scholarly journals Management of lateral end clavicle fractures-using lateral clavicle locking plate: a prospective study

Author(s):  
Nageswara Rao V. ◽  
Ravichandra V. ◽  
Lavanya K. M. ◽  
C. Ganapathi Swamy

<p class="abstract"><strong>Background:</strong> Lateral end clavicle fractures are one of the common upper limb fractures. They constitute 21–28% of all clavicle fractures. Of these 10–52% is displaced fractures. The management of fractures of lateral end clavicle remains debated and challenging. The objectivbe of this study is to evaluate the functional outcome following surgical treatment of unstable/displaced (Neer type II lateral clavicle fractures, and acromio-clavicular joint dislocations Rockwood grade III to V) lateral end clavicle fractures using lateral clavicle locking plate.</p><p class="abstract"><strong>Methods:</strong> It is a prospective study conducted in the orthopaedics department of GSL Medical College and General Hospital for a period of 3 years (April 2016 to March 2019) among a total of 60 patients.<strong></strong></p><p class="abstract"><strong>Results:</strong> About 23 (38.3%) belonged to 41–50 years age group, followed by 16 (26.7%) to 31–40 years age group and 13 (21.7%) to &gt;51 years age group and 8 (13.3%) to 18–30 years age group. The time from trauma to surgery ranged from 0-15 days with a mean of 5 days and the mean operating time was 41 minutes ranging between 23-70 minutes. Mean duration to union was 13.33±2.126 weeks and the mean Constant Murley score was 88.56. Functional outcome at 6 months follow up was excellent in 8 (13.3%), good in 37 (61.7%), fair in 13 (21.7%) and poor in 2 (3.3%) patients.</p><p class="abstract"><strong>Conclusions:</strong> Although there is no consensus as to a “gold standard” fixation method for unstable distal clavicle fractures, satisfactory outcomes could be obtained using the lateral clavicle locking plate resulting in sufficient stabilization and good functional outcome.</p>

Author(s):  
Sagar Panthi ◽  
Rishiswor Shrestha ◽  
Rajan Shakya

<p><strong>Background: </strong>Displaced mid-shaft clavicular fractures are treated by conservative methods which shows higher rate of malunion and non-union with suboptimal outcomes. Fracture fixation by pre-countered anatomical clavicular locking plate avoids these complications. This study aims to assess the radiological and functional outcome after open reduction and internal fixation by pre-countered anatomical clavicular locking plate.</p><p><strong>Methods:</strong> Fifty patients of mid-shaft clavicular fractures with age group of 18 to 60 years were treated with open reduction and internal fixation with precountered anatomical clavicular locking plate from, in the span of November 2018 to May 2020. All the patients were followed up for six months for the study. Final functional outcome was assessed in six months.</p><p><strong>Results:</strong> All the fractures united at the average time of 16.32±2.37 weeks. Mean Constant and Murley score was 96.0±5.20. The outcome was graded as excellent in 45 (90%), good in 4 (8%) and fair in 1 (2%) patients.</p><p><strong>Conclusions:</strong> Hence displaced mid-shaft clavicular fractures can be treated with by precountered anatomical clavicular locking plate.</p>


2020 ◽  
pp. 221049172097518
Author(s):  
Vineet Thomas Abraham ◽  
Chandrasekaran Marimuthu

Purpose: Fixation of displaced midshaft clavicle is well known to decrease nonunion, malunion and shoulder disability as compared to nonoperative treatment. This study was done to compare the clinical and functional outcome of group 1 clavicle fractures treated with anatomic locking plates (ALP) versus Titanium elastic nail (TEN). Methods: We studied patients presenting with displaced midshaft clavicle fractures treated with ALP or TEN. The study period was from Jan 2013 to Dec 2016. Patients were reviewed and at each visit clinical and radiological progress of union was noted, complications if any were noted, functional assessment was done using the quick Dash score and Constant Murley score. Results: A total of 116 patients met our inclusion criteria. 62 patients were treated with TEN and 54 with ALP. Bony union was achieved at an average of 11.8 weeks in the TENS group and 12.8 weeks in the ALP group post operatively and this was found to be significant. The mean postoperative Constant Murley score in the ALP and the TEN groups were 92.8 (range 80–97), and 93.7 (82–97) respectively. The mean postoperative quick dash score in the ALP and TEN groups were 2.48(range from 0 to 6.8) and 2.1 (range 0–9.1) respectively. Conclusion: Both Anatomical locking plate and TEN are good options for the treatment of non-comminuted mid clavicular fractures as they have a similar functional outcome. TEN nail insertion has the advantage of being minimally invasive, having a faster union time and may be recommended in midshaft clavicle fractures without comminution.


2020 ◽  
pp. 1-3
Author(s):  
Ravi Mehrotra ◽  
Sanjeev Mahawar ◽  
Dhruv Lashkare ◽  
Raj * Jaiswal

The study aimed to assess clinical, radiological as well as functional outcome in patients of scaphoid fracture following open reduction as compared to percutaneous xation with Herbert Screw. This study was conducted at Department of orthopedics, for 1 year on 30 patients of scaphoid fracture. Fractures were rst tried for percutaneous xation using volar approach, ORIF with volar approach was used when adequate reduction was not achieved. Patients were followed at 2 week interval till union. Clinical assessment at nal followup was performed using MMWS. The mean mean duration of presentation after injury of 19.9 days (3 to 162 days). The mean MMWS score was 93.8 (90-100) for percutaneous and 83.8 (70-95) for ORIF. Since fracture treated with percutaneous xation are associated with early union and early return to functional activity as compared to ORIF, Herbert screw for xation with percutaneous technique for scaphoid fracture must be encouraged for displaced or undisplaced fracture


2020 ◽  
Vol 6 (1) ◽  
pp. 359-363
Author(s):  
Dr. Abhishek Shenoy ◽  
Dr. Anil Bulagond ◽  
Dr. OB Pattanashetty ◽  
Dr. Dayanand BB

Author(s):  
Rajni Ranjan ◽  
Rakesh Kumar ◽  
Ajeet Singh

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Distal femoral fracture one of common surgical challenges for an orthopaedic surgeon. Distal femoral locking plate is a good implant to be used in this anatomical location. Aim of our study was to review functional outcome, union time and complications in distal femoral fracture treated with distal femoral locking plate.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A prospective study was done during June 2012 to July 2016. Patients were included on the basis of inclusion and exclusion criteria. These patients were managed with distal femoral locking plate by close or open method. Pritchett rating system was used to assess functional outcome of patient</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Total 28 patient were enrolled in our study. There were 21 male and 7 female. The age range was from 21 to 68 years. Functional outcome was excellent in 14 patient, good in 7 Patient fair in 3 and poor 4. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Distal femoral locking plate is a reliable implant for treatment of distal femoral fracture including osteoporotic fractures. Proper surgical technique is key to good result.</span></p>


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