scholarly journals Functional results of clavicle fractures in adults treated by open reduction and internal fixation using superior precontoured plate

2019 ◽  
Vol 6 (7) ◽  
pp. 2484
Author(s):  
M. Ahsan Wani ◽  
Mushtaq Ahmed Ganaie ◽  
Nuzhat Ul islam ◽  
Akther Rasool ◽  
Nisar Ahmed Dar
Keyword(s):  
Internal Fixation ◽  
Operative Treatment ◽  
Open Reduction ◽  
Road Traffic ◽  
Constant Score ◽  
Final Decision ◽  
Dash Score ◽  
College Hospital ◽  
Pull Out ◽  
The Mean

Background: Observe results of open reduction and internal fixation of fractures of the clavicle in adults using pre-contoured superior clavicle locking plate.Methods: This study was prospective study carried out in the Govt Medical college Hospital Baramullah Kashmir Department of Orthopaedics  from June 2014 to September 2016. A total of 25 patients with fresh fractures were treated with ORIF with a pre-contoured superior clavicle locking plate.Results: The mean age of patient was 30.08 years, males (64%),   right clavicle frequently fractured (52%) Robinson type 2B1 configuraion. (44%) sustained their injury due to a road traffic accident. The average 6 month Quick DASH score was 0.82, whereas the mean constant score was 94.8 at final follow-up. The complications were superficial wound infection in (4%), mechanical pull-out of the plate in (8%), numbness below the incision area in (12%), symptomatic hardware in (4%), and non-union in (4%).Conclusions: There has been a resurgence of interest in operative treatment for fractures that are displaced, comminuted, or that display significant shortening. Operative treatment is beneficial to only a subset of patients, in whom functional expectations and fracture characteristics have both been taken into account before taking the final decision.

scholarly journals FUNCTIONAL OUTCOME OF PROXIMAL HUMERUS FRACTURES TREATED WITH OPEN REDUCTION AND INTERNAL FIXATION WITH A LOCKING COMPRESSION PLATE: A CROSS SECTIONAL STUDY

2021 ◽  
Vol 10 (4) ◽  
pp. 3266-3269
Author(s):  
Abhishek Patil
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Proximal Humerus ◽  
Constant Score ◽  
Locking Compression Plate ◽  
Proximal Humerus Fractures ◽  
Compression Plate ◽  
Humerus Fractures ◽  
The Mean

Proximal humerus fractures account for about 4% to 5% of all fractures. Following distal forearm fracture, proximal humeral fracture is the second most common upper extremity fracture. Kirschner (K)-Wires, external fixation, tension band wiring, and rush pins, intramedullary nails, ORIF with plates, and shoulder hemiarthroplasty have all been offered as therapeutic options. The purpose of this study was to assess the functional outcome and complication rates following internal fixation of proximal humerus fractures using a locking compression plate. Patients over the age of 18 with closed proximal humerus fractures or open proximal humerus fractures (Gustilo and Anderson type I, Type II) received open reduction and internal fixation with locking compression plate in the current study. The participants in this study were 60 people who had a proximal humerus fracture and were treated with open reduction and a proximal humerus locking compression plate. Patients ranged in age from 20 to 85 years old, with a mean age of 51.14 +/- 17.30 years. The age group 36–55 years (37 percent) was the most prevalent, followed by 56–75 years (30 %). The majority of patients (76.7 %) were men who had been in automobile accidents on the right side (83 %) (63 %). According to the Neer classification, the most prevalent type of fracture was a three-part fracture (53 %). The maximum union time observed in this study was 16 weeks, with a minimum of 10 weeks. The average time to union is 12.52 +/- 1.14 weeks. The mean flexion at the end of six months was 121.660 +/- 19.84. The mean internal rotation was 57.330 +/- 8.48, the mean external rotation was 530 +/- 11.98, and the mean abduction was 1180 +/- 19.36. 75.28 +/- 9.66 [Mean +/- SD] is the Mean Constant score. Pain 14.10, ADL 18.26, range of motion 22.46, and power 20 were the mean scores observed on Constant Score for its various aspects. According to the Constant score, the functional outcome of the 60 patients was as follows: 8 patients had excellent outcomes (13%), 34 patients had good outcomes (56.7%), 16 patients had moderate outcomes (26.7%), and two patients had poor outcomes (26.7%) and (3 %). Internal fixation of proximal humerus fractures with a locking compression plate results in anatomical reduction and secure fixation, resulting in a favorable functional outcome.

scholarly journals Evaluation of open reduction and internal fixation of proximal humerus fractures using a locking plate with smooth pegs – A retrospective study

2018 ◽  
Vol 11 (6) ◽  
pp. 411-418
Author(s):  
Frida Hansson ◽  
Magdalena Riddar ◽  
Anders Ekelund
Keyword(s):  
Quality Of Life ◽  
Retrospective Study ◽  
Internal Fixation ◽  
Avascular Necrosis ◽  
Open Reduction ◽  
Locking Plate ◽  
Constant Score ◽  
Humeral Fracture ◽  
The Mean

Background Optimal treatment of displaced proximal humeral fractures is controversial. This retrospective study aims to identify complications and clinical outcomes using a locking plate with smooth pegs instead of screws (S3 plate). Method Eighty-two patients with displaced proximal humeral fracture classified with 2–4 fragments (Neer’s classification) treated with open reduction and internal fixation (ORIF) with S3 plate were studied retrospectively. Clinical outcome according to constant score; Single Shoulder Value; Disabilities of Arm, Shoulder and Hand; and European Quality of life-5 dimensions and complication rate defined radiologically including peg penetration, avascular necrosis, and loss of reduction was assessed minimum 2.5 years after surgery. Results A total of 11 peg penetrations were identified (13.6%). Avascular necrosis was seen in 8.5% (n = 7). Mean constant score at follow-up was 64.4 with a relative constant score of 87% (standard deviation 18%) compared to the contralateral uninjured side. The mean Disabilities of Arm, Shoulder and Hand score was 12.7 and mean European Quality of life-5 dimensions score 0.83. The mean Single Shoulder Value was 78.3. No cases of deep infection were seen. Conclusions Fixation with S3 plate shows a proper osteosynthesis and the functional outcome is good. Symptomatic peg penetrations are rare and the incidence is lower compared to what has been reported with locked screws.

scholarly journals Nightstick Fractures, Outcomes of Operative and Non-Operative Treatment

2019 ◽  
Vol 62 (1) ◽  
pp. 19-23
Author(s):  
Mohammed Ali ◽  
D. I. Clark ◽  
Amole Tambe
Keyword(s):  
Internal Fixation ◽  
Functional Status ◽  
Operative Treatment ◽  
Open Reduction ◽  
Associated Injuries ◽  
Clinical Notes ◽  
Satisfactory Outcome ◽  
Isolated Fracture ◽  
The Mean

Introduction: A nightstick fracture is an isolated fracture of the ulnar shaft. Although operative and non-operative treatments have been commonly decided by the degree of displacement of the fracture, still there is a controversy specially in those moderately displaced. Herein we report our experience with nightstick fractures. Objective: To evaluate operative and non-operative treatment of nightstick fracture. Materials and methods: We retrospectively reviewed the clinical notes, physiotherapy letters and radiographs of 52 patients with isolated ulnar shaft fractures. Outcome Measurements included radiographic healing, post-operative range of motion and complications. Results: The study included 13 females and 39 males, with a mean age of 26 years [range, 18–93 years]. The mean Follow-up period was 32 months ranged from 12 to 54 months. Ten patients were treated non-operatively; forty-two patients had open reduction and internal fixation including six open fractures. The average wait for surgery was 2.5 days. Mobilisation was commenced immediately after the surgeries non-load bearing. 40 patients had no complications post-operatively with good outcome and average of four visits follow-up. In the non-operative group, five out ten failed and had a mean follow-up of nine visits. Conclusion: Satisfactory outcome is to be expected with open reduction and internal fixation. Fractures with less than 50% displacement should be treated on individual bases, considering; age, pre-morbid functional status, co-morbidities, compliance and associated injuries.

scholarly journals Correlation between functional and radiological outcome after surgical stabilization of volar Barton fracture with plating: a comparative study

2020 ◽  
Vol 6 (4) ◽  
pp. 666
Author(s):  
Vikram Goud ◽  
Manoj Kanamarlapudi
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Functional Result ◽  
Dash Score ◽  
Statistical Relationship ◽  
Radiological Outcome ◽  
Distal Extremity ◽  
The Mean ◽  
Barton Fracture

<p class="abstract"><strong>Background:</strong> The objective of the study was to evaluate the functional and radiological outcomes after open reduction with internal fixation of volar Barton’s fracture of the wrist and compare their outcomes.</p><p class="abstract"><strong>Methods:</strong> Total of 30 cases of volar Barton fractures were operated by open reduction and internal fixation with plating. Mean follow up period was 6 months. Patients were assessed both radiological and functional outcome and compare between the two outcomes.<strong></strong></p><p class="abstract"><strong>Results:</strong> All fractures were healed in a mean period of 7 weeks (range 6-9 weeks). The mean disabilities of the arm, shoulder and hand (DASH) score was 13.21 points (range: 10.3 to 30), thus confirming the patient’s good functional capacity. The higher the DASH score was (i.e. the worse the functional result), the smaller were the flexion (p=0.01), pronation (p=0.03), supination (p&lt;0.0001) and radial deviation (p=0.005) of the wrist that underwent the surgical procedure after the fracture of the distal extremity of the radius. The radiological results were evaluated by modified Lidstrom criteria.</p><p class="abstract"><strong>Conclusions:</strong> The radiographic results did not influence the DASH score. There was no statistical relationship between the DASH score and the radial height or the volar tilt or the radial tilt of the distal extremity of the operated radius.</p>

scholarly journals Evaluation of functional and clinical outcome of open reduction and internal fixation of Barton’s fracture of the wrist in a central hospital of Kashmir

2021 ◽  
Vol 7 (5) ◽  
pp. 986
Author(s):  
Jawed A. Bhat ◽  
Faesal Khurseed ◽  
Abdul H. Javaid
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Road Traffic ◽  
Excellent Result ◽  
Functional Results ◽  
Functional Evaluation ◽  
College Hospital ◽  
Articular Fractures ◽  
Limited Range Of Motion

<p class="abstract"><strong>Background:</strong> Fractures of the distal end of radius continue to pose a management challenge. Defective alignment of extra articular as well as intra articular fractures result in a variety of complications like post traumatic arthritis, decreased in grip strength and endurance as well as limited range of motion and instability of carpus. The main aim of this study is to assess the functional results of open reduction and internal fixation in the treatment of volar Barton’s fracture.</p><p class="abstract"><strong>Methods:</strong> From December 2006 to December 2019, forty cases of volar Barton’s fracture were operated in Skims Medical College Hospital, Srinagar, Kashmir, however only 32 cases were included in the study group and 8 cases were lost to follow up. In the majority of our cases the injury was sustained as a result of road traffic accident followed by fall. Majority (24) of the cases were operated within one week of trauma, followed by six in two weeks and two in 3 weeks of time since injury.<strong></strong></p><p class="abstract"><strong>Results:</strong> Functional evaluation was done after a mean follow-up of 28.7 months. Fracture union was achieved within 8 to 12 weeks and excellent results were obtained in 18 cases and 10 cases were categorized as good followed by fair result in 4 cases. Median nerve compression was not observed in any case.</p><p class="abstract"><strong>Conclusions:</strong> Good to excellent result can be achieved after open reduction and internal fixation which restores joint congruity.</p>

Chest Trauma Evaluation and Outcome of Management in a Tertiary Hospital - One Year Experience

2020 ◽  
Vol 22 (2) ◽  
pp. 110-117
Author(s):  
Md Mahmudul Islam ◽  
Khondkar AK Azad ◽  
Md Aminul Islam ◽  
Rivu Raj Chakraborty
Keyword(s):  
Road Traffic Accident ◽  
Traffic Accident ◽  
Chest Trauma ◽  
Road Traffic ◽  
Tube Thoracostomy ◽  
Rib Fracture ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
The Mean

Background: Chest trauma is responsible for 50% of deaths due to trauma. This kind of death usually occurs immediately after the trauma has occurred. Various therapeutic options have been reported for management of chest injuries like clinical observation, thoracocentesis, tube thoracostomy and open thoracotomy. Objective: To observe the pattern and outcome of management in chest trauma Methods: This is an observational study carried out in Casualty department of Chittagong Medical College Hospital (CMCH), Chittagong, between April 2015 to March 2016. Our study was included all patients, both sexes, following chest injury at Casualty units of Chittagong Medical College Hospital. All the data were recorded through the preformed data collection sheet and analyzed. Result: The mean age was found 37.7±18.1 years with range from 12 to 80 years. Male female ratio was 11.8:1. The mean time elapsed after trauma was found 6.1±3.1 hours with range from 1 to 72 hours. Almost one third (35.7%) patients was affecting road traffic accident followed by 42(27.3%) assault, 35(22.7%) stab injury, 15(9.7%) fall and 7(4.5%) gun shot . More than three fourth (80.5%) patients were managed by tube thoracostomy followed by 28(18.2%) observation and 2(1.3%) ventilatory support. No thoracotomy was done in emergency department. 42(27.2%) patients was found open pneumothorax followed by 41(26.6%) rib fracture, 31(20.1%) haemopneumothorax, 14(9%) simple pneumothorax, 12(7.8%) haemothorax, 6(3.9%) chest wall injury, 5(3.2%) tension pneumothorax, and 3(1.9%) flail chest. About the side of tube 60(39.0%) patients were given tube on left side followed by 57(37.0%) patients on right side, 9(5.8%) patients on both (left & right) side and 28(18.2%) patients needed no tube. Regarding the complications, 13(30%) patients had persistent haemothorax followed by 12(29%)tubes were placed outside triangle of safety, 6(13.9%) tubes were kinked, 6(13.9%) patients developed port side infection, 2(4.5%)tube was placed too shallow, 2(4.5%) patients developed empyema thoracis and 2(4.5%) patients developed bronchopleural fistula. The mean ICT removal information was found 8.8±3.6 days with range from 4 to 18 days. Reinsertion of ICT was done in 6(4.7%) patients. More than two third (68.2%) patients were recovered well, 43(27.9%) patients developed complication and 6(3.9%)patients died. More than two third (66.9%) patients had length of hospital stay 11-20 days. Conclusion: Most of the patients were in 3rd decade and male predominant. Road traffic accident and tube thoracostomy were more common. Open pneumothorax, rib fracture and haemopneumothorax were commonest injuries. Nearly one third of the patients had developed complications. Re-insertion of ICT needed almost five percent and death almost four percent. Journal of Surgical Sciences (2018) Vol. 22 (2) : 110-117

scholarly journals Frequency of infra-orbital nerve injury after a Zygomaticomaxillary complex fracture and its functional recovery after open reduction and internal fixation

2017 ◽  
Vol 4 (2) ◽  
pp. 685 ◽  
Author(s):  
Maria Noor ◽  
Yaser Ishaq ◽  
Malik Adeel Anwar
Keyword(s):  
Internal Fixation ◽  
Nerve Injury ◽  
Open Reduction ◽  
Road Traffic ◽  
Maxillofacial Injuries ◽  
Female Ratio ◽  
Complex Fracture ◽  
Zygomaticomaxillary Complex Fracture ◽  
Nerve Recovery ◽  
Zygomaticomaxillary Complex

Background: Maxillofacial injuries are on the rise and the etiology of maxillofacial injuries varies from one country to another because of social, cultural and environmental factors. Road traffic accidents (RTAs) are still the most common cause of maxillofacial injuries. Nerve injury following fracture may involve traction, pressure, ischemia, inflammation and physical damage; therefore fractures of Zygomaticomaxillary complex (ZMC) are characterized by sensory neuropathy in the area of innervation of infra-orbital nerve both as presenting symptom and as a postop complication. The objectives of the study were to investigate the frequency of infra-orbital nerve paresthesia following ZMC fractures and determine the frequency of functional nerve recovery in patients with paresthesia treated with open reduction and internal fixation.Methods: Patients (n = 75) qualifying our inclusion criteria were selected, examined, reduced by surgery and followed up.Results: A total of 75 patients were included in the study with male: female ratio of 5:3. Mean age was 37.43±3.78 years, with majority of patients (72 %) presenting with RTAs. Infra-orbital nerve paraesthesia was found to be positive in 70.67% (n = 53) patients with 62.26% (n = 33) patients with functional nerve recovery after 3 months.Conclusions: Prognosis of infra-orbital nerve recovery after a Zygomaticomaxillary complex fracture can be enhanced by open reduction and internal fixation.

scholarly journals Outcomes of Pediatric Supracondylar Fractures of Humerus Treated by Posterior Triceps Splitting Approach

2016 ◽  
Vol 4 (1) ◽  
pp. 28
Author(s):  
Rajeev Dwivedi ◽  
Ruban Raj Joshi ◽  
Subin Byanjankar ◽  
Rahul Shrestha
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Standard Treatment ◽  
Functional Results ◽  
Supracondylar Fracture ◽  
Supracondylar Fractures ◽  
Radiological Criteria ◽  
Supracondylar Humeral Fractures ◽  
The Mean ◽  
Mean Time

Introduction: Close reductions and percutaneous pinning is the gold standard treatment for supracondylar fracture  of humerus. Open reduction and internal fixation is indicated in patients with unacceptable closed reduction, neurovascular compromise, and open fractures. Open reduction can be performed through various approaches. Every approach has their advantages and limitations. The aim of this study was  to assess the functional outcome of pediatric supracondylar fracture of humerus treated by posterior triceps splitting approach.   Methods: This was a prospective evaluation of 20 consecutive patients with displaced pediatric supracondylar humeral fractures operated by triceps spitting posterior approach in our institution for two years. At initial presentation, 19 cases were Gartland III  and one was flexion variant of injury. Complications such as reduction loss, pin migration, infection, osteonecrosis of any part of the elbow, bone healing, and functional results were evaluated. Flynn criteria were used to evaluate the final results.   Results: Twenty patients underwent open reduction and internal fixation by triceps splitting approach. Thirteen patients were male and seven were female with M:F ratio of 1.86:1. The mean age was 6.8 yr (SD=2.74, range 2-14). All the fractures united by six weeks; mean time for union was 4.5 wk (SD=0.94). All patients were assessed at six months using Flynn clinical and radiological criteria. Results were satisfactory in all patients.   Conclusion: Posterior triceps splitting approach is simple, safe and has good functional and radiological outcome. We recommend this approach  for open reduction and internal fixation in pediatric supracondylar fracture.

scholarly journals Functional and radiological outcomes in displaced heel fractures: Open reduction and internal fixation versus external fixation

2020 ◽  
Vol 12 (2) ◽  
Author(s):  
Sebastiano Ortu ◽  
Matteo Brusoni ◽  
Francesco Pisanu ◽  
Gianfilippo Caggiari ◽  
Emanuele Ciurlia ◽  
...  
Keyword(s):  
Internal Fixation ◽  
External Fixation ◽  
Open Reduction ◽  
Good Alternative ◽  
High Rate ◽  
Fast Learning ◽  
Scale Scores ◽  
The Mean ◽  
Heel Fractures ◽  
Complications Rate

Management of intra-articular heel fractures is controversial. The main goals of surgical treatment are restoring subtalar articular congruence and width, height, form and alignment of the heel. The gold standard is considered Open Reduction and Internal Fixation (ORIF), a complex technique with a high rate of complications. External Fixation (EF) could be a good alternative. In this study were identified 37 fractures in 35 patients (24 patients underwent ORIF and EF was performed in 13 cases) and the outcomes of the two techniques were compared. The mean surgical time for ORIF was 107.8 minutes, while for EF was 88.61 minutes and the ORIF group presented a higher rate of complications, despite of similar results in the mean postoperative AOFAS Ankle and Hindfoot Scale scores (73.31/100 points in the ORIF group and 75.40/100 points in the EF group). Fast learning curve, short surgery time and low complications rate make EF an alternative to ORIF in treating intraarticular heel fractures.

Surgical Treatment of Calcaneal Fractures with Use of β-Tricalcium Phosphate Ceramic Grafting

2008 ◽  
Vol 29 (10) ◽  
pp. 1015-1019 ◽  
Author(s):  
Sheng-Dan Jiang ◽  
Lei-Sheng Jiang ◽  
Li-Yang Dai
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Tricalcium Phosphate ◽  
Open Reduction ◽  
Clinical Results ◽  
Statistical Correlation ◽  
Calcaneal Fractures ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
The Mean

Background: The treatment of calcaneal fractures is challenging. Internal fixation and grafting with sintered β-tricalcium phosphate (β-TCP) ceramic is alternative to bone grafting in the treatment of calcaneal fractures. Methods: Seventy-four patients with intraarticular calcaneal fractures were treated with open reduction, internal fixation and grafting with sintered β-TCP ceramic. Followup was performed using the Maryland foot score as well as plain radiography. Results: All patients were followed for 15 (range, 12 to 26) months. Clinical results as assessed by the Maryland foot score were excellent in 40 of 74 cases (54.1%), good in 28 (37.8%), and fair in 6 (8.1%). Immediately after surgery, the mean Böhler angle was improved by 23 degrees, and 1 year after surgery, the mean Böhler angle decreased by 4 degrees. A similar change was also seen in Gissane angles and the height and width of the calcaneus. There was no statistical correlation between the severity of fracture and functional outcome in this series. All fractures healed. Conclusion: These findings suggest that use of β-TCP combined with open reduction and internal fixation is an effective and safe method for the surgical treatment of intra-articular calcaneal fractures. Level of Evidence: IV, Retrospective Case Study

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