scholarly journals Open versus closed reduction and K-wire fixation for supracondylar fracture of the humerus (Gartland type 3) in children

2021 ◽  
Vol 7 (3) ◽  
pp. 44-50
Author(s):  
Dr. Sanjay Upadhyay ◽  
◽  
Dr. Sunil Kumar Kirar ◽  
Dr. Sanat Singh ◽  
Dr. Atul Varshney ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Supracondylar Fracture ◽  
Wire Fixation ◽  
Test Population ◽  
Group 2 ◽  
Open Versus ◽  
The Right ◽  
Type 3

Background: The purpose of the study was to compare the presentation and postoperative resultsof children treated by open reduction and closed reduction for completely displaced Gartland type IIIsupracondylar humerus fractures (SCFs). Method: Supracondylar fracture of the humerus is acommon paediatric fracture seen in our OPD. Among them Type III fractures are displaced with nocortical contact, and reduction is difficult, and maintaining reduction is almost impossible withoutsome form of internal fixation. Therefore during surgery of type 3 fractures, fixation is done by twomethods. 1 open reduction and fixation with 2 cross k-wire 2. closed reduction and fixation with 2cross k-wire fixation. Following pinning, the elbow was immobilized in an above elbow slab inpronation with the elbow at 75 degrees of flexion. Result: The average age of patients was 5 years(age range, 3 to 10 years). The test population consisted of 18female (36%) and 32 male (64%)patients. There were 31 fractures (62%) in the right elbow and 19 fractures (38%) in the left. Group1 patients stayed in the hospital for 5 days while Group 2 stayed for only 2 days in the hospital. Alsogroup 1 patient required follow-up at eight postoperative days (for check dressing) and 11postoperative days for stitch removal while group 2 patients were directly called for k-wire removalat 3 weeks postoperatively. Both groups of patients were called after three weeks for k-wireremoval. Mean clinical follow-up for both groups was 6 months. Conclusion: The closed reductiontechnique was preferred because it required less hospitalization time, less number followup, andresulted in almost no visible surgical scars.

Long-Term Evaluation of Bennett’s Fracture

1994 ◽  
Vol 19 (3) ◽  
pp. 373-377 ◽  
Author(s):  
E. J. F. TIMMENGA ◽  
T. J. BLOKHUIS ◽  
M. MAAS ◽  
E. L. F. B. RAAIJMAKERS
Keyword(s):  
Closed Reduction ◽  
Open Reduction ◽  
Bennett’S Fracture ◽  
Wire Fixation ◽  
Term Evaluation ◽  
Restricted Mobility ◽  
Almost All

18 patients with Bennett’s fracture were evaluated after a mean follow-up period of 10.7 years. Treatment consisted of closed reduction and K-wire fixation in seven cases and open reduction with osteosynthesis in 11 cases. Overall, symptoms were few and restricted mobility of the thumb could not be demonstrated. The strength of the affected hand was decreased in all patients regardless of the type of treatment. Osteoarthritis was found to correlate with the quality of reduction of the fracture, but had developed in almost all cases even after exact reduction. Exact reduction, either by the open or closed method, should be the aim of treatment of Bennett’s fracture.

scholarly journals Comparative analysis of surgical outcome of treatment of supracondylar humerus fractures Gartland’s extension type III by using closed reduction and K –wire fixation versus open reduction and K –wire fixation method

2017 ◽  
Vol 3 (2) ◽  
pp. 271
Author(s):  
Nilesh Janardan Keche ◽  
Abhijit Bhimrao Kale ◽  
Binoti Arun Sheth ◽  
Ashok Kumar Rathod
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Fixation Method ◽  
Elbow Fracture ◽  
Supracondylar Humerus Fractures ◽  
Wire Fixation ◽  
Group 2 ◽  
K Wires ◽  
Group 1

<p class="abstract"><strong>Background:</strong> Supracondylar fractures of the humerus are the most common elbow fracture in children of the age group 4-12 years. The modern approach for its treatment includes closed reduction or open reduction and internal fixation with K wires. The aim of the present study was to evaluate the clinical and radiological results of children who were treated with the two surgical approaches<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> In our institute children who underwent surgical treatment for supracondylar humeral fractures by closed reduction or open reduction and internal fixation with K wires and whose data were available with regular follow-up of at least 1 year were included in the study. Each group included 25 children in each. Clinical and radiological outcomes were evaluated and compared among the study groups.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of the patients in both the groups were 6.84 and 6.64 in group 1 and group 2 respectively. Fractures were more in boys compared to girls in both the groups. Most of the fractures were seen on left side with posteromedial displacement of distal fragment in almost 80% in both the groups. Mean change in Baumann’s angle (BA), carrying angle and range of motion (ROM) as compared to normal side in both the groups after 3<sup>rd</sup> and 9<sup>th</sup> month of follow ups was found to be not statistically significant. Overall result according to Flynn’s criteria was 60% excellent in group 1 as compared to 52% in group 2. Mean satisfaction score was also more in group 1 children when compared to group 2<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Closed reduction with internal fixation with K wires was found to be a better choice of treatment with good functional results<span lang="EN-IN">.</span></p>

Open versus closed reduction and K-wire fixation for displaced supracondylar fracture of the humerus in children

2018 ◽  
Vol 29 (2) ◽  
pp. 397-403 ◽  
Author(s):  
Alaa A. Hussein al-Algawy ◽  
Adil Hasan Aliakbar ◽  
Ibrahim H. N. Witwit
Keyword(s):  
Closed Reduction ◽  
Supracondylar Fracture ◽  
Wire Fixation ◽  
Open Versus

scholarly journals A tissue-engineered urinary conduit in a porcine urinary diversion model

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Arkadiusz Jundziłł ◽  
Piotr Kwieciński ◽  
Daria Balcerczyk ◽  
Tomasz Kloskowski ◽  
Dariusz Grzanka ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Urinary Diversion ◽  
Porcine Model ◽  
Histological Evaluation ◽  
Metabolic Complications ◽  
Group 3 ◽  
Group 2 ◽  
The Right ◽  
Group 1

AbstractThe use of an ileal segment is a standard method for urinary diversion after radical cystectomy. Unfortunately, utilization of this method can lead to numerous surgical and metabolic complications. This study aimed to assess the tissue-engineered artificial conduit for urinary diversion in a porcine model. Tissue-engineered tubular polypropylene mesh scaffolds were used for the right ureter incontinent urostomy model. Eighteen male pigs were divided into three equal groups: Group 1 (control ureterocutaneostomy), Group 2 (the right ureter-artificial conduit-skin anastomoses), and Group 3 (4 weeks before urostomy reconstruction, the artificial conduit was implanted between abdomen muscles). Follow-up was 6 months. Computed tomography, ultrasound examination, and pyelogram were used to confirm the patency of created diversions. Morphological and histological analyses were used to evaluate the tissue-engineered urinary diversion. All animals survived the experimental procedures and follow-up. The longest average patency was observed in the 3rd Group (15.8 weeks) compared to the 2nd Group (10 weeks) and the 1st Group (5.8 weeks). The implant’s remnants created a retroperitoneal post-inflammation tunnel confirmed by computed tomography and histological evaluation, which constitutes urostomy. The simultaneous urinary diversion using a tissue-engineered scaffold connected directly with the skin is inappropriate for clinical application.

scholarly journals Closed Reduction and Percutaneous Kirschner Wire Fixation Combined with Plaster Cast versus Conventional Plaster Cast immobilization in the Treatment of Colles' Fracture – A Prospective Randomized Comparative Study

1970 ◽  
Vol 17 (2) ◽  
pp. 98-105 ◽  
Author(s):  
KS Uzzaman ◽  
KA Awal ◽  
MK Alam
Keyword(s):  
Comparative Study ◽  
Closed Reduction ◽  
Kirschner Wire ◽  
Plaster Cast ◽  
Cast Immobilization ◽  
Fixation Group ◽  
Wire Fixation ◽  
Colles Fracture ◽  
End Results

Purpo'e: To evaluate functional & anatomical results of the Colles’ fracture treated by two methods- i) Closed reduction & precutaneous kirschner wire (K- wire) fixation combined with plaster cast & ii) Conventional plaster cast immobilization after closed reduction.Methods: A randomized prospective comparative study was done from July 2003 to June 2005 on 52 patient with Colles' fracture in NITOR, Dhaka. 12 patients lost from follow up. Twenty patient (20) in each group were finally available for evaluation. The group treated by closed reduction & percutaneous K-wire fixation combined with plaster cast- designated as "Arm A" & another group treated conventionally by plaster cast only designated by "Arm-B". Male Female ratio was 1:3, Age range was 35 to 70 years (Mean age 52.5 years) Distribution of limbs side involvement almost equal. Mode of injuries were domestic fall & RTA (4:1) According to AO classification fracture were in both groups- A2 = 13, A3 = 10, C1 = 6, C2 = 8 & C3 = 3 (Total- 40). Follow up period was 6-14 months (mean = 6 month)Results: Union time for most of the fractures was 6-8 weeks. At final follow up Satisfactory Anatomical end results of percutuneous fixation group (Arm-A) were 80% and in conventional plaster cast group (Arm-B) were 35%. (P<0.01). Satisfactory functional end results in Arm-A group were 70% and in Arm-B group were 30% (P<0.01) Complications seen much more in conventional group (Arm-B) than percutaneous K-wire fixation group (Arm-B). Sarmiento & Latta’s criteria was used to evaluate the progress.Conclusion: The coventional plaster cast method for treatment of colles’ fracture usually can't maintain radial length & angulation in many instances and results significant anatomical difficultly and functional disability. On the other hand after close reduction additional fixation in the form of percutaneous crossed K-wire can maintain the reduction till bony union & prevent late collapse at fracture site & provides better result. Key Words: Colles' fracture; closed reduction; Plaster cast & Kirschner wire (K-wire) fixationDOI: 10.3329/jdmc.v17i2.6591J Dhaka Med Coll. 2008; 17(2) : 98-105

scholarly journals Closed Pan-talar Dislocation with Posterior Talar Process Fracture

2015 ◽  
Vol 1 (2) ◽  
pp. 32-35
Author(s):  
M Pramod Kumar ◽  
KM Gopinath ◽  
BN Roshan Kumar ◽  
GA Gautham Balaji
Keyword(s):  
Closed Reduction ◽  
Reduction Process ◽  
Road Accident ◽  
Review Of Literature ◽  
Open Injury ◽  
Accident Victim ◽  
Talar Fractures ◽  
The Right ◽  
Steinmann Pin

ABSTRACT Total dislocation of the talus has been reported as 0.06% of all dislocations and 2% of all talar fractures. It usually occurs from considerable violence. Total dislocation of the talus is frequently an open injury, or the skin may be tented over the dislocated talus leading to skin slough. Closed total dislocation of talus with posterior process injury is rare. The functional prognosis is poor due to osteonecrosis of the talus which develops in the majority of cases. Review of literature reported successful closed reduction in cases of closed pan-talar dislocation under anesthesia. However, there were few cases where there was difficulty in closed reduction. Operative technique has also been described in different reports of similar cases. Case report We present a case of pan-talar dislocation of the left talus in a 25-year-old road accident victim, with posterior talar process fracture. Reduction of dislocation was attempted in emergency department by external manipulation. Reduction process failed, and hence planned for reduction under anesthesia. It required a open reduction after a unsuccessful closed reduction attempt. The talus after reduction was found to be unstable hence, stabilized with trans-calcaneotalar Steinmann pin. At 1-year follow-up, the right ankle was pain free and stable. Motion was satisfactory. The talus after a follow-up of 1 year did not show any signs of subluxation or avascular necrosis. Conclusion The main obstacle to closed reduction appeared to be talus had button holed through dorsal fascia. The talus after reduction was found to be unstable hence stabilized with trans-calcaneotalar Steinmann pin. The management of the associated fracture will depend on many factors, particularly displacement of the fracture fragments. How to cite this article Kumar MP, Gopinath KM, Kumar BNR, Balaji GAG. Closed Pan-talar Dislocation with Posterior Talar Process Fracture. J Med Sci 2015;1(2):32-35.

scholarly journals Comparison of outcome of closed reduction and percutaneous pinning and, open reduction and internal fixation with k-wire in Gartland extension type III supracondylar fracture of distal humerus in pediatric population

2018 ◽  
Vol 1 (1) ◽  
pp. 1-3
Author(s):  
Bhogendra Bahadur KC ◽  
Norman Lamichhane ◽  
Chandra Bahadur Mishra ◽  
Bharat Bahadur Khatri ◽  
Sabita Dhakal
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Closed Reduction ◽  
Open Reduction ◽  
Operative Procedure ◽  
Distal Humerus ◽  
Supracondylar Fracture ◽  
P Value ◽  
Percutaneous Pinning ◽  
Type Iii

Background: Supracondylar fracture of the distal humerus is one of the commonest fracture in pediatric age group. Though there is consensus of treating type III fracture operatively, no study has compared the outcome between Closed Reduction and Percutaneous Pinning (CRPP) and Open Reduction and Internal Fixation (ORIF) with k-wire in our setup. Materials and Methods: Retrospective comparison study was done on eighty seven cases of Type III supracondylar fracture of distal humerus underwent operative procedure. Fifty four (54) cases underwent CRPP and 33 cases were managed with ORIF with k-wire, and they were followed up till 6 months post-operatively. Results : The mean time for radiological union in patient who underwent CRPP was 4.37±0.94 weeks and that for the patient who underwent ORIF was 4.45±0.13 weeks, the difference of which was statistically insignificant (p-value >0.05). 83.3% of CRPP group and 78.8% in ORIF group had excellent functional outcome and only 3% in ORIF group had poor functional outcome. Conclusion: Though both the group don’t have significant advantage of functional outcome among each other CRPP with limited attempt should be preferred to ORIF with k-wire for the advantage of avoiding surgical scar and reducing surgery time and exposure to anaesthetic agents.

scholarly journals TRATAMENTO CIRÚRGICO SPLITTING NAS TENDINITES AGUDAS EXPERIMENTAIS EM EQÜINOS

2002 ◽  
Vol 7 (2) ◽  
Author(s):  
A. L. G. ALVES ◽  
J. L. M. NICOLETTI ◽  
A. THOMASSIAN ◽  
C. A. HUSSNI ◽  
M. J. WATANABE
Keyword(s):  
Research Work ◽  
Control Group ◽  
Histopathological Analysis ◽  
Mean Values ◽  
Repair Tissue ◽  
Superficial Digital Flexor Tendon ◽  
Tendon Lesion ◽  
Group 2 ◽  
The Right

O objetivo deste trabalho foi avaliar a eficácia do tratamento cirúrgico “splitting” em lesões tendíneas agudas induzidas experimentalmente. Para tanto, foram utilizados 8 eqüinos sadios, submetidos à aplicação de colagenase (2ml–2,5mg/ml) nos tendões flexores digitais superficiais (TFDS) dos membros torácicos e após 7 dias da aplicação, foram realizadas incisões percutâneas - splitting - no local da lesão dos membros direitos (grupo tratado), permanecendo os membros esquerdos como grupo controle. Os 8 animais foram divididos em 2 grupos de mesmo número, segundo o período da realização das biópsias (grupo 1 - 30o dia e o grupo 2 - 60o dia após indução da tendinite). A monitoração dos animais foi realizada através de exames clínicos, ultra-sonográficos, análises macroscópica e histopatológica. Ao exame clínico não foi observada diferença significativa entre o grupo tratado e o controle. Com o exame ultra-sonográfico foi constatado que no grupo tratado houve uma significativa redução da área média da lesão naqueles membros em que foram observadas lesões iniciais maiores que 30% da área tendínea. Foram observadas menor celularidade do tecido de reparação e maior fibroplastia nos tecidos tratados, indicando melhor maturação tecidual neste grupo. Através dos resultados obtidos conclui-se que o splitting utilizado em lesões com áreas maiores que 30% da área transversal tendínea reduz o tempo de cicatrização da lesão e melhora a remodelação tecidual. Tendon splitting surgical treatment on experimental equine acute tendinitis Abstract The main aim of the present research work was to study the effects of the splitting on equine experimental tendinitis. Eight horses without soundness problems were used in this experiment. The tendinitis was induced by administration of collagenase (2 ml, 2.5 mg/ml) in the superficial digital flexor tendon (SDFT) of all animals. After 7 days of the induction of tendinitis, an intralesional splitting was carried out with a tendon knife in the right forelimbs, the left forelimbs kept as control. The 8 animals were divided in two groups of 4 according to the period that the biopsies took place: group 1, at the 30th day and group 2 at the 60th day after the splitting had been performed. The splitting and healing processes were monitored by clinical and sonographic examinations during all the experiment, Gross and histopathological analysis of the forelimbs were performed in both groups of animals, at the 30th and the 60th day after the splitting, respectively. Follow-up sonographic examinations displayed the fact that lesions bigger than 30% of the tendon area showed significant decrease in the mean values of the lesion area in the split tendons, when compared with the control group at the days 15, 30 and 60 after the splitting. Split members showed marked improvement in the severity rates and percentile of residual tendon lesion at the 60 day. The cellularity of the repair tissue was significantly lower. besides the fact that there were more mature repair tissue in the split tendons at 30 and 60 days after the splitting. These results allowed to conclude that the split technique used in acute large core lesions reduce the time of wound healing and improve the scar remodeling.

scholarly journals Ultrasonography-guided closed reduction in the treatment of displaced transphyseal fracture of the distal humerus

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Hai Zhou ◽  
Ge Zhang ◽  
Ming Li ◽  
Xiangyang Qu ◽  
Yujiang Cao ◽  
...  
Keyword(s):  
Closed Reduction ◽  
Elbow Flexion ◽  
Distal Humerus ◽  
Cubitus Varus ◽  
Radiographic Outcomes ◽  
The Mean ◽  
Low Incidence ◽  
The Right ◽  
Successful Reduction

Abstract Background To evaluate the clinical and radiographic outcomes of ultrasonography-guided closed reduction in the treatment of displaced transphyseal fracture of the distal humerus (TFDH). Methods Twenty-seven patients with displaced TFDH were successfully treated by the ultrasonography-guided closed reduction during January 2012 to December 2016 and were retrospectively reviewed. After the mean follow-up of 34.88 months, the clinical and radiographic outcomes of patients were evaluated. The cubitus varus of the affected elbows was also assessed at the latest follow-up. Results The successful rate of ultrasonography-guided closed reduction in the treatment of displaced TFDH was 84% (27/32). The twenty-seven patients with successful reduction were included for the following analysis. There were 20 males and 7 females included in the study, and the mean age at treatment was 15.39 ± 3.10 months; seventeen fractures occurred in the right side elbow and ten in the left side. At the last follow-up, there were significant decreases in the elbow flexion (3°, P = 0.027) and range of motion (5°, P = 0.003) between the injured and uninjured elbow, respectively, whereas no difference in elbow extension was detected (P = 0.110). Flynn’s criteria assessment showed that all the patients achieved excellent or good outcomes both in the functional and cosmetic categories. The clinical and radiographic carrying angles at the last follow-up were 11.67 ± 3.11° and 10.46 ± 3.88°, respectively. And the incidence of cubitus varus after treatment was 7.4% at the last follow-up. Conclusion The ultrasonography-guided closed reduction in the treatment of displaced TFDH is an effective procedure; the adequate fracture reduction can be acquired with the advantages of real-time, non-radioactive, and simple utilization. With the percutaneous pining fixation, satisfactory clinical and radiographic outcomes can be achieved with a low incidence of postoperative cubitus varus.

scholarly journals An Undescribed Monteggia Type 3 Equivalent Lesion: Lateral Dislocation of Radial Head with Both-Bone Forearm Fracture

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Adnan Kara ◽  
Mahmut Enes Kayaalp ◽  
Mehmet İşyar ◽  
Cem Sever ◽  
Melih Malkoç ◽  
...  
Keyword(s):  
Radial Head ◽  
Closed Reduction ◽  
Forearm Fracture ◽  
Diagnosis And Treatment ◽  
Lateral Dislocation ◽  
Both Bones ◽  
Type 3

Monteggia fractures are accepted as hard-to-recognize and easy-to-handle fractures. Adequate radiographic investigations and clinical examinations are necessities. This case holds unique features involving diagnosis and treatment. In this case, the radial head was dislocated laterally while both bones were fractured in the proximal diaphysis, being the first to be mentioned in the literature. Closed reduction of the ulna is the preferred method of handling and almost always results in reduction of the radial head. Literature obligates ulnar reduction as a preliminary to reduce and stabilize the radial head. Closed reduction reduced the ulna but the radial head was not reduced. Hence an intramedullary K-wire was used to reduce the radial head and a long arm cast was used to stabilize the reduction. The operation was successful and follow-up showed no complications.

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