scholarly journals Outcome of complex non-unions of femoral fractures managed with Ilizarov method of distraction osteogenesis

2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Karim Bakhsh ◽  
Faridullah Khan Zimri ◽  
Atiq -Ur- Rehman ◽  
Eid Mohammad ◽  
Muhammad Saaiq
Keyword(s):  
Distraction Osteogenesis ◽  
Case Series ◽  
Femoral Fractures ◽  
Functional Results ◽  
Rehabilitation Medicine ◽  
Bone Union ◽  
Ilizarov Method ◽  
Non Union ◽  
Femur Fractures ◽  
Case Series Study

Objective: To evaluate the management outcome of complex non-union of femoral fractures with Ilizarov method in terms of bone union, functional results and any complications. Methods: This case series study was carried out at the Departments of Orthopedic Surgery, National Institute of Rehabilitation Medicine (NIRM), Islamabad and Civil hospital, Quetta over a period of three and half years, January 1, 2015 to June 30,2018. Results: There were 50 patients in the study. There were 48(96%) males and 2(4%) females. The ages ranged between 17-54 years with a mean of 33.58±8.9 years. As per ASAMI criteria, the bone results were excellent in 17(34%), good in 30(60%), fair in 1(2%) and poor in 2(4%) patients. The functional results were excellent in 15(30%), good in 24(48%), fair in 8(16%) and poor in 3(6%). The bone union rate was 98% whereas infection eradication rate was 94%. The most frequent complications were pin tract infection affecting 80% patients, knee stiffness 60% patients and K-wires loosening 20% patients. Conclusion: The Ilizarov method provides an effective solution to address the complex non-union of femur fractures. It helps to ensure fracture healing, eradicates infection and provides good functional outcome. The attended complications are mild to moderate and manageable with conservative means. doi: https://doi.org/10.12669/pjms.35.4.244 How to cite this:Bakhsh K, Zimri FK, Atiq-Ur-Rehman, Mohammad E, Saaiq M. Outcome of complex non-unions of femoral fractures managed with Ilizarov method of distraction osteogenesis. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.244 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Presentation and management outcome of tibial infected non‑union with Ilizarov technique

2019 ◽  
Vol 35 (1) ◽  
Author(s):  
Karim Bakhsh ◽  
Atiq-Ur- Rehman ◽  
Faridullah Khan Zimri ◽  
Eid Mohammad ◽  
Wazir Ahmed ◽  
...  
Keyword(s):  
External Fixation ◽  
Case Series ◽  
Functional Results ◽  
Rehabilitation Medicine ◽  
Bone Transport ◽  
Fixation Index ◽  
Ilizarov Method ◽  
Fixation Time ◽  
Ilizarov Technique ◽  
Non Union

Objective: To document the presentation of tibial infected non-union and analyze the management outcome with Ilizarov technique in terms of bone results, functional outcome, bone transport time, external fixation time, external fixation index and any complications. Methods: This case series was conducted at the Departments of Orthopedic Surgery, National Institute of Rehabilitation Medicine (NIRM), Islamabad and Civil hospital, Quetta over a period of 3-years. Results: There were 56 patients with 53(94.64%) males and 3(5.35%) females. The age range was 16-50 years with a mean of 32.58±9.98years. According to ASAMI criteria, bone results were excellent in 37(66%), good in 10(17.85%), fair in 6(10.71%) and poor in 3(5.35%). The functional results were excellent in 37(66%), good in 9(16%), fair in 7(12.5%) and poor in 3(5.35%). The bone union rate was 98.21%. Conclusion: Ilizarov method beautifully addresses the formidable issue of infected non union of tibia with good outcome in terms of bone healing and infection eradication. The treatment period is relatively lengthy and hence patience on part of patient as well as the surgical team is imperative for achieving favourable outcomes. How to cite this:Bakhsh K, Atiq-Ur-Rehman, Zimri FK, Mohammad E, Ahmed W, Saaiq M. Presentation and management outcome of tibial infected non‑union with Ilizarov technique. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.67 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Prospective Evaluation of Role of Limb Reconstruction System (Rail External Fixator) in Open Fractures and Infected Non-union of Femur

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hemant Singh Chahar ◽  
Mayur Gupta ◽  
Vinod Kumar ◽  
Rohit Yadav ◽  
Jaydeep Patel ◽  
...  
Keyword(s):  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Case Series ◽  
Functional Results ◽  
Open Fractures ◽  
Long Bone ◽  
Limb Reconstruction ◽  
Non Union ◽  
Femur Fractures

Introduction: Severe open fractures continue to be a nightmare for orthopedicians even with use of more accepted line of treatment. Open fractures and infected non-union of femur bone are not infrequently seen in orthopedic wards as femur is the most common long bone injured. We present a case series of 14 such patients treated successfully with limb reconstruction system enabling recovery to pre-injury status and activities. Case Series: The present study was done to access the role of limb reconstruction system in the management of open femur fractures and in infected non-union with modifications to meet the requirements of each case. We viewed the results of treatment of 14 cases of late presentation with complicated open femur fractures and infected non-unions. Average time of fixator removal was 4 months–24 months. Average follow-up duration was 18 months (range 6?36 months). Evaluation of results was based on ASAMI criteria. The excellent bone results were obtained in 85.72% of cases while 7.14% showed good and 7.14% were poor results. Excellent functional results were observed in 71.43% of cases and 28.57% of cases shows good and fair results. Conclusion: The use of limb reconstruction system is based on compression and distraction technique. It was found to be a simple and effective modality for open injuries in terms of enhanced union rate, rapid rehabilitation, and easy care of soft-tissue injury along with bone loss, thus avoiding multiple surgeries. Keywords: Open fracture, non-union, femur, limb reconstruction system, ASAMI criteria.

scholarly journals A study of clinicoradiological and functional outcomes of intramedullary nailing in diaphyseal radius ulna fractures

2019 ◽  
Vol 5 (6) ◽  
pp. 1150
Author(s):  
Parag M. Tank ◽  
Yash S. Shah ◽  
Rutvik D. Dave ◽  
Vijay J. Patel
Keyword(s):  
Functional Outcome ◽  
Intramedullary Nailing ◽  
Functional Outcomes ◽  
Bone Fractures ◽  
Case Series ◽  
Functional Results ◽  
Dash Score ◽  
Retrospective Case ◽  
Non Union ◽  
Case Series Study

<p class="abstract"><strong>Background:</strong> The aim of this study was to evaluate the results of intramedullary nailing in diaphyseal fractures of radius and ulna in age group of 10 to 49 years and to understand its clinicoradiological and functional results.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective case series study of forearm bone fractures and the selected management for the same over a period of 3 years. We chose the cases in which intramedullary nailing was the treatment modality which were followed up over a period of minimum 6 months. Patients with galeazzi variety, monteggia variety, pathological fracture or non-union after previous surgery were excluded. The outcomes were then evaluated with disabilities of the arm, shoulder and hand (DASH) score, Green and O’Brien score, and Grace and Eversmann functional outcome score.<strong></strong></p><p class="abstract"><strong>Results:</strong> Of the 22 patients, 10 patients had excellent functional outcome according to Grace and Eversmann score, 7 patients had good outcome, 4 patients had acceptable while 1 was unacceptable. Green and O’Brien also had similar results, except that patients among fair category were 3 and poor category were 3. The mean DASH score was 16.2.</p><p><strong>Conclusions:</strong> This study shows that closed method for fixation by intramedullary nailing of both bone forearm fractures leads to excellent to good functional outcomes (according to DASH score, Green and O Brien, and Grace and Eversmann score) with less complications. In 6 months follow up x ray there is radiological union in all cases with no angulation, malunion or non-union. </p>

Comminuted Fractures of the Distal Femur Treated with Ilizarov External Fixator. Case Series Study

2017 ◽  
Vol 19 (6) ◽  
pp. 553-562 ◽  
Author(s):  
Łukasz Szelerski ◽  
Radosław Górski ◽  
Sławomir Żarek ◽  
Karol Mochocki ◽  
Paweł Małdyk
Keyword(s):  
External Fixator ◽  
Femoral Fractures ◽  
Bone Union ◽  
Ilizarov Method ◽  
Ilizarov External Fixator ◽  
Distal Femoral Fractures ◽  
Articular Fractures ◽  
Case Series Study ◽  
Limb Injuries ◽  
Ilizarov Apparatus

Background. Distal femoral fractures constitute a type of lower limb injuries that is rare and difficult to treat. Despite advances in surgical technique and development of implants used for internal fixation of fracture fragments, the treatment continues to result in numerous complications. The Ilizarov External Fixator reduces the risk of complications and allows for bone union. Material and methods. Six men with distal femoral fractures resulting from multisite and multiorgan injuries were treated at the Department of Orthopaedics and Musculoskeletal Traumatology of the Medical Uni­versity of Warsaw between 2008 and 2016. Mean age of the patients was 42.6 years. Four of them were mana­ged with the Ilizarov method as a primary treatment and two wore the apparatus as a second-line treatment following unsuccessful plate osteosynthesis. Results. Mean treatment duration with the Ilizarov apparatus was 29 weeks. Bone union was achieved in all patients. After the treatment, the patients ambulated unassisted, without orthopaedic aids. All patients re­turned to work. Conclusions. 1. The Ilizarov method allows for efficient fixation of comminuted distal femoral fractures, in­clud­ing C2 and C3 intra-articular fractures (AO/ASIF classification). 2. The use of the Ilizarov apparatus re­duces soft tissue laceration, preserves blood supply to the bone fragments, and allows for easier skin care, which is particularly important in the case of open fractures. 3. Early rehabilitation with the patient fully loading the operated limb reduces muscle atrophy and stimulates bone union.

Headless Compression Screw Fixation of Delayed Union Jones Fractures: A Case Series

2021 ◽  
Vol 23 (2) ◽  
pp. 121-127
Author(s):  
Ahmed Nagi ◽  
Mosab Elgalli ◽  
Islam Mubark ◽  
Bahaa A. Motawea ◽  
Charalampos Karagkevrekis
Keyword(s):  
Screw Fixation ◽  
Short Form ◽  
Case Series ◽  
Functional Results ◽  
Delayed Union ◽  
Compression Screw ◽  
Variable Pitch ◽  
Non Union ◽  
Headless Compression Screw ◽  
Case Series Study

Background. Different methods have been adopted to treat delayed union and non-union of fractures of the base of the fifth metatarsal using screws, plates and tension band wires. There has been increasing use of intramedullary screw fixation to treat these fractures with variable rates of success. The optimum screw diameter and properties have been a subject of debate. To assess the results of using a larger diameter 5.5 mm cannulated, headless variable-pitch screw to fix delayed union of Jones fracture of the base of the fifth metatarsal. Methods and methods. A case series study including 24 patients with delayed union of Jones fifth meta­tar­sal fractures. The fractures were fixed by a 5.5 mm cannulated variable-pitch compression titanium screw (Acumed® Acutrak 2® Screw System). Results. Radiological union was achieved in all patients at a mean of 7.2 weeks. At 12 months’ follow up, patients had a mean American Orthopedic Foot & Ankle Society midfoot score of 95.6. The mean Short Form 12 Physical and mental survey scores improved from 22.71 and 29.31 points preoperatively to 57.88 and 59.54 respectively. Conclusion.The headless compression screw achieved a satisfactory union rate for delayed union Lawren­ce zone II fractures of the base of the fifth metatarsal with satisfactory functional results.

scholarly journals HIRSCHSPRUNG’S DISEASE

2010 ◽  
Vol 17 (02) ◽  
pp. 223-231
Author(s):  
MUHAMMAD ZAFAR IQBAL ◽  
Hammad Azam ◽  
MUHAMMAD JAHANGIR ◽  
Muhammad Tahir ◽  
MUHAMMAD ANWAR ◽  
...  
Keyword(s):  
Hirschsprung's Disease ◽  
Hirschsprung’S Disease ◽  
Case Series ◽  
Abdominal Distension ◽  
Functional Results ◽  
International Studies ◽  
Stool Incontinence ◽  
Case Series Study ◽  
Duhamel Procedure ◽  
One Year

Introduction: Hirschsprung’s Disease is one of the most common congenital anomalies that Pediatric Surgeons manage. In spite of the various modifications of pull through procedures available, the long term functional results are less than ideal. However, Modified Duhamel Procedure is one which has relatively good functional results and that is the reason we have selected this procedure for Hirschsprung’s disease in Sheikh Zayed Hospital, Rahim Yar Khan. Objectives: To evaluate the outcome of patients after Modified Duhamel Procedure for Hirschsprung’s Disease. Design: This is case series study. Settings: Department of Pediatric Surgery Sheikh Zayed Medical College/ Hospital Rahim Yar Khan. Period: Seventeen cases were studied over a period of two year i.e. from November 2006 to December, 2008. Material and Method: Seventeen (17) cases from both sexes were operated for Hirschsprung’s Disease over a period of one year and Modified Duhamel Procedure was adopted for all these cases. All patients were diagnosed cases of rectosigmoidal aganglionosis and follow up was done over a period of one year according to a comprehensive Proforma. Four parameters like normal stool evacuation, abdominal distension, soiling and stool incontinence were followed and then the results were compared with other national and international studies. Results: Fever 19.4% (n=04), wound infection 19.4% (n=04), vomiting 9.52% (n=02), abdominal distension 4.76% (n=01), and bleeding per rectum 4.76% (n=01), were the immediate post operative complications. Fourteen patients (82.35%), used to pass stool once daily. Abdominal distension was observed occasionally in six patients (28.57%). Soiling was seen in five patients (29.41%). Out of Seventeen, stool incontinence was seen in only three patients (17.64%). Conclusion: Modified Duhamel Procedure with the help of linear cutter stapler device is quite safe, easy and less time consuming. Infact Modified Duhamel is a procedure of choice for Hirschsprung’s Disease. 

Chiari pelvic osteotomy does affect hip survival: a long-term follow-up study

2020 ◽  
pp. 112070002090183
Author(s):  
Josko Jelicic ◽  
Antea Buterin ◽  
Goran Vrgoc ◽  
Zeljko Butorac ◽  
Anton Tudor ◽  
...  
Keyword(s):  
Case Series ◽  
Hip Osteoarthritis ◽  
Pelvic Osteotomy ◽  
Functional Results ◽  
Retrospective Case ◽  
Case Series Study ◽  
Median Period ◽  
Chiari Pelvic Osteotomy

Background: The modern indications for Chiari pelvic osteotomy (CPO) have narrowed and the number of such operations performed has diminished markedly. So far published long-term experience with CPO indicate the fact that in selected patients satisfactory functional results can be achieved. The aim of this study was to investigate the parameters which influence CPO survival and its conversion into total hip arthroplasty (THA). Methods: This is a single-centre retrospective case-series study. In the period from 1976 to 2012, it included 172 CPO in 158 patients. Of those, in 43 patients (48 hips) the follow-up was discontinued, leaving 115 patients (124 hips) for final analyses. The median age at the time of the surgery was 34 years, and the mean duration of the follow-up was 19 years. Results: In 115 patients (124 CPO) included in the study, a total of 51 THA was performed in 49 patients. The median period between CPO and THA was 14 years. Conclusion: Supporting our results, we suggest that CPO should still be indicated in a selected group of younger patients even with advanced stage of hip osteoarthritis who prefer a joint-conserving procedure and consent to a predicted less optimal outcome.

scholarly journals 25-gauge vitrectomy with gas tamponade for rhegmatogenous retinal detachment: experienced vs. inexperienced surgeons

2020 ◽  
Author(s):  
Martin Pencak ◽  
Miroslav Veith ◽  
Zbynek Stranak ◽  
Jakub Dite ◽  
Jana Vranova ◽  
...  
Keyword(s):  
Retinal Detachment ◽  
Success Rate ◽  
Rhegmatogenous Retinal Detachment ◽  
Case Series ◽  
Functional Results ◽  
Complication Rates ◽  
Gas Tamponade ◽  
Single Operation ◽  
Case Series Study ◽  
The Mean

Abstract Introduction: To compare the results and complication rates of a 25-gauge pars plana vitrectomy (25g PPV) with gas tamponade for rhegmatogenous retinal detachment (RRD) between experienced and inexperienced surgeons.Materials and Methods: This is a retrospective comparative consecutive case series study of patients with uncomplicated RRD treated with 25g PPV with gas tamponade. Patients were divided into 2 groups: In Group 1 (ESG) the procedure was performed by an experienced vitreoretinal surgeon and in Group 2 (ISG) the procedure was performed by 2 inexperienced surgeons. Anatomical and functional results and complication rates were compared between the two groups.Results: 216 eyes were included in the study. In the ESG (106 eyes), the single operation success rate was 94.3%, and the final success rate was 100%. The mean best-corrected visual acuity (BCVA) improved from 0.38 decimal to 0.73 decimal. In the ISG (110 eyes), the single operation success rate was 93.6%, and the final success rate was 100.0%. The mean BCVA improved from 0.33 decimal to 0.74 decimal. The differences between groups were not statistically significant. There was no difference in complication rates between groups.Conclusions: A 25g PPV with gas tamponade for treatment of RRD yields excellent anatomical results and improvement in BCVA. With good technique and use of modern vitrectomy machines and instruments, even inexperienced surgeons can achieve high single operation success rate, suggesting a short learning curve. The complication rate is comparable between experienced and inexperienced surgeons.

scholarly journals Clinical outcomes of treatment with locking compression plates for distal femoral fractures in a retrospective cohort

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Masahiro Kiyono ◽  
Tomoyuki Noda ◽  
Hiroshi Nagano ◽  
Takashi Maehara ◽  
Yasuaki Yamakawa ◽  
...  
Keyword(s):  
Bone Fracture ◽  
Distal Femur ◽  
Femoral Fractures ◽  
Bone Union ◽  
Span Length ◽  
Union Rate ◽  
Non Union ◽  
Distal Femoral Fractures ◽  
Bridge Span ◽  
Comminuted Fractures

Abstract Background Plate fixation is one of the standard surgical treatments for distal femoral fractures. There are few reports on the relationship between the screw position and bone union when fixing by the bridging plate (relative stability) method. Methods This retrospective study included 71 distal femoral fractures of 70 patients who were treated with the locking compression plate for distal femur (DePuy Synthes Co., Ltd, New Brunswick, CA, USA). The following measurements were evaluated and analyzed: (1) bone union rate, (2) bridge span length (distance between screws across the fracture), (3) plate span ratio (plate length/bone fracture length), (4) number of empty holes (number of screw holes not inserted around the fracture), and (5) medial fracture distance (bone fracture distance on the medial side of the distal femur). Patient demographics (age), comorbidities (smoking, diabetes, chronic steroid use, dialysis), and injury characteristics (AO type, open fracture, infection) were obtained for all participants. Univariate analysis was performed on them. Results Of 71 fractures, 26 fractures were simple fractures, 45 fractures were comminuted fractures, and 7 fractures resulted in non-union. Non-union rate was significantly higher in comminuted fractures with bone medial fracture distance exceeding 5 mm. Non-union was founded in simple fractures with bone medial fracture distance exceeding 2 mm, but not significant (p = 0.06). In cases with simple fractures, one non-union case had one empty hole and one non-union case had four empty holes, whereas in cases with comminuted fractures, five non-union cases had two more empty holes. Conclusions We concluded that bone fragment distance between fracture fragments is more important than bridge span length of the fracture site and the number of empty holes. Smoking and medial fracture distance are prognostic risk factors of nonunion in distal femoral fractures treated with LCP as bridging plate.

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