Cross-Sectional Study to Assess the Functional Outcome of Neglected Bimalleolar Fracture

2016 ◽  
Vol 10 (6) ◽  
pp. 509-512
Author(s):  
Rajeev Shukla ◽  
Ravi Kant Jain ◽  
Shravan Patidar ◽  
Nikhil Jain ◽  
Pranav Mahajan
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Rating Scale ◽  
Weight Bearing ◽  
Functional Results ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Results Of Treatment ◽  
Trimalleolar Fractures

Introduction. Ankle fracture is the most common intra-articular fracture of a weight-bearing joint and accounts for 9% of all fractures. Ankle fractures are classified into 3 subgroups: unimalleolar, bimalleolar, and trimalleolar fractures. Accurate reduction and stable internal fixation is necessary in bimalleolar fractures; otherwise, it may lead to posttraumatic painful restriction of movements or osteoarthritis. The purpose of this study is to assess the functional outcome and results of treatment of neglected bimalleolar fracture. Materials and Methods. Seventeen neglected bimalleolar fracture patients were treated with open reduction and internal fixation. Patients were followed-up at 1, 2, and 5 years and functional ability was assessed by using the modified Weber Rating Scale. Results. The mean age of patients was 41.4 ± 13.28 years. After 2 year of surgery, 13 out of 17 patients showed excellent results and 4 patients had fair results. Conclusion. Good to excellent functional results were observed after long-term follow-up in neglected bimalleolar fracture treated with open reduction and internal fixation, and we advise surgical intervention in all such patients. Levels of Evidence: Therapeutic, Level III: Retrospective Cohort study

Operative versus Conservative Treatment for the Management of Displaced Midshaft Clavicle Fractures in Adults

2017 ◽  
Vol 13 (1) ◽  
pp. 81-85
Author(s):  
Md Maksudul Haque ◽  
Masud Ahmed ◽  
Md Zakir Hossain ◽  
Md Ali Faisal ◽  
Mohammad Saiful Islam ◽  
...  
Keyword(s):  
Conservative Treatment ◽  
Functional Outcome ◽  
Open Reduction ◽  
Plate Fixation ◽  
Major Complication ◽  
Armed Forces ◽  
Operative Management ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Non Union

Introduction: Displaced fractures of mid third clavicle are common in young athletic population and choice of management is still controversial. Recent studies have shown that these fractures do not have favourable outcomes with non-operative management and nonunion rates could be as high as 20%, in addition, there is symptomatic malunion with shortening. Objective: To compare the results of the operative versus that of conservative treatment for the management of displaced midshaft clavicular fractures. Materials and Methods: This prospective cross-sectional study was carried out in Orthopaedic and Trauma center, CMH, Dhaka, from the period of January 2014 to December 2016 to compare results of open reduction and internal fixation by plating with that of conservative management. Total 60 patients (30 in each group) were analyzed in terms of fracture union and functional outcome. Patients in the non-operative group were managed by triangular sling with or without strapping whereas in the operative group fractures were reduced and fixed with a contoured reconstruction plate. Patients were actively followed up for 12 months and functional outcome was measured by Rowe and Oxford shoulder scoring system. Complications were monitored clinically and radiologically. Results: All fractures in the operated group united compared with thirteen cases of symptomatic malunion (43.33%) in the non-operated group which is statistically significant. Rowe and Oxford scores was significantly higher in the operated group than the non-operated group in every occasion of follow-up. There was no major complication of surgery. In one patient (3.33%) plate had to be removed for hardware irritation and prominence. Conclusion: Open reduction and internal plate fixation in acute displaced midshaft clavicular fractures resulted in improved outcome decreased rate of non-union and symptomatic mal-union compared with non-operative treatment Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 81-85

scholarly journals Descriptive study of functional outcome and complication of fracture calcaneum treated with locking calcaneum plate

2019 ◽  
Vol 5 (3) ◽  
pp. 498
Author(s):  
Amit Jain ◽  
R. C. Meena ◽  
Laxman Choudhary ◽  
Jitesh Jain ◽  
Abhishek Chandra ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Weight Bearing ◽  
Descriptive Study ◽  
Calcaneal Fracture ◽  
Lateral Approach ◽  
Soft Tissue Envelope ◽  
Medical College ◽  
Type Iv

<p class="abstract"><strong>Background:</strong> Fracture of calcaneum accounts for about 2% of all fractures and 75% of all calcaneum fractures are intra-articular. Numerous controversies existed regarding optimal treatment of displaced intraarticular calcaneum fractures. In this study evaluate post-operative functional outcome and complication of fracture calcaneum treated with locking calcaneum plate.</p><p class="abstract"><strong>Methods:</strong> This hospital based prospective descriptive study was conducted on 108 patients (120 calcaneum fracture) operated between July 2016 to December 2018 by open reduction and internal fixation with locking calcaneum plate through extensive lateral approach at Department of Orthopaedics, SMS Medical college and hospital, Jaipur. All close displaced intraarticular calcaneal fracture was included in the study.<strong></strong></p><p class="abstract"><strong>Results:</strong> Average duration between injury and surgery was 8.3±2.97 days. Out of 120 calcaneum fracture 52 fractures (43.33%) were Sander’s type II, 52 fractures (43.33%) were Sander’s type III, and 16 fractures (13.33%) were Sander’s type IV. Pain on weight bearing was noted in 20 patients (16.66%) implant prominence was noted in 8 patients and delayed wound healing was seen in 4 patients. Maryland foot score was excellent in 44 fracture (36.67%), good in 56 fractures (46.67%), fair in 8 fractures (6.67%), and poor in 12 fractures (10%).</p><p class="abstract"><strong>Conclusions:</strong> Open reduction and internal fixation (ORIF) with locking calcaneum plate in an indicated case, with respect to soft tissue envelope and early rehabilitation, leads to better therapeutic results as compared to other operative technique.</p>

scholarly journals Functional Outcome Estimation of Bimalleolar Ankle Fractures Treated by Open Reduction and Internal Fixation at a Tertiary Care Center: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (230) ◽  
Author(s):  
Rajeev Dwivedi ◽  
Ankit Karki ◽  
Roshan Bhattarai ◽  
Badri Rijal
Keyword(s):  
Internal Fixation ◽  
Functional Outcomes ◽  
Open Reduction ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Ankle Fractures ◽  
Tertiary Care Center ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Ankle fractures account for about 9% of all fractures in adults. Open reduction and internal fixation is the preferred treatment for such injuries. However, surgery is not free of complications, and outcomes following surgery are not always satisfactory. Therefore, this study aimed to estimate the functional outcomes of bimalleolar ankle fractures treated by open reduction and internal fixation. Methods: This descriptive, cross-sectional study was carried out at a tertiary care center in the western region of Nepal among the patients with bimalleolar ankle fractures from March 2017 to August 2020 after approval from the Institutional review committee. Convenience sampling was done to reach the sample size. Twenty-nine cases were included in the study. Data were recorded in proforma and data analysis was done in the statistical package for social sciences (SPSS 16.0). The American Orthopedic Foot and Ankle Society (AOFAS) ankle-handfoot score was used to assess the final outcome. Results: At the final evaluation mean AOFAS ankle-handfoot score score was 89.86 (±7.95). According to the AOFAS ankle-hindfoot score, there were 19 excellent (65.51%), six good (20.68%), and four fair (13.79%) results. Complications in the form of superficial infection were seen in four (13.79%) cases. Conclusions: Functional outcomes following surgical treatment of bimalleolar ankle fractures are mostly excellent to good and complications following surgery are few, therefore, surgery is a better option of treatment in bimalleolar ankle fractures.

scholarly journals Functional Outcomes of Capitellum Fractures Treated by Open Reduction and Internal Fixation with Herbert Screw: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (230) ◽  
Author(s):  
Kapil Mani K.C. ◽  
Parimal Acharya ◽  
Suman Babu Marahatta ◽  
Arun Sigdel ◽  
Amuda K C ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Performance Index ◽  
Functional Outcomes ◽  
Open Reduction ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Herbert Screw ◽  
The Mean

Introduction: Based on the complex intra-articular nature of capitellum fractures, it has been sometimes difficult to formulate a universally accepted method of surgical treatment. The purpose of this study is to present the functional outcomes of capitellum fractures after fixation with Herbert screw including the safety and tips of the surgical approach. Methods: This descriptive cross-sectional study was done from December 2014 to November 2019. Ethical approval was taken. The study included 22 capitellum fractures treated by open reduction and internal fixation with Herbert screws either lateral or anterolateral approach. Functional outcomes were assessed with Mayo elbow performance index scores at the latest follow-up visit. Convenient sampling was done. Data entry was done using the Statistical Package for the Social Sciences (version16.0). Results: Out of 22 surgeries, the average time to unite the fracture was 11.13±1.20 weeks (range 9 to 15). The mean range of movement for flexion and extension was 138.41±8.22 degree while the mean supination and pronation range was 161.59±6.79 degree. The average time of follow-up in this series was 37.45±9.43 weeks (range 22 to 58 weeks). Similarly, the mean Mayo elbow performance index score at the latest follow-up was 90.22±8.65 (range 70 to 100). Conclusions: Careful assessment and radiological evaluation, anatomical reduction, and stable fixation with Herbert screws maintaining the minimal damage to the articular cartilage can maximize the functional outcomes and minimize the incidence of complications.

scholarly journals Study on functional outcome of bimalleolar ankle fractures treated by open reduction and internal fixation

2021 ◽  
Vol 7 (3) ◽  
pp. 518
Author(s):  
Nithin Gangadhran ◽  
Manju G. Pillai
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
External Rotation ◽  
Outcome Measurement ◽  
Weight Bearing ◽  
Ankle Fractures ◽  
Cortical Screw ◽  
Articular Fractures ◽  
Prospective Longitudinal

<p class="abstract"><strong>Background:</strong> Ankle injury is the most common weight bearing orthopaedic musculoskeletal trauma encountered in emergency medicine and practice. Ankle joint is highly congruous and any disturbance of normal articular relationship may result in some progressive arthrosis of biomechanical dysfunction. As with all intra-articular fractures it necessitates accurate reduction and stable internal fixation. The objectives were to study the functional outcome of surgical treatment of bimalleolar ankle fractures and to know the complications of open reduction internal fixation of bimalleolar fractures.</p><p class="abstract"><strong>Methods:</strong> 45 patients with malleolar fractures were included in this prospective longitudinal interventional study. Patients who underwent operative treatment were followed up regularly for 6 months with OPD visits and X-ray imaging at each stage. Patient parameters were recorded at immediate post op period, 6 weeks, 12 weeks and 24 weeks. Baird and Jackson scoring system for ankle were used for the functional outcome measurement.<strong></strong></p><p class="abstract"><strong>Results:</strong> Most common type of injury pattern was supination-external rotation with 21 cases (47% of cases). The results are excellent to good in 65% of patients, 27% of patients had fair and 8% had poor result. Syndesmotic screw fixation was done with 4.5 mm cortical screw in 7 cases. Most common complication was surgical site infection in 3 cases (6.67%). 2 patients underwent implant removal due to unresolved infection at 3 months.</p><p class="abstract"><strong>Conclusions:</strong> The results of operative fixation were satisfactory in 90% of patients. Most of the complications were minor and resolved within three weeks.</p><p class="abstract"> </p>

scholarly journals DEMOGRAPHIC AND CLINICAL PROFILE OF ADULT PATIENTS WITH SCAPHOID FRACTURES IN POPULATION OF DISTRICT D.I.KHAN, PAKISTAN

2020 ◽  
Vol 18 (2) ◽  
pp. 75-80
Author(s):  
Muhammad Shafiq Khan` ◽  
Nusrat Rasheed ◽  
Khadim Hussain ◽  
Muhammad Zubair Farooq
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Age Groups ◽  
Cross Sectional Study ◽  
Adult Patients ◽  
Management Options ◽  
Cross Sectional ◽  
Medical College ◽  
Scaphoid Fractures ◽  
Right Hand

Background: Scaphoid fractures are common and account for 60-70 % of all carpal fractures. The objectives of this study were to determine the demographic and clinical profiles of adult patients with scaphoid fractures in population of District D.I.Khan, Pakistan. Materials & Methods: This cross-sectional study was conducted in Department of Orthopedics, Gomal Medical College, D.I.Khan, Pakistan from January 2015 to December 2019. Sample size was 40. Demographic variables were sex, age groups and time to presentation in weeks. Research variables were; cause, laterality, site, management options, time to union in months and presence of infection. All variables were categorical and analyzed by count and percentages for sample and as CI at 80% CL for proportion for population using Wilson score for binomial distribution. Results: Forty patients included 34 (85%) men & 16 (15%) women, 24 (60%) in 17-30 and 16 (40%) in age group 31-50 years. Time to presentation was ≤1 week of injury in 19 (47.5%) patients and 21 (52.5%) presented later. Cause was fall on out-stretched hand in 27 (67.5%) and RTA in 13 (32.5%) patients. Right hand was involved in 29 (72.5%), left in 9 (22.5%) while bilateral in 2 (5%) patients. Site of fracture was waist in 24 (60%), proximal pole 11 (27.5%) and distal pole 5 (12.5%) cases. Conservative treatment was done in 7 (17.50%) patients, percutaneous screw fixation 7 (17.50%), open reduction and internal fixation through palmar in 11 (27.50%) and though dorsal 15 (37.50%) cases. Time to union was ≤3 in 7 (17.50%), >3-6 months 29 (72.5%), while >6 months in 4 (10%) patients. Presence of infection was 1/40 (2.38%). Conclusion: Scaphoid fractures are more common in men and younger adults and most are presented within a week of injury. These are caused mostly by fall on outstretched hand, involving right hand and involving waist. Substantial number of cases requires open reduction with internal fixation. Mostly unite in 3-6 months.

scholarly journals Functional Outcome Estimation of Calcaneum Fractures Treated by Open Reduction and Internal Fixation with Plate and Screws in A Tertiary Centre: A Descriptive Cross-sectional Study

2020 ◽  
Vol 58 (229) ◽  
Author(s):  
Rajeev Dwivedi ◽  
Mandir Khatri ◽  
Arjun KC
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Bone Fractures ◽  
Care Center ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Study Data ◽  
Foot And Ankle ◽  
Sectional Study ◽  
Cross Sectional

Introduction: Calcaneum fractures constitute about 60% of all tarsal bone fractures. Intra-articularfractures account for 70% of all calcaneal fractures. There are controversies regarding the operativetreatment of calcaneum fractures. Therefore this study aimed to estimate the functional outcomes ofcalcaneum fractures treated by open reduction and internal fixation with plate and screws. Methods: This descriptive, cross-sectional study was carried out at the tertiary care center in thewestern region of Nepal among the patients with displaced intra-articular calcaneum fractures fromFebruary 2017 to July 2020 after approval from the Institutional review committee. Convenientsampling was done to reach the sample size. Fifteen cases were included in the study. Data wererecorded in proforma and Data analysis was done in the statistical package for social sciences. TheAmerican Orthopedic Foot and Ankle Society Hindfoot score was used to assess the final outcome. Results: According to the American Orthopedic Foot and Ankle Society hindfoot scores, there werefive excellent (33.33%), seven good (46.66%), two fair (13.33%) and one poor (6.66 %) results. Conclusions: In displaced intra-articular calcaneum fractures, open reduction and internal fixationwith plates and screws result in a good number of satisfactory outcomes with very few unsatisfactoryresults. Hence it can be a better option of treatment in displaced intra-articular calcaneum fractures.  

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

EARLY RECOGNIZATION OF THE CHILDREN WITH ATTENTION DEFICIT HYPERACTIVITY DISORDER BY VANDERBILT ADHD RATING SCALE FOR TEACHERS AND PARENTS

2019 ◽  
pp. 85-91
Author(s):  
Dinh Duong Le ◽  
Van Thang Vo ◽  
Thi Mai Nguyen ◽  
Thi Han Vo ◽  
Huu Chau Duc Nguyen ◽  
...  
Keyword(s):  
Attention Deficit Hyperactivity Disorder ◽  
High Risk ◽  
Attention Deficit ◽  
Primary Schools ◽  
Rating Scale ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Hyperactivity Disorder ◽  
Teachers And Parents ◽  
Key Words Adhd

Objectives: The study aims to explore the prevalence of attention deficit hyperactivity disorder and to examine the associated factors with ADHD among primary students by Vanderbilt ADHD rating scale for teacher and parents. Methods: A cross-sectional study design was conducted in 564 students who selected randomly in 4 primary schools in Hue city. Vanderbilt ADHD rating scale for parents and teachers were applied to evaluate the ADHD of children over 6 months ago. Results: The overall prevalence of children who had high risk with ADHD was 4.1% (95%CI: 2.44 - 5.72), including 4.6% and 4.8% in the rating of teachers and parents, respectively. Male was more likely to have ADHD than female (OR adj: 4.64 (95%CI: 1.53 - 14.05) and lack of closely friend (OR adj: 5.11 (95% CI: 2.13 - 12.24). Conclusion: Vanderbilt ADHD diagnosis rating scale for teachers and parents can be used to early recognization children with a high risk of ADHD. Key words: ADHD, Vanderbilt, ratings scale, teacher, parent, children

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