS) and anatomical locking plate in the treatment of intertrochanteric fractures in elderly patients. <strong>Method: </strong>56 cases of intertrochanteric femur fracture from March 2009 to October 2011 were treated by surgical treatment. The cases were divided into A and B groups with A group treated with DHS and B group with anatomical locking plates. <strong>Results</strong><strong>: </strong>Treatments of the two groups were successful. Operation time, bleeding volume, postoperative drainage, hospitalization time and fracture healing time of B group were significantly less than that of A group (<em>p</em> &lt; 0.05). The incidence of postoperative complications in B group was significantly less than that in the A group (<em>p</em> &lt; 0.05). The excellent and good ratings of B group was 93.1% and 66.7% for the A group. The fine rating of B group was higher than that of A group (<em>p</em> &lt; 0.05). <strong>Conclusion: </strong>Anatomical locking plate internal fixation for the treatment of intertrochanteric fractures in the elderly has certain advantages.</p>

scholarly journals Comparison of Functional Outcomes of Tibial Plateau Fractures Treated with Nonlocking and Locking Plate Fixations: A Nonrandomized Clinical Trial

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Mohammad Ali Tahririan ◽  
Seyyed Hamid Mousavitadi ◽  
Mohsen Derakhshan
Keyword(s):  
Functional Outcomes ◽  
Tibial Plateau ◽  
Locking Plate ◽  
Plate Fixation ◽  
Tibial Plateau Fractures ◽  
Plate Method ◽  
Plate Group ◽  
Plateau Fracture ◽  
The Mean

Fixation of tibial plateau fractures with plate has been widely used. This prospective study was planned to compare locking plate fixation of tibial plateau fracture with nonlocking methods in terms of their functional outcomes. The subjects of the study were selected from consecutive patients suffering from tibial plateau fractures referred to Kashani Hospital in Isfahan, Iran, between 2012 and 2013 and were candidate for surgery. The final included patients were assigned to two groups, those who were treated with locking plate (n=20) and those who were treated with nonlocking plates (N=21). The mean duration of follow-up was 13.4 months (ranging between 10 and 17 months). The mean of knee scores was significantly higher in locking plate group than in nonlocking plate group at the follow-up time (80.20±10.21 versus 72.52±14.75, P=0.039). Also, the mean VAS pain severity score was significantly lower in locking plate group compared with nonlocking plate group (4.45±2.50 versus 6.00±2.59, P=0.046). This study confirmed superiority of the locking plate method over nonlocking plate method with regard to knee score as well as VAS pain score.

scholarly journals Treatment of distal clavicle fracture of Neer type II with locking plate in combination with titanium cable under the guide

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jun Wang ◽  
Jie Guan ◽  
Minbo Liu ◽  
Yongfeng Cui ◽  
Yuhang Zhang
Keyword(s):  
Locking Plate ◽  
Clavicle Fracture ◽  
Operation Time ◽  
Hook Plate ◽  
Type Ii ◽  
Distal Clavicle ◽  
Distal Clavicle Fracture ◽  
Plate Group ◽  
Clavicle Fractures ◽  
Distal Clavicle Fractures

AbstractTo observe and compare the curative effect of a locking plate plus titanium cable under the Guide device and clavicular hook plate in the treatment of Neer type II distal clavicle fractures. A prospective cohort study was conducted to analyse the clinical data of 36 patients with distal clavicle fractures from January 2016 to January 2019. The results were analysed. According to the random number method, the patients were divided into two groups: the titanium cable group (fixed with a titanium cable in combination with a locking plate) and hook plate group (fixed with a clavicular hook plate only). Under the guidance of a special device (for which a patent was obtained), in the titanium cable group, the coracoclavicular ligament was fixed with tension reduction, and then the distal clavicular fracture was fixed with a locking plate. In the hook plate group, the distal clavicle fracture was fixed with a hook plate. The incision length, operation time, bleeding volume and VAS score before, 1 week after and 1 year after the operation were compared between the two groups. The effect of the operation was evaluated by the Constant-Murley score before and 1 year after the operation. X-ray films were taken 2 days, 3 months, half a year and 1 year after the operation to observe the reduction and healing of fractures. At the same time, complications were recorded. The amount of bleeding was the same in the two groups. The operation time in the hook plate group was relatively short, and the difference was statistically significant (P < 0.05). The VAS score in the titanium cable group was significantly lower than that in the hook plate group one year after the operation. The Constant-Murley score in the titanium cable group and hook plate group was significantly higher 1 year after the operation. The number of postoperative complications in the titanium cable group was significantly lower than that in the hook plate group. The treatment of Neer type II distal clavicle fractures with a titanium cable plus a locking plate has a good curative effect, few complications and good postoperative recovery and thus is worth popularizing.

scholarly journals Surgical Strategy and Clinical Efficacy Analysis of Adjacent Segment Disease After Anterior Cervical Discectomy and Fusion

2020 ◽  
Author(s):  
Yangyang Chen ◽  
Guofu Pi ◽  
Yu Han ◽  
Jianguang Sun ◽  
Shilei Huang ◽  
...  
Keyword(s):  
Clinical Efficacy ◽  
Operation Time ◽  
Adjacent Segment ◽  
Intraoperative Blood Loss ◽  
Titanium Plate ◽  
Intervertebral Fusion ◽  
Plate Group ◽  
Significant Difference

Abstract Background: There are relatively few studies on the treatment of symptomatic adjacent segment disease(ASD) after anterior cervical discectomy and fusion(ACDF). The purpose of this study to compare the clinical efficacy of zero-profile(zero-p) intervertebral fusion and titanium plate combined with cage fusion for treating ASD after ACDF. Methods: Retrospective analysis was performed on patients who underwent ACDF and readmission due to concurrent symptomatic ASD from October 2014 to June 2019. Among them, 12 cases underwent anterior cervical decompression with zero-p intervertebral fusion (zero-p group), and 14 cases underwent anterior cervical decompression with titanium plate combined with cage fusion (titanium plate group). Operative time, intraoperative blood loss, postoperative Japanese 0rthopaedic Association (JOA) score, visual analogue scale (VAS) scores, neck disability index (NDI), dysphagia Bazaz grade, bone graft fusion Eck grade, C2-C7 Cobb Angle, and related complications were compared between the two groups. Results: The intraoperative blood loss difference between the two groups was not statistically significant (P>0.05). The operation time of the zero-p group was shorter than that of the titanium plate group, with significant differences(P<0.05). The Bazaz classification of dysphagia in the zero-p group was superior to the titanium plate group 1 month after the operation, and the difference was statistically significant (P<0.05); However, there was no statistically significant difference between the two groups in the Bazaz classification of dysphagia and the bone graft fusion Eck grade at the last follow-up (P>0.05). At the last follow-up, the JOA score, VAS score, NDI index, C2-C7 Cobb Angle were significantly different between the zero-P group and the titanium plate group (P<0.05). However, no significant difference was found between the two groups (P>0.05). During the follow-up period, all the patients did not have a rupture of the settler screw and esophageal injury and other related diseases.Conclusions: Both methods can achieve good clinical efficacy in the treatment of symptomatic ASD, and can restore and maintain the physiological curvature of the cervical spine to a certain extent. However, the advantages of zero-p intervertebral fusion including shorter operation time, reducing soft tissue injury, and less postoperative dysphagia.

scholarly journals Intramedullary Nailing Combined With Adjunct Plate or Blocking Screw for Proximal Tibial Fractures

2020 ◽  
Author(s):  
Jie Li ◽  
Qian Wang ◽  
Yao Lu ◽  
Zhong Li ◽  
Kun Zhang
Keyword(s):  
Intramedullary Nail ◽  
Weight Bearing ◽  
Operation Time ◽  
Tibial Fractures ◽  
Plate Versus ◽  
Full Weight Bearing ◽  
Plate Group ◽  
Proximal Tibial Fractures ◽  
Screw Group

Abstract Objective: To compare the traditional approach of intramedullary nail with an extra plate versus the nail combined with blocking screws for proximal tibia fractures without the knee involved.Methods: From January 2013 to January 2017, a total of 36 patients who suffered from proximal tibial fractures unaffecting the knee were enrolled into this prospective study, and divided into two groups by random number table method. Of them, 19 patients received an interlocking intramedullary nail combined with an extra plate for internal fixation of the fractures (the plate group), while the remaining 17 patients had fractures fixed with the nail combined with blocking screws (the screw group). The perioperative, follow-up and radiographic data were compared between the two groups.Results: All the 36 patients underwent operation smoothly without iatrogenic neurovascular injuries. The plate group proved superior the screw group regarding to operation time and intraoperative X-ray exposure (P＜0.05) , nevertheless the former was inferior to the latter in implant cost and hospital stay (P＜0.05) . The follow-up period lasted for 12～24 months with a mean of (15.62±4.71) months. There were no statistically significant differences in the time to return ambulation and the time to full weight-bearing activity between the two groups (P＞0.05) . At the latest follow up, no statistically significant differences were found between the two groups regarding knee range of motion and Johner-Wruhs grades for clinical consequences (P＞0.05) . In terms of anterior knee pain, the difference between the two groups was not statistically significant (P＞0.05) . In respect of radiographic assessment, the plate group had significantly less residual malalignment than the screw group, including anteroposterior and lateral displacements, as well as angulations in coronal and sagittal planes (P＜0.05) . To the latest follow up, all patients in both group got bony healing of the fractures without a statistical difference in fracture healing time between them (P＞0.05) , and no loosening or breaking of the implants were showed on images in anyone of them.Conclusion: Both the nail plus plate and nail plus blocking screw do achieve satisfactory clinical outcomes for proximal tibial fractures unaffecting the knee. By comparison, the nail combined with plate facilitates to regain and maintain better alignment of the leg regardless of higher implant cost.

Treatment of extra-articular and simple articular distal radial fractures with intramedullary nail versus volar locking plate

2013 ◽  
Vol 38 (7) ◽  
pp. 774-779 ◽  
Author(s):  
A. Safi ◽  
R. Hart ◽  
B. Těknědžjan ◽  
T. Kozák
Keyword(s):  
Clinical Outcomes ◽  
Intramedullary Nail ◽  
Locking Plate ◽  
Volar Locking Plate ◽  
Distal Radial Fractures ◽  
Surgery Outcome ◽  
Plate Group ◽  
Blinded Study ◽  
Group 2 ◽  
Fracture Types

The purpose of this prospective, randomized and blinded study was to compare the clinical outcomes of distal radial fractures treated with either an intramedullary nail or a volar locking plate. Sixty two patients were enrolled in the study and randomized to treatment with a MICRONAILTM (Group 1, 31 patients) or an adaptive plate (Group 2, 31 patients). Fracture types included were unstable extra-articular metaphyseal distal radial fractures and simple or multifragmentary sagittal articular distal radial fractures (AO classification types A2, A3, B1.1 and B1.2). All patients were evaluated at 6 weeks, 3 months and 12 months after surgery. Outcome measures included standard radiographic parameters, active wrist range of motion, the disabilities of the arm, shoulder and hand (DASH) and Mayo wrist scores. We concluded that treatment of this subset of distal radius fractures with minimally invasive intramedullary nailing gives better clinical outcomes at 6 weeks after surgery than treatment with a volar locking plate. By 3 and 12 months following surgery, there are no significant differences in outcome between the two treatment methods. Disadvantages of the MICRONAIL™ fixation system include risk of injury to the superficial branch of the radial nerve and a narrower spectrum of indications than volar locking plates.

scholarly journals A Novel Anatomical Locking Plate Combined With an Anterior Column Screw and Magic Screw for Acetabular Fractures Involving Both Columns: Reduction Effect and Functional Outcomes

2020 ◽  
Author(s):  
Gongzi Zhang ◽  
Shuwei Zhang ◽  
Yi Sui ◽  
Xiang Wang ◽  
Xiuyun Su ◽  
...  
Keyword(s):  
Acetabular Fracture ◽  
Locking Plate ◽  
Operation Time ◽  
Operative Approach ◽  
Acetabular Fractures ◽  
Fracture Classification ◽  
Reduction Effect ◽  
Transverse Fractures ◽  
Time From Injury

Abstract BackgroundA novel anatomical locking plate (NALP) was designed. The NALP is fixed via an anterior column screw and a Magic screw to apply pressure on the acetabular fracture ends. This study was performed to compare the reduction effect and clinical outcome of the NALP versus the anatomical locking plate (ALP) for acetabular fractures involving both columns.MethodsFrom January 2013 to January 2018, 22 patients with acetabular fractures involving both columns were treated using the NALP or ALP in a single institution. The general condition and type of fracture were recorded. The NALP and ALP groups were compared regarding the Letournel fracture classification, operative approach, time from injury to operation, intraoperative bleeding volume, and operation time. The radiographic reduction outcome and hip function at final follow-up were compared between the two groups based on the Matta scores and Harris hip scores, respectively.ResultsThe NALP was used in 10 patients, while the ALP was used in 12. Three patients had transverse fractures, 12 had transverse fractures involving posterior wall, and 7 had double-column fractures. The two groups had no significantly differ regarding sex, age, affected side, Letournel fracture classification, operative approach, or follow-up duration. The time from injury to the operation was 20.70±1.2 days in the NALP group and 13.17±7.5 days in the ALP group (p=0.089). The operation time was 332.20±128.9 minutes in the NALP group and 257.50±91.6 minutes in the ALP group (p=0.128). The intraoperative blood loss volume was 1550.00±869.5 ml in the NALP group and 666.67±370.1 ml in the ALP group (p=0.011). The Matta score at final follow-up was 1.10±0.8 in the NALP group and 2.46±1.9 in the ALP group (p=0.045). The Harris hip score at final follow-up was 87.50±10.5 in the NALP group and 81.00±10.1 in the ALP group (p=0.0782).ConclusionThe NALP achieves adequate compression of the acetabular fracture ends and obtains stronger fixation than the ALP.Trial registrationChiCTR,ChiCTR2000030825. Registered 15 March 2020 - Retrospectively registered, http://www.chictr.org.cn/ChiCTR2000030825

scholarly journals Comparison of the effect of two internal fixation methods for proximal clavicle fractures

2020 ◽  
Vol 66 (5) ◽  
pp. 654-658
Author(s):  
Haining Xu ◽  
Yan Nie ◽  
Lifang Han ◽  
Liang Li ◽  
Haitao Sui
Keyword(s):  
Blood Loss ◽  
Internal Fixation ◽  
Fracture Healing ◽  
Clinical Symptoms ◽  
Operation Time ◽  
Healing Time ◽  
Fixation Methods ◽  
Plate Group ◽  
Clavicle Fractures

SUMMARY OBJECTIVE To compare the effect of two internal fixation methods in the treatment of proximal clavicle fractures. METHODS Fifty patients with proximal clavicle fractures received surgical treatment. They were divided into a clavicular T-plate group and a double mini-plates group. The duration of the operation, blood loss during the operation, fracture healing time, and incision infection were evaluated between the two groups. RESULTS Operation time (t=2.063, P=0.058), intraoperative bleeding (t=1.979, P=0.062), and fracture healing time (t=1.082, P=0.066) were not statistically significant in the two groups. The patients were followed up for 12-18 months; one patient in the T-plate group had early removal of nails, but no clinical symptoms. At the 2-month follow-up, the ASES score in the double mini-plates group was significantly better than in the T-plate group (P<0.001); but at the 6-month follow-up, 1-week before removal of internal fixation and the final follow-up, the two groups had no significant differences (P>0.05). CONCLUSIONS Both internal fixations have similar clinical results in the duration of operation, blood loss during the operation, and fracture healing time. The double mini-plates fixation presents advantages by reducing complications and speeding fracture healing; thus it is a more effective method to treat proximal clavicle fractures.

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