scholarly journals Management of intercondylar fractures of the distal humerus in adults using bi-columnar plating through trans-olecranon approach

2021 ◽  
Vol 7 (6) ◽  
pp. 1156
Author(s):  
Vijendra Yadav ◽  
Parvez Ahmad Ganie ◽  
Rajendra Pranav Prasad ◽  
Madhan Jeyaraman
Keyword(s):  
Functional Outcome ◽  
Distal Humerus ◽  
Postoperative Rehabilitation ◽  
Good Healing ◽  
Difficult Challenge ◽  
Clinical And Radiological Results ◽  
A Prospective Study ◽  
Condylar Fractures ◽  
Study Participants

<p class="abstract"><strong>Background: </strong>Inter-condylar fractures of the distal humerus are uncommon injuries and present the most difficult challenge among fractures of the lower end of the humerus. The principle involves anatomical reduction and fixation with stabilization of extra-osseous implants. The functional outcome has been greatly influenced by the early graduated rehabilitative exercise. We aimed to evaluate the functional outcome of inter-condylar fractures of the distal humerus in adults using bi-columnar plating through a trans-olecranon approach.</p><p class="abstract"><strong>Methods:</strong> A prospective study with 40 adult patients with inter-condylar fracture of the distal humerus were managed with bi-columnar plating through a trans-olecranon approach and were followed up for 12 months. The functional outcome was analysed by Mayo’s Elbow Performance Score (MEPS) at the end of 12 months follow up.</p><p class="abstract"><strong>Results: </strong>The average age of study participants were 50.8 years. A total of 24 cases were due to RTA and 16 cases were due to direct falls. Out of 40 cases, 6 (15%) were of B1 type, 2 (5%) were of type B2, 12 (30%) were of C1, 10 (25%) of C2, and 10 (25%) were of the type of C3 according to AO classification. According to MEPS at the end of the 12th-month follow-up, excellent results were seen in 24 (60%), good in 8 (20%), fair in 6 (15%), and poor results in 2 (5%) cases.</p><p class="abstract"><strong>Conclusions: </strong>Anatomically, bi-columnar plating for distal humerus is useful in providing stable fixation for complex distal articular fractured by trans-olecranon approach and facilitating early postoperative rehabilitation. Clinical and radiological results showed a good healing rate with a good range of motion.  </p>

scholarly journals Evaluation of functional outcome after osteosynthesis of intra articular distal humerus fracture with pre contoured locking compression plates

2020 ◽  
Vol 6 (6) ◽  
pp. 1215
Author(s):  
Faisal S. Mohammed ◽  
Akshay B. Ingale
Keyword(s):  
Functional Outcome ◽  
Distal Humerus ◽  
Distal Humerus Fracture ◽  
Performance Score ◽  
Mayo Elbow Performance Score ◽  
Locking Compression Plates ◽  
Humerus Fractures ◽  
Distal Humerus Fractures ◽  
Extensor Lag

<p><strong>Background:</strong> Intra articular distal humerus fractures are challenging and cumbersome to treat. Therefore osteosynthesis of such fractures is required. The aim of our study was to evaluate the functional outcome of intra articular distal humerus fractures AO type  13C by osteosynthesis using olecranon osteotomy with pre contoured locking compression plates in orthogonal plate configuration.</p><p><strong>Methods:</strong> Thirty patients were included in our study comprising of 18 males and 12 females. Mean age was 39.63 years with mean follow up of 34 weeks. 7 were AO type 13C1, 9 were AO type 13C2 and 14 were AO type 13C3. Osteosynthesis was done for all fractures by olecranon osteotomy approach. Functional outcome was assessed using mayo elbow performance score.</p><p><strong>Results:</strong> Mean flexion attained at the end of follow up was 127.56 degrees with mean extensor lag of 7.16 degrees. Mean arc of motion was 120.4 degrees. Mean mayo elbow performance score at the end of follow up was 80.36. Mayo elbow performance score in patients aged less than 40 years of age was not statistically significant as compared to patients more than 40 years of age. Functional outcome was also dependent on fracture subtype.</p><p><strong>Conclusions:</strong> Osteosynthesis of distal humerus fractures AO type 13C using pre contoured locking compression plates in orthogonal plate configuration by olecranon osteotomy provides excellent visualization of fracture and better functional outcome.</p>

scholarly journals Displaced Colles fractures: Functional outcome following closed reduction and stabilization with percutaneous K-wires

2013 ◽  
Vol 2 (1) ◽  
pp. 14-20 ◽  
Author(s):  
RR Manandhar ◽  
S Lakhey ◽  
BK Pandey ◽  
RL Pradhan ◽  
S Sharma ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Invasive Technique ◽  
Percutaneous Pinning ◽  
Fracture Stabilization ◽  
Excellent Functional Outcome ◽  
Post Traumatic ◽  
K Wires ◽  
A Prospective Study ◽  
Traumatic Arthritis

Background: Displaced Colles fractures are generally treated by manipulation and below elbow cast application. Malunion is a common complication resulting in pain, mid carpal instability and post-traumatic arthritis. Fracture stabilization by percutaneous pinning is a simple, minimally invasive technique which helps prevent dislodgment of the fracture thereby minimizing complications. The study aims to assess the amount of collapse after closed manipulation and percutaneous pinning with K-wires and its correlation with the functional outcome of the wrist after union. Methods: A prospective study was conducted from October 2006 to November 2009. Fifty adults (27 female, 23 male) with an average age of 40.72 years with type II fractures underwent closed manipulation and percutaneous pinning with crossed K-wires as the primary procedure. Serial radiographs were taken to document the amount of collapse. The functional outcome was assessed using Mayo Wrist Score. Results: At the final follow up of 6 months the collapse in the mean dorsal angle was 1.15 and mean ulnar variance 0.51. Functionally 25 patients (53.19%) had excellent, 17 patients (36.17%) good and 5 patients (10.63%) had satisfactory or fair outcome. Conclusions: Displaced Colles fractures should be reduced and stabilized with percutaneous K-wires to achieve an excellent functional outcome. DOI: http://dx.doi.org/10.3126/noaj.v2i1.8135 Nepal Orthopaedic Association Journal Vol.2(1) 2011: 14-20

scholarly journals Prospective randomized controlled trial comparing the functional outcome of olecranon osteotomy versus triceps tongue elevation for surgical exposure of distal humerus in adults

2018 ◽  
Vol 7 (4) ◽  
pp. 134-139
Author(s):  
Asish Rajak ◽  
Rajiv Maharjan ◽  
Bikram Prasad Shrestha ◽  
Pashupati Chaudhary ◽  
Rosan PS Kalawar
Keyword(s):  
Functional Outcome ◽  
Controlled Trial ◽  
Distal Humerus ◽  
Mature Adult ◽  
Demographic Profiles ◽  
Randomized Controlled ◽  
Prospective Randomized Controlled Trial ◽  
Significant Difference ◽  
Randomized Control

Background: Fractures of the distal end of the humerus are difficult to treat. The goal of treatment is to achieve a stable, painless elbow with early adequate range of motion. They are operated mainly by posterior approach among which olecranon osteotomy (bony component violation) and triceps tongue elevation (soft tissue component breach) were used in this study. Objectives: The aim of this study was to compare olecranon osteotomy and triceps tongue elevation in terms of functional outcome (Mayo elbow performance index), rates of complications and others. Methodology: A randomized control trial was conducted including 39 eligible adults (20 in triceps tongue elevation and 19 in olecranon osteotomy group) presenting to B.P. Koirala Institute of Health Sciences during the study period of 12 months duration. All skeletally mature adult patients with isolated traumatic closed intra-articular or distal end fracture of humerus without distal neurovascular deficit were included. Patients with polytrauma, refractures, compartment syndrome and patient not giving consent were excluded from the study. They were operated and followed up at 2, 6, 12 and 24 weeks. Results: The demographic profiles of the two groups were comparable. There was significant difference between the intraoperative time between the two groups (p=0.009). At final follow up, there were no significant differences in functional outcome and complications. Conclusion: The approaches are comparable in terms of union, post-operative function and complications. There was increased intraoperative time in the olecranon osteotomy approach suggesting that patients who cannot tolerate longer intraoperative time may benefit from triceps tongue elevation approach. 

scholarly journals The functional outcome of local infiltration of a periarticular cocktail of analgesics on post-operative pain in patients undergoing total knee arthroplasty

2021 ◽  
Vol 12 (1) ◽  
pp. 567-570
Author(s):  
Pradeep P ◽  
Thiyagarajan U ◽  
Senthil Loganathan ◽  
Raghavendar B
Keyword(s):  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Pain Score ◽  
Knee Arthroplasty ◽  
Local Infiltration ◽  
Post Operative Pain ◽  
Walking Capacity ◽  
Total Knee ◽  
A Prospective Study

Total knee arthroplasty is becoming a more frequently performed orthopedics surgery these days aimed mainly to improve the functional outcome and correct deformity in patients suffering from arthritis of the knee joint. To evaluate the results, we conducted a prospective study from March 2017 to December 2019. The pain was evaluated every 4th hourly during the first 24 hours and thereon every 6th hourly till 5th POD. The 2MWT was administered during the 2nd POD and 6MWT was administered during the 6 weeks follow up to check for the muscle endurance when walking. In our study, we had 22 patients who were between 55-60 years, 21 patients between 61-70 years and 17 patients between 71-80 years. Based on analysis of our results, the mean VAS pain score was 4 on POD 0 and VAS pain score was 3 on Post-operative day 1 and 2. The 2 MWT administered on the 2nd POD showed that 35 patients (58.3%) were able to walk 30 meters. The rest of the 25 patients (42%) were not able to do the 2MWT due to various reasons like pain (15) and dizziness (10). The 6MWT administered at 6 weeks showed that all the patients were able to walk an average of 480 meters. Periarticular cocktail of analgesics used in Total knee arthroplasty was associated with a favorable improvement in walking capacity, pain management in the immediate post-operative period and improved knee function. Periarticular administration of a cocktail of analgesics helped to improve the patient's ambulatory status.

scholarly journals Evaluation of functional outcome following ORIF of bimalleolar fractures of the ankle-A prospective study of 30 patients

2020 ◽  
Vol 11 (4) ◽  
pp. 6051-6055
Author(s):  
Yeshwanth subash ◽  
Vishnu S ◽  
Damodharan
Keyword(s):  
Functional Outcome ◽  
Functional Outcomes ◽  
Surgical Intervention ◽  
Early Mobilization ◽  
Foot And Ankle ◽  
The Mean ◽  
American Orthopaedic ◽  
A Prospective Study ◽  
Mean Time

Bimalleolar fractures are common injuries, and stable fracture patterns can be treated conservatively, while complicated, unstable fractures would require surgical intervention. This study aimed to evaluate the functional outcome following ORIF (Open reduction and internal fixation) of these fractures. This was a study of 30 patients with bimalleolar fractures who presented between January 2013 to January 2016 treated with ORIF with a follow-up period of 3 years. Functional outcome was performed with the AOFAS (American Orthopaedic Foot and ankle society) score. The mean age of the patients was 41.6 years. There was a female preponderance seen in our study with the left side being more commonly affected. The mean time to fracture union was 12.13 weeks, and we had excellent outcomes in 18 patients, good in 10, while two patients had a fair result. We did not lose any of our patients to follow up. All of our patients were happy with the functional outcome achieved. No significant complications were seen in our study. ORIF in bimalleolar fractures enables restoration of the ankle mortise to an anatomical position and facilitates early mobilization of the ankle resulting in good functional outcomes.

A PROSPECTIVE FOLLOW UP STUDY OF FUNCTIONAL OUTCOME OF SUPRACONDYLAR HUMERUS FRACTURE WITH INTERCONDYLAR EXTENSION TREATED WITH OLECRANON OSTEOTOMY APPROACH

2021 ◽  
pp. 76-79
Author(s):  
Pradeep Choudhary ◽  
Mahesh Bhati ◽  
Ramniwas Bishnoi ◽  
Aditya Srimal ◽  
Jayesh Chouhan
Keyword(s):  
Functional Outcome ◽  
Distal Humerus ◽  
Humerus Fracture ◽  
Distal Humerus Fracture ◽  
Range Of Movement ◽  
Mayo Elbow Performance Score ◽  
Humerus Fractures ◽  
Distal Humerus Fractures ◽  
Frequent Presence

Introduction- Olecranon osteotomy is standard approach for low transcondylar and intercondylar distal humerus fractures. Distal humerus fractures are difcult to manage successfully because of the local anatomic constraints, the frequent presence of comminution,displacement and osteopenia. We studied the functional outcome and complications following surgical xation using this approach. Material And Methods- A total 20 consecutive patients(male:15,female:5),having mean age 42.1yrs, of Distal Humerus fractures who will attend the casualty or O.P.D during the thesis period(June2018 to October2020) at Mahatma Gandhi Hospital & Mathuradas Mathur Hospital Jodhpur (Rajasthan) will be included in study group and managed surgically using olecranon osteotomy approach. Functional outcome was evaluated using the Mayo Elbow Performance Score(MEPS) and complications were observed. Results- Mean loss of extension was 10°.Mean exion achieved was 122.75°.Mean range of movement at treated elbow was 113°. All fractures united by the end of 3 months. Final results were excellent in 8 cases; good in 7 cases; fair in 4 and poor in one case. Most common complication in our study was discomfort due to hardware(6 cases). Supercial infection occurred in 2 cases. Screw/wire backout occurred in 2 cases. Elbow stiffness and malunion happened in one case. Functional outcome was also dependant on fracture subtype. Conclusion- Intraarticular distal humerus fracture treated with olecranon osteotomy approach had good articular exposure and surgical xation. This approach had good functional outcome and fewer complications.

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