Fractures of the Calcaneus: Open Reduction and Internal Fixation From the Medial Side a 21-Year Prospective Study

1997 ◽  
Vol 18 (11) ◽  
pp. 685-692 ◽  
Author(s):  
Billie D. Burdeaux
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Weight Bearing ◽  
Full Weight Bearing ◽  
Medial Approach ◽  
Medial Side ◽  
Successful Group ◽  
American Orthopaedic ◽  
System Time

Since 1974, 61 displaced fractures of the calcaneus have been treated by open reduction and internal fixation by a modified medial approach technique. Surgery was performed through a 5-cm incision posterior to the neurovascular bundle. A single threaded pin was passed longitudinally through the tuberosity and into the sustentacular fragment, giving stable fixation. Reduction of the depressed posterior facet fragments was accomplished from the medial side in 77% of cases, occasionally assisted by fluoroscopy. Postoperatively all fractures were immobilized in a cast for 4 weeks. At the end of 4 weeks the pin was removed, and full weight bearing in a walking cast was started and continued for 4 weeks. At 8 weeks after surgery, the walking cast was removed, and the patient began walking in a shoe. These cases were evaluated at a mean follow-up of 4.4 years. There were 49 successful cases (80.3%) and 12 unsuccessful cases (19.7%). A high number of superior results was found in the successful group as shown by the mean score of 94.7 (American Orthopaedic Foot & Ankle Society Scoring System). Time to return to work was a mean of 4.9 months.

scholarly journals Treatment of subtrochanteric fracture femur by open reduction and internal fixation by long proximal femoral nailing

2019 ◽  
Vol 6 (1) ◽  
pp. 164
Author(s):  
Prabhu P. Munavalli ◽  
Gururaj N. G.
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Road Traffic ◽  
Weight Bearing ◽  
Subtrochanteric Fracture ◽  
High Rate ◽  
Full Weight Bearing ◽  
Subtrochanteric Fractures ◽  
Fractures In Children ◽  
Pathologic Fractures

<p class="abstract"><strong>Background:</strong> Subtrochanteric fractures are devasting injuries that most commonly affect the elderly population and also in young.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 20 cases of subtrochanteric fracture admitted to KIMS, Huballi between November 2008 to August 2010 treated with left proximal femoral nail (LPFN) by open method. Cases were taken according to inclusion and exclusion criteria, i.e., fresh subtrochanteric fracture in adults. Pathologic fractures, multiple fractures, fractures in children, old neglected fractures were excluded from the study. Objectives of this study were to study subtrochanteric fractures and to determine effectiveness of LPFN in tretment of subtrochanteric fractures by open reduction and internal fixation (ORIF).<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study of 20 cases, there were 16 male and 4 female patients with age ranging from 17 years to 75 years with most patients in between 21-40 years. 65% of the cases admitted were road traffic accidents, 25% due to fall from height and 10% due to trivial fall with right side being more common side affected. Russell and Taylor type IA fracture accounted for 40% of cases. Mean duration of hospital stay was 24 days and mean time of full weight bearing was 14 weeks in our patients. Good to excellent results were seen in 85% of cases in our study.</p><p class="abstract"><strong>Conclusions:</strong> Subtrochanteric fractures of femur can be successfully treated by ORIF by LPFN resulting in proper anatomical reduction and hence alignment and high rate of bone union.</p>

scholarly journals Aesthetic Treatment of Tillaux-Chaput fractures

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0022
Author(s):  
Shi-Ming Feng
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Weight Bearing ◽  
Ankle Arthroscopy ◽  
X Rays ◽  
The Mean ◽  
American Orthopaedic ◽  
Ankle Function ◽  
Primary Healing

Category: Arthroscopy Introduction/Purpose: This study aim to investigate the clinical result of treating Tillaux-Chaput fractures using the all-inside ankle arthroscopy technique. Methods: We retrospectively evaluated 23 Tillaux-Chaput fractures patients who underwent all-inside ankle arthroscopy technique and were follow-up from May 2013 to June 2016. There were 15 males and 8 females, with the mean age of 30.4 years (range, 10-57 years). Right ankle was involved in 15 patients and left ankle in 8 patients. Eighteen patients had single Tillaux-Chaput fractures and 5 patients had combined proximal fibular fractures. While 20 cases were diagnosed by X-rays and 3 cases by CT. Ankle arthroscopy was used through the anterolateral and anteriormedal approaches for closed reduction and internal fixation using Herbert screw(s). The joints function was performed using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot scale score. Results: Operative incisions of 23 cases were primary healing without complications of nerve, vessel and tendon injuries. The period of follow-up was 19.6 months (range, 12-25 months) and the time of Fracture union was 23.3 weeks (range, 12-36 weeks). At the time of last follow-up, none of the patients had any restriction in the ankle function and range of motion, with the ankle pain and weight-bearing walking pain. AOFAS score was changed from preoperative 53.3 points to 92.1 points, with the excellent-good rate of 100%. Conclusion: All-arthroscopy teatment by the anterolateral and anteriormedal approaches is a precise and effective method for closed reduction and internal fixation of Tillaux-Chaput fractures and deserves clinical application.

scholarly journals Knee arthroplasty for acute fractures around the knee

2020 ◽  
Vol 5 (10) ◽  
pp. 713-723
Author(s):  
Thomas Tampere ◽  
Matthieu Ollivier ◽  
Christophe Jacquet ◽  
Maxime Fabre-Aubrespy ◽  
Sébastien Parratte
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Distal Femur ◽  
Weight Bearing ◽  
Young Patients ◽  
Revision Arthroplasty ◽  
Patient Specific ◽  
Full Weight Bearing ◽  
Articular Fractures ◽  
Primary Arthroplasty

Results of open reduction and internal fixation for complex articular fractures around the knee are poor, particularly in elderly osteoporotic patients. Open reduction and internal fixation may lead to an extended hospital stay and non-weight-bearing period. This may lead to occurrence of complications related to decubitus such as thrombo-embolic events, pneumonia and disorientation. Primary arthroplasty can be a valuable option in a case-based and patient-specific approach. It may reduce the number of procedures and allow early full weight-bearing, avoiding the above-mentioned complications. There are four main indications: 1) Elderly (osteoporotic) patients with pre-existing (symptomatic) end-stage osteoarthritis. 2) Elderly (osteoporotic) patients with severe articular and metaphyseal destruction. 3) Pathological fractures of the distal femur and/or tibia. 4) Young patients with complete destruction of the distal femur and/or tibia. The principles of knee (revision) arthroplasty should be applied; choice of implant and level of constraint should be considered depending on the type of fracture and involvement of stabilizing ligaments. The aim of treatment is to obtain a stable and functional joint. Long-term data remain scarce in the literature due to limited indications. Cite this article: EFORT Open Rev 2020;5:713-723. DOI: 10.1302/2058-5241.5.190059

scholarly journals FUNCTIONAL OUTCOMES FOLLOWING SYNDESMOTIC SCREW FIXATION- A COMPARISON OF SCREW REMOVAL VERSUS RETENTION.

2020 ◽  
pp. 68-71
Author(s):  
Rahul Thampi ◽  
Balu C Babu ◽  
Melvin J George ◽  
Druvan Shaji ◽  
V K Bhaskaran ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Screw Fixation ◽  
Weight Bearing ◽  
Foot And Ankle ◽  
Level Of Evidence ◽  
Syndesmotic Screw

BACKGROUND: - The incidence of distal tibiofibular syndesmotic injury in ankle fractures is about 13%. The integrity of syndesmosis is a critical factor which stabilizes ankle mortise during weight-bearing besides load transmission. The primary purpose of the study was to assess the functional outcome in patients with Weber B and C fractures and to decide whether the syndesmotic screws are to be removed or not before weight-bearing. MATERIALS AND METHODS: - This was a prospective observational study involving patients (>18 years of age) who had undergone open reduction and internal fixation of an ankle fracture belonging to Weber B or C classification who had screw stabilization of a disrupted syndesmosis. The study period was three years commencing from August 2014. They were divided into two groups based on the syndesmotic screw retention or removal before weight-bearing. The patients were then regularly followed up with American Orthopaedic Foot and Ankle Society (AOFAS) ankle/hindfoot score and Visual Analogue Score-Foot and Ankle (VAS-FA) score were used to assess the functional outcome. Clinical and radiographic evaluations were done with each follow-up at 4,6,9,12 months. RESULTS: - We identified 32 fractures in 32 patients. Treatment undertaken was open reduction and internal fixation for the malleolli and syndesmotic screw fixation in all patients, and syndesmotic screws were removed in 17 and retained in 15. None of the patients were managed conservatively. We lost a patient to long-term follow-up. The AOFAS score was seen to be progressively increasing (92.3 – 96.75) and higher in the removed group as compared to retained. The VAS-FA score was also seen to be increasing besides being higher in the removed group (160.17 to 187). None of the patients failed the operative stabilization. Also, none of the patients had long-term complications like non-union, mal-union or screw back out excepting one patient who had persistent pain in the retained group. CONCLUSION: It is safe and better to remove the syndesmotic screw prior to weight bearing, when compared to retaining them insitu. Level of evidence IV-prognostic

scholarly journals Differences in femoral component subsidence rate after THA using an uncemented collarless femoral stem: full weight-bearing with an enhanced recovery rehabilitation versus partial weight-bearing

2021 ◽  
Author(s):  
Franziska Leiss ◽  
Julia Sabrina Götz ◽  
Matthias Meyer ◽  
Günther Maderbacher ◽  
Jan Reinhard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Enhanced Recovery ◽  
Weight Bearing ◽  
Femoral Stem ◽  
Full Weight Bearing ◽  
Partial Weight Bearing ◽  
Fill Ratio ◽  
Stem Subsidence ◽  
Partial Weight

Abstract Background Femoral component subsidence is a known risk factor for early failure of total hip arthroplasty (THA) using cementless stems. The aim of the study was to compare an enhanced recovery concept with early full weight-bearing rehabilitation and partial weight-bearing on stem subsidence. In addition, the influence of patient-related and anatomical risk factors on subsidence shall be assessed. Methods One hundred and fourteen patients underwent primary cementless THA and were retrospectively analyzed. Sixty-three patients had an enhanced recovery rehabilitation with early full weight-bearing and 51 patients had rehabilitation with partial weight-bearing (20 kg) for 6 weeks. Postoperative subsidence was analyzed on standing pelvic anterior–posterior radiographs after 4 weeks and 1 year. Subsidence was measured in mm. Anatomical and prosthetic risk factors (stem size, canal flare index, canal fill ratio as well as BMI and demographic data) were correlated. Results Femoral stem subsidence rate was significantly higher for the group with an enhanced recovery concept compared to the group with partial weight-bearing at the first radiological follow up after 4 weeks [2.54 mm (SD ± 1.86) vs. 1.55 mm (SD ± 1.80)] and the second radiological follow up after 1 year [3.43 mm (SD ± 2.24) vs. 1.94 (SD ± 2.16)] (p < 0.001, respectively). Stem angulation > 3° had a significant influence on subsidence. Canal flare index and canal fill ratio showed no significant correlation with subsidence as well as BMI and age. Conclusion In the present study, cementless stem subsidence was significantly higher in the group with enhanced recovery rehabilitation compared to partial weight-bearing. Small absolute values and differences were demonstrated and therefore possibly below clinical relevance. Anatomical radiological parameters and anthropometric data did not appear to be risk factors for stem subsidence.

scholarly journals Preliminary Results of Subtalar Arthroereisis with Vulpius Procedure for Symptomatic Flatfoot in Patients with Type I Osteogenesis Imperfecta

2020 ◽  
Vol 18 (1) ◽  
pp. 67
Author(s):  
Cheng-Min Hsu ◽  
Sheng-Chieh Lin ◽  
Kuan-Wen Wu ◽  
Ting-Ming Wang ◽  
Jia-Feng Chang ◽  
...  
Keyword(s):  
Osteogenesis Imperfecta ◽  
Weight Bearing ◽  
Life Quality ◽  
Type I ◽  
Foot And Ankle ◽  
Flexible Flatfoot ◽  
Subtalar Arthroereisis ◽  
Viable Approach ◽  
American Orthopaedic

In this retrospective study, we aim to assess the safety and feasibility of adapting subtalar arthroereisis (SA) for type I osteogenesis imperfecta (OI) patients with symptomatic flatfoot. From December 2013 to January 2018, six type I OI patients (five girls and one boy, 12 feet) with symptomatic flexible flatfoot were treated with SA and the Vulpius procedure. All the patients were ambulatory and skeletally immature with failed conservative treatment and unsatisfactory life quality. The median age at the time of surgery was 10 years (range 5–11), and the median follow-up period was 55 months (range 33–83). All functional and radiographic parameters improved (p < 0.05) after the procedure at the latest follow-up. The median American Orthopaedic Foot and Ankle Society ankle-hindfoot scale improved from 68 (range 38–80) to 95 (range 71–97). All of the patients ambulated well without significant complications. The weight-bearing radiographs showed maintained correction of the tarsal bone alignment with intact bony surfaces adjacent to implants during the post-operative follow-up period. This is the very first study on symptomatic flatfoot in pediatric patients with type I OI. Our data suggest that SA is a potentially viable approach, as functional improvements and maintained radiographic correction without significant complication were observed.

scholarly journals Nascent Malunion of an Isolated Intraarticular Fracture of the Ulnar Head

2019 ◽  
Vol 09 (03) ◽  
pp. 240-243
Author(s):  
Frank Nienstedt ◽  
Markus Mariacher ◽  
Günther Stuflesser ◽  
Wilhelm Berger
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Excellent Result ◽  
Corrective Osteotomy ◽  
Fracture Dislocation ◽  
Intraarticular Fracture ◽  
Ulnar Head ◽  
Ulnar Styloid Fracture ◽  
Palmar Approach

Abstract Background Isolated fractures of the ulnar head are rare. Only few cases have been reported in literature. Case Description We report a case of a 16-year-old student who was treated for an ulnar styloid fracture conservatively. An associated displaced intraarticular fracture of the ulnar head has been overlooked. He presented late in our clinic with a symptomatic nascent malunion of the ulnar head fracture. A corrective osteotomy by a palmar approach was performed. Fixation by screws was used with an excellent result at 7-year follow-up. Literature Review The rare cases of isolated ulnar head fractures reported in literature were treated by open reduction and internal fixation only in case of fracture dislocation. Clinical Relevance The authors highlight the fact that even a nascent malunion of an isolated intraarticular fracture of the ulnar head may be treated successfully by open reduction and internal fixation.

Results of Treatment of Chronic Dorsal Fracture-Dislocations of the Proximal Interphalangeal Joints of the Fingers

1998 ◽  
Vol 23 (6) ◽  
pp. 798-801 ◽  
Author(s):  
O. ISHIDA ◽  
Y. IKUTA
Keyword(s):  
Articular Cartilage ◽  
Internal Fixation ◽  
Open Reduction ◽  
Proximal Interphalangeal Joint ◽  
Interphalangeal Joint ◽  
Fracture Dislocation ◽  
Results Of Treatment ◽  
Palmar Plate ◽  
Fracture Dislocations

We reviewed 20 cases of chronic dorsal fracture-dislocation of the proximal interphalangeal joint, with a mean follow-up period of 74 months. In patients without comminuted palmar fragments, open reduction and internal fixation or osteotomy of the malunited fragment provided good results. In treating patients with damaged articular cartilage or with comminuted palmar fragments by palmar plate arthroplasty, poor results were obtained because of secondary osteoarthritic changes.

scholarly journals Hip dislocation following the treatment of femoral neck fracture: Case report

2010 ◽  
Vol 138 (3-4) ◽  
pp. 248-251
Author(s):  
Zoran Vukasinovic ◽  
Igor Seslija ◽  
Borislav Dulic
Keyword(s):  
Femoral Neck ◽  
Femoral Neck Fracture ◽  
Open Reduction ◽  
Weight Bearing ◽  
Young Patients ◽  
Hip Dislocation ◽  
Full Weight Bearing ◽  
Limited Range Of Motion ◽  
Femoral Head Osteonecrosis ◽  
Neck Fracture

Introduction. Femoral neck fractures are very rare in young patients and are frequently complicated by femoral head osteonecrosis and femoral neck nonunion. Case Outline. A 19-year-old girl with hip dislocation following the treatment of the femoral neck fracture is presented. The femoral neck fracture was initially treated by open reduction and three-screw fixation. After detecting the nonunion of femoral neck, valgus osteotomy was done. Secondary, iatrogenic, hip dislocation appeared. The patient had pains, and in clinical findings a shorter leg and limited range of motion in the hip - altogether 40 degrees. She was then successfully treated by open reduction, together with Chiari pelvic osteotomy and joint transfixation. Transfixation pin was removed three weeks following the operation. After that, the patient was put into the abduction device and physical therapy was started. The mentioned regimen lasted four months after the surgery, then the abduction device was removed and walking started. Full weight bearing was allowed eight months after surgery. Conclusion. As we have not found the literature data concerning the above mentioned problem, we solved it in the way that we usually do for the treatment of developmental dislocation of the hip in adolescence.

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