scholarly journals An evaluation of functional outcome following surgical management of fractures of the proximal humerus with Neer’s scoring system

2017 ◽  
Vol 4 (1) ◽  
pp. 46
Author(s):  
Yeshwanth Subash ◽  
Lydia M. ◽  
Kamalakumar K. ◽  
Ilavarasan M. Dhamu
Keyword(s):  
Functional Outcome ◽  
Surgical Management ◽  
Scoring System ◽  
Soft Tissues ◽  
Proximal Humerus ◽  
Articular Surface ◽  
Treatment Options ◽  
Early Mobilization ◽  
Functional Results ◽  
Non Union

<p class="abstract"><strong>Background:</strong> <span lang="EN-GB">Fractures of the proximal humerus are complex injuries associated with significant morbidity. Various options are available for management including non-operative treatment, depending upon the pattern of the fracture, quality of the bone and the surgeon's familiarity with the techniques. The age of the patient, physical activity and the medical fitness also largely influence the treatment options. The aim of this study was to evaluate the functional outcome following surgical management of these fractures and to compare the results with studies as available in literature</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-GB">30 patients with fractures of the proximal humerus managed by surgical means were studied from January 2012 to January 2014 and were followed up for a minimum period of two years</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-GB">All the fractures treated united clinically by 8 weeks and radiologically by 16 weeks. There were no cases of delayed or non-union in our series. The fractures were more common in men with a gender distribution of 1.3:1 and were also more common in the age group of 50 to 65 years (53%). As per the Neer’s scoring system, 60% patients had excellent results while 33% patients had satisfactory results. They were all pain free and successfully returned to their pre-injury work. 6% patients had an unsatisfactory result</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-GB">Surgical management of proximal humerus fractures following the principles of articular surface reconstruction, restoration of the anatomy, stable fixation, with minimal injury to the soft tissues and early mobilization, gives good functional results</span><span lang="EN-IN">.</span></p>

scholarly journals Assessment of functional outcome of surgical management of proximal humerus fracture treated with PHILOS plate

2018 ◽  
Vol 4 (5) ◽  
pp. 736
Author(s):  
Jairam D. Jagiasi ◽  
Mihir R. Patel ◽  
Sagar G. Daliya ◽  
Amol Bochare ◽  
Manan Vora
Keyword(s):  
Functional Outcome ◽  
Scoring System ◽  
Proximal Humerus ◽  
Plate Fixation ◽  
Surgical Techniques ◽  
Functional Results ◽  
Operative Management ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Philos Plate

<p class="abstract"><strong>Background:</strong> Proximal humeral fractures were treated conservatively in the past and often had compromised functional results. With the advancement of surgical techniques, these fractures, especially displaced, are now more often managed operatively; to meet the needs of the patient, provide early rehabilitation and better functional outcome. The aim of this study was to assess the functional outcome of operative management of proximal humeral fractures with Philos plate fixation.</p><p class="abstract"><strong>Methods:</strong> In this prospective study, 30 patients aged 19-75 years (mean age 47.1 years) with fractures of the proximal humerus, including two-, three-, and four-part fractures, were treated by open reduction internal fixation with Philos plating. Patients’ functional outcomes were evaluated based on subjective (35 points) and objective (65 points) parameters, as per the constant scoring system.<strong></strong></p><p class="abstract"><strong>Results:</strong> Functional outcome based on the constant scoring system of the patient at 6 month follow-up were compared. Excellent results were seen in 12 patients (40%), 2 had very good results (6.66%), 9 patients were having good (30%) and 6 had fair (20%) functional outcome. One patient had poor functional results (3.33%). Avascular necrosis (AVN) of the humeral head was observed in one patients.</p><p class="abstract"><strong>Conclusions:</strong> Philos plate fixation for proximal humeral fractures provides good stable fixation with good functional outcome and is a feasible option.</p><p> </p>

scholarly journals Operative management of tibial plateau fractures: an assessment of functional and radiological outcomes with Rasmusssens scoring system

2017 ◽  
Vol 3 (6) ◽  
pp. 1092
Author(s):  
Yeshwanth Subash ◽  
Ilavarasan M. Dhamu ◽  
Jagadeesh B. ◽  
Preethi N. ◽  
Manoj Jayaram ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Bone Grafting ◽  
Scoring System ◽  
Tibial Plateau ◽  
Articular Surface ◽  
Weight Bearing ◽  
Early Mobilization ◽  
Functional Results ◽  
Tibial Plateau Fractures ◽  
Stable Internal Fixation

<p class="abstract"><strong>Background:</strong> Fractures of the proximal tibia involve a major weight bearing joint and are intra-articular injuries which frequently result in functional impairment. They require an accurate reduction of the articular surface with stable internal fixation. If these fractures are not managed appropriately, they often result in high rates of morbidity in the form of knee stiffness and arthritis. This study was done to assess the functional and radiological outcomes following various surgical modalities and to compare them with other studies as available in literature.</p><p class="abstract"><strong>Methods:</strong> 30 patients with tibial plateau fractures treated by various surgical modalities at Saveetha Medical College and Hospital were studied from January 2013 to February 2015 and were followed up for a minimum period of 6 months. Functional and radiological outcomes were assessed by the Rasmussens scoring system.<strong></strong></p><p class="abstract"><strong>Results:</strong> All 30 patients fulfilling the inclusion criteria were thoroughly evaluated and were taken up for surgery with various modalities of fixation which included cannulated cancellous screws, T and L buttress plates and locking compression plates. Articular surface elevation with bone grafting was done in depressed fractures. Early knee mobilization was started and strict non-weight bearing walking was advocated. We had a 90% acceptable functional result which was comparable with other studies.</p><p><strong>Conclusions:</strong> In our study, we conclude that accurate reduction of the articular surface with stable internal fixation and early mobilization with bone grafting in depressed fractures with protracted weight bearing till fracture union gives good functional results. Also radiological values often do not often correlate well with functional outcomes. </p>

scholarly journals Comparative Study of Conservative Vs Surgical Management of Clavicle Fractures

2021 ◽  
Vol 6 (1) ◽  
pp. 1-5
Author(s):  
Vivek Phanswal
Keyword(s):  
Functional Outcome ◽  
Surgical Management ◽  
Clavicle Fracture ◽  
Delayed Fracture ◽  
Non Union ◽  
Conservative Group ◽  
Excellent Outcome ◽  
Fracture Management ◽  
Clavicle Fractures ◽  
Radiological Union

Background: Clavicle Fractures is one of the common fractures of upper limb accounting for approximately 40 % of all shoulder fractures. Till recently all clavicle fracture were treated conservatively, but now interest in surgical management is rising. This study was carried out to see if Surgical management outweighs the conservative treatment of Fractures Of Clavicle. Methods: A total of 40 cases satisfying inclusion and exclusion criteria were included in the study. Alternate patients were allocated to operative and conservation groups. In total 20 patients were operated operatively and 20 patients were treated conservatively. Outcome was analysed in terms of radiological union and functional outcome of the patient. Constant and Murley score was used as a score to evaluate final outcome. Results: In this study, the 20 patients who were operated upon had an average union time of 7.8 weeks; 1 patient had delayed fracture union by 12 wks. 20 patients in conservative group had normal union of fractures with 1 patient going into non-union. Average union time in the conservative group was 9.4 weeks, which was more than the 7.8 weeks seen in the group treated operatively. Mal-union was present in 7 of the 20 patients treated conservatively, and 5 of these 7 had a visible deformity. Out of these patients with mal-union 1 had poor functional outcome, 3 had good to excellent outcome and 3 had satisfactory functional outcome. 4 of these had restricted movements terminally and 2 had pain on movement. Conclusions: From our study based on patients of clavicle fractures, it can be concluded that the operative group had significantly higher excellent outcomes as compared to the conservatively- managed group, based on the Constant and Murley score. Keywords: Clavicle Fractures, Constant and Murley Score, Operative Clavicle Fracture Management, Clavicle Fracture Functional Outcome.

Scaphoid Non-Union: Factors Affecting the Functional Outcome of Open Reduction and Wedge Grafting with Herbert Screw Fixation

1993 ◽  
Vol 18 (2) ◽  
pp. 219-224 ◽  
Author(s):  
R. NAKAMURA ◽  
E. HORII ◽  
K. WATANABE ◽  
K. TSUNODA ◽  
T. MIURA
Keyword(s):  
Surgical Treatment ◽  
Functional Outcome ◽  
Open Reduction ◽  
Screw Fixation ◽  
Functional Results ◽  
Bony Union ◽  
Proximal Fragment ◽  
Factors Affecting ◽  
Non Union ◽  
Herbert Screw

50 patients with scaphoid non-union were treated by open reduction, anterior wedge bone grafting and internal fixation using the Herbert screw. Intra-operative image intensiner control enabled us to insert the screw into the scaphoid accurately. An excellent or good functional outcome was less likely when more than 5 years had elapsed since injury, the non-union was in the proximal third, when sclerosis of the proximal fragment was present, and when reduction of carpal and scaphoid deformity was unsatisfactory. These four factors are believed to be the primary determinants affecting the functional results of the surgical treatment of scaphoid non-union, even when bony union is achieved.

scholarly journals Proximal Humeral Fractures: A Review of Current Concepts

2013 ◽  
Vol 7 (1) ◽  
pp. 361-365 ◽  
Author(s):  
James C. Widnall ◽  
Sujay K. Dheerendra ◽  
Joby Jacob George Malal ◽  
Mohammed Waseem
Keyword(s):  
Elderly Population ◽  
Proximal Humerus ◽  
Treatment Options ◽  
The Elderly ◽  
Open Reduction Internal Fixation ◽  
Non Union ◽  
Majority Group ◽  
Medullary Nailing ◽  
Humerus Fractures ◽  
Arthroplasty Surgery

The majority of proximal humerus fractures are sustained via low energy falls in the elderly population. These patients can attain an acceptable level of function via non-operative treatment. There is yet to be a clear consensus on treatment options suitable for those that fall outside of this majority group. Open reduction internal fixation, intra medullary nailing and arthroplasty surgery have all been used to varying effects. Good results are achievable if complications such as mal-union, non-union and avascular necrosis can be avoided. This review aims to clarify the options available to the current day trauma surgeon.

scholarly journals Demographic profile and functional outcome following fixation of malleolar fractures in adults

2020 ◽  
Vol 6 (2) ◽  
pp. 313
Author(s):  
Rejo V. Jacob ◽  
Sanjeev Kumar ◽  
Naveen K. Singh ◽  
Prateek Girotra
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Scoring System ◽  
Open Reduction ◽  
External Rotation ◽  
Early Mobilization ◽  
Common Mechanism ◽  
Demographic Profile ◽  
Malleolar Fractures ◽  
Male Preponderance

<p class="abstract"><strong>Background:</strong> Malleolus are important structures which forms part of ankle mortise and provide stability to it. This article underlines the current demographic profile of patients sustaining malleolar fractures in adults. It also discusses the modalities of treatment and functional outcomes following open reduction and internal fixation of these fractures as well as the improvement in functional outcome following early mobilization.</p><p class="abstract"><strong>Methods:</strong> 30 patients sustaining malleolar fractures who attended the Department of Orthopedics were included in the study. The patients were operated as and when the soft tissue condition permitted and were followed up in outpatient department at 6 weeks, 3 months and 6 months where functional outcome based on Baird and Jackson scoring system was assessed.<strong></strong></p><p class="abstract"><strong>Results:</strong> In this study, the average age of patients was 43.8 years with a male preponderance. Supination-external rotation was the most common mechanism of injury following a slip or twisting injury. According to Baird and Jackson scoring system 20% patients had excellent, 50% patients had good results, 20% patients had fair results and 10% patients had poor results.</p><p class="abstract"><strong>Conclusions:</strong> 70% patients had excellent to good results following fixation of malleolar fractures. Early mobilization was started in 5 patients with 80% patients showing excellent results. Open reduction and Internal fixation proved to be an excellent procedure leading to union in all cases, less complication and early resumption of routine activities.</p><p> </p>

scholarly journals Evaluation of talus fractures treated with fixation- correlation of functional outcome with the fracture type and wound condition

2018 ◽  
Vol 4 (4) ◽  
pp. 647
Author(s):  
Neetin Pralhad Mahajan ◽  
Nikhil Dilip Palange ◽  
Eknath Pawar ◽  
Amit Supe ◽  
Prasannakumar G. S.
Keyword(s):  
Functional Outcome ◽  
Open Reduction ◽  
Articular Surface ◽  
Early Mobilization ◽  
Angular Deformity ◽  
Consecutive Series ◽  
Fracture Type ◽  
Type Iv ◽  
Early Motion ◽  
Satisfactory Outcome

<p class="abstract"><strong>Background:</strong> Fractures of talus are one of the most difficult ones to treat owing to the problems of complicated fracture patterns, wound problems, risk of osteonecrosis etc. This study aims to evaluate the relation of the fracture type and wound with the functional outcome after open reduction and fixation.</p><p class="abstract"><strong>Methods:</strong> The study was conducted in Sir J. J. Group of Hospitals from June 2014 to March 2018. A consecutive series of 28 patients with displaced fractures of talus were selected after approval from ethical committee. All patients were operated and evaluated at average of 6 months after surgery.<strong></strong></p><p class="abstract"><strong>Results:</strong> The Hawkins score was used to evaluate the functional outcome. 60% of patients of type II gained good to very good score as compared to 40% of patients of type III and 30% of type IV. With increase in severity of the fracture, percentage of score decreased.</p><p><strong>Conclusions:</strong> Most precise method of restoring and maintaining the anatomy of talus fracture is open reduction and internal fixation to allow early motion. Surgery for displaced fractures consists of anatomically correct reconstruction to avoid articular surface incongruence and angular deformity as well as preservation and rapid restoration of talar blood supply. This will ensure early mobilization and satisfactory outcome. Open fractures have worse functional outcome than closed fractures owing to lower union rates, higher osteonecrosis rates and higher re-operation and infection rates. </p>

scholarly journals Conservative Treatment of Chronic Mallet Fracture Non-union after Failed Pin Fixation

2020 ◽  
Vol 3 (1) ◽  
pp. 25-28
Author(s):  
Hara A
Keyword(s):  
Conservative Treatment ◽  
Articular Surface ◽  
Functional Results ◽  
Fracture Site ◽  
Distal Phalanx ◽  
Joint Surface ◽  
Mallet Finger ◽  
Non Union ◽  
Mallet Fracture ◽  
Pin Fixation

Introduction: Operative treatment of mallet finger fractures is generally recommended for patients in whom more than one-third of the articular surface is involved with volar subluxation. We present a case of conservative treatment with chronic nonunion of a mallet finger fracture after failed mallet finger surgery. Presentation of Case: A 16-year-old boy presented with a bony fragment (mallet formation) of his left long finger. The fragment occupied 40% of the articular surface, with volar subluxation of the distal phalanx. Percutaneous needle curettage of the fracture site and pinning were performed. Six weeks later, the fragment was displaced and had rotated. Hence, all the pins were removed, and a splint was applied. The fracture displayed nonunion and volar subluxation of the distal phalanx. The patient continued with the splinting, and the fracture finally healed. At 27 months after the surgery, radiological examination showed very good remodeling of the distal interphalangeal joint surface with anatomic joint congruence. Functional results at 27 months were good according to Crawford’s classification. Conclusion: Chronic nonunion of a mallet finger can be cured conservatively even when a fracture gap is seen along with displacement of the fragment and volar subluxation of the distal phalanx.

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