scholarly journals Minimally invasive open reduction of greater tuberosity fractures by a modified suture bridge procedure

2022 ◽  
Vol 10 (1) ◽  
pp. 117-127
Author(s):  
Ling-Peng Kong ◽  
Juan-Juan Yang ◽  
Fu Wang ◽  
Fan-Xiao Liu ◽  
Yong-Liang Yang
2021 ◽  
Author(s):  
Lingpeng Kong ◽  
Juanjuan Yang ◽  
Yongliang Yang ◽  
Fu Wang

Abstract Background: This study aims to describe a new procedure of minimally invasive open reduction by a modified suture bridge with anchors for avulsion-type greater tuberosity fracture of the humerus and to evaluate its clinical effectiveness.Methods: From January 2015 to January 2018, 16 patients who were diagnosed with an avulsion-type greater tuberosity fracture of the proximal humerus and treated with minimally invasive open reduction by modified suture bridges with anchors were retrospectively studied. Endpoints were assessed preoperatively and postoperatively and included the visual analog scale (VAS), the University of California Los Angeles (UCLA) shoulders score, the American Shoulder and Elbow Surgeons score (ASES), and the range of motion (ROM) for shoulders.Results: There were 7 males and 9 females with an average age of 44.94 years. Six fractures involved the left shoulder, and 10 involved the right shoulder. The time between injury and operation ranged from 1 to 5 days, with an average of 2.32 days. The average length of stay was 6.5 ± 0.85 days; the mean operation time was 103.1 ± 7.23 minutes; and the mean amount of operative blood loss was 51.88 ± 6.40 ml. All patients achieved bone union within 3 months after surgery. The VAS score significantly decreased at 3 weeks postoperatively (p = 0.002), as did the average degree of forward elevation (p = 0.047). The mean degree of abduction increased at 6 weeks after the operation (p = 0.035), and the average degree of external rotation and internal rotation improved at 3 months postoperatively (p = 0.012; p = 0.007). The ASES score and the UCLA score improved at the 6-week follow-up (p = 0.092; p = 0.029). No procedure-related death or incision-related superficial or deep tissue infection was identified in any case. No iatrogenic neurovascular injuries or fractures were found in this study.Conclusion: The fracture block was fixed firmly by minimally invasive open reduction with a modified suture bridge with anchors. Patients were allowed to move their shoulder early after surgery and recovered quickly. It is an efficient method for the treatment of avulsion-type greater tuberosity fractures of the humerus.


2021 ◽  
Author(s):  
Lingpeng Kong ◽  
Juanjuan Yang ◽  
Yongliang Yang ◽  
Fu Wang

Abstract Background: This study aims to describe a new procedure of minimally invasive open reduction by a modified suture bridge with anchors for avulsion-type greater tuberosity fracture of the humerus and to evaluate its clinical effectiveness.Methods: From January 2015 to January 2018, 16 patients who were diagnosed with an avulsion-type greater tuberosity fracture of the proximal humerus and treated with minimally invasive open reduction by modified suture bridges with anchors were retrospectively studied. Endpoints were assessed preoperatively and postoperatively and included the visual analog scale (VAS), the University of California Los Angeles (UCLA) shoulders score, the American Shoulder and Elbow Surgeons score (ASES), and the range of motion (ROM) for shoulders.Results: There were 7 males and 9 females with an average age of 44.94 years. Six fractures involved the left shoulder, and 10 involved the right shoulder. The time between injury and operation ranged from 1 to 5 days, with an average of 2.32 days. The average length of stay was 6.5 ± 0.85 days; the mean operation time was 103.1 ± 7.23 minutes; and the mean amount of operative blood loss was 51.88 ± 6.40 ml. All patients achieved bone union within 3 months after surgery. The VAS score significantly decreased at 3 weeks postoperatively (p = 0.002), as did the average degree of forward elevation (p = 0.047). The mean degree of abduction increased at 6 weeks after the operation (p = 0.035), and the average degree of external rotation and internal rotation improved at 3 months postoperatively (p = 0.012; p = 0.007). The ASES score and the UCLA score improved at the 6-week follow-up (p = 0.092; p = 0.029). No procedure-related death or incision-related superficial or deep tissue infection was identified in any case. No iatrogenic neurovascular injuries or fractures were found in this study.Conclusion: The fracture block was fixed firmly by minimally invasive open reduction with a modified suture bridge with anchors. Patients were allowed to move their shoulder early after surgery and recovered quickly. It is an efficient method for the treatment of avulsion-type greater tuberosity fractures of the humerus.


2021 ◽  
Author(s):  
Lingpeng Kong ◽  
Juanjuan Yang ◽  
Yongliang Yang ◽  
Fu Wang

Abstract Background: This study aims to describe a modified surgical method of minimally invasive open reduction by a modified suture bridge with anchors for avulsion-type greater tuberosity fracture of the humerus and to evaluate its clinical effectiveness.Methods: From January 2015 to January 2018, 16 patients who were diagnosed with an avulsion-type greater tuberosity fracture of the proximal humerus and treated with minimally invasive open reduction by modified suture bridges with anchors were retrospectively studied. All patients were followed up with clinical examination and radiographs at 3 weeks, 6 weeks, 3 months, 6 months and 12 months after surgery and then every 6 months. Outcomes were assessed preoperatively and postoperatively with the visual analog scale (VAS), the University of California Los Angeles (UCLA) shoulders score, the American Shoulder and Elbow Surgeons score (ASES), and the range of motion (ROM) for shoulders.Results: There were 7 males and 9 females with an average age of 44.94 years. Six fractures involved the left shoulder, and 10 involved the right shoulder. The time between injury and operation ranged from 1 to 5 days, with an average of 2.32 days. The average length of stay was 6.5 ± 0.85 days; the mean operation time was 103.1 ± 7.23 minutes; and the mean amount of operative blood loss was 51.88 ± 6.40 ml. All patients achieved bone union within 3 months after surgery. The VAS score significantly decreased at 3 weeks postoperatively (p = 0.002), as did the average degree of forward elevation (p = 0.047). The mean degree of abduction increased at 6 weeks after the operation (p = 0.035), and the average degree of external rotation and internal rotation improved at 3 months postoperatively (p = 0.012; p = 0.007). The ASES score and the UCLA score improved at the 6-week follow-up (p = 0.092; p = 0.029). No procedure-related death or incision-related superficial or deep tissue infection was identified in any case. No iatrogenic neurovascular injuries or fractures were found in this study.Conclusion: The fracture block was fixed firmly by minimally invasive open reduction with a modified suture bridge with anchors. Patients were allowed to move their shoulder early after surgery and recovered quickly. It is an efficient method for the treatment of avulsion-type greater tuberosity fractures of the humerus.


2021 ◽  
Author(s):  
Lingpeng Kong ◽  
Juanjuan Yang ◽  
Fanxiao Liu ◽  
Yong Han ◽  
Qingsen Lu ◽  
...  

Abstract Background: This study aims to describe a new procedure of minimally invasive open reduction by a modified suture bridge with anchors for avulsion-type greater tuberosity fracture of the humerus and to evaluate its clinical effectiveness.Methods: From January 2015 to January 2018, 16 patients who were diagnosed with an avulsion-type greater tuberosity fracture of the proximal humerus and treated with minimally invasive open reduction by modified suture bridges with anchors were retrospectively studied. Endpoints were assessed preoperatively and postoperatively and included the visual analog scale (VAS), the University of California Los Angeles (UCLA) shoulders score, the American Shoulder and Elbow Surgeons score (ASES), and the range of motion (ROM) for shoulders.Results: There were 7 males and 9 females with an average age of 44.94 years. Six fractures involved the left shoulder, and 10 involved the right shoulder. The time between injury and operation ranged from 1 to 5 days, with an average of 2.32 days. The average length of stay was 6.5 ± 0.85 days; the mean operation time was 103.1 ± 7.23 minutes; and the mean amount of operative blood loss was 51.88 ± 6.40 ml. All patients achieved bone union within 3 months after surgery. The VAS score significantly decreased at 3 weeks postoperatively (p = 0.002), as did the average degree of forward elevation (p = 0.047). The mean degree of abduction increased at 6 weeks after the operation (p = 0.035), and the average degree of external rotation and internal rotation improved at 3 months postoperatively (p = 0.012; p = 0.007). The ASES score and the UCLA score improved at the 6-week follow-up (p = 0.092; p = 0.029). No procedure-related death or incision-related superficial or deep tissue infection was identified in any case. No iatrogenic neurovascular injuries or fractures were found in this study.Conclusion: The fracture block was fixed firmly by minimally invasive open reduction with a modified suture bridge with anchors. Patients were allowed to move their shoulder early after surgery and recovered quickly. It is an efficient method for the treatment of avulsion-type greater tuberosity fractures of the humerus.


2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Wei Zhao ◽  
Yuhui Zhang ◽  
Dongni Johansson ◽  
Xingyu Chen ◽  
Fang Zheng ◽  
...  

Objective. The study aims to compare minimally invasive percutaneous plate osteosynthesis (MIPO) and open reduction internal fixation (ORIF) in the treatment of proximal humeral fracture in elder patients. Method. PubMed, Medline, EMbase, Ovid, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wangfang, and VIP Database for Chinese Technical Periodicals were searched to identify all relevant studies from inception to October 2016. Data were analyzed with Cochrane Collaboration’s Review Manage 5.2. Results. A total of 630 patients from 8 publications were included in the systematic review and meta-analysis. The pooled results showed that MIPO was superior to ORIF in the treatment of proximal humeral fracture in elder patients. It was reflected in reducing blood loss, operation time, postoperative pain, or fracture healing time of the surgery and in improving recovery of muscle strength. Concerning complications, no significant difference was seen between MIPO and ORIF. Conclusion. The MIPO was more suitable than ORIF for treating proximal humeral fracture in elder patients.


Author(s):  
Prashant Kamble ◽  
Nandan Marathe ◽  
Sudhir Sharan ◽  
Ayush Sharma ◽  
Ashwin Sathe ◽  
...  

<p class="Body"><strong>Background : </strong>Distal tibia fractures or pilon fractures are usually the result of combined compressive and shearing forces, which may lead to instability of the metaphysis. Poor vascularity, lack of muscle cover and frequent intra-articular extension often make these fractures very challenging to manage. There are plenty of options available to treat a distal tibia fracture which includes intramedullary nailing, external fixation, open reduction and internal fixation and minimally invasive plate osteosynthesis (MIPO). The aim of this study was to evaluate the results of MIPO with respect to the healing of fracture site, the incidences of complications and to conclude whether MIPO circumvents the problems of formal open reduction and fixation with other implants.</p><p class="Body"><strong>Methods: </strong>A series of forty patients with fracture of the distal tibia on preoperative X-rays were treated with minimally invasive plate osteosynthesis using pre-contoured locking plates from June 2014 to October 2018 and followed up at regular intervals with X-rays and monitoring for complications.</p><p class="Body"><strong>Result: </strong>The functional scores were evaluated using Teeny and Wiss clinical rating system for ankle joints. Thirty-two patients had an ‘Excellent’ or ‘Good’ outcome. One patient was diagnosed with a soft tissue complication and delayed union and 3 patients were diagnosed with malunion without significant functional disability at follow up. <strong></strong></p><p class="Body"><strong>Conclusion: </strong>Minimally invasive plate osteosynthesis with pre-contoured locking plates is associated with high union rate and good functional outcomes. It is an effective treatment modality for distal tibia fractures.</p>


Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Asad Mehmood Lak ◽  
Abdullah M Abunimer ◽  
Amina Rahimi ◽  
Ian Tafel ◽  
Hasan Aqdas Zaidi

Abstract INTRODUCTION High-grade spondylolisthesis is a relatively uncommon condition. The optimal surgical approach for management remains debatable. Although in-situ fusion is preferred due to its lower risk of neural injury, it does not correct spinal alignment. In contrast, reduction corrects the deformity and provides a high rate of fusion, but has the potential for high rates of neural injury. We herein report our experience and surgical outcomes following minimally invasive versus open management of intermediate- to high-grade spondylolisthesis. METHODS A multicenter, retrospective cohort analysis of adult patients aged more than 18 yr with grade II or higher spondylolisthesis, who underwent surgery from January 2008 until February 2019, was performed. RESULTS Sixty-two patients were included in the final analysis. A total of 41 patients were treated with an open approach and 21 with a minimally invasive surgical approach (MIS). More specifically, 18 patients underwent in-situ fusion, 11 underwent MIS reduction, and 33 had an open reduction. The total rate of complications was 40.3%. The rate of complications in the MIS group was 52.3% compared to 34.1% in the open surgery group (P = .166). The rate of complications was 27.8% in the in-situ fusion group, 72.7% in the MIS-reduction group, and 36.4% in the open-reduction group. Our comparisons of the rate of complications in the no-reduction group vs the MIS-reduction group, and the MIS-reduction group vs the open-reduction group were statistically significant (P = .027 and P = .07, respectively). However, there was no statistically significant difference between the rate of complications in the no-reduction group vs the open-reduction group (P = .757), nor between the rate of complications in the MIS group vs the open surgery group (P = .166). CONCLUSION MIS reduction is associated with a high rate of complications in the management of high-grade spondylolisthesis.


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