scholarly journals Evaluation of compound tibial fractures managed with an Ilizarov ring fixator

2020 ◽  
Vol 6 (4) ◽  
pp. 710
Author(s):  
Praveen Ravi ◽  
Muthumanickam Ramanujam ◽  
Jambu Nageswaran ◽  
Sundar Suriyakumar
Keyword(s):  
Open Fractures ◽  
Tibial Fractures ◽  
Long Bone ◽  
Type Ii ◽  
Ring Fixator ◽  
Type Iiia ◽  
Type Iiib ◽  
Ilizarov Ring Fixator ◽  
Ilizarov Fixator ◽  
The Ideal

<p class="abstract"><strong>Background:</strong> The tibia is the most commonly fractured long bone and because of its location and the tenuous soft tissue coverage, its more prone for open fractures tibia than any other long bone. The ideal management of such fractures still remains controversial. We have evaluated the healing of fractures and functional outcomes in patients with open tibial fractures treated with an Ilizarov ring fixator.</p><p class="abstract"><strong>Methods:</strong> 32 patients who had open fractures of the tibia (II, IIIA or IIIB) who were treated with an Ilizarov fixator were included in the study. The patients were followed up for a minimum period of 1 year after removal of the fixator. Functional and radiological results were analysed using association for the study of applications of methods of Ilizarov scoring.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 20 cases of type IIIB, 7 cases of type IIIA, 5 cases of type II fractures. Union was achieved in all patients. Mean time for union was 25.2 weeks, with faster union times in type II, type IIIA fractures. Six cases of type IIIB needed flap cover. Limb discrepancy was seen in 3 cases. 17 cases of pin tract infections were seen, most of which were grade 3 and were managed with antibiotics. Two cases had delayed union, of which one was treated with bone marrow aspirate injection and the other one with bone grafting. At one year, 21 (65.6%) had excellent results, six (18.7%) had good results, four (12.5%) had fair outcomes and one (3.2%) had a poor result.</p><p class="abstract"><strong>Conclusions:</strong> Despite the associated complications, Ilizarov fixator is the ideal treatment for compound tibial fractures.</p>

scholarly journals Outcomes of Ilizarov Ring Fixator in Infected Nonunion of Tibia

2021 ◽  
pp. 724-730
Author(s):  
Muhammad Hamayun Hameed ◽  
Abdul Hamid Kakar ◽  
Hassan Amir Us Saqlain ◽  
Syed Sajid Hussain ◽  
Masood Ahmed Qureshi ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Functional Results ◽  
Bony Union ◽  
External Fixators ◽  
Infected Nonunion ◽  
Ring Fixator ◽  
Ilizarov Ring Fixator ◽  
Ilizarov Fixator ◽  
Poor Outcomes ◽  
Tibial Mechanical Axis

Objective: This study was designed to evaluate the effectiveness of Ilizarov. We aimed to explore the infection rate, bony union, and functional outcomes of Ilizarov fixators. Methodology: This retrospective study was conducted in Orthopedic department of Bolan Medical Complex Hospital Quetta Pakistan from June 2020 to June 2021. In this timeframe total of fifty-five patients of infected nonunion tibia were enrolled for Ilizarov technique treatment. For surgical intervention, patients were placed in a supine position on a radiolucent table. Ilizarov fixator was prepared on the behalf of patient's limb length, infection site, and ankle and knee functional status. We applied assembled Ilizarov fixator at the tibial shaft while keeping in mind that the rings were positioned in on the proximal and distal fragments. The ring was placed parallel to the joints whereas pins were inserted perpendicular to the tibial mechanical axis. Results: A total of 55 patients were recruited for this study. The mean age of the selected participants was 45.65±16.69 years. The overall successful bone results of the ASAMI score were observed as 80% whereas 88% functional outcomes were achieved. In bone results, we observed 28 (50.9%) cases with excellent results, 16 (29%) with good, 7 (12.7%) with fair, and 3 (5.4%) with poor outcomes. On the other hand, 25 (45.4%) cases observed excellent functional results, 25 (45.4%) with good, 4 (7.6%) with fair, and 2 (3.6%) with poor outcomes. Conclusion: Our results show a high success ratio therefore we recommend Ilizarov external fixators for infected nonunion tibial fracture. This method helps to recover limbs without any amputations. However, the discomfort of patients is one of the main problems with this method of treatment.

scholarly journals Management of infected non-union of lower limb long bone fractures using ilizarov technique: a study of outcomes

2017 ◽  
Vol 3 (3) ◽  
pp. 557 ◽  
Author(s):  
Hrishikesh Pande ◽  
Chander Mohan Singh ◽  
Anjan Prabhakara ◽  
Vivek Mathew Philip ◽  
Mohd Shezan Iqbal ◽  
...  
Keyword(s):  
Lower Limb ◽  
Bone Fractures ◽  
Lower Limbs ◽  
Long Bone ◽  
Long Bones ◽  
Ilizarov Technique ◽  
Infected Nonunion ◽  
Ring Fixator ◽  
Long Bone Fractures ◽  
Ilizarov Ring Fixator

<p class="abstract"><strong>Background:</strong> Nonunion of long bone fractures is a common condition treated by an orthopaedic surgeon. Many nonunions can be treated effectively by internal fixation with or without bone grafting but, an infected nonunion can prove to be a tough challenge. The Ilizarov method is effective in managing infected nonunion of long bones. This study aims to assess the outcome of management of infected nonunions of long bones of lower limb with Ilizarov Ring fixator using bone and functional results as per Association for the Study and Application of Methods of Ilizarov (ASAMI) Scoring System.</p><p class="abstract"><strong>Methods:</strong> We retrospectively analysed 18 patients (16 Male: 2 Female; Mean age 43.2 years) managed with Ilizarov technique for an infected tibial or femoral nonunion between 01 January 2013 and 31 December 2014. They were followed up for an average of 25.4 months after removal of fixator. They were assessed for functional and Bone (radiological) outcomes using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> 17 limbs were salvaged and union could be achieved. One limb required amputation due to severe persistent intractable infection. None required any additional skeletal stabilisation after removal of fixator frame except casting in a few patients for a period of 6 weeks. Mean time to union was 211.83 days (range 136 - 320days/median 184) or 7.01 months. As per the ASAMI score, Bone results were excellent in 10, good in 5, fair in 2 and poor in 1. Functionally 7 were graded as excellent, 6 as good, 3 as fair and 1 as poor and 1 patient underwent amputation.</p><p><strong>Conclusions:</strong> The Ilizarov’s method remains one of the most versatile and successful means of achieving bone healing in infected nonunions of long bones of lower limbs with additional benefits of correcting bone defects, deformities and limb length inequalities. </p>

Operative management of type II and type IIIa open tibial fractures presenting from 6–24 hours after injury

2011 ◽  
Vol 22 (3) ◽  
pp. 262-266 ◽  
Author(s):  
Kamal Bali ◽  
Sameer Aggarwal ◽  
Vishal Kumar ◽  
Aditya Krishna Mootha ◽  
Saurabh Rawall ◽  
...  
Keyword(s):  
Operative Management ◽  
Tibial Fractures ◽  
Type Ii ◽  
Open Tibial Fractures ◽  
Type Iiia

scholarly journals Electrophysiological properties of maxillary trigeminal Aβ-afferent neurons of rats

2021 ◽  
Vol 17 ◽  
pp. 174480692110212
Author(s):  
Yuya Okutsu ◽  
Akihiro Yamada ◽  
Sotatsu Tonomura ◽  
Ryan J Vaden ◽  
Jianguo G Gu
Keyword(s):  
Type I ◽  
Type Ii ◽  
Afferent Neurons ◽  
Success Rates ◽  
Fast Kinetics ◽  
Electrophysiological Properties ◽  
Type Iiia ◽  
Type Iiib ◽  
Slow Kinetics ◽  
Conduction Velocities

Aβ-afferents in maxillary or V2 trigeminal ganglion (TG) neurons are somatosensory neurons that may be involved in both non-nociceptive and nociceptive functions in orofacial regions. However, electrophysiological properties of these V2 trigeminal Aβ-afferent neurons have not been well characterized so far. Here, we used rat ex vivo trigeminal nerve preparations and applied patch-clamp recordings to large-sized V2 TG neurons to characterize their electrophysiological properties. All the cells recorded had afferent conduction velocities in the range of Aβ-afferent conduction speeds. However, these V2 trigeminal Aβ-afferent neurons displayed different action potential (AP) properties. APs showed fast kinetics in some cells but slow kinetics with shoulders in repolarization phases in other cells. Based on the derivatives of voltages in AP repolarization with time (dV/dt), we classified V2 trigeminal Aβ-afferent neurons into four types: type I, type II, type IIIa and type IIIb. Type I V2 trigeminal Aβ-afferent neurons had the largest dV/dt of repolarization, the fastest AP conduction velocities, the shortest AP and afterhyperpolarization (AHP) durations, and the highest AP success rates. In contrast, type IIIb V2 trigeminal Aβ-afferent neurons had the smallest dV/dt of AP repolarization, the slowest AP conduction velocities, the longest AP and AHP durations, and the lowest AP success rates. The type IIIb cells also had significantly lower voltage-activated K+ currents. For type II and type IIIa V2 trigeminal Aβ-afferent neurons, AP parameters were in the range between those of type I and type IIIb V2 trigeminal Aβ-afferent neurons. Our electrophysiological classification of V2 trigeminal Aβ-afferent neurons may be useful in future to study their non-nociceptive and nociceptive functions in orofacial regions.

scholarly journals Usage of Unreamed Interlocking Nails for the Management of Gustilo Anderson Grade 2 and 3 Open Fractures of Shaft of Tibia – A Prospective Study

2016 ◽  
Vol 22 (3) ◽  
Author(s):  
Tariq Zaman ◽  
Omer Khalid Farooq ◽  
Faisal Nazeer Hussain
Keyword(s):  
Delayed Union ◽  
Open Fractures ◽  
Tibial Fractures ◽  
Bone Union ◽  
Type Ii ◽  
Tibial Shaft ◽  
Fracture Geometry ◽  
Interlocking Nail ◽  
Emergency Procedures ◽  
A Prospective Study

<p>Long bones fractures are the main emergency procedures in most trauma centers. Tibial fractures are commonly open as described by the Gustilo classification. Grade III fractures of the tibia (diaphysis) are very challenging injuries. Intramedullary nailing is one of the best known treatments for tibial fractures. It’s still being debated which is the most appropriate surgical approach to treat such fractures especially the choice between reamed vs. unreamed nails. This study was designed to determine the outcome of unreamed interlocking nail in open type II and IIIA tibial shaft fractures in terms of infection, bone union, delayed union and nonunion.</p><p><strong>Patients and Methods:</strong><strong>  </strong>It was a prospective, quasi – experimental study, conducted at Department of Orthopedics, Lahore General Hospital/PGMI Lahore upon sixty patients. All subjects with Grade II and III open fractures of shaft of tibia were operated using the unreamed nails. They were followed regularly on 3<sup>rd</sup> then 10<sup>th</sup>, 20<sup>th</sup>, 30<sup>th</sup> post-op days. Later a monthly OPD follow up for 9 months was maintained. Records were maintained and analyzed using SPSS 20. Modified Anderson criteria was used to segregate results from poor to excellent.<strong></strong></p><p><strong>Results:</strong><strong>  </strong>Mean age of all patients was 32.82 ± 8.87 years. Fracture geometry shows that 9 patients had transverse, 27 had oblique, 18 had spiral and 6 patients had comminuted fracture. According to the Gustilo – Anderson Classification 43 fractures were Type II and 17 fractures were Type IIIA. Only 9 patients developed infection. Union was seen in 51 (85%) patients and delayed union was observed in 7 (11.66%) subjects. Two patients (3.34%) had nonunion. According to the Modified Anderson grading 47 (78.34%) patients had excellent, 7 (11.66%) patients had good and 6 (10%) patients had poor results.<strong></strong></p><p><strong>Conclusion:</strong><strong>  </strong>On the basis of the results obtained, it was shown that unreamed interlocking nail for treating type II and III A fractures of tibial shaft shows promising and effective results in terms of low rate of infection and bone union. Overall excellent results were seen in 47 (78.34%) patients according to the modified Anderson criteria.</p>

Glenoid Rim Lesions Associated with Recurrent Anterior Dislocation of the Shoulder

1998 ◽  
Vol 26 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Louis U. Bigliani ◽  
Peter M. Newton ◽  
Scott P. Steinmann ◽  
Patrick M. Connor ◽  
Stephen J. McIlveen
Keyword(s):  
Anterior Dislocation ◽  
Type I ◽  
Type Ii ◽  
Recurrent Instability ◽  
Fracture Fragment ◽  
Type Iiia ◽  
Type Iiib ◽  
Anterior Glenoid ◽  
Bony Fragment ◽  
The One

Twenty-five shoulders with recurrent instability and associated anterior glenoid rim lesions were reviewed to 1) develop a classification system of the lesions, 2) evaluate radiographic techniques in detecting the lesions, and 3) analyze the outcome of surgery. Lesions were classified into three types: Type I, a displaced avulsion fracture with attached capsule; Type II, a medially displaced fragment malunited to the glenoid rim; and Type III, erosion of the glenoid rim with less than 25% (Type IIIA) or greater than 25% (Type IIIB) deficiency. Lesions were detected by plain radiographs (19 shoulders) or supplemental CT-arthrograms (12 shoulders) or both. In 16 Type I fractures, both the bony fragment and capsule were reattached to the glenoid rim. In five Type II and three Type IIIA lesions, only the capsule was repaired to the remaining glenoid rim. In the one Type IIIB lesion, a coracoid transfer was performed. At an average followup of 30 months, 22 shoulders (88%) had satisfactory results without recurrent instability, whereas three shoulders (12%) had postoperative redislocations. The majority of recurrent anterior dislocations with associated glenoid rim lesions can be treated by suturing the fracture fragment or capsule or both to the glenoid rim and addressing associated capsular laxity.

Predictability of salvage and outcome of Gustilo and Anderson type-IIIA and type-IIIB open tibial fractures using Ganga Hospital Scoring system

Injury ◽  
2015 ◽  
Vol 46 (2) ◽  
pp. 282-287 ◽  
Author(s):  
P. Madhuchandra ◽  
Mohammed Rafi ◽  
Sathish Devadoss ◽  
A. Devadoss
Keyword(s):  
Scoring System ◽  
Tibial Fractures ◽  
Open Tibial Fractures ◽  
Type Iiia ◽  
Type Iiib
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