scholarly journals Outcome of internal fixation procedure: miniplate vs cross K wires for displaced metacarpal metaphyseal fracture

2020 ◽  
Vol 8 (11) ◽  
pp. 3866
Author(s):  
Naveed Ali Shair ◽  
Abdullah Tariq ◽  
Muhammad Shakeel ◽  
Muhammad Kashif ◽  
Ejaz Ahmad ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Operation Time ◽  
Study Groups ◽  
Fixation Procedure ◽  
Female Ratio ◽  
Orthopedic Injury ◽  
Wire Fixation ◽  
Metaphyseal Fracture ◽  
K Wires ◽  
Duration Of Operation

Background: Metacarpal fractures are considered a frequent orthopedic injury seen commonly in emergency units. Objectibe of thestudy was to compare the outcome of internal fixation procedure of miniplate versus cross kirschner wires (k-wires) for displaced metacarpal metaphyseal fractures.Methods: In this experimental prospective study, 100 patients with metacarpal metaphyseal fracture were considered. internal fixation was done by miniplate in one group and cross k wires in other group. Outcomes in terms of radiological union were compared between both groups. The data was analyzed by using SPSS for windows (version 26.0).Results: Mean age of the patients was 38.70±13.61 years. Male to female ratio of the patients was 1.2:1. The radiological success was noted in 76 (76.0%) patients. Statistically insignificant difference was found between the study groups in terms of radiological success of the patients (p=0.6396). K wire fixation was recorded to have significantly shorter duration of operation time in comparison to miniplate fixation (p=0.0001).Conclusions: The internal fixation procedure of both miniplate and k wire are equally effective in terms of radiological success for management displaced metacarpal metaphysis fractures. As compared to miniplate fixation, K wire fixation was found to have significantly shorter duration of operation time.

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>

scholarly journals OPEN REDUCTION AND K-WIRE FIXATION OF DISPLACED UNSTABLE LATERAL CONDYLE FRACTURES OF THE HUMERUS IN CHILDREN

2011 ◽  
Vol 18 (03) ◽  
pp. 501-509
Author(s):  
NOOR AKBAR SIAL ◽  
MUHAMMAD JAVAID IQBAL ◽  
MUHAMMAD KALEEM SHAUKAT
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Late Presentation ◽  
Lateral Condyle ◽  
Post Injury ◽  
Medical College ◽  
Fractures In Children ◽  
Pin Fixation ◽  
Wire Fixation ◽  
K Wires

Background: Lateral condyle fractures in children are the second most common fracture about the elbow. The problem arises in those cases which are difficult to treat by pop cast or by close reduction with percutaneous pin fixation. Late presentation is another challenge. We selected surgical treatment for such cases up to 12 weeks to evaluate our results. Objective: To study the usefulness of open reduction and K-wire fixation of displaced, unstable with or without rotation of fractures lateral condyle of the humerus in children presenting up to 12 weeks post injury Design: Prospective. Setting: Three teaching orthopaedic units Independent Medical College / Punjab Medical College, and University Medical College Faisalabad. Period: From January 2008 to December 2010. Method: In this prospective study a series of 22 patients were treated using technique of open reduction and internal fixation with k-wires. The results were assessed by criteria of Agarwal et al with little modification after follow-up for 1 year. Results: Excellent to good results were observed in all the12 patients presenting at 1–4 weeks post injury. In 5 patients presenting at 5–8 weeks, the results were excellent in one, good in 2, fair in1 and poor in one patient. In 5 patients presenting at 9-12 weeks good in 1 fair in 2 and poor in 2 patients. Conclusions: Open reduction and internal fixation is an effective treatment in all cases of displaced fractures of the lateral condyle of the humerus presenting up to 12 weeks post injury on the basis of low surgical complications and high union rate.

scholarly journals Comparison of clinical and radiological results of fixation methods with retrograde intramedullary Kirschner wire and plate-screw in extra-articular metacarpal fractures

2021 ◽  
Vol 32 (2) ◽  
pp. 397-405
Author(s):  
Mehmet Baydar ◽  
Abdurrahman Aydın ◽  
Ayşe Şencan ◽  
Osman Orman ◽  
Serkan Aykut ◽  
...  
Keyword(s):  
Grip Strength ◽  
Kirschner Wire ◽  
Operation Time ◽  
Wound Complications ◽  
Radiographic Outcomes ◽  
Significant Difference ◽  
Wire Fixation ◽  
K Wires ◽  
Surgery Duration

Objectives: In this study, we aimed to compare clinical and radiographic outcomes of retrograde intramedullary Kirschner-wire (K-wire) fixation with those of plate-screw (PS) fixation. Patients and methods: A total of 98 metacarpal shaft fractures in 75 patients (65 males, 10 females; mean age: 31.2±10.9 years; range, 16 to 65 years) were included between January 2011 and December 2017. The total joint active range of motion (AROM) and grip strength of the healthy and broken hands were evaluated. The Visual Analog Scale (VAS) and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores were recorded. We compared surgery duration, number of fluoroscopy images, and cost-effectiveness for each technique. Results: The overall mean follow-up was 21.9 (range, 12 to 56) months. At the last follow-up, total joint AROM (p=0.072), VAS score (p=0.298), QuickDASH score (p=0.132), and hand grip strength (p=0.947) were similar between the groups. Radiological union occurred in the PS and K-wire groups in a mean of 5.84 (range, 3 to 8) and 4.46 (range, 3 to 20) weeks, respectively (p=0.173). A significant difference was found in surgery duration (p=0.021) and number of fluoroscopy images (p<0.05) between the PS and K-wire groups. Two wound complications were observed in the PS group and one with K-wires. Conclusion: Retrograde intramedullary K-wire fixation has certain advantages such as being less invasive and more accessible with shorter operation time, compared to PS fixation. Similar radiological and clinical scores can be obtained in patients undergoing retrograde intramedullary K-wire fixation or PS fixation.

scholarly journals Clinical analysis of internal fixation femoral neck fractures with two or three cannulated screws

2021 ◽  
pp. 18-18
Author(s):  
Igor Kostic ◽  
Milan Mitkovic ◽  
Sasa Milenkovic ◽  
Milorad Mitkovic
Keyword(s):  
Femoral Neck ◽  
Internal Fixation ◽  
Operation Time ◽  
Study Groups ◽  
Clinical Analysis ◽  
Healing Time ◽  
Femoral Neck Fractures ◽  
Fixation Group ◽  
Significant Difference ◽  
Harris Score

Introduction/Objective. Angular stability and dinamyc fixation are key factors to successful healing of femoral neck fractures. We evaluate the efficacy of internal fixation of femoral neck fractures with two parallel self-tapping antirotation screws (SAF) compared to standard, three cannulated cancellous screws (CCS) fixation. Methods. One-hundred fractures were retrospectivaly analysed, divided in two groups in which two SAF screws were used in parallel (n=50) or three standard AO screws in an inverted triangle configuration (n=50). The groups were compared with operation time, time of consolidation, femoral neck shortening, Harris score and reoperation rates. Results. SAF parallel fixation group of patients achieved consolidation rate of 86% compared to 74% in CCS fixation group, without statistically significant difference between the examined groups (p>0,05). Dynamization of implants was significantly positively correlated with the fracture healing time in both examined groups (SAF: r = 0.324, p = 0.025; CCS: r = 0.572, p = 0.001), with significantly shorter healing time in SAF patients - on average 15 weeks (15.02?1.44) in relation to the CCS group of patient - 19 weeks (19.81?2.94) (?2/z =7.048, p <0.001). There was no statistically significant difference in the Harris score and reoperation rate among the study groups (?2 = 2.44, p = 0.487; ?2 = 0.500, p = 0.696). Conclusion. Our results suggested that dual parallel fixation (SAF) is simpler, less invasive and it demands less time for performing. It is not inferior to fixation with 3 screws, from the point of biomechanics, possible complications, healing and functional recovery.

scholarly journals Treatment Result Following Fluoroscopic Guided Close Reduction and Internal Fixation by Per-Cutaneous Crossed K-Wires of Extension Type Gartland Type-II and Type-III Supracondylar Fracture of Humerus in Children

2021 ◽  
Vol 20 (2) ◽  
pp. 32-36
Author(s):  
Tafhim Ehsan Kabir ◽  
ANM Humayun Kabir ◽  
Alak Kanti Biswas ◽  
Rahma Binte Anwar ◽  
Touhidul Islam ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Supracondylar Fracture ◽  
Treatment Result ◽  
Type Ii ◽  
Supracondylar Fractures ◽  
Female Ratio ◽  
Type Iii ◽  
K Wires ◽  
Tract Infections

Background : Supracondylar fractures of the humerus is one of the most common fractures in children. Failure to treat properly leads to malunion of the fracture site. For that, closed reduction and percutaneous pinning is considered to be the golden choice for treatment. There are many methods in which percutaneous k-wire fixation can be done. The aim of this study is to report the advantages of percutaneous fixation using cross pinning from both medial and lateral sides. Materials and methods : A total number of seventy pediatric patients with Gartland type II and type III supracondylar fracture of the humerus were recruited from the outpatient department of two different hospitals between January 2018 and September 2020. All of them were treated using closed reduction and internal fixation using percutaneous crossed k-wires. The treatment outcomes were evaluated using Flynn’s criteria and were compared with other similar studies. Results : The mean age of study subjects was 8.14 ± 2.8 and the male to female ratio was 1.6:1. In 27(38.6%) cases the left arm was involved while in 43(61.4%) cases the right arm was involved. Preoperative complications included 1(1.4%) case with radial nerve palsy and 4(5.7%) cases with pulseless pink hand. When evaluating cosmetic outcome using Flynn’s criteria, there were 57(81.4%) excellent, 10(14.3%) good and 3(4.3%) fair outcomes. On evaluating outcome according to range of motion deficit outcomes were excellent in 35(50%), good in 22(31.4%), fair in 5(7.2%) and poor in 8(11.4%) children. Post-operative complications were 1(1.4%) ulnar nerve neuropraxia and 5(7.2%) superficial pin tract infections. Conclusion : Closed reduction and internal fixation using percutaneous crossed kwires placed from the medial and lateral side gives satisfactory cosmetic and functional outcomes in majority of the patients with Gartland type II and III supracondylar fractures of the humerus. Chatt Maa Shi Hosp Med Coll J; Vol.20 (2); July 2021; Page 32-36

scholarly journals A clinical study of closed reduction and percutaneous Kirschner wire fixation of displaced supracondylar fractures of humerus in children

2017 ◽  
Vol 3 (2) ◽  
pp. 282
Author(s):  
Mohammad Asimuddin ◽  
Raju H. Kulkarni
Keyword(s):  
Closed Reduction ◽  
Kirschner Wire ◽  
Fracture Pattern ◽  
Supracondylar Fractures ◽  
Female Ratio ◽  
Lateral Entry ◽  
Kirschner Wire Fixation ◽  
Supracondylar Humerus Fractures ◽  
Wire Fixation ◽  
K Wires

<p class="abstract"><strong>Background:</strong> Supracondylar fractures of the humerus are the most common fracture pattern of the elbow in children. Displaced supracondylar fractures are notorious for difficulty in reduction, maintenance of reduction and frequent involvement of neurovascular structures. The purpose of this study was to evaluate the results of stabilization of these fractures by closed reduction and percutaneous Kirschner wire fixation.</p><p class="abstract"><strong>Methods:</strong> Thirty cases of displaced supracondylar humerus fractures were included in the study. The mean age of the patient was 8.3 years [ranges from 4-14 years]. The male to female ratio was 2:1 and left side was involved in 23 cases whereas 7 had right sided injuries. All fractures were of extension type [Gartland’s type III]. Posteromedial displacement was noted in 22 cases whereas 8 fractures were posterolaterally displaced. In 20 cases, lateral entry wires alone were used whereas in 10 cases one lateral and one medial K-wire were used. K- wires were removed after 3 weeks post-operatively and follow-up was done at 6 weeks,12 weeks, 6 months and 12 months, when they  were evaluated according to Flynn’s criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> Results were graded using Flynn’s criteria. Excellent results were achieved in 18 [60%], good in 6 [20%] fair in 4 [13.3%], while poor results were seen in 2 [6.7%] patients.</p><p><strong>Conclusions:</strong> Closed reduction and percutaneous fixation using Kirschner wires is a safe and efficient method for fixation of displaced supracondylar fractures of the humerus in children. </p>

Nonunion after trapeziometacarpal arthrodesis: comparison between K-wire and internal fixation

2014 ◽  
Vol 40 (4) ◽  
pp. 351-355 ◽  
Author(s):  
H. P. Singh ◽  
C. Hoare ◽  
N. Beresford-Cleary ◽  
R. Anakwe ◽  
M. Hayton
Keyword(s):  
Clinical Outcome ◽  
Internal Fixation ◽  
Senior Author ◽  
Union Rate ◽  
Good Clinical Outcome ◽  
Non Union ◽  
Wire Fixation ◽  
Headless Compression Screws ◽  
K Wires

We reviewed 63 trapeziometacarpal arthrodeses (57 patients) performed in our unit between April 2007 and May 2013 for osteoarthritis. K-wires, plates, headless compression screws and memory staples were used for fixation. The average age of patients was 50 (range 20–78) years and there were 36 men and 21 women with a mean follow-up of 36 (range 6–62) months. K-wires were used in 31 cases, staples in 12, plates in five, and screws in 15 joints. The overall non-union rate was 11%, however, when using K-wires for fixation, it was 20%. Union was achieved in all cases when staples or screws were used for fixation. Disabilities of the Arm, Shoulder and Hand scores were higher in cases where non-union occurred compared with those that united (66.7 vs. 21.9). Trapeziometacarpal arthrodesis for osteoarthritis gives good clinical outcome with lower (DASH) scores when union occurs. K-wire fixation led to a 20% non-union rate, and as a result, the senior author no longer uses this method of fixation.

Open reduction of pediatric lateral condyle fractures: a systematic review

2021 ◽  
pp. 175857322110102
Author(s):  
Michael D Eckhoff ◽  
Josh C Tadlock ◽  
Tyler C Nicholson ◽  
Matthew E Wells ◽  
EStephan J Garcia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Internal Fixation ◽  
Range Of Motion ◽  
Lateral Condyle ◽  
Elbow Fracture ◽  
Infection Rates ◽  
Fixation Techniques ◽  
K Wires ◽  
Pediatric Elbow Fracture ◽  
The Cost

Introduction Lateral condyle fractures are the second most common pediatric elbow fracture. There exist multiple options for internal fixation including buried K-wires, unburied K-wires, and screw fixation. Our study aims to review the current literature and determine if fixation strategy affects outcomes to include fracture union, postoperative range of motion, and need subsequent surgery. Methods A systematic review of Pubmed, MEDLINE, and EMBASE databases was performed. Included articles involve pediatric patients with displaced lateral condyle fractures treated with internal fixation that reported outcomes to include union rates and complications. Results Thirteen studies met inclusion criteria for a total of 1299 patients (472 buried K-wires, 717 unburied K-wires, and 110 screws). The patients’ average age was 5.8 ± 0.6 years, male (64%), and had 16.3 months of follow-up. No differences in union and infection rates were found. Unburied K-wires had the shortest time to union and the greatest elbow range of motion postoperatively. Conclusions Our systematic review demonstrates similar outcomes with union and infection rates between all fixation techniques. Unburied K-wires demonstrated a shorter time to union and the greatest postoperative range of motion. Additionally, unburied K-wires may be removed in clinic, decreasing the cost on the healthcare system. Evidence Level 3.

scholarly journals Postural ergonomics and work-related musculoskeletal disorders in neurosurgery: lessons from an international survey

2021 ◽  
Author(s):  
Georgios Mavrovounis ◽  
Torstein R. Meling ◽  
Jesus Lafuente ◽  
Konstantinos N. Fountas ◽  
Andreas K. Demetriades
Keyword(s):  
Musculoskeletal Disorders ◽  
Latin American ◽  
Univariate Analysis ◽  
Operating Time ◽  
Public Hospitals ◽  
Female Ratio ◽  
American Federation ◽  
Work Related ◽  
Work Related Musculoskeletal Disorders ◽  
Duration Of Operation

Abstract Background Work-related musculoskeletal disorders (WMSDs) affect a significant percentage of the neurosurgical workforce. The aim of the current questionnaire-based study was to examine the prevalence of WMSDs amongst neurosurgeons, identify risk factors, and study the views of neurosurgeons regarding ergonomics. Methods From June to August 2020, members of the “European Association of Neurosurgical Societies,” the “Neurosurgery Research Listserv,” and the “Latin American Federation of Neurosurgical Societies” were asked to complete an electronic questionnaire on the topics of WMSDs and ergonomics. Results A total of 409 neurosurgeons responded to the survey, with a 4.7 male to female ratio. Most of the surgeons worked in Europe (76.9%) in academic public hospitals. The vast majority of the participants (87.9%) had experienced WMSDs, mainly affecting the shoulder, neck, and back muscles. The most common operations performed by the participants were “Craniotomy for convexity/intrinsic tumors” (24.1%) and “Open lumbar basic spine” (24.1%). Neurosurgeons agreed that ergonomics is an underexposed area in the neurosurgical field (84.8%) and that more resources should be spend (87.3%) and training curricula changes should be made (78.3%) in order to alleviate the burden of WMSDs on neurosurgeons. Univariate analysis did not reveal any associations between the development of WMSDs and age, gender, tenure, average duration of operation, operating time per week, type of operation, and surgical approach. Conclusions The problem of WMSDs ought to be more closely addressed and managed by the neurosurgical community. More studies ought to be designed to investigate specific ergonomic parameters in order to formulate practice recommendations.

Staged Management of Severely Displaced Calcaneal Fractures With Transarticular Pinning: A Damage Control Strategy

2021 ◽  
pp. 107110072110130
Author(s):  
Kyeong-Hyeon Park ◽  
Chang-Wug Oh ◽  
Joon-Woo Kim ◽  
Hee-June Kim ◽  
Dong-Hyun Kim ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Internal Fixation ◽  
Kirschner Wire ◽  
Wound Complications ◽  
Calcaneal Fractures ◽  
Simple Method ◽  
Wire Fixation ◽  
The Mean ◽  
Radiographic Union

Background: Severely displaced calcaneal fractures can result in considerable morphology derangement and may be accompanied by soft tissue compromise. Delayed operative restoration of the calcaneal morphology may result in acute retensioning of the damaged soft tissue with associated wound-related complications. In this study, we describe a staged treatment of displaced intra-articular calcaneal fractures that uses temporary transarticular Kirschner wire (K-wire) fixation and staged conversion to definite fixation. Methods: We identified all of the patients who were treated at our institution for calcaneal fractures between 2015 and 2019. A total of 17 patients with 20 calcaneal fractures were selectively treated with 2-stage management. Temporary transarticular K-wire fixation was performed 24 hours after the injury to restore calcaneal morphology and the surrounding soft tissue. After the soft tissue was considered safe, delayed open reduction and internal fixation was performed. The time to definite surgery, radiographic alignment, wound complications, time to radiographic union, and hindfoot American Orthopaedic Foot & Ankle Society (AOFAS) scores were recorded. Results: The average follow-up period was 17 months (range, 12-43). The average Böhler angle increased from a mean of −22 degrees (range, −109 to 25) to 25 degrees (range, 0 to 47) after temporary transarticular K-wire fixation. The mean time from temporary pinning to conversion to definite internal fixation was 20 (range, 10-32) days. There were no immediate postoperative complications. The average time to radiographic union was 13.7 (range, 10-16) weeks. The mean AOFAS score was 87 (range, 55-100). No infections or wound complications were reported during the follow-up period. Conclusion: Temporary transarticular pinning for staged calcaneal fracture treatment is safe and effective in restoring the calcaneal morphology. This novel and relatively simple method may facilitate delayed operation and decrease wound-related complications. Level of Evidence: Level IV, retrospective case series.

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