Calcaneus Fracture Fixation: Soft Tissue Complications With Minimally Invasive Versus Extensile Lateral Approaches

OrthoMedia ◽  
2022 ◽  
2003 ◽  
Vol 16 (03) ◽  
pp. 191-195 ◽  
Author(s):  
K. Hurter ◽  
P. Schawalder ◽  
H. G. Schmökel

SummaryA trend toward minimally invasive procedures in the treatment of fractures in human patients is apparent in recent publications. Percutaneous plating is one method of fracture fixation, conceived to minimise soft tissue damage and preserve soft tissue and bone vascularity. The use of fewer screws, in longer bridging plates, is also a relatively new technique in the stabilisation of comminuted diaphyseal fractures in human patients. A combination of these techniques was applied in two dogs with comminuted tibial fractures.The plates were passed subfascially and the screws inserted through skin incisions over the proximal and distal ends of the plate. Follow-up radiographs revealed fracture healing with callus formation after four or five weeks. Percutaneous plating seems to be a useful technique in small animals. Further studies on larger numbers of patients are needed to define the benefits and the limitations of this technique.


2021 ◽  
Vol 5 (2) ◽  
pp. 205-211
Author(s):  
Eric B. Wilkinson ◽  
Johnathan F. Williams ◽  
Kyle D. Paul ◽  
Jun Kit He ◽  
Justin R. Hutto ◽  
...  

2017 ◽  
Vol 11 (3) ◽  
pp. 236-241 ◽  
Author(s):  
Rajeev Shukla ◽  
Nikhil Jain ◽  
Ravi Kant Jain ◽  
Shravan Patidar ◽  
Vivek Kiyawat

Introduction. Managing fractures of distal tibia is still a subject of debate for orthopaedic surgeons in terms of both, reduction and fixation. Subcutaneous location and soft tissue anatomy predisposes it to angular and rotational instability as well as other bony and soft tissue complexities. Minimally invasive plating offers many advantages over conventional open techniques. It causes minimal soft tissue dissection and surgical trauma to the bone. Minimally invasive plate osteosynthesis(MIPO) maintains biological configuration of distal tibia and fracture hematoma and also provides a construct, which is biomechanically more stable. Objectives. Evaluation of results of MIPO in management of distal tibia fractures considering radiological union, ankle function restoration, and complications. Materials and Methods. In our study, 25 closed distal one-third tibia fracture with/without articular extension were taken, fulfilling the inclusion criteria (AO classification: 10, 43A1; 3, 43A2; 2, 43B1; 4, 43B2; and 6, 43C1). MIPO with locking plates was the treatment undertaken. Patients were followed up for 18 months prospectively. Results. Average injury-hospital interval was 11.16 hours and average injury-operation interval was 2.44 days. All fractures showed radiological union at an average duration of 20.5 weeks (14-28 weeks). Olerud and Molander score was used for evaluation at 3, 6, and 18 months. One patient had union with valgus angulation >5° but there was no nonunion. There was 1 superficial postoperative wound infection. Conclusion. Our study shows that plating with MIPO is an effective treatment for closed distal one-third tibia fractures, considering union time and complications rate. Younger age promotes early union and functional recovery. Levels of Evidence: Therapeutic, Level II: Prospective


2019 ◽  
Vol 122 ◽  
pp. 106-111
Author(s):  
Chester J. Donnally ◽  
Karthik Madhavan ◽  
Julian G. Lugo-Pico ◽  
Lee Onn Chieng ◽  
Steven Vanni

2020 ◽  
Author(s):  
Krzysztof Ficek ◽  
Paweł Gwiazdoń ◽  
Jolanta Rajca ◽  
Grzegorz Hajduk

Abstract Background: Subcutaneous, spontaneous, complete ruptures of the Achilles tendon are usually caused indirectly by trauma associated with rapid movement. When minimally invasive Achilles tendon repair is performed, an active rehabilitation protocol can be implemented that allows for fast, measurable progress, reduced tissue atrophy, and an improved range of motion, thereby reducing pain and increasing patients’ overall physical well-being. However, overestimating the effectiveness of rehabilitative interventions can lead to arbitrary advancements in rehabilitation that significantly exceed the permitted levels of daily or professional activity. This issue can lead to various side effects and slow rehabilitation. The aim of the study was to evaluate the influence of adverse effects on objective outcomes after minimally invasive Achilles tendon repair.Methods: The study included 36 individuals with complete Achilles tendon rupture who underwent the percutaneous Ma-Griffith technique. The same rehabilitation protocol was used.Results: Five side effects were identified during rehabilitation: deformation of the repair construct (DRC), irritation of the sural nerve (SNI), morning ankle stiffness (MAS), edema of the soft tissue around the tendon (OST) and suture knots. DRC and MAS were associated with a longer time being required to achieve full ankle range of motion. SNI and OST were associated with a longer time being required to meet the criteria for dynamic training. None of the side effects were related to the isokinetic strength of the ankle plantar and dorsiflexors.Conclusions: The incidence of the assessed side effects in the postoperative period is not related to the type of activity, whether it is professional or amateur. Among the identified side effects, deformation of the regenerated shape of the heel tendon and MAS cause a delay in the recovery of full ankle range of motion. Calf nerve irritation and soft tissue swelling increase the time it takes to meet the criteria for starting dynamic training.Trial registration:The study was approved by the ethics committee of the Academy of Physical Education in Katowice (no. 13/2007)


2020 ◽  
Vol 6 (4) ◽  
pp. 526-528
Author(s):  
Dr. Sunil G Kulkarni ◽  
Dr. Vijay Dattu ◽  
Dr. Nikhil Lambat ◽  
Dr. Shrinivas Jadhav ◽  
Dr. Tejas Patil ◽  
...  

2018 ◽  
Vol 57 (3) ◽  
pp. 557-571 ◽  
Author(s):  
Sherif Mohamed Abdelgaid ◽  
Ahmed Fawaz Moursy ◽  
Eyad Abd Allah Elgebaly ◽  
Aly Mohamed Aboelenien

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