scholarly journals Operative fixation for complex tibial fractures

2012 ◽  
Vol 94 (1) ◽  
pp. 34-38 ◽  
Author(s):  
AJP Hutchinson ◽  
AE Frampton ◽  
R Bhattacharya
Keyword(s):  
English Literature ◽  
Surgical Techniques ◽  
Delayed Union ◽  
Tibial Fractures ◽  
Fixation Technique ◽  
Non Union ◽  
Fixation Techniques ◽  
Secondary Procedures ◽  
Operative Fixation ◽  
Tibial Shaft Fractures

INTRODUCTION The management of open tibial shaft fractures remains challenging. Intramedullary nailing and external fixation are the most commonly used fixation techniques although the optimal fixation technique remains unresolved. In this article the outcomes of these two surgical techniques are compared. METHODS A comprehensive literature search was conducted through MEDLINE® using Ovid® and MeSH (Medical Subject Heading) terms for articles published in the English literature between 1999 and 2009. The outcome measures compared were time to fracture union, infection rates and complications. RESULTS Forty-one studies were identified, of which only three met the inclusion criteria. The average time to union was variable. Delayed union and non-union appeared to be more prevalent in the external fixator group although this was not statistically significant. Both techniques were associated with secondary procedures as well as infection. CONCLUSIONS The current literature indicates little evidence to suggest the superiority of one fixation technique over another for open tibial fractures.

scholarly journals Study on Percutaneous Intramedullary Nailing In Adult Diaphyseal Humeral Fractures

2021 ◽  
pp. 207-211
Author(s):  
Mohsin Aijaz Soomro ◽  
Ajmal Khan Silro ◽  
Raheel Akbar Baloch ◽  
Najeeb Ur. Rehman ◽  
Muhammad Faraz Jokhio ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Delayed Union ◽  
Humeral Fractures ◽  
Bone Union ◽  
Fixation Technique ◽  
Non Union ◽  
Medical College ◽  
Fixation Techniques ◽  
A Prospective Study

Objective: The objective of this research was to evaluate close fixation techniques for fractures of humerus via percutaneous intramedullary nailing. Methodology: This was a prospective study, carried out in Suleman Roshan Medical College Tando Adam Pakistan from January 2019 to January 2020. About 60 patients with humeral shaft fractures were made part of this study with a follow-up period of about 1 to 2 years. The inclusion criteria were humeral fractures that were of less than 7 days prior to surgery, the displacement of fracture >20° in sagittal as well as coronal plane, and the distance measuring >2cm between the two fragments. All patients were treated via the closed fixation technique. Multiple nails that were slender as well as flexible (3-5) were used in the close fixation technique including rush nails (45 patients) and ender nails (15 patients). All the patients within their follow-up periods were evaluated for ROM, pain, or any kind of deformity, and all the patients were assessed radiographically to check the process of bone union. Results: The outcome was analyzed before implant i.e at six months and after the implant was removed. About 86% patients (n= 52) revealed satisfactory outcomes at six months. About 5 patients revealed non-union or delayed union that was healed after 2nd surgery of bone grafting in 3 patients and injections associated with bone marrow in 2 patients. Stiffening of the shoulder was found to be a frequent complication that decreased significantly when the position of nail insertion was changed during the research. Conclusion: The technique of intramedullary nailing displayed many benefits including minimum tissue stress, a quick surgery time, decreased period of hospital stay, and rapid bone union.

scholarly journals Titanium Elastic Nailing System (TENS) for Tibia Fractures in Children: Functional Outcomes and Complications

2016 ◽  
Vol 55 (204) ◽  
pp. 55-60 ◽  
Author(s):  
Kapil Mani KC ◽  
Parimal Acharya ◽  
Arun Sigdel
Keyword(s):  
Functional Outcomes ◽  
Skin Irritation ◽  
Limb Lengthening ◽  
Delayed Union ◽  
Tibial Fractures ◽  
Entry Site ◽  
Superficial Infection ◽  
Non Union ◽  
Fractures In Children ◽  
Tibia Fractures

Introduction: Closed reduction and cast application is still regarded as first line treatment for pediatric tibial fractures. Over the past few decades, management of pediatric tibial fractures has shifted more towards operative intervention because of quicker recovery, shorter rehabilitation period, less immobilization, lack of stiffness of adjoining joints, and less psychological impact to the children. Flexible intramedullary nails not only fulfill the above advantage but also maintain alignment and rotation.Methods: This was a retrospective study of pediatric tibial fractures fixed with two titanium elastic nails through proximal ends of bones. Alignment of fracture, any infection, delayed union, non union, limb length discrepancy, motion of knee joint, and fracture union time were measured during follow-up examination.Results: Forty-five patients were enrolled into the study out of which 28 (62.2%) were male and 17 (37.8%) were female. Average age of patient was 9.48±2.17 years and average time taken to heal the fractures (both clinical and radiological) was 11.17±2.81 weeks. There were 2 (4.4%) of malunion, 4 (8.8%) of delayed union, 3 (6.6%) of limb shortening, 2 (4.4%) of limb lengthening, 6 (13.6%) of nail prominence and skin irritation, 2 (4.4%) of superficial infection at nail entry site and one case of re-fracture.Conclusions: Titanium elastic nail fixation is a simple, easy, rapid, reliable and effective method for management of pediatric tibial fractures in patients with operative indications. There may be the chances of complication following the TENS in tibia but these are avoidable as well as manageable with careful precautions. Keywords: complications; functional outcomes; tibia fractures. | PubMed

A New Fixation Technique for the Lapidus Bunionectomy

2005 ◽  
Vol 95 (4) ◽  
pp. 405-409 ◽  
Author(s):  
James C. Wang ◽  
Brendan M. Riley
Keyword(s):  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Preliminary Report ◽  
Delayed Union ◽  
Oral Antibiotics ◽  
Fixation Technique ◽  
Short Course ◽  
Time To Initiation ◽  
Fixation Techniques

Presented here is a preliminary report of 102 patients who underwent first metatarsocuneiform joint arthrodeses performed with external fixation for the correction of hallux valgus. The advantages of using external fixation are the ability to initiate early weightbearing, predictable fusion, and removal of all of the hardware postoperatively. In the 102 patients reported here, the average time to initiation of unassisted full weightbearing was 13.1 days. The average time to fusion was 5.3 weeks, with removal of the external fixator at an average of 5.5 weeks postoperatively. There was no incidence of delayed union or nonunion. There was one case of pin-tract irritation, which resolved with appropriate pin care and a short course of oral antibiotics. External fixation is an effective alternative to traditional internal fixation techniques in metatarsocuneiform joint arthrodesis. (J Am Podiatr Med Assoc 95(4): 405–409, 2005)

Percutaneous bone grafting in the treatment of the delayed union and non-union of tibial fractures

Injury ◽  
2002 ◽  
Vol 33 (3) ◽  
pp. 239-245 ◽  
Author(s):  
J. Kettunen ◽  
E.A. Mäkelä ◽  
V. Turunen ◽  
O. Suomalainen ◽  
K. Partanen
Keyword(s):  
Bone Grafting ◽  
Delayed Union ◽  
Tibial Fractures ◽  
Non Union

scholarly journals A Rare Presentation with Segmental Gap Non-union in Proximal Phalanx Fracture of Thumb in Child: A Case Report

2021 ◽  
Vol 11 (9) ◽  
Author(s):  
Pankaj K. Sharma ◽  
Vinit K. Verma ◽  
Raj S. Potalia
Keyword(s):  
Bone Grafting ◽  
Functional Outcomes ◽  
Pediatric Population ◽  
English Literature ◽  
Proximal Phalanx ◽  
Delayed Union ◽  
Delayed Presentation ◽  
Rare Presentation ◽  
Non Union ◽  
Sporadic Cases

Introduction:Traumatic injuries of to hand are not uncommon in the pediatric population and most of them are managed by conservative means and rarely surgical intervention required. There is a very rare incidence of delayed union or non-union in these fractures and found a very few numbers of sporadic cases documented in English literature. Case Report:We described delayed presentation of post-traumatic gap non-union of proximal phalanx of thumb in a child who presented with severe disability of hand especially writing and grasping. He was managed as open reduction, tibial strut bone grafting, and internal fixation with crossed Kirchner wire and followed for a period of minimum of 2 years. The fracture united radiologically and healed well clinically, whereas functional outcomes were excellent. There was no difficulty in writing and activity of daily living with operated hand while having comparative cosmetic appearance to other hand. Conclusion:Non-union of phalanx fractures are very rare in the pediatric population whereas excellent clinical and functional outcomes can be achieved with adequate stable fixation and autologous bone grafting. Keywords:Gap non-union, proximal phalanx, fracture, skeletally immature, tibial strut graft

scholarly journals A detaching, V-shaped tibial tubercle osteotomy is a safe procedure with a low complication rate

2020 ◽  
Vol 140 (12) ◽  
pp. 1867-1872
Author(s):  
Akkie Rood ◽  
Jordy van Sambeeck ◽  
Sander Koëter ◽  
Albert van Kampen ◽  
Sebastiaan A. W. van de Groes
Keyword(s):  
Surgical Techniques ◽  
Case Series ◽  
Tibial Fractures ◽  
Patella Alta ◽  
Tibial Tubercle ◽  
Trochlear Groove ◽  
Complication Rates ◽  
Safe Procedure ◽  
Tibial Tubercle Osteotomy ◽  
Non Union

Abstract Introduction In patients with recurrent patellar dislocations, a tibial tubercle osteotomy (TTO) can be indicated to correct patella alta or an increased trochlear groove–tibial tubercle distance. Several surgical techniques are described. Previous studies emphasize that detaching osteotomies results in devascularisation, which can lead to non-union and tibial shaft fractures. The aim of this study was to report the complication rates directly related to the surgical technique of a V-shaped TTO, where the tubercle is completely released from its periosteum using a step-cut osteotomy. Methods The retrospective case series comprised a large cohort of 263 knees with patella alta in 203 patients who underwent a V-shaped TTO, with or without additional realignment procedures, between March 2004 and October 2017. Data were obtained from available patient files. Complications were defined as minor or major. Results Thirteen major complications were registered (4.9%) including two tibial fractures (0.75%) and one non-union (0.37%). Five complications (1.9%) were defined as minor. Removal of the screws because of irritation or pain was seen in 22 cases (8.2%). Conclusion A V-shaped TTO is a safe procedure. The presumed higher risk for tibial fractures or pseudo-arthrosis could not be confirmed.

Delayed Union and Non-Union of Tibial-Shaft Fractures

1964 ◽  
Vol 46 (3) ◽  
pp. 557-569 ◽  
Author(s):  
HARILAOS T. SAKELLARIDES ◽  
PETER A. FREEMAN ◽  
B. DAVID GRANT
Keyword(s):  
Delayed Union ◽  
Tibial Shaft ◽  
Non Union ◽  
Shaft Fractures ◽  
Tibial Shaft Fractures

scholarly journals Results of non-surgical treatment of isolated closed tibial shaft fractures

2021 ◽  
Vol 12 (4) ◽  
pp. 2303-2307
Author(s):  
Nizam Ahmed ◽  
Madan Lal ◽  
Niaz Hussain Keerio ◽  
Ghazanfar Ali Shah ◽  
Aftab Alam Khanzada ◽  
...  
Keyword(s):  
Delayed Union ◽  
Tibial Fractures ◽  
Tibial Shaft ◽  
Physical Handicap ◽  
Shaft Fractures ◽  
The Mean ◽  
Non Surgical Treatment ◽  
Tibial Shaft Fractures

This Research aimed to see how well isolated closed tibial fractures retained their reduction after being immobilized in a cast. Medical data were gathered for all patients of identified solitary closed tibial shaft fractures treated non-surgically. Males were more typically impacted than females among the 32 individuals evaluated. The mean age was 27.68 years old (SD=7.06). Direct trauma with motorcycle was the most prevalent causes of injury. The average follow-up time for each patient was 9.1 months (SD=2.36). According to the AO/OTA classification, 34.4 % of the fractures are A1.1, 28.1% are A2.1, and 37.5 % are A3. The average time for all fractures to heal was 13.7 weeks (SD=3.24). In the 22nd week, there was one occurrence of delayed union. Shortening of bone was less than 1 cm in 93.75 % of patients and more than 1.5 cm in 6.25% of patients. In 2 (6.25%) of the patients, the anterior or posterior angulation was more than 10 degrees. Furthermore, even with uncomplicated tibial fractures, there appears to be a debate about therapy selection when considering long-term physical handicap and a longer follow-up time.

scholarly journals Scoring systems for early prediction of tibial fracture non-union: an update

2021 ◽  
Author(s):  
George D. Chloros ◽  
Nikolaos K. Kanakaris ◽  
James S. H. Vun ◽  
Anthony Howard ◽  
Peter V. Giannoudis
Keyword(s):  
Tibial Fracture ◽  
Scoring Systems ◽  
Trauma Centre ◽  
Predictive Values ◽  
Non Union ◽  
Post Operative Period ◽  
Male Patients ◽  
Level I ◽  
Healing Score ◽  
Tibial Shaft Fractures

Abstract Purpose To evaluate the available tibial fracture non-union prediction scores and to analyse their strengths, weaknesses, and limitations. Methods The first part consisted of a systematic method of locating the currently available clinico-radiological non-union prediction scores. The second part of the investigation consisted of comparing the validity of the non-union prediction scores in 15 patients with tibial shaft fractures randomly selected from a Level I trauma centre prospectively collected database who were treated with intramedullary nailing. Results Four scoring systems identified: The Leeds-Genoa Non-Union Index (LEG-NUI), the Non-Union Determination Score (NURD), the FRACTING score, and the Tibial Fracture Healing Score (TFHS). Patients demographics: Non-union group: five male patients, mean age 36.4 years (18–50); Union group: ten patients (8 males) with mean age 39.8 years (20–66). The following score thresholds were used to calculate positive and negative predictive values for non-union: FRACTING score ≥ 7 at the immediate post-operative period, LEG-NUI score ≥ 5 within 12 weeks, NURD score ≥ 9 at the immediate post-operative period, and TFHS < 3 at 12 weeks. For the FRACTING, LEG-NUI and NURD scores, the positive predictive values for the development of non-union were 80, 100, 40% respectively, whereas the negative predictive values were 60, 90 and 90%. The TFHS could not be retrospectively calculated for robust accuracy. Conclusion The LEG-NUI had the best combination of positive and negative predictive values for early identification of non-union. Based on this study, all currently available scores have inherent strengths and limitations. Several recommendations to improve future score designs are outlined herein to better tackle this devastating, and yet, unsolved problem.

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