scholarly journals Therapeutic analysis of Herbert screw fixation for capitellar fractures via the anterior approach in adolescent patients

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lingpeng Ju ◽  
Linjun Jiang ◽  
Yuan Zhang ◽  
Jun Wu ◽  
Ming Li ◽  
...  
Keyword(s):  
Performance Index ◽  
Open Reduction ◽  
Anterior Approach ◽  
Screw Fixation ◽  
Rating System ◽  
Bony Union ◽  
Imaging Data ◽  
Herbert Screw ◽  
Elbow Function

Abstract Objective The aim of this study is to analyze the efficacy of open reduction and Herbert screw fixation for coronal fractures of the capitellum via the anterior approach in adolescents. Methods We retrospectively analyzed the clinical and imaging data of 15 adolescents with capitellar fractures who were admitted to our hospital from May 2014 to May 2019. The fracture was reduced through the cubital crease incision via the anterior approach and was internally fixated with Herbert screws. A follow-up was conducted after the operation to examine fracture healing and elbow function. The postoperative functional recovery of patients was evaluated with the Mayo Elbow Performance index (MEPI) and the Broberg-Morrey rating system. Results Patients underwent surgery 3.7 days after injury on average. Intraoperative fracture reduction was satisfactory. No vascular injury or nerve injury occurred. Bony union occurred in an average of 6 weeks after the operation. All adolescents completed a 12- to 36-month follow-up. At the last follow-up, the Mayo Elbow Performance index was considered excellent in 12 patients and good in three patients. The Broberg-Morrey score was considered excellent in 12 patients, good in two patients, and fair in one patient. Conclusion Open reduction with Herbert screw fixation via the anterior approach is a feasible surgical method for the treatment of coronal fractures of the capitellum in adolescents. Levels of evidence Therapeutic, retrospective study-Level IV

scholarly journals Therapeutic Analysis of Herbert Screw Fixation for Capitellar Fractures via the Anterior Approach in Children

2021 ◽  
Author(s):  
Lingpeng Ju ◽  
Linjun Jiang ◽  
Yuan Zhang ◽  
Jun Wu ◽  
Ming Li ◽  
...  
Keyword(s):  
Performance Index ◽  
Open Reduction ◽  
Anterior Approach ◽  
Screw Fixation ◽  
Rating System ◽  
Bony Union ◽  
Imaging Data ◽  
Herbert Screw ◽  
Elbow Function

Abstract Objective: To analyse the efficacy of open reduction and Herbert screw fixation for coronal fractures of the capitellum via the anterior approach in children.Methods: We retrospectively analysed the clinical and imaging data of 15 children with capitellar fractures who were admitted to our hospital from May 2014 to May 2019. The fracture was reduced through the cubital crease incision via the anterior approach and was internally fixated with Herbert screws. A follow-up was conducted after the operation to examine the fracture healing and elbow function. The postoperative functional recovery of patients was evaluated with the Mayo Elbow Performance index (MEPI) and the Broberg-Morrey rating system.Results: Patients underwent surgery 3.7 days after injury on average. Intraoperative fracture reduction was satisfactory. No vascular injury or nerve injury occurred. Bony union occurred in an average of 6 weeks after the operation. All children completed 12- to 36-month follow-up. At the last follow-up, the Mayo Elbow Performance index was considered excellent in 12 patients and good in three patients. The Broberg-Morrey score was considered excellent in 12 patients, good in two patients, and fair in one patient. Conclusion: Open reduction and Herbert screw fixation via the anterior approach are an ideal surgical method for the treatment of coronal fractures of the capitellum in children.Levels of Evidence: Therapeutic, retrospective study-Level IV

Scaphoid Non-Union: Factors Affecting the Functional Outcome of Open Reduction and Wedge Grafting with Herbert Screw Fixation

1993 ◽  
Vol 18 (2) ◽  
pp. 219-224 ◽  
Author(s):  
R. NAKAMURA ◽  
E. HORII ◽  
K. WATANABE ◽  
K. TSUNODA ◽  
T. MIURA
Keyword(s):  
Surgical Treatment ◽  
Functional Outcome ◽  
Open Reduction ◽  
Screw Fixation ◽  
Functional Results ◽  
Bony Union ◽  
Proximal Fragment ◽  
Factors Affecting ◽  
Non Union ◽  
Herbert Screw

50 patients with scaphoid non-union were treated by open reduction, anterior wedge bone grafting and internal fixation using the Herbert screw. Intra-operative image intensiner control enabled us to insert the screw into the scaphoid accurately. An excellent or good functional outcome was less likely when more than 5 years had elapsed since injury, the non-union was in the proximal third, when sclerosis of the proximal fragment was present, and when reduction of carpal and scaphoid deformity was unsatisfactory. These four factors are believed to be the primary determinants affecting the functional results of the surgical treatment of scaphoid non-union, even when bony union is achieved.

scholarly journals Clinical results of cannulated screw internal fixation via direct anterior approach for femoral neck fractures in young adults: a retrospective study

2020 ◽  
Author(s):  
Yi Yuan ◽  
Rui Huang ◽  
Jia-fu Yang ◽  
Fa-dong Li ◽  
zu-jian xu ◽  
...  
Keyword(s):  
Young Adults ◽  
Femoral Neck ◽  
Open Reduction ◽  
Anterior Approach ◽  
Screw Fixation ◽  
Direct Anterior Approach ◽  
Femoral Neck Fractures ◽  
Cannulated Screw ◽  
Harris Score

Abstract Purpose: To investigate the effectiveness of open reduction and cannulated screw fixation via direct anterior approach (DAA) for the treatment of femoral neck fractures in young adults. Methods: The data from 43 young patients with irreducible femoral neck fractures who underwent this procedure from January 2013 to December 2017 were retrospectively analyzed. Garden's alignment index was measured after the operation and at the final follow-up to determine the reduction quality, and the Harris score was recorded at the final follow-up to assess hip function. Results: The average follow-up duration was 19 months (range, 12-31 months). Implant failure was observed in 3 cases and was associated with femoral neck shortening, and nonunion occurred in 2 patients. A total of 6 patients Exhibited features of avascular necrosis (AVN), four of whom (Ficat grade III) underwent total hip arthroplasty and two of whom (Ficat grade II) were asymptomatic at the final follow-up. There were no statistically significant differences in Garden's alignment index, as measured on X-ray radiographs, immediately after surgery and at the final follow-up. At the final follow-up, the mean Harris score was 82.41±14.06. The Harris score was considered excellent for 17 cases, good for 13 cases, fair for 3 cases, and poor for 4 cases. The rate of excellent and good outcomes was 81.1%. Conclusions: For cases of irreducible femoral neck fractures, open reduction and cannulated screw fixation via DAA can yield relatively good clinical outcomes.

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.

Dorsal Fracture Dislocations of the Proximal Interphalangeal Joint Treated by Open Reduction and Interfragmentary Screw Fixation: Indications, Approaches and Results

2006 ◽  
Vol 31 (2) ◽  
pp. 138-146 ◽  
Author(s):  
J. Y. L. LEE ◽  
L. C. TEOH
Keyword(s):  
Open Reduction ◽  
Screw Fixation ◽  
Early Mobilization ◽  
Proximal Interphalangeal Joint ◽  
Patient Comfort ◽  
Joint Function ◽  
Fracture Dislocations ◽  
Pip Joint ◽  
Joint Congruity

Many operative and non-operative treatments of dorsal fracture dislocations of the proximal interphalageal (PIP) joint have been described. Return of good joint function requires anatomical reduction of the articular fragments and restoration of joint congruity and a stable functional arc of motion, with the fixation construct stable enough for early mobilization. To prevent recurrent dorsal subluxation, the attachments of the ligamentous palmar restraints and the bony buttress provided by the palmar lip of the middle phalanx base must be restored. Open reduction and internal interfragmentary screw fixation using 1.5 or 1.3 mm screws was employed in 12 fingers in 10 patients with unstable dorsal fracture dislocations of the PIP joints of Schenck grades III and IV. At an average follow-up of 8.7 months, all patients in this series achieved good to excellent results and an average total active interphalangeal motion of 132° (range 105°–165°). Additional benefits over non-operative techniques included improved patient comfort and simplified nursing care and therapy supervision.

scholarly journals Scaphoid Fracture: Functional Outcome Following Fixation with Herbert Screw

2012 ◽  
Vol 9 (4) ◽  
pp. 267-273 ◽  
Author(s):  
N P Parajuli ◽  
D Shrestha ◽  
D Dhoju ◽  
R Shrestha ◽  
V Sharma
Keyword(s):  
Functional Outcome ◽  
Open Reduction ◽  
Screw Fixation ◽  
Scaphoid Fracture ◽  
Operative Management ◽  
University Hospital ◽  
Volar Approach ◽  
Herbert Screw ◽  
Scaphoid Fractures ◽  
Radiological Union

Background Most scaphoid fractures though heal uneventfully with cast treatment, immobilization with cast is associated with complication like wrist stiffness. Open reduction and fixation with Herbert Screw though technically demanding procedure can yield excellent results and prevents complication like nonunions and loss of wrist function. Objectives To assess clinical outcome and radiological union of scaphoid fracture after operative management following Herbert screw fixation in patient attending Dhulikhel Hospital. Methods All scaphoid fracture, treated from Feb 2007 till Feb 2011, were retrospectively studied in Dhulikhel Hospital, Kathmandu University Hospital. Fifteen patients with scaphoid fractures were treated with Herbert screw. Fourteen were males and one was female. Serial radiographs were taken to assess radiographic union and functional outcome was assessed using Modified Mayo wrist score. Results Out of 15 patients, 13 scaphoid had waist fractures and two had proximal pole factures. All scaphoid were treated with open reduction and Herbert screw fixation either by volar approach or by dorsal approach. All fractures maintained good alignment post operatively. Nine (60%) patients had excellent results with normal wrist range of motion, five (33.3%) patients had good results and one (6.7%) patient had poor outcome. In 14 (93.3%) patients good radiological union was seen at final follow up at six months time. Conclusion Fixation with Herbert screw for scaphoid fracture is an effective and convenient way of treatment with satisfactory functional outcome and less complication.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6342 Kathmandu Univ Med J 2011;9(4):267-73

Experience with Scaphoid Grafting

1997 ◽  
Vol 22 (2) ◽  
pp. 153-160 ◽  
Author(s):  
N. J. BARTON
Keyword(s):  
Clinical Result ◽  
Bone Grafting ◽  
Bony Union ◽  
Radiological Outcome ◽  
Proximal Pole ◽  
Herbert Screw ◽  
Scaphoid Fractures ◽  
Radiological Results ◽  
Clinical And Radiological Results

Over a period of 24 years, the author has used five different methods of bone-grafting for ununited scaphoid fractures. The clinical and radiological results have been reviewed, with a minimum follow-up of 1 year. Radiologically the best results (78% definite union) were obtained with a “wedge” graft and Herbert screw, while the worst results followed the original Russe operation. The clinical result often did not coincide with the radiological outcome. All methods led to a decrease in pain in most cases, but little or no pain was achieved most often by the modified Russe graft. With proximal pole fractures, bony union was only achieved in 54% but the symptoms were always lessened.

scholarly journals Missed Capitellar Fracture Caused by Avoidance of Radiological Evaluation in Pregnancy

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Barış Polat ◽  
Ramadan Özmanevra ◽  
Deniz Aydın ◽  
Enes Sarı ◽  
Mehmet Yalçınozan
Keyword(s):  
Pregnant Woman ◽  
Open Reduction ◽  
Screw Fixation ◽  
Posterolateral Approach ◽  
Radiological Evaluation ◽  
Compression Screw ◽  
Delayed Treatment ◽  
Headless Compression Screw ◽  
History Of

In this paper, we report a pregnant woman with a missed capitellar fracture of the elbow, who was treated successfully with open reduction and internal fixation using two headless screws. A 29-year-old 6-month pregnant woman presented to the emergency department due to a history of falling on her outstretched hand. A long-arm splint was applied without radiological evaluation due to pregnancy. She came to the orthopaedics and traumatology outpatient clinic 6 weeks after trauma and her examination after splint removal revealed pain and restriction in the elbow joint movements. Radiography was taken by using a lead shield in order to protect the fetus. Radiographs showed a displaced osteochondral capitellar fracture. Using the posterolateral approach as described by Kocher, the fracture was fixed using headless canulated compression screws. The follow-up examination showed excellent functional and radiological results. Radiological evaluation should not be avoided in case of obvious fracture findings after trauma even in case of pregnancy. It is also highlighted that good results in terms of union and functional recovery can be achieved with open reduction and headless compression screw fixation followed by early rehabilitation even in delayed treatment of capitellum fractures.

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