scholarly journals Treatment of Periprosthetic Femoral Fractures Vancouver Type B2: Revision Arthroplasty Versus Open Reduction and Internal Fixation With Locking Compression Plate

2019 ◽  
Vol 10 ◽  
pp. 215145931987685 ◽  
Author(s):  
C. Baum ◽  
M. Leimbacher ◽  
P. Kriechling ◽  
A. Platz ◽  
D. Cadosch
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Operating Time ◽  
Group Versus ◽  
Revision Arthroplasty ◽  
Femoral Fractures ◽  
Length Of Hospital Stay ◽  
Invasive Procedure ◽  
Less Invasive ◽  
Revision Operations

Introduction: The Vancouver algorithm recommends revision arthroplasty (RA) for Vancouver type B2 (VTB2) fractures. However, open reduction and internal fixation (ORIF) using locking compression plates (LCP) may be a valid and less invasive alternative treatment. Materials and Methods: Between January 2007 and March 2017, we retrospectively recruited all patients treated with either ORIF with LCP or RA for VTB2 fractures in our clinic. All of the following were reviewed: the length of hospital stay, the operating time, the need for blood transfusions during and/or after surgery, implant-related and patient-related complications, need for revision surgery, and the radiological outcome. Additionally, the functional outcome was investigated. Results: Fifty-nine patients were recruited. Thirty-five (59.3%) patients underwent RA, while 24 (40.7%) patients received ORIF with LCP. The median surgical time was 137.50 minutes in the LCP group compared to 160.00 minutes in the RA group ( P = .051). Three (12.5%) patients in the LCP group and 10 (28.6%) patients in the RA group experienced an implant-associated complication ( P = .131). Patient-related complications occurred in 3 (12.5%) patients in the LCP group versus 6 (17.1%) patients in the RA group ( P = .628). The mean preoperative Parker mobility score was 9 points in both groups and decreased in both groups to a mean of 5 points in the LCP and 7 points in the RA group. Discussion: Open reduction and internal fixation with LCP seems to be a less invasive procedure for VTB2 fractures in comparison to RA. It is a bone-sparing procedure that can be advantageous for further revision operations. Moreover, some fractures can only be anatomically reduced by ORIF with LCP, whereas for proximal fractures with a radiologically unambiguously loosened stem RA might be advantageous. Conclusion: In line with previously published studies, our data suggest that ORIF using LCP is a valid treatment option for VTB2 fractures.

Revision Arthroplasty Versus Open Reduction and Internal Fixation of Vancouver Type-B2 and B3 Periprosthetic Femoral Fractures

JBJS Reviews ◽  
2021 ◽  
Vol 9 (8) ◽  
Author(s):  
Thomas Haider ◽  
Philip Hanna ◽  
Amin Mohamadi ◽  
Nelson Merchan ◽  
Megan McNichol ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Revision Arthroplasty ◽  
Femoral Fractures ◽  
Periprosthetic Femoral Fractures

scholarly journals Complications Associated with Lisfranc Injury Open Reduction Internal Fixation versus Primary Arthrodesis: A Matched Cohort Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0039
Author(s):  
William V. Probasco ◽  
Benjamin E. Stein ◽  
Cyrus Fassihi ◽  
Nazia Hossain
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Perioperative Complications ◽  
Financial Burden ◽  
Length Of Hospital Stay ◽  
Cost Of Care ◽  
Wound Complications ◽  
Prior History ◽  
Inpatient Setting ◽  
Hardware Failure

Category: Trauma; Midfoot/Forefoot Introduction/Purpose: Lisfranc injuries are complex injuries of the midfoot in which the optimal course of treatment remains controversial. The objective of this study was to identify whether open reduction and internal fixation (ORIF) was associated with greater risk for surgical complications and/or greater financial burden in comparison to a primary arthrodesis (PA). Methods: A retrospective database review was conducted using the PearlDiver database to identify all Medicare patients who underwent a Lisfranc ORIF or PA in an inpatient setting from 2006-2013. Exclusion criteria included age >85 years and a prior history of foot or ankle trauma/infection/malignancy within 5 years of index surgery. Patients were matched in a 1:1 statistical manner to precisely control for potential influence of comorbidities and demographics, resulting in two cohorts with 2746 patients in each. Perioperative complications (within 30 days) were compared between the cohorts, in addition to the respective costs associated with each procedure. Complications were broken down into major (PE/DVT, MI, CVA, sepsis, mortality, nerve injury) or minor (UTI, PNA, hardware failure, transfusion, wound complications) categories. Results: No significant differences in major perioperative complications were noted between the two procedures. Significant differences were however noted in the incidence of minor perioperative complications, including higher rates of hardware failure (OR 0.26 (CI 95%, 0.07-0.752, P=0.021) and transfusion (OR 0.37 (CI 95%, 0.13-0.94, P=0.045) in the ORIF cohort. There was additionally a higher incidence of 30 day readmission (OR 0.35 (CI 95%, 0.24-0.51, P<0.001) with ORIF. Length of hospital stay (LOS) was shorter in the PA cohort (x̅; = 2.59 days) compared to the ORIF cohort (x̅; = 5.58 days, p < 0.001). Higher mean total hospital costs were noted for ORIF (x̅ = $66,342.56) compared to PA (x̅ = $40,761.65, p < 0.001). Conclusion: Within our study population, ORIF has a significantly higher rate of hardware failure and transfusion, and 2.5 times the risk of readmission within 30 days. When comparing the total cost of care, there was a significantly greater cost with ORIF. LOS was also significantly longer in the ORIF group. One weakness of this study was the ability to account for patients <65, as these were pooled into a single age group by the database. While revealing with regard to the aforementioned variables, further research still needs to be conducted on the functional outcomes of these procedures. [Table: see text][Table: see text][Table: see text]

scholarly journals 1224 Effect of Distal Brachioradialis Release During Open Reduction and Internal Fixation of Distal Radius Fractures

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Hafez ◽  
A Shaat ◽  
M Zain ◽  
M A Sajid ◽  
A Butt
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
Open Reduction ◽  
Group Versus ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Volar Approach ◽  
Normal Ranges ◽  
Significant Difference ◽  
The Impact

Abstract Aim The study aim is to determine the impact of the brachioradialis release during the open reduction and internal fixation of distal radius fractures using a volar approach Method Total of 40 patients was treated with Open reduction and internal fixation of intra articular distal radius fractures. Distal release of Brachioradialis was performed to 19 patients, while 21 patients had no release of BR during surgery. Radiological parameters including Radial height, Inclination and volar tilt were measured 1 month post-operatively, while functional outcomes assessed with modified mayo wrist scores and Quick-dash scores Results There is no significant difference between age, gender and pre-operative conditions indicating that both the groups (BR release and without BR release) have similar demographic characteristics. Pre-operatively both groups had disturbed values for radial height, inclination, and volar tilt. Postoperatively, the mean of both groups was closer to normal ranges for radial inclination and volar tilt; however, radial height was the least adequately restored radiological parameter for both study group (11.54 ± 1.35 for BR group versus 10.21 ± 2.29 for Non-BR group). Pain, functional status, and grip strength had similar values in both groups whereas BR group showed higher ROM and DASH scores with P values of 0.048 and 0.025 respectively. Conclusions Brachioradialis release enhances the reduction and operative fixation, restoring the necessary radiological and subsequent functional parameters in distal radius fractures with reported no complications.

Fractures of the tibial pilon treated by open reduction and internal fixation (locking compression plate-less invasive stabilising system): Complications and sequelae

Injury ◽  
2018 ◽  
Vol 49 ◽  
pp. S60-S64 ◽  
Author(s):  
Juan C. Rubio-Suarez ◽  
Rafael Carbonell-Escobar ◽  
E. Carlos Rodriguez-Merchan ◽  
Aitor Ibarzabal-Gil ◽  
Enrique Gil-Garay
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Locking Compression Plate ◽  
Less Invasive ◽  
Tibial Pilon ◽  
Compression Plate

scholarly journals Long-Term Incidence of Total Knee Arthroplasty after Open Reduction and Internal Fixation of Proximal Tibial and Distal Femoral Fractures: A Nationwide Cohort Study

2021 ◽  
Vol 10 (23) ◽  
pp. 5685
Author(s):  
Kuang-Ting Yeh ◽  
Wen-Tien Wu ◽  
Ru-Ping Lee ◽  
Chen-Chie Wang ◽  
Jen-Hung Wang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Cohort Study ◽  
Internal Fixation ◽  
Knee Arthroplasty ◽  
Open Reduction ◽  
Femoral Fractures ◽  
Posttraumatic Arthritis ◽  
Research Database ◽  
Fracture Group ◽  
Total Knee

Knee fractures often require open reduction internal fixation (ORIF) for knee function recovery. More than one fifth of patients with knee fractures subsequently develop posttraumatic arthritis, and over 5% of them need total knee arthroplasty (TKA). We conducted this nationwide retrospective cohort study using the data of 2,000,000 people in the general population who received TKA and were followed up in the 17-year period 2001–2017, through random sampling of the Taiwan National Health Insurance Research Database. We matched the ORIF and non-fracture groups by a propensity score, based on age, sex, index date of surgery, and comorbidities enrolled in CCI calculated at a 1:1 ratio. The average proportion of subjects receiving TKA after ORIF for distal femoral or proximal tibial fractures was 2.0 per 1000 person-years, which was significantly higher than that in the non-fracture group. Patients aged 20–65 years and males represented a significantly higher proportion of subjects receiving TKA after ORIF than that in the non-fracture group. The proportion of subjects receiving TKA for the 20–65-year subgroup of the ORIF group was 4%, and that for the male subgroup was 1.5%; both rates increased over the 17-year follow-up period. More aggressive intraoperative and postoperative adjuvant therapies may be necessary for these subgroups.

scholarly journals Management of Distal Femoral fractures with Locking Compression Plate- A Prospective study

2021 ◽  
Vol 12 (1) ◽  
pp. 61-68
Author(s):  
Abhijit Maruti Kadam ◽  
Sujay K Mahadik ◽  
Sagar Rampure ◽  
Rahil B Jiwani
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Knee Flexion ◽  
Open Reduction ◽  
Femoral Fractures ◽  
Common Type ◽  
Locking Compression Plate ◽  
Distal Femoral Fractures ◽  
Compression Plate ◽  
Type Of Fracture

Background: Distal femoral fractures are one of the common type of fractures seen after motor vehicular accidents. The optimal management of these fractures requires open reduction and internal fixation by plates and screws. Various studies have shown that open reduction and internal fixation by plates and screws result in early post-operative knee mobilization which is essential for good union and better functional outcome. Aims and Objective: The current study was conducted to evaluate the results of fracture lower end of femur treated by open reduction and internal fixation using locking compression plate. Materials and Methods: This was a prospective clinical study in which the cases with fracture lower end of femur were included on the basis of a predefined inclusion and exclusion criteria. Fractures were categorised by Mullers classification. All patients were treated by distal femoral locking compression plates and screws. The cases were followed up for radiological union and functional outcome (Neer’s scoring). The statistical analysis was done using SSPS 21.0 software. P value less than 0.05 was taken as statistically significant. Results: Out of the 20 studied cases there were 13 (65%) males and 7 (35%) females with a M:F ratio of 1:0.53. Road traffic accidents were the most common cause (75%) of distal femoral fractures. The most common type of fracture seen in studied cases was found to be Mullers C2 type of fracture (45%) followed by Mullers C3 (20%) and Mullers C1 (15%). All patients were treated by open reduction and internal fixation. Mean Injury to surgery interval was found to be 4.25 days in studied cases. Postoperatively desirable knee flexion (1100) was achieved in 10 (50%) cases whereas in 8 patients 910-1090knee flexion was achieved. In 2 (10%) patients less than 900 knee flexion could be achieved. The functional outcome (as assessed by Neer’s score) showed that Good and fair results were seen in 13 (65 %) and 6 (30 %) patients. Poor functional outcome was seen in only 1 (5 %) patient. Conclusion: Locking compression plate is found to have good results in patients with traumatic distal femoral fractures in terms of early mobilization and functional outcome. Particularly in intra-articular fractures it provides good angular stability by its triangular reconstruction principle.

scholarly journals COMPARATIVE STUDY OF INTERNAL FIXATION OF DISTAL FEMORAL FRACTURES IN ADULTS USING DYNAMIC CONDYLAR SCREW AND DISTAL FEMORAL NAIL

2020 ◽  
pp. 15-17
Author(s):  
Anindya Basu ◽  
Imran Khan ◽  
Debarshi Jana
Keyword(s):  
Internal Fixation ◽  
Operating Time ◽  
Femoral Fractures ◽  
Simple Type ◽  
Distal Femoral Fractures ◽  
Medical College ◽  
Femur Fractures ◽  
Dynamic Condylar Screw ◽  
Femoral Nail ◽  
Intraarticular Fractures

Background: Distal femoral fractures are uncommon, usually complex and account for about 7% of all femoral fractures. These fractures often are unstable and comminuted and tend to occur in elderly or multiply injured patients. The incidence is highest in women older than 75 years and in adolescent boys and men 15-24 years. Aim: To compare the results of different modes of internal fixation of different type of distal femur fractures by Distal Femoral Nail and Dynamic Condylar Screw. Materials and Methods: The study was conducted in the department of orthopedics, R.G. Kar Medical College & Hospital; 1,K.B. Sarani, Kolkata – 700004. The main source of patients was those adults presenting with distal femoral fractures attending either emergency or outdoor & also patients referred from peripheral hospitals. Distal femoral fractures of AO/OTA type A fractures (i.e. extra-articular supracondylar) & AO/OTA type C1 & C2 fractures (i.e. articular simple, metaphyseal simple type & articular simple & metaphyseal multifragmentary type respectively). Results: Most of the patients were operated on an average of 6.5th day from injury. Average intra-operative blood loss and operating time for DFN were significantly low compared to the other group. The average duration of hospital stay was 14.7 days overall. No groups showed significant higher duration of the same. Conclusion: Dynamic condylar Screws give results in treating pure supracondylar or complete intraarticular fractures, although with less satisfactory outcomes especially in the latter.

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