Joint sparing Kirschner-wire fixation for displaced proximal phalangeal neck fractures: randomized prospective comparative study

2019 ◽  
Vol 45 (6) ◽  
pp. 560-566 ◽  
Author(s):  
Ahmed Fathy Sadek
Keyword(s):  
Comparative Study ◽  
Kirschner Wire ◽  
Level Of Evidence ◽  
Active Motion ◽  
Kirschner Wire Fixation ◽  
Group I ◽  
Wire Fixation ◽  
Total Active Motion ◽  
Prospective Comparative Study ◽  
The Mean

The aim of this study was to compare two joint sparing Kirschner-wire fixation techniques for displaced proximal phalangeal neck fractures. Forty-six patients with proximal phalangeal neck fractures managed by either percutaneous antegrade flexible intramedullary nailing (Group I) or crossed Kirschner-wires (Group II) were recruited for a randomized prospective comparative study. Clinical and radiological assessment of all patients was done in addition to the Kang scoring system, Disability of Arm, Shoulder and Hand score and total active motion. The mean time for radiological union for both groups was 5.8 weeks. The mean postoperative total active motion, Kang and the Disability of Arm, Shoulder and Hand scores were better in Group I patients, but without any statistically significant differences. Closed reduction and percutaneous Kirschner-wire fixation by a joint sparing approach will yield good functional results with no or minimal complications in proximal phalangeal neck fractures. Level of evidence: II

Outcomes of flexor tendon repairs in zone 2 subzones with early active mobilization

2017 ◽  
Vol 42 (9) ◽  
pp. 896-902 ◽  
Author(s):  
K. Moriya ◽  
T. Yoshizu ◽  
N. Tsubokawa ◽  
H. Narisawa ◽  
S. Matsuzawa ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Repair ◽  
Level Of Evidence ◽  
Active Motion ◽  
Risk Of Rupture ◽  
Total Active Motion ◽  
A2 Pulley ◽  
Active Mobilization ◽  
The Mean ◽  
Difficult Area

We report on the outcomes of flexor tendon repair in zone 2 subzones with early active mobilization in 102 fingers in 88 consecutive patients. There were 28, 53, 15, and six fingers with repairs in zones 2A to 2D, respectively. Rupture of the repair occurred in four fingers, all in zone 2B. Excluding those with repair ruptures, the mean total active motion was 230° (range 143°–286°). Evaluated with Tang’s criteria, the outcomes were ranked excellent in 39 fingers, good in 46, fair in ten, poor in three, and failure in four. The outcomes in zone 2C were significantly inferior to those in zones 2B and 2D ( p = 0.02). Our results suggest that the tendon laceration in the area covered by the A2 pulley (zone 2C) is the most difficult area to obtain satisfactory active digital motion and tendon repair in zone 2B is the area where the risk of rupture is highest. Level of evidence: IV

Outcome of Proximal Chevron Osteotomy for Hallux Valgus With and Without Transverse Kirschner Wire Fixation

2008 ◽  
Vol 29 (11) ◽  
pp. 1101-1106 ◽  
Author(s):  
Keun-Bae Lee ◽  
Chang-Young Seo ◽  
Chang-Ich Hur ◽  
Eun-Sun Moon ◽  
Jae-Jun Lee
Keyword(s):  
Hallux Valgus ◽  
Kirschner Wire ◽  
Kirschner Wires ◽  
Fixation Group ◽  
Chevron Osteotomy ◽  
Kirschner Wire Fixation ◽  
Group I ◽  
Wire Fixation ◽  
Group Ii ◽  
Severe Hallux Valgus

Background: Proximal chevron osteotomy (PCO) for hallux valgus is inherently more stable than the other forms of proximal metatarsal osteotomy, but complications, such as, delayed union, nonunion, and malunion can occur. In this study, we have compared results of two axial Kirschner wire fixation with or without transverse Kirschner wires in PCO for moderate to severe hallux valgus deformities. Methods: A prospective study was conducted on 65 patients (85 feet) that underwent PCO and a distal soft tissue procedure for moderate to severe hallux valgus. Patients were divided into two groups, two axial Kirschner wire fixation (Group I) and two axial and supplementary transverse Kirschner wire fixation (Group II). Group I comprised 41 feet of 32 patients and Group II 44 feet of 33 patients. Results: Average AOFAS scores were 52.8 points in group I and 49.6 points in group II preoperatively, and 92.8 and 89.6 points, respectively, at last followup. Patients were very satisfied or satisfied in 92.7% in Group I and 93.2% in Group II. Average hallux valgus angles in Groups I and II changed from 34.9 degrees and 37.2 degrees preoperatively to 12.3 degrees and 13.9 degrees postoperatively, and intermetatarsal angles in Groups I and II changed from an average of 17.9 degrees and 17.2 degrees preoperatively to 10.3 degrees and 10.4 degrees postoperatively. No significant inter-group differences were found. Conclusion: Supplementary transverse Kirschner wire fixation is not recommended for proximal metatarsal chevron osteotomy since two axial Kirschner wires provided sufficient stability. Level of Evidence: I, Prospective Radomized Study

scholarly journals Management of Pediatric Displaced Distal Metaphyseal Forearm Fracture: Comparison between Cast Immobilization and Percutaneous Kirschner Wire Fixation

2013 ◽  
Vol 2 (1) ◽  
pp. 1-6
Author(s):  
D Shrestha ◽  
D Dhoju ◽  
N Parajuli ◽  
G Dhakal ◽  
R Shrestha
Keyword(s):  
Clinical Outcomes ◽  
Closed Reduction ◽  
Forearm Fracture ◽  
Kirschner Wire ◽  
Cast Immobilization ◽  
Kirschner Wire Fixation ◽  
Group I ◽  
Alternative Treatment Option ◽  
Wire Fixation ◽  
Group Ii

Background: Distal metaphyseal forearm fracture is one of the common injuries in children. Closed reduction and above elbow cast is the standard method of treatment but reported to be associated with redisplacement rate of 7-25%. Closed reduction and fixation with percutaneous Kirschner wire is an alternative treatment option to prevent redisplacement. Methods: Thirty five children (group I) of age between 6 to 13 yrs with displaced ( more than 50% of cortical diameter) or angulated (more than 20°) distal metaphyseal forearm fracture managed with closed reduction and above elbow cast were compared with 21 children (group II) managed with closed reduction and percutaneous crossed Kirschner fixation. Clinical outcomes and complications were compared in both groups after 12 weeks of follow up. Results: Preoperative variables in both the groups were comparable. Mean loss of elbow flexion and extension (12° vs. 4°, p =0.08), wrist dorsflexion and palmerflexion (27° vs. 14°, p=0.12) and forearm supination and pronation (27° vs. 15°, p= 0.143) were more in group I but were statistically not significant. Complications rate (28.4% vs. 19.04%, p= 0.04) was higher in group I (such as fracture redisplacement and swelling) than in group II (pin tract infection). Conclusions: Grossly displaced or angulated distal metaphyseal forearm both bone fracture in children treated with either closed reduction and above elbow cast or closed reduction with crossed Kirschner wire fixation have no statistically significant clinical outcomes in terms of loss of movement of elbow, wrist and forearm but complication rate is higher in cast group. Percutaneous Kirschner wire fixation prevents redisplacement. DOI: http://dx.doi.org/10.3126/noaj.v2i1.8133 Nepal Orthopaedic Association Journal Vol.2(1) 2011: 1-6

scholarly journals Recovery of rock climbing performance after surgical reconstruction of finger pulleys

2016 ◽  
Vol 41 (4) ◽  
pp. 406-412 ◽  
Author(s):  
M. Bouyer ◽  
A. Forli ◽  
A. Semere ◽  
B. J. Chedal Bornu ◽  
D. Corcella ◽  
...  
Keyword(s):  
Sport Performance ◽  
Rock Climbing ◽  
Surgical Reconstruction ◽  
Pinch Strength ◽  
Level Of Evidence ◽  
Active Motion ◽  
Significant Difference ◽  
Total Active Motion ◽  
The Mean ◽  
High Level

This study evaluated recovery of sport performance and correction of bowstringing after surgical reconstruction of closed finger pulley rupture in high-level rock climbers. A total of 38 patients treated with an extensor retinaculum graft were assessed. The mean follow-up time was 85 months, and 30 patients returned to their previous climbing level. The mean total active motion score was 96% of the opposite side. All patients had an excellent Buck-Gramcko score. There was no significant difference in grip strength and tip pinch strength in the crimp position between the injured side and the opposite side. A total of 31 patients were examined with ultrasonography. In 18, flexor bowstringing effects had returned to near-normal values. There was an association between rock climbing level recovery and the flexor bowstringing correction (odds ratio, 6.9; 95% confidence interval, 1.1–42.8). If flexor bowstringing was corrected, patients were more likely to regain their preinjury sport performance. The ultrasonography measurement was a useful tool for predicting functional recovery. Level of evidence: 4

scholarly journals A new technique to determine the tension in extensor pollicis longus reconstruction

2019 ◽  
Vol 44 (8) ◽  
pp. 790-794 ◽  
Author(s):  
Fumiki Kamoi ◽  
Makoto Kondo ◽  
Masanori Hayashi ◽  
Shigeharu Uchiyama ◽  
Hiroyuki Kato
Keyword(s):  
Tendon Graft ◽  
Level Of Evidence ◽  
Active Motion ◽  
Extensor Pollicis Longus ◽  
Longus Tendon ◽  
Distal Edge ◽  
Total Active Motion ◽  
The Mean ◽  
A New Technique ◽  
Extensor Pollicis Longus Tendon

We present an original technique for determining the tension of the extensor pollicis longus tendon after reconstruction. We treated 20 patients using this technique for an extensor pollicis longus tendon graft or extensor indicis tendon transfer and reviewed the results. The tension of the reconstructed extensor pollicis longus was adjusted so that the centre of the distal edge of the thumbnail was elevated 2 cm above the operation table. The mean retropositional distance of the treated thumbs was 1.2 cm less than the contralateral thumbs. The mean total active motion of the thumb was 90%. This technique resulted in satisfactory thumb function. Level of evidence: IV

Outcomes of release of the entire A4 pulley after flexor tendon repairs in zone 2A followed by early active mobilization

2015 ◽  
Vol 41 (4) ◽  
pp. 400-405 ◽  
Author(s):  
K. Moriya ◽  
T. Yoshizu ◽  
N. Tsubokawa ◽  
H. Narisawa ◽  
K. Hara ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Flexor Digitorum Profundus ◽  
Level Of Evidence ◽  
Active Motion ◽  
Total Active Motion ◽  
Active Mobilization ◽  
The Mean ◽  
Flexor Digitorum ◽  
Flexor Digitorum Profundus Tendon

We report the outcomes of repair of the flexor digitorum profundus tendon in zone 2a in 22 fingers. The tendon was repaired with a six-strand repair method and the A4 pulley was completely released. Release of the C2 pulley combined with the A4 pulley was necessary in 12 fingers, nine fingers underwent a complete release of the A3, C2, and A4 pulleys, and one finger underwent a release of the C1, A3, C2, and A4 pulleys. The mean total active motion of the three finger joints was 234° at 5 to 12 months of follow-up. No bowstringing was noted in these fingers. The good and excellent recovery of active digital motion was in 20 (91%) out of 22 fingers according to Strickland’s criteria or Tang’s criteria. Our results suggest that release of the A3, C2, and A4 pulleys makes the repair surgery easier and does not cause tendon bowstringing. Level of Evidence: IV

Sign in / Sign up

Export Citation Format

Share Document