scholarly journals The use of locking plates in complex midfoot fractures

2012 ◽  
Vol 94 (8) ◽  
pp. 593-596 ◽  
Author(s):  
E Bayley ◽  
N Duncan ◽  
A Taylor
Keyword(s):  
Articular Surface ◽  
Open Reduction Internal Fixation ◽  
Locking Plates ◽  
Lateral Column ◽  
Improved Outcomes ◽  
Fracture Dislocations ◽  
Angle Stable ◽  
Post Traumatic ◽  
Neurological Injuries

INTRODUCTION Complex fracture dislocations of the midfoot are uncommon. Improved outcomes have been demonstrated where it has been possible to restore and maintain the length and alignment of the medial column as well as the congruity of the articular surfaces. We present our experience with the use of angle-stable locking plates in the stabilisation of complex midfoot fracture dislocations. METHODS Twelve patients were identified on a prospective trauma database between 2003 and 2009. All fractures involved the medial column with four associated fracture subluxations of the lateral column also. Patients underwent open reduction internal fixation (ORIF) with restoration of the medial column axis, reduction of the articular surface congruity and stabilisation with angle-stable locking plates. RESULTS There were no post-operative infections or neurological injuries. Ten of the twelve patients required metalwork removal. There were no implant failures prior to removal of the metalwork. At a mean follow-up of 12.4 months (range: 4–32 months), 11 patients had minimal symptoms of swelling, discomfort or stiffness in the midfoot. This did not restrict their daily activities. One patient developed post-traumatic arthritis and collapse of the medial longitudinal arch. Two patients declined removal of the metalwork. CONCLUSIONS Angle-stable locking plates provide satisfactory stabilisation following ORIF of complex midfoot fracture dislocations. Most patients will require removal of the metalwork. Following removal of metalwork, the majority of patients will maintain the length, alignment and stability of the midfoot.

scholarly journals Mid-Term Outcomes After Open Reduction Internal Fixation of Proximal Interphalangeal Joint Dorsal Fracture-Dislocations Through a Volar, Shotgun Approach and a Review of the Literature

2017 ◽  
Vol 11 (1) ◽  
pp. 1073-1080 ◽  
Author(s):  
Juan Marcelo Giugale ◽  
Juntian Wang ◽  
Robert A. Kaufmann ◽  
John R. Fowler
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Articular Surface ◽  
Open Reduction Internal Fixation ◽  
Radiographic Evaluation ◽  
Patient Reported ◽  
Fracture Dislocations ◽  
Post Traumatic ◽  
Shotgun Approach ◽  
Traumatic Arthritis

Background: Proximal interphalangeal (PIP) fracture dislocations remain a complex injury pattern to treat. There are several treatment methods available aimed to restore stability, preserve range of motion, and reconstitute the articular surface. This study looked at the mid-term clinical and radiographic results of open reduction internal fixation through a shotgun approach of comminuted PIP fracture dislocations. Methods: A retrospective review was conducted of all PIP fracture dislocations treated through a volar, shotgun approach at a single institution over a 15-year period. Patients identified were contacted and asked to return to the office for clinical and radiographic evaluation. Patient reported outcomes were assessed with the Michigan hand questionnaire (MHQ) and visual analog scale (VAS) for pain. Results: 5 patients returned to the office for further evaluation with average follow-up of 69 months (range, 33-133 months). 3 patients were found to have post traumatic arthritis on radiographs. 1 case had recurrent instability and one case had a deep infection, both necessitating further surgical intervention. Average PIP arc of motion was found to be 79°. Average VAS score of 0 and MHQ result of 95 (out of a possible score of 100) indicating no residual pain and excellent functionality of the affected hand. Conclusion: Open reduction internal fixation of comminuted PIP fracture dislocations utilizing the volar, shotgun approach provides excellent mid-term functional results despite the high incidence of post traumatic arthritis.

Extension-Block Pinning for Unstable Dorsal Proximal Interphalangeal Joint Fracture-Dislocations: A Simple, Percutaneous Technique With Reproducible Outcomes

Hand ◽  
2022 ◽  
pp. 155894472110663
Author(s):  
Christopher A. Worgul ◽  
Andrew B. Stein
Keyword(s):  
Range Of Motion ◽  
Articular Surface ◽  
Kirschner Wire ◽  
Proximal Phalanx ◽  
Treatment Delay ◽  
Joint Fracture ◽  
Fracture Dislocations ◽  
Pip Joint

Background: Proximal interphalangeal (PIP) joint fracture-dislocations can be technically challenging injuries to treat, and no technique has proven to be superior nor lead to predictably good outcomes. We describe our experience of treating unstable dorsal fracture-dislocations of the PIP joint with extension-block pinning (EBP) at our institution over a 22-year period. Methods: In all, 23 patients with 24 unstable dorsal fracture-dislocations of the PIP joint treated with EBP between January 1998 and October 2020 were identified. All patients underwent closed reduction of the PIP joint and insertion of a Kirschner wire into the proximal phalanx, creating a mechanical block. Range of motion and joint congruity were assessed at final clinic follow-up. Long-term function was assessed via completion of a Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) questionnaire. Spearman’s correlation coefficient was utilized to assess if any association existed between treatment delay, pin-in-body days, or amount of articular surface involved and QuickDASH score. Results: Mean range of motion at final follow-up was 83.3° and 22 of 24 PIP joints demonstrated a congruent reduction. In all, 15 of the 23 patients completed the QuickDASH questionnaire at a median long-term follow-up of 57.5 months (range: 3-157 months). Average QuickDASH score was 18.8, indicating minimal long-term disability. No statistically significant associations were found between treatment delay, pin-in-body days, or amount of articular surface involved and QuickDASH score. Conclusions: EBP offers a simple and innovative method to treat a complex injury of the PIP joint. It is technically straightforward and cheap, and produces excellent functional outcomes with minimal long-term disability.

scholarly journals Bilateral symmetrical anterior fracture dislocation of shoulder

2020 ◽  
Vol 6 (3) ◽  
pp. 635
Author(s):  
Yogendra Kumar ◽  
Shashi Kul Bhaskar ◽  
Bharti Lal ◽  
Vijendra Gahnolia
Keyword(s):  
Unusual Case ◽  
Open Reduction Internal Fixation ◽  
Fracture Dislocation ◽  
Seizure Disorders ◽  
Shoulder Joints ◽  
Fracture Dislocations ◽  
Bilateral Fracture ◽  
Seizure Episode ◽  
Anterior Direction

<p>The incidence of simultaneous bilateral shoulder joint dislocation is rare and is almost always posterior usually caused by violent muscle contraction as in patients with seizure disorders or who experience electric shock or undergo electroconvulsive therapy. simultaneous bilateral fracture-dislocation is even rarer, with a few cases reported in the literature. We report an unusual case with dislocation of the both shoulder joints in anterior direction after a seizure episode, With symmetrical unifocal 2-part extraarticular vertical fracture of proximal end segment of humerus (11A3) both sides. Although there have been a few reports of bilateral symmetrical fracture dislocations of the shoulder in the past, an injury pattern resembling our case has, to the best of our knowledge, not been described in the literature so far. Our report describes regarding the mechanism of injury in a case of a bilateral symmetrical anterior fracture dislocation following a seizure episode that treated with open reduction internal fixation using proximal humerus internal locking system (PHILOS). At final follow-up, the patient had healed fractures, painless near normal range of motion.</p>

Sagittal Wrist Motion of Carpal Bones Following Intraarticular Fractures of the Distal Radius

2005 ◽  
Vol 30 (3) ◽  
pp. 282-287 ◽  
Author(s):  
M. LUTZ ◽  
A. RUDISCH ◽  
F. KRALINGER ◽  
V. SMEKAL ◽  
G. GOEBEL ◽  
...  
Keyword(s):  
Distal Radius ◽  
Sagittal Plane ◽  
Articular Surface ◽  
Contralateral Side ◽  
Open Reduction Internal Fixation ◽  
Carpal Bone ◽  
Maximum Flexion ◽  
Intraarticular Fractures ◽  
Flexion And Extension

Forty patients (mean age, 37 years) with intraarticular C2 and C3 Colles fractures were treated by open reduction, internal fixation and bone grafting. At a mean follow-up of 8 years radiocarpal and midcarpal motion was evaluated, the depth of the articular surface of the distal radius in the sagittal plane was measured and the presence of arthritis was noted. The fractures healed with a mean palmar tilt of 6°, a mean ulnar tilt of 18° and ulna variance within 1 mm of the contralateral side. The depth of the articular surface of the distal radius was 1.3 mm greater than the uninvolved side. Measurement of carpal bone angles relative to the radius in maximum flexion and extension revealed lunate extension of 23°, lunate flexion of 15°, capitate extension of 62°, capitate flexion of 40°. There was a significant correlation between articular surface depth and radiocarpal motion.

scholarly journals Percutaneous posteroanterior screw fixation for Haraguchi type 1 posterior malleolar fracture in tri-malleolar fracture: Operative technique and randomized clinical results

2021 ◽  
Vol 29 (1) ◽  
pp. 230949902199799
Author(s):  
Tianming Yu ◽  
Jichong Ying ◽  
Jianlei Liu ◽  
Dichao Huang ◽  
Hailin Yan ◽  
...  
Keyword(s):  
Screw Fixation ◽  
Malleolar Fracture ◽  
Malleolar Fractures ◽  
Posterior Malleolar Fracture ◽  
Post Traumatic ◽  
Group 2 ◽  
Traumatic Arthritis ◽  
Group 1

Purpose: The study described a novel surgical treatment of Haraguchi type 1 posterior malleolar fracture in tri-malleolar fracture and patient outcomes at intermediate period follow-up. Methods: All patients from January 2015 to December 2017 with tri-malleolar fracture of which posterior malleolar fractures were Haraguchi type 1, were surgically treated in this prospective study. Lateral and medial malleolar fractures were managed by open reduction and internal fixation through dual incision approaches. 36 cases of Haraguchi type 1 posterior malleolar fractures were randomly performed by percutaneous posteroanterior screw fixation with the aid of medial exposure (group 1). And 40 cases were performed by percutaneous anteroposterior screw fixation (group 2). Clinical outcomes, radiographic outcomes and patient-reported outcomes were recorded. Results: Seventy-six patients with mean follow-up of 30 months were included. There were no significant differences in the mean operation time (81.0 ± 11.3 vs. 77.2 ± 12.4), ankle function at different periods of follow-up, range of motions and visual analog scale (VAS) at 24 months between the two groups ( p > 0.05). However, the rate of severe post-traumatic arthritis (Grade 2 and 3) and the rate of step-off rather than gap in radiological evaluation were lower in group 1 than that in group 2 ( p < 0.05). Conclusion: Using our surgical technique, more patients had good outcome with a lower rate of severe post-traumatic arthritis, compared with the group of percutaneous anteroposterior screw fixation. Percutaneous posteroanterior screw fixation can be a convenient and reliable alternative in treating Haraguchi type 1 posterior malleolar fracture.

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

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.

scholarly journals The association between body mass index and recovery from post-traumatic stress disorder after the nuclear accident in Fukushima

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Masato Nagai ◽  
Tetsuya Ohira ◽  
Masaharu Maeda ◽  
Seiji Yasumura ◽  
Itaru Miura ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Stress Disorder ◽  
Error Variance ◽  
Normal Weight ◽  
Post Traumatic Stress ◽  
Post Traumatic

AbstractPost-traumatic stress disorder (PTSD) and obesity share common risk factors; however, the effect of obesity on recovery from PTSD has not been assessed. We examined the association between body mass index (BMI) and recovery from PTSD after the Great East Japan Earthquake. We analyzed 4356 men and women with probable PTSD aged ≥ 16 years who were living in evacuation zones owing to the radiation accident in Fukushima, Japan. Recovery from probable PTSD was defined as Post-traumatic Stress Disorder Checklist-specific scores < 44. Using Poisson regression with robust error variance adjusted for confounders, we compared the prevalence ratios (PRs) and 95% confidence intervals (CIs) for this outcome in 2013 and 2014. Compared with point estimates for normal weight (BMI: 18.5–24.9 kg/m2), especially in 2013, those for underweight (BMI: < 18.5 kg/m2) and obesity (BMI: ≥ 30.0 kg/m2) tended to slightly increase and decrease, respectively, for recovery from probable PTSD. The multivariate-adjusted PRs (95% CIs) for underweight and obesity were 1.08 (0.88–1.33) and 0.85 (0.68–1.06), respectively, in 2013 and 1.02 (0.82–1.26) and 0.87 (0.69–1.09), respectively, in 2014. The results of the present study showed that obesity may be a useful predictor for probable PTSD recovery. Obese victims with PTSD would require more intensive support and careful follow-up for recovery.

scholarly journals Long-Term Follow-up of Patients with Post-Traumatic Refractory High Intracranial Pressure Treated with Lumbar Drainage

2011 ◽  
Vol 39 (1) ◽  
pp. 79-83 ◽  
Author(s):  
J. A. Llompart-Pou ◽  
J. M. Abadal ◽  
J. Pérez-bárcena ◽  
M. Molina ◽  
M. Brell ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Lumbar Drainage ◽  
Long Term Follow Up ◽  
Post Traumatic

scholarly journals Treatment of adult post-traumatic stress disorder using a future-oriented writing therapy approach

2009 ◽  
Vol 2 (4) ◽  
pp. 243-255 ◽  
Author(s):  
Reginald D. V. Nixon ◽  
Leonard W. Kling
Keyword(s):  
Post Traumatic Stress Disorder ◽  
Traumatic Stress ◽  
Expressive Writing ◽  
Stress Disorder ◽  
Post Treatment ◽  
Future Research ◽  
Post Traumatic Stress ◽  
Post Traumatic ◽  
Ptsd Severity

AbstractThe aim of this pilot study was to test whether a future-oriented expressive writing intervention is able to reduce post-traumatic stress disorder (PTSD) severity and associated symptoms such as depression and unhelpful trauma-related beliefs. In an uncontrolled pre-/ post-design participants attended 8 weeks of manualized therapy. Assessment was undertaken pre- and post-treatment, and participants also completed a 3-month follow-up assessment. Of the 17 participants who began therapy, 13 were treatment completers. Results indicated a significant decrease in PTSD severity, depression and unhelpful trauma-related cognitions from pre- to post-treatment and at 3-month follow-up. Clinically meaningful change was more modest; however, three participants reported PTSD remission at 3-month follow-up. It is concluded that expressive writing with a focus on achieving future goals and personal change may have some utility in reducing post-traumatic stress but future research will need to investigate this with greater methodological rigour before firm conclusions can be made.

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