Long-term comparative study of internal fixation with Kirschner wires or cannulated screws for displaced medial epicondyle fractures of the humerus in children: a 10-year follow-up of 42 cases

Background Several minimally invasive techniques were developed for management of intraarticular calcaneal fractures. This study aimed to compare the functional and radiological outcomes of 2 minimally invasive reduction and fixation techniques using cannulated screws or Kirschner wires (K-wires) for fixation. Methods This study was a retrospective comparative review of patients with displaced intraarticular calcaneal fractures, who were treated with cannulated screws or K-wires techniques. Clinical and radiological data were collected and compared between both groups. Functional outcomes and patient satisfaction using the Maryland Foot Score (MFS) and the visual analogue scale (VAS) of pain, in addition to the complications, were compared between both groups. Results In total, 70 patients were included in the study: 34 in the cannulated screws group, with a mean age of 35.2 ± 4 years, and 36 in the K-wires groups, with a mean age of 33.4 ± 3 years. The operative time was shorter in the K-wires group (40.5 ± 5.6 minutes) compared to the cannulated screw group (49.5 ± 4.5 minutes), P < .001. There were no statistically significant differences between both groups regarding the radiological parameters, including Bohler’s angle, angle of Gissane, calcaneal width, height, or length. The mean MFS, mean VAS, and complications were not different between the 2 groups. Conclusion Treatment of displaced intraarticular calcaneal fractures with minimally invasive reduction and fixation using either cannulated screws or K-wires can achieve similar excellent functional and radiological outcomes, with high patient satisfaction. The use of K-wires has the advantage of reduced operative time than cannulated screws. Levels of Evidence: Level III: Retrospective comparative study

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Use of small cannulated screws for fixation in foot surgery

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-90-5-240 ◽

2000 ◽

Vol 90 (5) ◽

pp. 240-246 ◽

Cited By ~ 3

Author(s):

AE Burns

Keyword(s):

Effective Means ◽

Bone Screws ◽

Cannulated Screws ◽

Implant Fixation ◽

Foot Surgery ◽

Fixation Failure ◽

Untoward Event ◽

Patient Noncompliance

Use of cannulated bone screws, as compared with use of traditional bone screws, has been reported to decrease surgical time, allow for more precise screw placement, and reduce sources of error. Cannulation of the smaller-size screws that are routinely used in foot surgery has not been available until the last few years. This article reports on the use of the small cannulated screws manufactured by Alphatec Manufacturing, Inc (Palm Desert, California). The screw sizes available in the Mini Lag Screw System are 2.7, 3.5, and 4.0 mm. A long-term clinical and radiographic prospective evaluation of 70 procedures performed on 49 patients was conducted. The follow-up time for all patients was 2 years. None of the 70 implants fractured, and seven procedures (in seven patients) resulted in some type of implant-fixation failure. All of the fixation failures, however, appeared to be related to an untoward event or patient noncompliance. These smaller cannulated screws proved to be a reliable and effective means of fixation in foot surgery.

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Long-Term Follow-Up of the Fixation of Intracapsular Hip Fractures with Multiple Cannulated Screws

Journal of Orthopaedic Trauma ◽

10.1097/00005131-199304000-00092 ◽

1993 ◽

Vol 7 (2) ◽

pp. 194

Author(s):

Stanley E. Asnis

Keyword(s):

Hip Fractures ◽

Cannulated Screws ◽

Long Term Follow Up

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Hemiarthroplasty versus internal fixation for displaced intracapsular hip fractures: A long-term follow-up of a randomised trial

Yearbook of Orthopedics ◽

10.1016/s0276-1092(10)79792-3 ◽

2010 ◽

Vol 2010 ◽

pp. 40-42

Author(s):

M.F. Swiontkowski

Keyword(s):

Internal Fixation ◽

Hip Fractures ◽

Randomised Trial ◽

Long Term Follow Up

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A Long-Term Follow-up, Multicenter, Comparative Study of the Radiologic, and Clinical Results Between a CaO-SiO2-P2O5-B2O3 Bioactive Glass Ceramics (BGS-7) Intervertebral Spacer and Titanium Cage in 1-Level Posterior Lumbar Interbody Fusion

Clinical Spine Surgery ◽

10.1097/bsd.0000000000000950 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Jae Hyup Lee ◽

Sun Ki Kim ◽

Sung Shik Kang ◽

Seung Jung Han ◽

Choon-Ki Lee ◽

...

Keyword(s):

Comparative Study ◽

Bioactive Glass ◽

Interbody Fusion ◽

Glass Ceramics ◽

Posterior Lumbar Interbody Fusion ◽

Clinical Results ◽

Lumbar Interbody Fusion ◽

Long Term Follow Up

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Long-term follow-up of replacement compared with internal fixation for displaced femoral neck fractures: Results at ten years in a randomised study of 450 patients

Yearbook of Orthopedics ◽

10.1016/s0276-1092(10)79781-9 ◽

2010 ◽

Vol 2010 ◽

pp. 42-43

Author(s):

M.F. Swiontkowski

Keyword(s):

Femoral Neck ◽

Internal Fixation ◽

Femoral Neck Fractures ◽

Randomised Study ◽

Displaced Femoral Neck Fractures ◽

Long Term Follow Up

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Long-term growth and alignment after occipitocervical and atlantoaxial fusion with rigid internal fixation in young children

Journal of Neurosurgery Pediatrics ◽

10.3171/2015.5.peds14728 ◽

2016 ◽

Vol 17 (1) ◽

pp. 94-102 ◽

Cited By ~ 25

Author(s):

Benjamin C. Kennedy ◽

Randy S. D’Amico ◽

Brett E. Youngerman ◽

Michael M. McDowell ◽

Kristopher G. Hooten ◽

...

Keyword(s):

Cervical Spine ◽

Young Children ◽

Internal Fixation ◽

Growth Patterns ◽

Long Term Effects ◽

Fusion Construct ◽

Rigid Internal Fixation ◽

Vertical Growth

OBJECT The long-term consequences of atlantoaxial (AA) and occipitocervical (OC) fusion and instrumentation in young children are unknown. Anecdotal reports have raised concerns regarding altered growth and alignment of the cervical spine after surgical intervention. The purpose of this study was to determine the long-term effects of these surgeries on the growth and alignment of the maturing spine. METHODS A multiinstitutional retrospective chart review was conducted for patients less than or equal to 6 years of age who underwent OC or AA fusion with rigid instrumentation at 9 participating centers. All patients had at least 3 years of clinical and radiographic follow-up data and radiographically confirmed fusion. Preoperative, immediate postoperative, and most recent follow-up radiographs and/or CT scans were evaluated to assess changes in spinal growth and alignment. RESULTS Forty children (9 who underwent AA fusion and 31 who underwent OC fusion) were included in the study (mean follow-up duration 56 months). The mean vertical growth over the fused levels in the AA fusion patients represented 30% of the growth of the cervical spine (range 10%–50%). Three different vertical growth patterns of the fusion construct developed among the 31 OC fusion patients during the follow-up period: 1) 16 patients had substantial growth (13%–46% of the total growth of the cervical spine); 2) 9 patients had no meaningful growth; and 3) 6 patients, most of whom presented with a distracted atlantooccipital dislocation, had a decrease in the height of the fused levels (range 7–23 mm). Regarding spinal alignment, 85% (34/40) of the patients had good alignment at follow-up, with straight or mildly lordotic cervical curvatures. In 1 AA fusion patient (11%) and 5 OC fusion patients (16%), we observed new hyperlordosis (range 43°–62°). There were no cases of new kyphosis or swan-neck deformity, evidence of subaxial instability, or unintended subaxial fusion. No preoperative predictors of these growth patterns or alignment were evident. CONCLUSIONS These results demonstrate that most young children undergoing AA and OC fusion with rigid internal fixation continue to have good cervical alignment and continued growth within the fused levels during a prolonged follow-up period. However, some variability in vertical growth and alignment exists, highlighting the need to continue close long-term follow-up.

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Long-term outcome in 132 consecutive patients after posterior internal fixation and fusion for Grade I and II isthmic spondylolisthesis

Journal of Neurosurgery Spine ◽

10.3171/spi.2005.2.3.0289 ◽

2005 ◽

Vol 2 (3) ◽

pp. 289-297 ◽

Cited By ~ 24

Author(s):

Markus Wenger ◽

Nicola Sapio ◽

Thomas-Marc Markwalder

Keyword(s):

Internal Fixation ◽

Posterior Instrumentation ◽

Neurological Dysfunction ◽

Leg Pain ◽

Low Grade ◽

Isthmic Spondylolisthesis ◽

Content Type ◽

Fine Print

Object. The authors assessed the late outcome of patients with Meyerding Grade I and II isthmic spondylolisthesis (IS) who underwent posterior instrumentation and posterolateral fusion (PLF). Decompression and posterior internal fixation with PLF is the classic surgical treatment for painful low-grade IS. Nevertheless, outcome data are scarce and of limited value mainly because they represent small numbers of patients, short follow-up periods, or both. Methods. The authors obtained data in the cases of 132 consecutive adult patients (mean age 40.6 years, range 15.2–69.9 years) with IS who underwent treatment between 1984 and 2003. Assessment involved analysis of responses to mailed questionnaires, clinical charts and, in cases in which unsatisfactory results were suspected, results of clinical reevaluations. Spondylolisthesis was present at L3–4 in three patients, L4–5 in 14, L3–4 in one, L3–5 in one, L5—S1 in 113, and S1–2 in one. Signs and symptoms included back and leg pain (65.3%), leg pain alone (26.3%), back pain alone (8.4%), and neurological dysfunction (18%). At a mean follow-up duration of 9.9 years (range 0.5–19.4 years), favorable results were reported for back and leg pain in 91.7 and 87.1% of patients, respectively. The mean visual analog scale scores were 2.13 for back and 1.59 for leg pain. Eighty-four patients resumed full- or part-time work, and 56.8% were capable of performing housework more easily. In 45.5% of the patients analgesic medications were not required, and 43.9% required them sporadically. The majority (63.6%) of patients reported they would undergo surgery again and recommended it to others. Thirteen (9.9%) suffered adjacent-segment morbidity, and in seven (5.3%) pseudarthrosis was documented. There were two deep and one superficial infections (2.3%). Conclusions. Posterior instrumentation and PLF, with possible neurodecompression, yielded favorable long-term results in this retrospective study of 132 patients with low-grade IS.

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