scholarly journals Prospective study of clinical, radiological and functional outcome of anterior bridge plating for shaft of humerus fracture

2020 ◽  
Vol 6 (6) ◽  
pp. 1245
Author(s):  
Abhishek Kumar ◽  
Rahul Bade
Keyword(s):  
Los Angeles ◽  
Minimally Invasive ◽  
Internal Fixation ◽  
Functional Outcome ◽  
Road Traffic ◽  
Plate Osteosynthesis ◽  
Treatment Protocol ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Bridge Plating

<p class="abstract"><strong>Background:</strong> Shaft of humerus (SOH) fracture has been conventionally treated with either open reduction internal fixation with plate osteosynthesis or immobilization as conservative treatment. Intramedullary interlocking nailing (IMIL) and anterior bridge plating (ABP) are both newer modalities of internal fixation for SOH fracture. Rotator cuff irritation is a known complication of IMIL nailing of the humerus. Here, we present clinical, radiological, and functional outcome of SOH fracture fixation by ABP using a minimally invasive method.</p><p class="abstract"><strong>Methods:</strong> Thirty patients with SOH fracture were treated surgically via an anterior minimally invasive plate osteosynthesis (MIPO) approach with ABP. There were 21 male and 9 female patients, and the average age was 38.6±10.45 years. The mechanism of injury was road traffic accidents (60%) and ground level fall (40%). Functional assessments were obtained with University of California at Los Angeles (UCLA) score and mayo elbow performance index (MEPI) during the follow-up period.<strong></strong></p><p class="abstract"><strong>Results:</strong> At the end of 6 months follow-up, 29 (96.7%) patients had excellent to good UCLA and MEPI scores. Varus/valgus angulation was reported in 4 (13.3%) patients. Two patients (6.7%) had radial nerve neuropraxia and delayed union, while 1 (3.3%) patient had screw back-out or loosening. The mean duration of radiation exposure was 178±41.2 seconds. ABP for SOH fractures is a safe and effective treatment modality.</p><p class="abstract"><strong>Conclusions:</strong> This treatment protocol produces high rates of union, excellent functional recovery, and minimal biological disruption.</p>

scholarly journals Evaluation of functional outcome of distal tibial fractures stabilized with distal tibial locking plate

2020 ◽  
Vol 7 (1) ◽  
pp. 39
Author(s):  
Naveen Kumar ◽  
Manoj Thakur ◽  
Sandeep Kashyap
Keyword(s):  
Minimally Invasive ◽  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Open Reduction Internal Fixation ◽  
Tibial Fractures ◽  
P Value ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Distal Tibial Fractures

<p class="abstract"><strong>Background:</strong> The present study is an attempt to evaluate the results of locking compression plate for distal tibia in lower tibial fractures using open reduction internal fixation and minimally invasive plate osteosynthesis technique.</p><p class="abstract"><strong>Methods: </strong>Prospective and retrospective study was conduct on patients attending the outpatient department (OPD)/Emergency OPD in Indira Gandhi Medical College, Shimla during September 2015 to August 2016 with distal tibial fractures. The patients treated with locking compression plates using minimally invasive plate osteosynthesis (MIPO) or open reduction internal fixation (ORIF) are reviewed for inclusion and exclusion criteria. All data were collected and analyzed by Epi-info software.</p><p class="abstract"><strong>Results: </strong>Out of 52 patients, 48.4% patients undergo open reduction internal fixation had excellent results and 28.6% patients undergo surgery by MIPPO technique had excellent results. p value is 0.352 which is not significant. Overall, 40.4% patients had excellent results. In our study, 32.6% patients having AO/OTA type A fractures had excellent score while type B and C had 1.9% excellent score. This is attributed to more comminution and involvement of ankle joint. Overall, 40.4% patients had excellent score. P value is 0.863 which is insignificant.</p><p class="abstract"><strong>Conclusions: </strong>We observed excellent/ good functional outcome in 65.3% of patients.</p>

scholarly journals Outcome of minimally invasive plate osteosynthesis in distal tibial fractures

2017 ◽  
Vol 17 (2) ◽  
pp. 18-22
Author(s):  
Nabees Man Singh Pradhan ◽  
JA Khan ◽  
B Acharya ◽  
S Shrestha ◽  
R Tamrakar ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Internal Fixation ◽  
Plate Osteosynthesis ◽  
Distal Tibia ◽  
Tibial Fractures ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Type I ◽  
Distal Tibial Fractures ◽  
Non Union ◽  
The Mean

Introduction: Distal tibial fractures present as a major challenge for the orthopedic trauma surgeons. Most non-operative treatments result in non-union or malunion and needs prolonged immobilization of the knee and ankle joints, with resulting stiffness. Open reduction and internal fixation as well as external fixation has high rate of infection and non-union. Minimally Invasive Plate Osteosynthesis has been shown to have a better outcome and has been the procedure of choice in most distal tibial fractures since the introduction of the locking compression plate. The objective of the study is to review the outcome of Minimally Invasive Percutaneous Osteosynthesis (MIPO) in unstable distal tibial fractures.Methods: Charts of patients who underwent MIPO from the year 2008 to 2013 for unstable distal tibial fractures over five years at Patan Hospital and Om Hospital were reviewed. All displaced closed fractures and Gustillo Anderson Type I and II fractures were included in the study. Plates consisted of the anatomically contoured 4.5 mm LCP and 3.5 mm LCP-Pilon form plate. A simple uniplanar external fixator was used to retain the reduction till the plate was inserted and secured with locking screws. The outcome of MIPO in distal tibial fractures were followed up and evaluated.  Clinical and radiological assessments were performed at 6 weeks, and at 3, 6, 9, 12 and 24 months.Results: Of the 75 patients (45 male, 30 female) age ranging from 19 to 70 years (mean 47 years), 5 patients were lost to follow-up. 28 patients at 3 months, 32 at 6 months, and 8 at 9 months met the criteria for a healed fracture. Two patients required autologous bone grafting at 9 months for non-union ultimately resulting in the fracture union at 16 months. There was one malunion attributable to the loss of reduction during plate fixation. There were no deep infections, no soft tissue complications and no failures of fixation. The cause of fracture were RTA (n=35), fall from height (n=9), twisting of ankle as a result of fall from standing height (n=22), and others (n=11). The mean time for surgery from the time of injury was 5 (range, 2 to 14) days; the mean hospital stay was 10 (range, 7 to 21) days.Conclusion: MIPO is an effective treatment for closed, unstable fractures of the distal tibia, avoiding the complications associated with more traditional methods of internal fixation and/or external fixation.Journal of Society of Surgeons of NepalVol. 17, No. 2, 2014, Page: 7-11

Management of feline tibial diaphyseal fractures using orthogonal plates performed via minimally invasive plate osteosynthesis

2017 ◽  
Vol 20 (1) ◽  
pp. 6-14 ◽  
Author(s):  
Andrew Craig ◽  
Philip G Witte ◽  
Tristram Moody ◽  
Karen Harris ◽  
Harry W Scott
Keyword(s):  
Minimally Invasive ◽  
Bone Healing ◽  
Plate Osteosynthesis ◽  
Plate Fixation ◽  
Major Complication ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Diaphyseal Fractures

Objectives The objective was to assess the medium- and long-term outcomes (radiographic and owner questionnaire) of feline tibial diaphyseal fractures with orthogonal plate fixation via a minimally invasive plate osteosynthesis (MIPO) approach. Methods Medical records and radiographs of cats that had tibial diaphyseal fractures stabilised with orthogonal plates were obtained (2012–2016). Immediate postoperative radiographs were reviewed to assess the construct configuration and follow-up radiographs (where available) were used to assess bone healing and implant-related complications. An owner-completed questionnaire (feline musculoskeletal pain index [FMPI]) was used at a minimum of 6 months following surgery to assess the cats’ ability to perform normal activities. Results Eight feline tibial diaphyseal fractures met the inclusion criteria. One major complication was observed, most likely due to an operative technical error. There were no further complications following revision surgery. Six of the eight cases that had radiographic follow-up either had clinical bone union or showed evidence of bone healing. All cases were classified as successful according to FMPI. Conclusions and relevance Orthogonal plating of feline tibial diaphyseal fractures via an MIPO approach resulted in successful outcomes and a lower complication rate compared with previously reported techniques.

scholarly journals Comparison between Minimally Invasive Plate Osteosynthesis and Conventional Open Plating for Midshaft Clavicle Fractures: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Enzhe Zhao ◽  
Rui Zhang ◽  
Dou Wu ◽  
Yao Guo ◽  
Qiang Liu
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Cohort Studies ◽  
Functional Outcome ◽  
Plate Osteosynthesis ◽  
Meta Analysis ◽  
Operation Time ◽  
Cochrane Library ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Clavicle Fractures

Objective. The aim of this study was to compare the functional outcome and complications in midshaft clavicle fractures receiving minimally invasive plate osteosynthesis and conventional open plating. Methods. Relevant studies were searched in the databases of Medline, EMBASE, Cochrane Library, Ovid, and Web of Science from inception to March 1, 2019. Pooled data were analyzed with Cochrane Collaboration’s Review Manager 5.3. Results. A total of 7 studies were included, of which 2 were randomized controlled trials, 3 were retrospective cohort studies, and 2 were prospective cohort studies including 316 patients. No statistical differences in functional outcome (weighted mean difference [WMD] = 0.99, P=0.12), operation time (WMD = −10.44, P=0.07) and time to bone union (WMD = −0.23, P=0.70) were observed between the two groups. However, minimally invasive plate osteosynthesis reduced rates of skin numbness (odds ratio (OR) = 0.25, 95% CI : 0.13 to 0.48; P<0.0001) and complications (OR = 0.33, 95% CI : 0.16 to 0.71; P=0.005) compared with conventional open plating. Conclusion. This systematic review and meta-analysis found no differences in terms of functional outcomes, operation time, and fracture healing time between minimally invasive plate osteosynthesis and conventional open plating. However, minimally invasive plate osteosynthesis had apparent advantages in rates of skin numbness and complications.

scholarly journals Radiological parameters determining outcome in pilon fractures treated by minimally invasive plate osteosynthesis

2019 ◽  
Vol 5 (3) ◽  
pp. 490
Author(s):  
Vishnu Sankar Appusamy ◽  
Karthik Ramachandran ◽  
Arvind Manoj Kumbakrishnakumar
Keyword(s):  
Minimally Invasive ◽  
Functional Outcome ◽  
Soft Tissues ◽  
Plate Osteosynthesis ◽  
Soft Tissue Injury ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Surgical Trauma ◽  
Radiological Parameters ◽  
Pilon Fractures

<p class="abstract"><strong>Background:</strong> Tibial pilon fractures are one of the challenging fractures to manage in the field of orthopaedics due to its complex fracture patterns as well as associated soft tissue injury. Minimally invasive plate osteosynthesis (MIPO) technique aims to reduce the surgical trauma to the surrounding soft tissues and hence maintain a more biologically favourable environment for fracture healing. The purpose of the study is to analyse the various factors especially radiological parameters determining functional outcome in pilon fractures treated by MIPO technique.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study conducted from June 2015 to May 2018. The study included 46 patients (33 males, 13 females) with pilon fractures treated by minimally invasive plate osteosynthesis. All patients were followed for average period of 2 years. Functional outcome was assessed using American Orthopedic Foot and Ankle Score (AOFAS).<strong></strong></p><p class="abstract"><strong>Results:</strong> Among 46 patients, 21 patients (45.65%) had excellent, 16 patients (34.78%) had good and 6 patients (13.04%) had fair functional outcome. The quality of reduction was the most important parameter determining the functional outcome. We found that patients with higher lateral distal tibial angle (LDTA), anterior distal tibial angle (ADTA) and length of lateral malleolus (LLM) had better functional outcome than patients with lower values. The timing of surgery had no significant influence on the functional outcome of the patients.</p><p class="abstract"><strong>Conclusions:</strong> We like to conclude that apart from the quality of fracture reduction, radiological parameters like ADTA, LDTA, and LLM also play a crucial role in determining the functional outcome in pilon fractures.</p><p class="abstract"> </p>

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