Locking compression plate fixation of femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity: a retrospective study

Abstract Background To investigate the clinical efficacy of locking compression plate fixation for the treatment of femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity. Methods A retrospective analysis was conducted on 37 patients with femoral intertrochanteric fractures combined with preexisting proximal femoral deformity between January 2013 and July 2019. The patients included 24 males and 13 females aged from 23 to 69 years old, with an average age of 47.5 years. The preexisting proximal femoral deformities resulted from poliomyelitis sequela, proximal femoral fibrous dysplasia, malunion and implant failure combined with coxa vara after intramedullary nailing fixation. There were 6 cases of 31-A2.1, 6 cases of 31-A2.2, 20 cases of 31-A3.1, and 5 cases of 31-A3.2, determined based on the AO classification of intertrochanteric fractures. All fractures were managed through open reduction and locking plate fixation. The hip disability and osteoarthritis outcome score (HOOS) was used to assess hip function before injury and at the last postoperative follow-up. The short form 36 (SF-36) Health Survey Questionnaire was used to assess quality of life. Results Thirty-seven patients were followed up for 12 to 27 months (average, 20.7 months). All patients achieved bone healing within 5.1 months on average (range, 3 to 6 months). Postoperative complications included deep vein thrombosis in three patients, bedsores in one and delayed union in one patient. No other complications, such as surgical site infection, fat embolism, nonunion and re-fracture, were presented. There was no significant difference in the HOOS scores and the SF-36 Health Questionnaire outcomes at pre-injury and at the last postoperative follow-up (p > 0.05). Conclusions It is difficult to perform intramedullary fixation of femoral intertrochanteric fractures in patients with preexisting proximal femoral deformity, while locking compression plate fixation is a simple and effective method of treatment.

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Comminuted olecranon fractures: locking compression plate fixation verses conventional plate fixation

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20213382 ◽

2021 ◽

Vol 7 (5) ◽

pp. 1001

Author(s):

Neetin P. Mahajan ◽

Mrugank A. Narvekar ◽

Lalkar L. Gadod ◽

G. S. Prasanna Kumar

Keyword(s):

Plate Fixation ◽

Normal Function ◽

Locking Compression Plate ◽

Locking Plates ◽

Plate Group ◽

Significant Difference ◽

Compression Plate ◽

Conventional Plate ◽

Olecranon Fractures

Background: A variable consensus exists on the optimal management strategies for olecranon fractures. Though the mechanical properties of the conventional plates and the locking plates used show no difference, pre-contoured locking plates provide a significant advantage over non-locking plates in unstable fractures. The aim of the study was to compare clinical and radiological outcomes in the management of the comminute olecranon fractures by anatomically pre-contoured locking compression plates and the conventional plates.Methods: The present study was a prospective study of 50 patients with comminuted olecranon fracture, with 25 patients each randomized into two groups, those that underwent fixation of the fracture using a pre-contoured locking compression plate (group LCP) and those fixed using a conventional plate (3.5 mm reconstruction plate) (group CP). Patients were followed up to 1 year with functional outcome assessed at each follow-up with Mayo elbow performance score.Results: The mean MEPS (LCP vs CP) at 1.5 (47 vs. 43.4) and 3 (67.4 vs 61.6) months follow up showed a statistically significant difference between the two groups, but the difference was not significant at 6 (86.4 vs 85.6) and 12 (88.4 vs 87) months. The time to union (4.3 months vs 5.0 months) was not significantly different between the groups. There were 11 complications in group LCP and 12 complications in group CP.Conclusions: In the present study, we suggest that the use of a pre-contoured locking compression plate provides better outcomes at earlier periods as compared to the conventional plate; thus, returning the patient to normal function at the earliest.

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Chronic Achilles Tendinopathy

The American Journal of Sports Medicine ◽

10.1177/0363546507303558 ◽

2007 ◽

Vol 35 (10) ◽

pp. 1659-1667 ◽

Cited By ~ 65

Author(s):

Wolf Petersen ◽

Robert Welp ◽

Dieter Rosenbaum

Keyword(s):

Synergistic Effect ◽

Short Form ◽

Achilles Tendinopathy ◽

Eccentric Training ◽

Treatment Groups ◽

Alternative Treatment Option ◽

Sf 36 ◽

Significant Difference ◽

Chronic Achilles Tendinopathy

Background Previous studies have shown that eccentric training has a positive effect on chronic Achilles tendinopathy. A new strategy for the treatment of chronic Achilles tendinopathy is the AirHeel brace. Hypothesis AirHeel brace treatment improves the clinical outcome of patients with chronic Achilles tendinopathy. The combination of the AirHeel brace and an eccentric training program has a synergistic effect. Study Design Randomized controlled clinical trial; Level of evidence, 1. Methods One hundred patients were randomly assigned to 1 of 3 treatment groups: (1) eccentric training, (2) AirHeel brace, and (3) combination of eccentric training and AirHeel brace. Patients were evaluated at 6, 12, and 54 weeks after the beginning of the treatment protocol with ultrasonography, visual analog scale (VAS) for pain, American Orthopaedic Foot and Ankle Society (AOFAS) ankle score, and Short Form-36 (SF-36). Results The VAS score for pain, AOFAS score, and SF-36 improved significantly in all 3 groups at all 3 follow-up examinations. At the 3 time points (6 weeks, 12 weeks, and 54 weeks) of follow-up, there was no significant difference between all 3 treatment groups. In all 3 groups, there was no significant difference in tendon thickness after treatment. Conclusions The AirHeel brace is as effective as eccentric training in the treatment of chronic Achilles tendinopathy. There is no synergistic effect when both treatment strategies are combined. Clinical Relevance The AirHeel brace is an alternative treatment option for chronic Achilles tendinopathy.

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Mid-Term (4-10 year) Outcomes of INBONE I Total Ankle Arthroplasty with Deformity Analysis

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000190 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0001

Author(s):

Andrew Harston ◽

James Nunley ◽

Mark Easley ◽

James DeOrio ◽

Samuel Adams ◽

...

Keyword(s):

Short Form ◽

Total Ankle Arthroplasty ◽

Coronal Plane ◽

Consecutive Series ◽

Ankle Arthroplasty ◽

Sf 36 ◽

Significant Difference ◽

Patient Reported ◽

Plane Deformity

Category: Ankle, Ankle Arthritis Introduction/Purpose: Concerns for limited coronal plane stability prompted the manufacturer and designers of the INBONE total ankle arthroplasty system to replace the original saddle-shaped talar component (INBONE I) with a sulcus-shaped talar component (INBONE II). Prior to the availability of the INBONE II talar component, numerous INBONE I total ankle replacements were performed. To our knowledge mid-term outcomes of INBONE I total ankle arthroplasty have not been reported. This study compares the mid-term outcomes of patients with and without preoperative coronal plane deformity who underwent total ankle replacement with the INBONE I prosthesis. In our opinion, the longer-term outcomes of the INBONE I prosthesis are important for patient and surgeon education. Methods: A consecutive series of patients, from May, 2007 to September, 2011, at a single institution who underwent total ankle arthroplasty with the INBONE I Total Ankle Arthroplasty (Wright Medical) were prospectively enrolled. Pain and patient- reported function were assessed preoperatively and at yearly follow-ups with use of a visual analog scale (VAS) for pain, the American Orthopaedic Foot & Ankle Society (AOFAS) ankle- hindfoot score, the Short Musculoskeletal Function Assessment (SMFA), and the Short Form-36 (SF-36) Health Survey. We analyzed the data for complications, reoperations, and failures (defined as undergoing revision for exchange or removal of the metallic components for any reason). Patients were grouped according to coronal plane tibiotalar alignment (preoperative coronal plane malalignment of >10 degrees and <10 degrees deformity) and outcomes compared. Results: One-hundred fifty-five INBONE I prostheses were implanted in 151 patients, with minimum 4 year clinical and radiographic follow-up. Follow-up ranged from 48-113 months with an average of 67 months. There was significant (p<0.05) improvement in the VAS, AOFAS, SMFA, and SF-36 scores at most recent follow-up. Forty-five patients (29%) had 49 additional surgeries for impingement, loosening/subsidence, malalignment, ligament instability, polyethylene exchange, and/or infection. There were 14 implant failures with overall survivorship of 90.3%. There was no statistically significant difference in outcomes between patients with coronal plane deformity >10 degrees (47.7%) and <10 degrees (52.3%). Patients with >10 degrees had fewer reoperations (19 vs. 30) and fewer revisions (5 vs. 9) when compared to patients with <10 degrees deformity. Conclusion: Patients who underwent INBONE I total ankle arthroplasty demonstrated significant improvement in pain and patient-reported outcomes at a mean of 5.7 years post-operatively. The patients with preoperative coronal plane tibiotalar deformity had similar pain relief, function, and need for additional surgeries and revisions. Despite the presumed shortcomings of the INBONE I’s saddle-shaped talar design, this operation shows promising results, with or without deformity, at mid-term follow- up with survivorship of 90.3%.

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Investigation of a novel implant design for the treatment of reverse oblique femoral intertrochanteric fractures

10.21203/rs.2.15562/v1 ◽

2019 ◽

Author(s):

Rui Zhang ◽

Kangyi Wang ◽

Peng Luo ◽

Xiaoshan Guo

Keyword(s):

Axial Load ◽

Biomechanical Properties ◽

Locking Compression Plate ◽

Implant Design ◽

Intertrochanteric Fractures ◽

Lateral Plate ◽

Significant Difference ◽

Compression Plate ◽

Load To Failure ◽

Buttress Plate

Abstract Objective: To evaluate the biomechanical properties of intramedullary fixation, lateral plate, medial buttress plate and bilateral plate for fixing reverse oblique intertrochanteric fractures. Methods: Twenty-four synthetic femoral bone models (Synbone) were divided into four groups [proximal femoral nail anti-rotation (PFNA), proximal femoral medial buttress plate (PFMBP), proximal femoral locking compression plate (PFLCP) and proximal femoral medial buttress plate + proximal femoral locking compression plate (PFMBL+PFLCP)], and an unstable, reverse oblique femoral intertrochanteric fracture was made. After fixation, each model underwent axial load testing, torsion testing, and axial load-to-failure testing. The stiffness of axial and torsion, the torque of different torsion angles and the failure load of every model were recorded. Results: The bilateral plate showed the best performance in axial load, torsion, and load-to-failure testing. The stiffness of axial and torsion in the PFMBP was superior to the PFNA [162.05±22.05 N/mm vs. 119.13±29.14 N/mm in axial, (1.36±0.32) N × mm/deg vs. (1.10±0.13) N × mm/deg in torsion, P<0.05], whereas there was no significant difference between PFMBP, PFLCP and PFLCP+PFMBP in torsion stiffness [(1.36±0.32) N × mm/deg, (1.45±0.44) N × mm/deg, (1.45±0.18) N × mm/deg, P>0.05]. Conclusion: Our newly designed medial buttress plate achieved greater stiffness in axial load and torsion than PFNA and PFLCP to fix reverse oblique intertrochanteric fractures in biomechanical research, whereas the bilateral plate showed better stiffness than PFMBP.

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Locking Compression Plate fixation of radial and tibial fractures in a young dog

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632946 ◽

2005 ◽

Vol 18 (03) ◽

pp. 194-198 ◽

Cited By ~ 13

Author(s):

P. M. Montavon ◽

C. S. Schwandt

Keyword(s):

Intramedullary Nail ◽

Tibial Fracture ◽

Plate Fixation ◽

Locking Compression Plate ◽

Tibial Fractures ◽

Compression Plate

SummaryA six-month-old, male Bernese Mountain Dog in which radius-ulna and tibia-fibula concomitant fractures were treated each with a 3.5 mm Locking Compression Plate (LCP) is presented. Both fractures were approached and plated medially. The tibial fracture had to be revised with a 4.5 mm intramedullary nail and a new 3.5 mm LCP at the second post-operative day because of fixation breakdown. The follow-up radiographs taken at days 14 and 53 revealed uneventful healing of both fractures. Implants were removed 53 days after surgery.

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Effect of age on clinical and radiographic outcomes and adverse events following 1-level lumbar arthroplasty after a minimum 2-year follow-up

Journal of Neurosurgery Spine ◽

10.3171/spi/2008/8/2/101 ◽

2008 ◽

Vol 8 (2) ◽

pp. 101-107 ◽

Cited By ~ 10

Author(s):

Richard D. Guyer ◽

Fred H. Geisler ◽

Scott L. Blumenthal ◽

Paul C. McAfee ◽

Bradford B. Mullin

Keyword(s):

Clinical Outcome ◽

Adverse Events ◽

Short Form ◽

Similar Clinical Outcome ◽

Sf 36 ◽

Significant Difference ◽

Vas Scores ◽

Group 2 ◽

Group 1

Object Lumbar arthroplasty is approved in the US for the treatment of degenerative disc disease at 1 level in skeletally mature patients. However, a bias toward older patients (> 45 years of age) who are otherwise indicated for the procedure may exist. In this study, the clinical outcomes of patients from the Charité Investigational Device Exemption (IDE) study were analyzed on the basis of patient age. Methods There were 276 patients enrolled in the IDE study of the Charité Artificial Disc who underwent 1-level arthroplasty at either L4–5 or L5–S1, including 71 nonrandomized and 205 randomized individuals. Patient data were analyzed based on age (18–45 years [217 patients, Group 1] compared with 46–60 years [59 patients, Group 2]). Statistical analyses were performed based on 2-year postoperative improvements in Oswestry Disability Index (ODI), 36-item Short Form Health Survey (SF-36), and visual analog scale (VAS) scores (clinical outcome), as well as range of motion (radiographic outcome), and adverse events. Results There was no significant difference between the groups with respect to level implanted, operative time, blood loss, changes in ODI and VAS scores or any of the 8 component scores of the SF-36, compared with baseline, at all time points throughout the 24-month follow-up period (p > 0.10). Patient satisfaction was equivalent at 24 months, with 87% satisfaction in Group 1 and 85% satisfaction in Group 2 (no statistical difference). In addition, no significant differences were identified with respect to adverse events including approach related, neurological, technique related, or reoperation. Conclusions Although patients > 45 years of age may have comorbidities or contraindications for arthroplasty for a number of reasons, particularly osteopenia, this analysis demonstrates that patients who are indicated for 1-level arthroplasty experience similar clinical outcome, satisfaction, or adverse events compared with their younger counterparts.

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The Usefullness of Subtalar Arthroscopy in Surgical Treatment of Sanders Type 2 Calcaneal Fractures Using a Sinus Tarsi Approach

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000317 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0003

Author(s):

Chul-Hyun Park ◽

Dong-Il Chun ◽

Hongjoon Choi ◽

Jaeho Cho ◽

JAEWOO PARK

Keyword(s):

Short Form ◽

Calcaneal Fractures ◽

Sinus Tarsi ◽

Sf 36 ◽

Intraoperative Fluoroscopy ◽

Sinus Tarsi Approach ◽

Significant Difference ◽

American Orthopaedic ◽

Clinical And Radiological Results

Category: Ankle, Trauma Introduction/Purpose: The sinus tarsi approach was designed to provide a direct view of the posterior facet and reduce soft tissue and neurovascular injuries. However, it is difficult to expose posterior facet using sinus tarsi approach because of limited surgical view. Confirmation of reduction status in intra-articular calcaneal fractures has traditionally been performed by intraoperative fluoroscopy such as Brodens view. Recently some reports indicate that there is a role for subtalar arthroscopy in these fractures. We thought that combination of intraoperative fluoroscopy and subtalar arthroscopy could more accurately restore joint congruity and provide better clinical outcomes. The purpose of this study was to clarify whether this combined checking has better clinical and radiological results comparing with intraoperative fluoroscopy only. Methods: Forty-five displaced calcaneal fractures involving the posterior facet were consecutively treated using a sinus tarsi approach by a single surgeon. Among them, 25 fractures were confirmed reduction of posterior facet by fluoroscopy (Fluoroscopy group) and 20 fractures were confirmed by combined fluoroscopy and subtalar arthroscopy (Arthroscopy group). Clinical evaluations were performed using the visual analogue scale (VAS) and the Ankle-Hindfoot Scale developed by the American Orthopaedic Foot and Ankle Society (AOFAS), and short form (SF)-36 v2 questionnaires. Radiographic evaluations were performed using calcaneal lateral radiographs and CT. Changes in Böhler’s angle were evaluated from the preoperative and last follow-up lateral radiograph of calcaneus. Reduction of the posterior facet was graded according to articular step, defect, and angulation of the posterior facet in CT. Results: There were no significant differences in terms of VAS, AOFAS score, and SF-36 v2 between Fluoroscopy and Arthroscopy groups at the last follow-up. No significant difference was observed in change of Böhler’s angles between the groups. Reduction of the posterior facet was graded excellent in 5 feet (20%), good in 12 (48%), and fair in 8 (32%) in Fluoroscopy group and excellent in 7 feet (35%), good in 11 (55%), and fair in 2 (10%) in Arthroscopy on postoperative CT. Screw penetration of posterior facet were observed in 4 feet of Fluoroscopy group and 1 foot of Arthroscopy group on postoperative CT. Conclusion: Subtalar arthroscopy appears to be useful in detecting joint incongrucencies in sinus tarsi approach of intra-articular calcaneal fractures.

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Potential outcome of locking compression plate in proximal humerus fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20184238 ◽

2018 ◽

Vol 4 (6) ◽

pp. 835

Author(s):

J. P. V. Jebaraj ◽

B. Sundararaja

Keyword(s):

Functional Outcome ◽

Proximal Humerus ◽

Bone Fractures ◽

Plate Fixation ◽

Locking Compression Plate ◽

Proximal Humerus Fractures ◽

Non Union ◽

Compression Plate ◽

Humerus Fractures

Background: Fractures of proximal humerus bone needs immediate attention as the delayed treatment might result in non-union, malunion, and avascular necrosis which are responsible for the pain and dysfunction. The aim of the present study is to evaluate the functional outcome of displaced proximal humerus bone fractures that are surgically managed by locking compression plate and to assess the potential complication.Methods: The present study is the combination of both prospective and retrospective in which 30 patients with either Neer’s three part or Neer’s four-part proximal humerus fractures which were fixed with locking plate by a single surgeon. Functional outcome was measured by Constant Murley scoring (CMS) system.Results: The final follow-up of the study showed that 21 patients (70%) had the result that ranged from good to excellent score whereas, 6 patients (20%) had moderate score and 3 patients had poor score in functional outcome according to CMS system. During follow-up, 3 complications (10%) were encountered.Conclusions: The study concluded that proximal humerus locked compression plate is a valuable surgical method for the fixation of comminuted fractures of the proximal humerus as it is associated with excellent functional outcome. It also provides a stable fixation to permit early mobilization. Regaining medial cortical contact and establishing anatomical reductions decreases the complications that are associated with plate fixation.

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Comparing durability of water- and land-based exercise benefits among older adults in South Korea: A randomized controlled trial with 1-year follow-up

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-200109 ◽

2021 ◽

pp. 1-11

Author(s):

Se Jun Oh ◽

Sang Heon Lee

Keyword(s):

Exercise Intervention ◽

External Rotation ◽

Short Form ◽

Controlled Trial ◽

Weight Bearing ◽

Aquatic Exercise ◽

Step Test ◽

Sf 36 ◽

Partial Weight

BACKGROUND: Aquatic exercise can improve strength, flexibility, and aerobic function while safely providing partial weight-bearing support through viscosity and buoyancy. OBJECTIVE: The aim of the present study was to compare the effects of water-based exercise with land-based exercise before and after a 10-week exercise intervention and again at one-year follow-up. METHODS: Eighty participants aged 65 years and older were randomly assigned to either a water- or a land-based 10-week exercise program. Assessment included the Senior Fitness Test (SFT), the Modified Falls-Efficacy Scale, and the 36-Item Short-Form Health Survey (SF-36). Hip and knee strength was also measured. All assessments were completed at three time points: pre- (T1), post- (T2), and at 1-year follow-up (T3). RESULTS: Significant differences were observed between the two groups on three parameters: the SFT timed up-and-go test; lower hip muscle strength in extension, adduction, and external rotation; and quality of life (QoL) measured by the SF-36 (p< 0.05). No significant differences were observed in the SFT chair stand test, dominant arm curl test, two-minute step test, chair sit-and-reach test, back scratch test, and Modified Falls-Efficacy Scale. CONCLUSION: Aquatic exercise provided greater improvement of physical health and QoL among older people than land-based exercise.

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Dynamic fixation using rigid tape in rehabilitation after surgery of terrible triad injury of the elbow: A randomized trial

Journal of Back and Musculoskeletal Rehabilitation ◽

10.3233/bmr-200279 ◽

2021 ◽

pp. 1-8

Author(s):

Shenxing Du ◽

Lihong Wei ◽

Bangjian He ◽

Zhen Fang ◽

Eryuan Zhou ◽

...

Keyword(s):

Muscle Strength ◽

Short Form ◽

Terrible Triad ◽

Dynamic Fixation ◽

Rehabilitation Programs ◽

Hinged External Fixation ◽

Sf 36 ◽

Significant Difference ◽

General Rehabilitation ◽

Time Point

OBJECTIVE: The aim of the study was to identify the efficacy of dynamic fixation using rigid tape (RT) in rehabilitation after surgery of terrible triad injury of the elbow (TTIE). METHODS: Sixty patients who underwent surgery of TTIE were equally randomly divided into RT group and hinged external fixation brace (HEFB) group. Dynamic fixations were applied for 8 weeks. General rehabilitation programs were performed for 3 months, 5 times a week. Follow-up (FU) was at six months. Main outcomes included pain (Visual Analogue Scale, VAS), muscle strength, range of motion (ROM), Elbow Function (Mayo Elbow Performance Index, MEPI), Quality of Life (QOL) (Short Form 36 Questionnaire, SF-36). RESULTS: There were significant time x group interactions for pain, ROM, MEPI, SF-36 (all p= 0.000), which demonstrated positive efficacy of both the two interventions. Difference at each time-point (except for baseline) of pain and ROM between the two groups was statistically significant (all p< 0.05). Some differences between the two groups were not statistically significant which at 14d on MEPI (p= 0.108) and at 21d (p= 0.259) and FU (p= 0.402) on QOL. Moreover, the increased muscle strength at each time-point had no statistically significant difference between the two groups (all p> 0.05). CONCLUSIONS: Both RT and HEFB could significantly improve the postoperative functional outcomes of the TTIE. However, early rehabilitation intervention could increase pain, which affected the corresponding function (MEPI) and QOL. Note that this kind of impact was short-term and reversible. The muscle strength and ROM were not affected by the increased severe pain, maintaining a trend of improvement. In addition, the subjects in the RT group improved faster and more efficiently and had better results with pain, ROM, MEPI, and QOL compared to the subjects in the HEFB group.

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