Radiographic analysis of the restoration of hip joint center following open reduction and internal fixation of acetabular fractures: a retrospective cohort study

Abstract Purpose To compare the rates of ulnar nerve neuropathy following ulnar nerve subcutaneous anterior transposition versus no transposition during open reduction and internal fixation (ORIF) of distal humerus fractures. Methods This was a retrospective cohort study at an academic level I trauma centre. A total of 97 consecutive patients with distal humerus fractures underwent ORIF between 2011 and 2018. All included patients were treated with plates (isolated lateral plates excluded) and had no pre-operative ulnar neuropathy. Subcutaneous ulnar nerve anterior transposition was compared versus no transposition at the time of ORIF. The main outcome measure was the rate of ulnar nerve neuropathy. The secondary outcomes were the severity of the ulnar nerve neuropathy and the rate of ulnar nerve recovery. Results Twenty-eight patients underwent subcutaneous ulnar nerve anterior transposition during ORIF, whereas 69 patients had no transposition. Transposition was associated with significantly higher rates of ulnar nerve neuropathy (10/28 versus 10/69; P = 0.027). An adjusted logistic regression model demonstrated an odds ratio of 4.8 (1.3, 17.5; 95% CI) when transposition was performed. Ulnar nerve neuropathy was classified as McGowan grades 1 and 2 in all neuropathy cases in both groups (P = 0.66). Three out of ten cases recovered in the transposition group, and five out of ten cases recovered in the no transposition group over a mean follow-up of 11.2 months (P = 1.00). Conclusion We do not recommend performing routine subcutaneous ulnar nerve anterior transposition during ORIF of distal humerus fracture as it was associated with a significant 5-fold increase in ulnar nerve neuropathy.

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Comparison of Medial Malleolar Fracture Healing at 8 Weeks After Open Reduction Internal Fixation Versus Percutaneous Fixation: A Retrospective Cohort Study

The Journal of Foot & Ankle Surgery ◽

10.1053/j.jfas.2016.11.003 ◽

2017 ◽

Vol 56 (2) ◽

pp. 277-281 ◽

Cited By ~ 6

Author(s):

Glenn M. Weinraub ◽

Patrick Levine ◽

Eric Shi ◽

Aarron Flowers

Keyword(s):

Cohort Study ◽

Internal Fixation ◽

Fracture Healing ◽

Retrospective Cohort Study ◽

Open Reduction ◽

Retrospective Cohort ◽

Open Reduction Internal Fixation ◽

Percutaneous Fixation ◽

Malleolar Fracture

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Effect of Early Weightbearing Following Open Reduction and Internal Fixation of Unstable Ankle Fractures on Wound Complications or Failures of Fixation

Foot & Ankle International ◽

10.1177/1071100719867932 ◽

2019 ◽

Vol 40 (12) ◽

pp. 1397-1402 ◽

Cited By ~ 3

Author(s):

Casey Pyle ◽

Michael Kim-Orden ◽

Tyler Hughes ◽

Brian Schneiderman ◽

Robert Kay ◽

...

Keyword(s):

Cohort Study ◽

Internal Fixation ◽

Retrospective Cohort Study ◽

Open Reduction ◽

Retrospective Cohort ◽

Ankle Fractures ◽

Wound Complications ◽

Fracture Union ◽

Wound Breakdown ◽

Hardware Failures

Background: There is a growing trend toward early weightbearing as tolerated (WBAT) after open reduction and internal fixation (ORIF) of ankle fractures. To date, studies have excluded fractures with associated syndesmotic injuries from their cohorts. Methods: In this retrospective cohort study, a chart review was performed at a single level 1 trauma center, identifying all unstable ankle fractures that underwent operative fixation between July 2016 and July 2017. After exclusion criteria, 63 patients were identified and 31 were included in the final analysis, with 14 undergoing syndesmotic fixation. WBAT was initiated after suture removal, between 2 and 4 weeks postoperatively. Outcomes included fracture union, radiographic maintenance of alignment, hardware failures, wound complications, and the need for repeat surgery. Results: Weightbearing was initiated at an average of 17.8 days. All 31 patients progressed toward fracture union, with no hardware failures. Three patients developed superficial wound breakdown, which was treated with protected weightbearing in all cases and oral antibiotics in 1 case. All 3 went on to heal from their incisions. One patient had delayed wound breakdown and required a split-thickness skin graft that subsequently healed without complication. One patient underwent hardware removal 6 months postoperatively. There were no revision ORIF procedures. Conclusion: There is literature supporting early WBAT after ORIF of unstable ankle fractures in patients without major comorbidities. This article supports this trend, demonstrating that a group of ankle fractures requiring syndesmotic fixation were included in the early weightbearing cohort without a higher rate of catastrophic failure or increased wound problems. Level of Evidence Level IV, retrospective cohort study.

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Comment on “The role of ulnar nerve subcutaneous anterior transposition during open reduction and internal fixation of distal humerus fractures: a retrospective cohort study”

International Orthopaedics ◽

10.1007/s00264-020-04862-w ◽

2020 ◽

Vol 44 (12) ◽

pp. 2709-2710

Author(s):

Bin-Fei Zhang ◽

Yu-Min Zhang

Keyword(s):

Cohort Study ◽

Internal Fixation ◽

Ulnar Nerve ◽

Retrospective Cohort Study ◽

Open Reduction ◽

Retrospective Cohort ◽

Distal Humerus ◽

Humerus Fractures ◽

Distal Humerus Fractures

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Update of a Retrospective Cohort Study of Changes in Hip Joint Phenotype of Dogs Evaluated by the OFA in the United States, 1989-2003

Veterinary Surgery ◽

10.1111/j.1532-950x.2008.00475.x ◽

2009 ◽

Vol 38 (3) ◽

pp. 398-405 ◽

Cited By ~ 14

Author(s):

JOHN B. KANEENE ◽

ULREH V. MOSTOSKY ◽

ROSEANN MILLER

Keyword(s):

United States ◽

Cohort Study ◽

Hip Joint ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

The United States

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Arthroplasty Versus Internal Fixation for the Treatment of Undisplaced Femoral Neck Fractures: A Retrospective Cohort Study

Journal of Orthopaedic Trauma ◽

10.1097/bot.0000000000001940 ◽

2020 ◽

Vol 34 (3) ◽

pp. S9-S14

Author(s):

Shaikh Afaq ◽

Nathan N. O'Hara ◽

Emil H. Schemitsch ◽

Sofia Bzovsky ◽

Sheila Sprague ◽

...

Keyword(s):

Cohort Study ◽

Femoral Neck ◽

Internal Fixation ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Femoral Neck Fractures

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Comparison of outcomes of ORIF versus bidirectional tractor and arthroscopically assisted CRIF in the treatment of lateral tibial plateau fractures: a retrospective cohort study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-021-02447-w ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Xiangtian Deng ◽

Hongzhi Hu ◽

Yiran Zhang ◽

Weijian Liu ◽

Qingcheng Song ◽

...

Keyword(s):

Cohort Study ◽

Internal Fixation ◽

Clinical Outcomes ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Tibial Plateau ◽

Clinical Score ◽

Lateral Tibial Plateau ◽

Significant Difference

Abstract Background Lateral tibial plateau fractures (TPFs) are often treated with conventional open reduction and internal fixation (ORIF) through standard anterolateral sub-meniscal arthrotomy. There has been increasing support for “bidirectional rapid redactor” device-assisted closed reduction and internal fixation (CRIF) for treating TPFs. The aim of the present study is to compare the clinical and radiological outcomes between CRIF and ORIF procedures. Methods We performed a retrospective cohort study of 55 lateral TPF patients (Schatzker types I–III) who accepted surgical treatment at our trauma level 1 center between January 2016 and January 2018. They were divided into the CRIF group (32 patients) and the ORIF group (23 patients) based upon the different surgical protocols. The patients’ clinical outcome analysis was evaluated by using the Knee Society Score (KSS) and Rasmussen’s clinical score. For radiological assessment, changes in tibial plateau width (TPW), articular depression depth (ADD), medial proximal tibial angle (MPTA), and posterior tibial slope angle (PTSA) were evaluated using radiographs and computed tomography (CT) scan. Results The CRIF group had a mean follow-up of 28.9 months, and the ORIF group had a mean follow-up of 30.7 months (p>0.05). Furthermore, there was no statistically significant difference in terms of age, gender, injury mechanism, follow-up time, time interval from injury to surgery, and Schatzker classification in the two groups. With respect to the clinical outcomes including the KSS score and Rasmussen’s clinical score, there was also no significant difference (p>0.05). Nevertheless, the CRIF group had lower intra-operative blood loss, shorter hospitalization days, and better range of movement of the knee joint than the ORIF group (p<0.05). Furthermore, CRIF had better radiological results when compared to the ORIF group using Rasmussen’s radiological score (p<0.05), although no significant difference was observed in TPW, ADD, MPTA, and PTSA between the two groups (p>0.05). Conclusion The present study showed that CRIF could achieve comparable clinical outcomes and better radiological results for treating lateral TPFs as compared with conventional ORIF.

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