Open reduction and Herbert screw fixation of Pipkin type IV femoral head fracture in an adolescent: A case report

<p class="abstract">Isolated coronal shear fractures of capitellum are very rare, accounting for nearly 1% of all elbow fractures. There are various approaches and implants documented for management of such fractures. One of them is lateral Kocher’s approach and Herbert screw fixation. Our case report is strengthening this approach and Herbert screw fixation and shows good short term functional outcome along with radiological union.</p><p class="abstract"> </p>

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A case report of femoral head fracture with osteochondral lesion treated by osteosynthesis and biomimetic scaffold: 2-year clinical and radiological follow-up

Journal of Experimental Orthopaedics ◽

10.1186/s40634-021-00362-x ◽

2021 ◽

Vol 8 (1) ◽

Author(s):

Alessandro Casiraghi ◽

Claudio Galante ◽

Marco Domenicucci ◽

Stefano Cattaneo ◽

Andrea Achille Spreafico ◽

...

Keyword(s):

Case Report ◽

Femoral Head ◽

Articular Surface ◽

Osteochondral Lesion ◽

Hip Dislocation ◽

Fracture Dislocation ◽

Osteochondral Lesions ◽

Femoral Head Fracture ◽

Osteochondral Scaffold

AbstractThe aim of the present study was to present clinical and radiological outcome of a hip fracture-dislocation of the femoral head treated with biomimetic osteochondral scaffold.An 18-year-old male was admitted to the hospital after a motorcycle-accident. He presented with an obturator hip dislocation with a type IVA femoral head fracture according to Brumback classification system. The patient underwent surgery 5 days after accident. The largest osteochondral fragment was reduced and stabilized with 2 screws, and the small fragments were removed. The residual osteochondral area was replaced by a biomimetic nanostructured osteochondral scaffold. At 1-year follow-up the patient did not complain of hip pain and could walk without limp. At 2-year follow-up he was able to run with no pain and he returned to practice sports. Repeated radiographs and magnetic resonance imaging studies of the hip showed no signs of osteoarthritis or evidence of avascular necrosis. A hyaline-like signal on the surface of the scaffold was observed with restoration of the articular surface and progressive decrease of the subchondral edema.The results of the present study showed that the biomimetic nanostructured osteochondral scaffold could be a promising and safe option for the treatment of traumatic osteochondral lesions of the femoral head.Study Design: Case report.

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Asymmetric bilateral hip dislocations and unilateral femoral head fracture: A CASE report

Trauma Case Reports ◽

10.1016/j.tcr.2018.09.011 ◽

2018 ◽

Vol 17 ◽

pp. 48-51

Author(s):

Erdem Değirmenci ◽

Yasin Emre Kaya ◽

Kutay Engin Özturan

Keyword(s):

Case Report ◽

Femoral Head ◽

Femoral Head Fracture

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

10.21203/rs.3.rs-341049/v1 ◽

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

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

Journal of Hand Surgery (European Volume) ◽

10.1016/0266-7681(93)90114-u ◽

1993 ◽

Vol 18 (2) ◽

pp. 219-224 ◽

Cited By ~ 63

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.

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Scaphoid Fracture: Functional Outcome Following Fixation with Herbert Screw

Kathmandu University Medical Journal ◽

10.3126/kumj.v9i4.6342 ◽

2012 ◽

Vol 9 (4) ◽

pp. 267-273 ◽

Cited By ~ 2

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

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