Functional outcome after open reduction and internal fixation for traumatic diastasis of the pubic symphysis a one year follow-up study

Background: Pubic diastasis often results in anteroposterior compression (APC) injuries based on Young and Burgess classification. It is caused due to high-energy trauma and of much clinical importance is given when coexists with urogenital and neurological complications with hemodynamic instability. Open reduction and internal fixation with plating facilitates early mobilisation with better results and is the preferable mode of stabilisation. We evaluated the clinical and functional outcome of such patients in a one-year follow-up period.Methods: In our study, we included 20 patients with APC II injuries who underwent an open reduction by single or dual plating technique by the Pfannenstiel approach, were followed for one year.Results: Among 20 patients, 14 patients (70%) were operated with single superior plating, six patients (30%) were performed with dual plating, i.e., both superior and anterior plating. Among 20 patients, two patients (10%) were operated for primary arthrodesis with double plating. Only one among 20 (5%) had implant failure due to early weight bearing and were re-operated with primary arthrodesis with plating. Results were analysed based on a scoring system which includes five criteria such as anterior pelvic pain, dyspareunia and sexual dysfunction, ability to sit, gait abnormalities and walking distance. Among 20 patients ten patients (50%) had excellent results, six patients (30%) had good results, two patients (10%) had fair results, two patients (10%) had poor results.Conclusions: Open reduction and internal fixation of traumatic pubic diastasis in type II APC injuries with single or dual plating had given better results and early functional recovery.

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A Prospective Study on Functional Outcome of Open Reduction and Internal Fixation of Acetabular Fractures

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2020/v32i1330597 ◽

2020 ◽

pp. 174-183

Author(s):

Venkata Kiran Pillella ◽

J. Lionel John

Keyword(s):

Prospective Study ◽

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Acetabular Fractures ◽

Medical College ◽

The Mean ◽

One Year ◽

A Prospective Study

The current study is a prospective study on the functional outcome of open reduction and internal fixation of acetabular fractures. About 30 patients were analyzed for the functional outcome of acetabular fractures treated by open reduction and internal fixation over a period of one year and eight months from March 2017 to October 2018 with a minimum follow up period of 9 months at Sree Balaji Medical College & Hospital, Chromepet, Chennai. The mean age of the patient was 37.96 year ranging from 20 - 60 years. The Joel Matta score was used for calculation of radiological outcome of 30 patients. The results were excellent in 19 (66.3%), good in 8 (26.6%), fair in 3 (10%), and poor in 0 (0%) patients. Functional outcome of displaced acetabular fractures more than 2 mm displacement was found to have excellent results on open reduction and internal fixation.

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Functional Outcome of Intercondylar Distal Humerus Fractures Surgically Treated with Open Reduction and Internal Fixation with a Principle Based on Orthogonal Plating Technique

Birat Journal of Health Sciences ◽

10.3126/bjhs.v6i1.37625 ◽

2021 ◽

Vol 6 (1) ◽

pp. 1336-1340

Author(s):

Santosh Thapa ◽

Ranjib Kumar Jha ◽

Ashish Rajthala

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Distal Humerus ◽

Plating Technique ◽

Significant Difference ◽

Dual Plating ◽

Humerus Fractures ◽

Distal Humerus Fractures ◽

One Year

Introduction: Owing to the complex articular structure, paucity of metaphyseal bone and thin soft tissue covering, treatment of intra-articular distal humerus fractures still pose challenge to surgeons. Although it comprises 2% of all fractures the massive complication rate to the treatment is worrisome. This study aims to evaluate the outcome of surgical treatment of these fractures by open reduction and internal fixation by dual orthogonal plates. Objectives: The objective of the study is to evaluate the functional outcome of intercondylar humerus fractures managed with open reduction and internal fixation with orthogonal dual plating technique. Methodology: Eighteen patients (19 – 68 years old) with AO/OTA type 13C fractures were evaluated after surgery for one year with MEPS and range of motion. Complications were categorized as major or minor complications. Functional comparisons were made between simple articular type C1/C2 and complex articular type C3 fractures at one year. Result: There were 2 (11.11%) type C1 fracture and 8 (44.44%) each in type C2 and C3 fractures. Eight (44.44%) patients obtained excellent, 7 (38.89%) obtained good and 3 (16.7%) obtained fair results. There was no poor outcome. Average MEPS score was 83.33 and there was no significant between the subgroups (p = 0.07). The average flexion was 118.06° and it was significantly impaired in type C3 fractures (p = 0.03). Three patients obtained full extension, and remaining patients had mean extension deficit of 12°. Average arch of motion was 108.06° with significant difference between two subgroups (p = 0.008). The mean arc of motion for supination-pronation was 154.44°. There was 5 minor and 2 major complications (total - 38.9%). Conclusion: The surgical management with open reduction and internal fixation by dual plates in orthogonal configuration for the intercondylar distal humeral AO type C fractures has good or excellent functional outcome in majority of the patients.

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Treatment of Tibial Avulsion Fracture of Posterior Cruciate Ligament by Open Reduction and Internal Fixation

Journal of Nobel Medical College ◽

10.3126/jonmc.v9i1.29419 ◽

2020 ◽

Vol 9 (1) ◽

pp. 17-21

Author(s):

Ranjib Kumar Jha ◽

Santosh Thapa

Keyword(s):

Clinical Outcome ◽

Internal Fixation ◽

Functional Outcome ◽

Posterior Cruciate Ligament ◽

Open Reduction ◽

Avulsion Fracture ◽

Cruciate Ligament ◽

Avulsion Injury ◽

The Mean

Background: An avulsion fracture of posterior cruciate ligament from tibial attachment is more common in younger age group. It should be fixed otherwise it may lead to secondary changes in knee. Various techniques and approaches are available to fix posterior cruciate ligament avulsion. Different biomechanical studies have shown that, results both open and arthroscopic methods of fixation of posterior cruciate ligament avulsion by screws are comparable. The purpose of study is to evaluate functional and clinical outcome of open reduction and fixation of posterior cruciate ligament avulsion injury through posteromedial approach. Materials and Methods: The study enrolled 19 cases of isolated posterior cruciate ligament avulsion injury with mean age of 33.21±9.07 year. All cases were treated by open reduction and internal fixation through modified posterior approach. The patients having duration of injury more than 12 weeks were excluded. The minimum follow up duration was 12 months. Results were assessed clinically and radiologically. Final functional outcome was assessed using the Lysholm scoring for knee. Results: The mean duration of follow up was 14±1.85 months. All patients achieved union at 3months. At final follow up the mean range of motion was 125.42±6.37 degree (range 110 to 135 degree) without any extensor lag. The functional outcome assessed by Lysholm scoring system was excellent in 15 cases and good in 4 cases. Conclusion: Open reduction and internal fixation with early range of motion exercises provides good clinical outcome and stable knee.

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PROXIMAL HUMERUS FRACTURES;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.12.571 ◽

2017 ◽

Vol 24 (12) ◽

pp. 1788-1793

Author(s):

Faisal Abdul Jabbar ◽

Rehana Ali Shah

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Avascular Necrosis ◽

Open Reduction ◽

Proximal Humerus ◽

Case Series ◽

Proximal Humerus Fractures ◽

Humerus Fractures ◽

The Mean

Objectives: The aim of our study is to study the radiological and functionaloutcome of proximal humerus fractures treated via open reduction and internal fixation usingthe proximal humerus internal locking system or PHILOS. Study Design: Case series study.Period 05 years duration from January 2011 to December 2015. Setting: Large tertiary carecentre in Karachi, Pakistan. Materials and methods: The study population consisted of n=50patients all of whom underwent open reduction and internal fixation utilizing the proximalhumeral internal locking system or PHILOS for fractures of the proximal humerus. The inclusioncriterion was all the patients with closed fractures of the proximal humerus and were belongingto 2,3 and 4 part of the Neer system of classification. Physiotherapy was started as soon aspossible for the patients. Serial radiographic imaging in two views was done at 6, 12, 24 and52 weeks postoperatively. For the functional outcome of the procedure Constant and Murleyscoring system was used. Data was analyzed using IBM SPSS version 21. Results: The studypopulation consisted of n= 50 patients of which n= 35 were males and n= 15 were femaleshaving a mean age of 38.50 years. The mean duration of follow up was 24 months. All thepatients in the study had union of fracture both radiographically and clinically, the mean timeduration for the radiographically evident union of the humerus bone was 12 weeks with a rangeof 8 to 20 weeks, the mean Constant Murley score for the functional outcome of the shoulderjoint was 79 at the final follow up with a range of 50 to 100. Complications were found in n= 9patients and varus malunion was the most common complication. In our case series we did notobserve complications such as avascular necrosis, non union or implant failure. Conclusion:According to the results of our study the proximal humerus internal locking system or PHILOSis a good method for open reduction and internal fixation of the proximal humerus fractures andprovides a stable fixation, and has lower incidence of complications such as avascular necrosis.

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Functional outcome of elbow joint in AO type 13C fractures treated with open reduction and internal fixation using dual plates

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20191793 ◽

2019 ◽

Vol 5 (3) ◽

pp. 509

Author(s):

Uyyalawada Sreedhar Reddy ◽

Bheemsingh Samorekar ◽

Vinay J. Mathew ◽

Anil Kumar Mettu

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Distal Humerus ◽

Range Of Movement ◽

Excellent Outcome ◽

Significant Difference ◽

Dual Plating ◽

Type C ◽

A Prospective Study

Background: Distal end of the humerus, with its unique orientation of articular surfaces supported by a meagre amount of cancellous bone, makes its fracture a constant challenge to orthopaedic surgeons. Aim of the study is to evaluate the functional outcome of surgical management of intercondylar AO type C fractures of distal end of humerus using dual plating.Methods: A prospective study was conducted at our hospital between January 2015 to December 2016. Thirty five consecutive patients with intercondylar (AO Type C) fracture of distal humerus, included in study as per inclusion criteria. All patients were treated surgically using triceps reflecting approach and posterior trans-olecranon approach with ulnar nerve exploration and fixation using dual plating and tension band wiring for olecranon osteotomy wherever done.Results: In 35 patients, final results using MEPS scoring system excellent outcome is noticed in 15 patients (42.86%), good results is noticed in 13 patients (37.14%), fair result is noticed in 5 patients (14.29%) and poor result is noticed in 2 patients (5.71%). There was statistical significant difference in flexion range of movement arc at 2 and 6 months in our study.Conclusions: Open reduction and internal fixation of AO type 13C fractures is challenge to surgeon, preoperative planning and mastering the technique over a period of time gives good to excellent functional outcomes.

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Functional outcome of displaced middle third clavicular fractures treated by plate osteosynthesis

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20210499 ◽

2021 ◽

Vol 7 (2) ◽

pp. 335

Author(s):

A. Palanivel

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Plate Osteosynthesis ◽

Locking Compression Plate ◽

Activity Level ◽

Clavicular Fracture ◽

Union Rate ◽

Compression Plate

Background: Clavicle fracture is a common traumatic injury around the shoulder girdle due to its subcutaneous position. Recent studies have shown a higher rate of nonunion and shoulder dysfunction in subgroups of patients with clavicle fractures. The purpose of the study was to prospectively analyse the functional outcome of mid-third displaced clavicular fractures treated by open reduction and internal fixation with plate osteosynthesis. To study the outcome of displaced middle-third clavicular fracture streated by plate osteosynthesis.Methods: This was a prospective comparative on-randomized study was conducted in Government District Head Quarters Hospital Nagapattinam with a follow-up ranging from September 2018 to January 2019 5 months. Thirty-four cases of middle third displaced (Robinson type 2b1 and 2b2) clavicular fractures are treated with plate osteosynthesis. We used a reconstruction plate, a locking compression plate, and a 1/3rd tubular plate for study.Results: The mean time to union was 9.5 weeks. At the latest follow-up, the entire patients returned to the pre-injury activity level. One case had a superficial infection which was treated with intravenous antibiotics. There is no difference between the reconstruction group and the locking compression plate group in terms of functional outcome and union rate. We also noticed that road traffic accident and direct injury to the shoulder causes Robinson type 2b2 fractures.Conclusions: Open reduction and rigid internal fixation of displaced midshaft clavicular fracture have resulted in a good fracture union rate and excellent functional outcome.

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Timing of Open Reduction and Internal Fixation of Ankle Fractures

Foot & Ankle Orthopaedics ◽

10.1177/2473011417s000388 ◽

2017 ◽

Vol 2 (3) ◽

pp. 2473011417S0003

Author(s):

Direk Tantigate ◽

J. Turner Vosseller ◽

Justin Greisberg ◽

Benjamin Ascherman ◽

Christina Freibott ◽

...

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Functional Outcomes ◽

Ankle Fracture ◽

Open Reduction ◽

Demographic Variables ◽

Ankle Fractures ◽

Significant Difference ◽

The Mean

Category: Ankle, Trauma Introduction/Purpose: Unstable ankle fractures are typically treated with open reduction and internal fixation (ORIF) for stabilization in an effort to ultimately prevent post-traumatic arthritis. It is not uncommon for operative treatment to be performed as an outpatient in the ambulatory surgery setting several days to a couple weeks after the injury to facilitate things from a scheduling perspective. It is unclear what effect this delay has on functional outcome. The purpose of this study is to assess the impact of delayed operative treatment by comparing the functional outcomes for groups of patients based on the amount of time between the injury and surgery. Methods: A retrospective chart review of 122 ankle fracture patients who were surgically treated by ORIF over a three year period was performed. All ankle fracture patients older than 18 years with a minimum of 24 months of follow-up were included. A total of 61 patients were included for this study. Three patients were excluded; 2 patients had an open injury and 1 patient presented with a delayed union. Demographic data, comorbidities, injury characteristics, duration from injury to surgery, operative time, length of postoperative stay, complications and functional outcomes were recorded. Functional outcome was determined by Foot and Ankle Outcome Score (FAOS) at the latest follow-up visit. Comparison of demographic variables and the subcategory of FAOS including symptoms, pain, activities of daily living (ADL), sport activity and quality of life (QOL) was performed between patient underwent ORIF less than 14 days after injury and 14 days or greater. Results: A total of 58 patients were included in this study. Thirty-six patients (62.1%) were female. The mean age of patients was 48.14 ± 16.84 years (19-84 years). The mean follow-up time was 41.48 ± 12.25 months (24-76 months). The duration between injury and operative fixation in the two groups was 7 ± 3 days (<14 days) and 18 ± 3 days (>14 days), respectively. There was no statistically significant difference in demographic variables, comorbidities, injury characteristics, or length of operation. Each subcategory of FAOS demonstrated no statistically significant difference between these two groups. (Table 1) Additionally, further analysis for the delayed fixation more than 7 days and 10 days also revealed no significant difference of FAOS. Conclusion: Open reduction and internal fixation of ankle fracture more than 14 days does not significantly diminish functional outcome according to FAOS. Delay of ORIF for ankle fractures does not play a significant role in the long-term functional outcome.

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Intra articular fracture of distal end of radius treated by open reduction and internal fixation with buttress plate-a clinical study

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20171895 ◽

2017 ◽

Vol 3 (3) ◽

pp. 518

Author(s):

Pavankumar H. Patil ◽

Srinivas Pamarathi

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Point System ◽

Unstable Fracture ◽

Articular Fracture ◽

Medical College ◽

Articular Fractures ◽

Buttress Plate

Background: Recognition of fracture patterns and fixation of fracture to secure and maintain reduction is the key for successful management of more complex intra articular fractures of distal radius. Devices like buttress plates have been shown to provide excellent stability for an unstable fracture with either dorsal or volar metaphyseal comminution. The objective of the study was to evaluate the functional outcome of intra articular fracture of distal end of radius treated by open reduction and internal fixation by buttress plate using Criteria of Gartland and Werley Point System.Methods: Twenty patients with intra articular fracture of distal end radius were treated by open reduction and internal fixation by buttress plate in Al-Ameen medical college, Bijapur. Statistical analysis: The data obtained was represented as percentage.Results: The study included 20 patients, 11 males and 9 females aged from 21 to 69 years with mean of 40.2 years. The average duration of follow-up was 7 months ranged from 6-10 months. Using the Demerit scoring system of Gartland and Werley, we had 20% excellent results, 45% good results, 20% fair results and 15% poor result whereas, excellent to good results were found in 65% of patients. Conclusions: Open reduction and internal fixation by buttress plate provides better functional outcome in treating the intra articualar fracture of distal end radius. Excellent to good results are produced by using buttress plate for fixation of intra articular fractures of distal end radius. So, this procedure can be used as alternative to other procedures in treating intra articular fractures of distal end radius.

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Paratricepital approach for open reduction and internal fixation of delayed presentation of pediatric supracondylar humerus fracture

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20195802 ◽

2019 ◽

Vol 6 (1) ◽

pp. 107

Author(s):

Ramachandra Subbasetty ◽

Dayanand Manjunath ◽

Deepak Shivanna ◽

Narasimha Murthy

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Perioperative Complications ◽

Humerus Fracture ◽

Delayed Presentation ◽

Supracondylar Humerus Fracture ◽

Fractures In Children ◽

The Mean

Background: Delayed presentation of pediatric displaced supracondylar humerus fracture is relatively common. Management of such cases have higher incidence of perioperative complications and usually require open reduction and pinning. Open reduction can be done by various approaches, each having its own advantage and disadvantages.Methods: A prospective study was done comprising 20 children with displaced Supracondylar fracture presented 2-14 days of injury, Mean patient age was 6 years. 15 were boys and 5 were girls. Children in whom closed reduction and percutaneous pinning was achieved, vascular injury and more than 2 weeks old fracture cases were excluded. Paratricepital approach was used for Open reduction and pinning for all the cases. The functional outcome was assessed using Flynn criteria.Results: In all cases the fracture had united at complete follow-up and the mean follow-up period was 16 months. The outcome was excellent in 15 (75%), good in 3 (15%), fair in 1 (5%), and poor in 1 (5%) patients. The mean Baumann angle was 76º in the affected elbow and 73º in the normal elbow. Average time for complete union in the current study was 7 weeks. Pin tract infection was seen in 2, stiffness in 2 patients, cubitus varus in 1 patient. No case of compartment syndrome or iatrogenic nerve injury was seen was recorded.Conclusions: Finally, we concluded that triceps sparing paratricepital approach is an easy, simple and safe approach for exposure and internal fixation of supracondylar humeral fractures in children with excellent functional outcome.

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Timing of Open Reduction and Internal Fixation of Ankle Fractures

Foot & Ankle Specialist ◽

10.1177/1938640018810419 ◽

2018 ◽

Vol 12 (5) ◽

pp. 401-408 ◽

Cited By ~ 2

Author(s):

Direk Tantigate ◽

Gavin Ho ◽

Joshua Kirschenbaum ◽

Henrik Bäcker ◽

Benjamin Asherman ◽

...

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Demographic Variables ◽

Ankle Fractures ◽

Wound Complications ◽

Posttraumatic Arthritis ◽

Injury Characteristics ◽

Significant Difference

Background. Unstable ankle fractures are treated with open reduction internal fixation (ORIF) to prevent posttraumatic arthritis. Typically, ORIF is performed as an ambulatory surgery several days to a few weeks after injury. It is unclear what effect this delay may have on functional outcome. This study aimed to assess the effect of timing of ankle ORIF on wound complications and functional outcome. Methods. A retrospective review of 121 patients who underwent ankle ORIF was performed. A total of 58 patients had a follow-up of at least 24 months. Time between injury and surgery greater than 14 days was defined as “delayed.” Demographic variables, injury characteristics, length of surgery, and postoperative stay were documented. Comparison of demographic variables, wound complications, and functional outcome determined by Foot and Ankle Outcome Score (FAOS) was performed. Results. 118 patients were included. The duration between injury and surgery was 6 days in the “early” group and 19 days in the “delayed” group. There were no significant differences in demographic variables, injury characteristics, and length of surgery between the groups. Wound complications in the early and delayed groups were 5% and 11.8%, although this difference was not statistically significant. Among 58 patients who had a follow-up of at least 24 months, the median follow-up time was 38 (range, 24-76) months. Each subscale of FAOS demonstrated no significant difference. Conclusion. Ankle ORIF more than 14 days after injury did not significantly increase the rate of wound complication, nor did it impair ultimate functional outcome in this group. Levels of Evidence: Level III

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