scholarly journals Evaluation of results of three and four-part fracture dislocations of proximal humerus in young adults using philos (proximal humerus internal locking system)

2018 ◽  
Vol 6 (2) ◽  
pp. 585
Author(s):  
Amit Thakur ◽  
Khalid Muzzafar ◽  
Sumeet Singh Charak ◽  
Bias Dev ◽  
Abdul Ghani
Keyword(s):  
Proximal Humerus ◽  
Young Patients ◽  
Soft Tissue Injuries ◽  
Functional Results ◽  
High Energy ◽  
High Rate ◽  
Fracture Dislocation ◽  
Rotator Cuff Insufficiency ◽  
Fracture Dislocations ◽  
Adequate Management

Background: The fractures of proximal humerus constitute about 5% of fractures in adults third in number to fracture colles and hip usually in elderly patients due to a low energy trauma. In young patients the fractures are mostly due to high energy trauma and as such are associate with other soft tissue injuries. A sub group of young patients have a three or four fracture dislocation of shoulder joint. The aim of this study was to find the results of fixation by PHILOS in these young patients.Methods: This study was done in a teritiary referral centre over a period of about 1 year. All patients were operated within three weeks. Open fractures, patients with age more than 50 years were excluded from the study. All patients underwent open reduction and fixation using commercially available PHILOS. A minimum of 6 months follows up was essential for inclusion into the study. Final functional results were evaluated by Constant Murley scoring.Results: 14 patients were included in the study. The average age of patients was 38.42years. All fractures united. We had 71.4% excellent or good results. The complications noted were shoulder stiffness in 3, inadequate post op reduction, rotator cuff insufficiency, head necrosis, secondary osteo arthritis 1 each.Conclusions: Despite the relatively high rate of complications encountered in the management of these complicated high-energy fractures, the PHILOS plating system could be considered an adequate management of these patients.

scholarly journals Surgical management of complex humerus head fractures

2010 ◽  
Vol 2 (1) ◽  
pp. 14 ◽  
Author(s):  
Mohamed M.H. El-Sayed
Keyword(s):  
Proximal Humerus ◽  
Age Groups ◽  
Osteoporotic Fractures ◽  
Scoring Systems ◽  
High Energy ◽  
High Rate ◽  
Trauma Patients ◽  
Fracture Dislocations ◽  
Philos Plate

The locked plate systems provided adequate fixation of osteoporotic fractures of the proximal humerus in the elderly. But is the PHILOS plate adequate for stabilization of high-energy fractures, and fracture-dislocations of the proximal humerus in relatively younger age populations? In this retrospective study, performed at a referral, academic supervised, level III-trauma center, all high-energy trauma patients under the age of 55 years, with closed, 3 part, 4 part fractures, and/or fracture dislocations, were included in this study. Patients with open fractures, osteoporotic low-energy fractures, as well as patients older than 55 years were excluded. Fifty-nine patients entered and completed the study. They were all managed by open reduction and internal fixation using the PHILOS plate system. Patients’ age ranged between 31-52 years, with a mean of 42 years. A minimal follow-up period of two years was a mandatory inclusion criterion in this study. All the patients who did not complete the follow-up period were excluded from the study. The results were evaluated using the Constant, Neer and DASH scoring systems, which revealed favorable results in 41 patients (69.5%). The results were comparable to the recent articles published in the literature in relatively older age groups. It was concluded that, despite the relatively high rate of complications encountered in the management of these complicated high-energy fractures, the PHILOS plating system could be considered an adequate management of polytrauma patients.

scholarly journals Trans-scaphoid Perilunate Fracture Dislocation

2021 ◽  
Author(s):  
Hee-Soo Kim ◽  
Won-Tack Oh ◽  
Il-Hyun Koh ◽  
Yun-Rak Choi ◽  
Ho-Jung Kang
Keyword(s):  
Operative Treatment ◽  
Treatment Options ◽  
Young Patients ◽  
High Energy ◽  
Review Article ◽  
Fracture Dislocation ◽  
Fracture Dislocations ◽  
Wrist Anatomy ◽  
Perilunate Fracture Dislocation ◽  
And Function

Trans-scaphoid perilunate fracture dislocations, which account for more than half of total cases of perilunate injuries, are common in young patients and occur as a result of high-energy injuries, and improper management can impair wrist alignment and function. Understanding the related wrist anatomy and pathomechanics may help surgeons evaluate and diagnose patients. Early operation to reduce and fix the injuries should be considered to achieve optimal clinical and radiological outcomes. In this review article, we present an overview of wrist pathoanatomy, the pathomechanics of trans-scaphoid perilunate fracture dislocations, operative treatment options including an arthroscopic procedure, and reported clinical and radiological outcomes.

FACTORS AFFECTING THE FUNCTIONAL RESULTS OF OPEN REDUCTION AND INTERNAL FIXATION FOR FRACTURE-DISLOCATIONS OF THE PROXIMAL INTERPHALANGEAL JOINT

Hand Surgery ◽  
2015 ◽  
Vol 20 (01) ◽  
pp. 107-114 ◽  
Author(s):  
Kentaro Watanabe ◽  
Yoshitake Kino ◽  
Hiroki Yajima
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Functional Results ◽  
Fracture Dislocation ◽  
Factors Affecting ◽  
Flexion Extension ◽  
Motion Exercise ◽  
Fracture Dislocations ◽  
Pip Joint ◽  
The Mean

To clarify the factors affecting functional results of fracture-dislocations of the proximal interphalangeal (PIP) joint treated by open reduction and internal fixation (ORIF), 60 patients, including 38 patients with a dorsal fracture-dislocation and 22 with a pilon fracture, were analysed. The mean ratio of articular surface involvement was 48.5% and a depressed central fragment existed in 75.3% of the cases. ORIF was performed in 47 patients through a lateral approach using Kirschner wires and in 13 through a palmar approach using a plate or screws. The mean flexion, extension and range of motion (ROM) of the PIP joint was 89.5°, 11.5° and 78.0°, respectively. Stepwise regression analysis revealed that a delayed start of active motion exercise after surgery, elderly age and ulnar ray digit were factors affecting functional outcomes. Although ORIF allows accurate restoration of the articular surfaces, an early start of motion exercise is essential for good results.

scholarly journals Treatment of unusual locked posterior fracture–dislocation of the shoulder: a case series

2020 ◽  
Vol 23 (4) ◽  
pp. 190-196
Author(s):  
Ho Yeon Park ◽  
Seok Jung Kim ◽  
Yoo Joon Sur ◽  
Jae Woong Jung ◽  
Chae-gwan Kong
Keyword(s):  
Total Shoulder Arthroplasty ◽  
Young Patients ◽  
Case Series ◽  
High Energy ◽  
Fracture Dislocation ◽  
Long Term Outcome ◽  
First Choice ◽  
Vas Scores ◽  
The Mean

Background: Locked posterior fracture-dislocation of the shoulder (LPFDS) is a very rare injury that occurs predominantly in young patients following high-energy trauma. The long-term outcome of the treatment of this injury is often poor. This study sought to present the characteristics of injury, discuss the pathological anatomy, and to report the treatment outcomes of our case series. Methods: Between January 2012 and May 2018, a total of 234 patients who underwent surgical treatment for proximal humerus fractures were reviewed. Among them, six patients (mean age, 54.7 years; range, 35–76 years) with LPFDS were included in this study. Four patients were treated with open reduction and internal fixation (ORIF) with locking plates, one with hemiarthroplasty, and one with reverse total shoulder arthroplasty. Clinical results were evaluated by Constant, American Shoulder and Elbow Surgeons (ASES), and visual analog scale (VAS) scores and radiologic evaluation was conducted using follow-up radiographs. Results: The mean length of follow-up was 26.2 months (range, 12–54). The mean Constant, ASES, and VAS scores were 66.7, 65.5, and 2.2, respectively. Four patients who underwent ORIF achieved bony union, but avascular necrosis (AVN) of the humeral head was observed in two patients. No complications were observed in the patients who underwent arthroplasty surgery until final follow-up. Conclusions: In the treatment of LPFDS, replacement arthroplasty can produce predictable results. The approach of ORIF may be considered as a first choice of treatment in young patients but is sometimes correlated with postoperative complications such as AVN and the functional outcomes may be unpredictable. Therefore, patients should undergo careful diagnosis and treatment of this type of injury.

Dorsal Fracture-Dislocation of the Tarsal Navicular

2017 ◽  
Vol 107 (3) ◽  
pp. 226-230 ◽  
Author(s):  
Isidro Jimenez ◽  
Juan Pedro Rodriguez-Alvarez ◽  
Ricardo Navarro-Navarro
Keyword(s):  
Clinical Case ◽  
Case Reports ◽  
High Energy ◽  
Fracture Dislocation ◽  
Published Data ◽  
Excellent Outcome ◽  
Appropriate Treatment ◽  
Chopart Joint ◽  
Fracture Dislocations ◽  
Tarsal Navicular Bone

Fracture-dislocations of the tarsal navicular are rare and highly complex injuries to the midfoot. The only published data on this type of fracture are clinical case reports. These injuries are normally caused by high-energy trauma, and their pathophysiology and most appropriate treatment remain unclear. We report a clinical case of a dorsal fracture-dislocation of the tarsal navicular bone associated with a medial swivel dislocation of the Chopart joint caused by a bicycle fall in a 20-year-old healthy man. Open reduction and percutaneous pinning in a novel arrangement was performed, with an excellent outcome 18 months after the injury.

scholarly journals Complex Ankle Fractures, Presentation of 3 Cases and Review of the Literature

2020 ◽  
pp. 1-6
Author(s):  
Montoya Saenz Rocio ◽  
Montoya Saenz Rocio ◽  
Carlos Cano ◽  
Marques Parrilla Carlos
Keyword(s):  
Soft Tissue ◽  
Elderly Population ◽  
Young Patients ◽  
Soft Tissue Injuries ◽  
The Elderly ◽  
High Energy ◽  
Ankle Fractures ◽  
Inherent Risk ◽  
Fixation Devices ◽  
Main Complication

Ankle fractures represent a significant percentage of all fractures, and there is currently an increased incidence, both among the elderly population with associated comorbidities and among young patients with high-energy traumas. These fractures have an inherent risk of complications. In this connection, it is crucial that we turn our attention to soft tissue injuries, with wound infection as the main complication in this category. The last objective of this study is to highlight the possible derived complications in complex ankle fractures, and to explain the advantages of the use of different fixation devices, through the presentation of three clinical cases treated in our center. We conclude in order to prevent or reduce the complications resulting from the direct surgical treatment of high-energy trauma in the distal end of the tibia, it is essential to properly manage the soft tissue based on the type of lesion and the characteristics of the patient.

Cases of Missed Posterior Fracture-Dislocation of the Shoulder

2020 ◽  
Author(s):  
Morteza Nakhaei Amroodi ◽  
Farzad Amouzadeh Omrani ◽  
Naser Ghanbari ◽  
Melika Alaedini
Keyword(s):  
Young Adults ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Rare Condition ◽  
High Energy ◽  
Posterior Dislocation ◽  
Humerus Fracture ◽  
Fracture Dislocation ◽  
High Energy Trauma ◽  
X Ray

Proximal humerus fracture-dislocation is a rare condition that occurs mostly in young adults due to high energy trauma and about 60-79 percent of misdiagnosis is occurred in the first diagnosis. In this article, we present two patients with proximal humerus fracture-posterior dislocation the fractures of whom were diagnosed, but after the radiographic studies including x-ray and computer tomography (CT) scan, the posterior dislocation was misdiagnosed. In addition, complications, management, and avoidance of this misdiagnosis were discussed.

Dorsal fracture-dislocation of the radiocarpal joint: a new classification and implications in surgical treatment

2020 ◽  
Vol 45 (7) ◽  
pp. 700-708
Author(s):  
Marco Biondi ◽  
Giulio Lauri
Keyword(s):  
Surgical Treatment ◽  
Soft Tissue Injuries ◽  
Fracture Dislocation ◽  
Type I ◽  
New Classification ◽  
Level Of Evidence ◽  
Type Iv ◽  
Radiocarpal Joint ◽  
Fracture Dislocations ◽  
Preoperative Ct

Dorsal dislocations and fracture-dislocations of the radiocarpal joint are a spectrum of pathology involving both the bony and ligamentous structures that stabilize the radiocarpal joint. We retrospectively reviewed 63 dorsal radiocarpal dislocations treated in our Institute in order to propose a new classification and define surgical treatment. Preoperative CT-scan findings together with clinical and radiological outcomes were recorded. We identified four main types of lesions: Type I, pure dorsal radiocarpal dislocation; Type IIA, dorsal wall impaction and radial styloid avulsion; Type IIB, as IIA with additional intra-articular die punch; Type III, volar and dorsal marginal fragments; Type IV, larger volar and dorsal fragments. For each type of lesion, we propose specific options for treatment that are progressively more invasive. We believe that this classification adequately addresses the whole spectrum of bony and soft tissue injuries that occurs in dorsal radiocarpal fracture-dislocations giving a practical guide for surgical treatment. Level of evidence: IV

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