Study of the Various Factors Involved in Monteggia Fractures Treated by Open Reduction and Internal Fixation in Government Medical College, Trichur

2021 ◽  
Vol 8 (39) ◽  
pp. 3406-3410
Author(s):  
Rohit Ashok Ranjolker ◽  
Krishnakumar Cherungottil i Viswanathanunn

BACKGROUND The various factors involved in Monteggia fractures treated by open reduction and internal fixation (ORIF) were studied in patients presenting to Government Medical College, Trichur. Its distribution based on age, gender, and nature of trauma, were observed in the patients. METHODS This study was a prospective descriptive study, conducted in Department of Orthopaedics, Medical College, Thrissur from 1, January, 2016 to 1, July, 2017. Patients were assessed according to age, sex, side of injury, co-morbidities and final functional assessment was made according to Broberg and Morrey score. A total of 37 patients were observed. The patients were assessed, deemed fit for the study, and subjected to operation. Radial head reduction, fixation if needed, then ulna fracture was opened, reduced, and fixed with plate and screws. Postoperative plaster slab was applied, then converted to full above elbow cast, and retained for as long as needed. Post-operative mobilization was by home physiotherapy only. RESULTS Our study showed that open reduction and internal fixation of ulna outcome in Monteggia fractures leads to good elbow function and minimal loss of physical capacity. Immobilization of more than 2 months have very high chances of elbow stiffness. Early active mobilization after surgery is necessary for good functional outcome. Other than mild stiffness and loss of range of motion in some cases, very few other complications were found in our series. CONCLUSIONS Rigid internal fixation of ulna and early active mobilization is the key to achieve a good functional outcome and minimal loss of physical capacity in Monteggia fractures. Very few of the complications that were described in the literature were seen in the study. Even with restricted resources and minimal facilities, almost no permanent or debilitating morbidity or complications were seen in our series. Early active mobilization after surgery was the most important deciding factor for good functional outcome. Prolonged immobilization of more than one month consistently produces poor results. KEYWORDS Monteggia, Broberg and Morrey, Bado Classification, Internal Fixation, Ulna Fracture

Author(s):  
Amit Jain ◽  
R. C. Meena ◽  
Laxman Choudhary ◽  
Jitesh Jain ◽  
Abhishek Chandra ◽  
...  

<p class="abstract"><strong>Background:</strong> Fracture of calcaneum accounts for about 2% of all fractures and 75% of all calcaneum fractures are intra-articular. Numerous controversies existed regarding optimal treatment of displaced intraarticular calcaneum fractures. In this study evaluate post-operative functional outcome and complication of fracture calcaneum treated with locking calcaneum plate.</p><p class="abstract"><strong>Methods:</strong> This hospital based prospective descriptive study was conducted on 108 patients (120 calcaneum fracture) operated between July 2016 to December 2018 by open reduction and internal fixation with locking calcaneum plate through extensive lateral approach at Department of Orthopaedics, SMS Medical college and hospital, Jaipur. All close displaced intraarticular calcaneal fracture was included in the study.<strong></strong></p><p class="abstract"><strong>Results:</strong> Average duration between injury and surgery was 8.3±2.97 days. Out of 120 calcaneum fracture 52 fractures (43.33%) were Sander’s type II, 52 fractures (43.33%) were Sander’s type III, and 16 fractures (13.33%) were Sander’s type IV. Pain on weight bearing was noted in 20 patients (16.66%) implant prominence was noted in 8 patients and delayed wound healing was seen in 4 patients. Maryland foot score was excellent in 44 fracture (36.67%), good in 56 fractures (46.67%), fair in 8 fractures (6.67%), and poor in 12 fractures (10%).</p><p class="abstract"><strong>Conclusions:</strong> Open reduction and internal fixation (ORIF) with locking calcaneum plate in an indicated case, with respect to soft tissue envelope and early rehabilitation, leads to better therapeutic results as compared to other operative technique.</p>


Author(s):  
Pavankumar H. Patil ◽  
Srinivas Pamarathi

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Recognition of fracture patterns and fixation of fracture to secure and maintain reduction is the key for successful management of more complex intra articular fractures of distal radius. Devices like buttress plates have been shown to provide excellent stability for an unstable fracture with either dorsal or volar metaphyseal comminution. The objective of the study was to evaluate the functional outcome of intra articular fracture of distal end of radius treated by open reduction and internal fixation by buttress plate using Criteria of Gartland and Werley Point System.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Twenty patients with intra articular fracture of distal end radius were treated by open reduction and internal fixation by buttress plate in Al-Ameen medical college, Bijapur. </span><span lang="EN-IN">Statistical analysis: The data obtained was represented as percentage</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The study included 20 patients, 11 males and 9 females aged from 21 to 69 years with mean of 40.2 years. The average duration of follow-up was 7 months ranged from 6-10 months. Using the Demerit scoring system of Gartland and Werley, we had 20% excellent results, 45% good results, 20% fair results and 15% poor result whereas, excellent to good results were found in 65% of patients. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Open reduction and internal fixation by buttress plate provides better functional outcome in treating the intra articualar fracture of distal end radius. Excellent to good results are produced by using buttress plate for fixation of intra articular fractures of distal end radius. So, this procedure can be used as alternative to other procedures in treating intra articular fractures of distal end radius.</span></p>


Author(s):  
Venkata Kiran Pillella ◽  
J. Lionel John

The current study is a prospective study on the functional outcome of open reduction and internal fixation of acetabular fractures. About 30 patients were analyzed for the functional outcome of acetabular fractures treated by open reduction and internal fixation over a period of one year and eight months from March 2017 to October 2018 with a minimum follow up period of 9 months at Sree Balaji Medical College & Hospital, Chromepet, Chennai. The mean age of the patient was 37.96 year ranging from 20 - 60 years. The Joel Matta score was used for calculation of radiological outcome of 30 patients. The results were excellent in 19 (66.3%), good in 8 (26.6%), fair in 3 (10%), and poor in 0 (0%) patients. Functional outcome of displaced acetabular fractures more than 2 mm displacement was found to have excellent results on open reduction and internal fixation.


2003 ◽  
Vol 17 (8) ◽  
pp. 555-562 ◽  
Author(s):  
Sevki Kabak ◽  
Mehmet Halici ◽  
Mehmet Tuncel ◽  
Levent Avsarogullar ◽  
Ali Baktir ◽  
...  

2021 ◽  
Vol 10 (4) ◽  
pp. 3266-3269
Author(s):  
Abhishek Patil

Proximal humerus fractures account for about 4% to 5% of all fractures. Following distal forearm fracture, proximal humeral fracture is the second most common upper extremity fracture. Kirschner (K)-Wires, external fixation, tension band wiring, and rush pins, intramedullary nails, ORIF with plates, and shoulder hemiarthroplasty have all been offered as therapeutic options. The purpose of this study was to assess the functional outcome and complication rates following internal fixation of proximal humerus fractures using a locking compression plate. Patients over the age of 18 with closed proximal humerus fractures or open proximal humerus fractures (Gustilo and Anderson type I, Type II) received open reduction and internal fixation with locking compression plate in the current study. The participants in this study were 60 people who had a proximal humerus fracture and were treated with open reduction and a proximal humerus locking compression plate. Patients ranged in age from 20 to 85 years old, with a mean age of 51.14 +/- 17.30 years. The age group 36–55 years (37 percent) was the most prevalent, followed by 56–75 years (30 %). The majority of patients (76.7 %) were men who had been in automobile accidents on the right side (83 %) (63 %). According to the Neer classification, the most prevalent type of fracture was a three-part fracture (53 %). The maximum union time observed in this study was 16 weeks, with a minimum of 10 weeks. The average time to union is 12.52 +/- 1.14 weeks. The mean flexion at the end of six months was 121.660 +/- 19.84. The mean internal rotation was 57.330 +/- 8.48, the mean external rotation was 530 +/- 11.98, and the mean abduction was 1180 +/- 19.36. 75.28 +/- 9.66 [Mean +/- SD] is the Mean Constant score. Pain 14.10, ADL 18.26, range of motion 22.46, and power 20 were the mean scores observed on Constant Score for its various aspects. According to the Constant score, the functional outcome of the 60 patients was as follows: 8 patients had excellent outcomes (13%), 34 patients had good outcomes (56.7%), 16 patients had moderate outcomes (26.7%), and two patients had poor outcomes (26.7%) and (3 %). Internal fixation of proximal humerus fractures with a locking compression plate results in anatomical reduction and secure fixation, resulting in a favorable functional outcome.


Author(s):  
Siddaram Patil ◽  
Girish P. B.

<p class="abstract"><strong>Background:</strong> A great deal of work has been directed toward using these symptoms to classify the severity of head injury. Loss of consciousness or coma and posttraumatic amnesia (difficulty in remembering new information after waking up from the coma) are the two most common symptoms used. A mild head injury is one in which the period of unconsciousness is less than twenty minutes and post traumatic amnesia lasts for less than one hour, while a head injury in which the person is unconscious for at least one day and experiences post traumatic amnesia for more than twenty four hours is considered severe<span lang="EN-IN">. </span></p><p class="abstract"><strong>Methods:</strong> 50 Cases coming to O.P.D and casualty of Chigateri general hospital and Bapuji hospital attached to JJM Medical College, Davangere were studied<span lang="EN-IN">.  </span></p><p class="abstract"><strong>Results:</strong> Evidence of C.S.F rhinorrhoea was noticed in 1(2%) case which managed conservatively. Maxillary fracture was noticed in 05 (10%) cases which were managed conservatively. Zygomatic fractures were noticed in 07 (14%) cases which were managed by open reduction and internal fixation with mini plates under general anesthesia<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> Mandibular fractures were noticed in 10 (20%) of cases which were managed by open reduction and internal fixation with mini plates under general anesthesia<span lang="EN-IN">.</span></p>


2018 ◽  
Vol 1 (1) ◽  
pp. 1-3
Author(s):  
Bhogendra Bahadur KC ◽  
Norman Lamichhane ◽  
Chandra Bahadur Mishra ◽  
Bharat Bahadur Khatri ◽  
Sabita Dhakal

Background: Supracondylar fracture of the distal humerus is one of the commonest fracture in pediatric age group. Though there is consensus of treating type III fracture operatively, no study has compared the outcome between Closed Reduction and Percutaneous Pinning (CRPP) and Open Reduction and Internal Fixation (ORIF) with k-wire in our setup. Materials and Methods: Retrospective comparison study was done on eighty seven cases of Type III supracondylar fracture of distal humerus underwent operative procedure. Fifty four (54) cases underwent CRPP and 33 cases were managed with ORIF with k-wire, and they were followed up till 6 months post-operatively. Results : The mean time for radiological union in patient who underwent CRPP was 4.37±0.94 weeks and that for the patient who underwent ORIF was 4.45±0.13 weeks, the difference of which was statistically insignificant (p-value >0.05). 83.3% of CRPP group and 78.8% in ORIF group had excellent functional outcome and only 3% in ORIF group had poor functional outcome. Conclusion: Though both the group don’t have significant advantage of functional outcome among each other CRPP with limited attempt should be preferred to ORIF with k-wire for the advantage of avoiding surgical scar and reducing surgery time and exposure to anaesthetic agents.


2016 ◽  
Vol 10 (6) ◽  
pp. 509-512
Author(s):  
Rajeev Shukla ◽  
Ravi Kant Jain ◽  
Shravan Patidar ◽  
Nikhil Jain ◽  
Pranav Mahajan

Introduction. Ankle fracture is the most common intra-articular fracture of a weight-bearing joint and accounts for 9% of all fractures. Ankle fractures are classified into 3 subgroups: unimalleolar, bimalleolar, and trimalleolar fractures. Accurate reduction and stable internal fixation is necessary in bimalleolar fractures; otherwise, it may lead to posttraumatic painful restriction of movements or osteoarthritis. The purpose of this study is to assess the functional outcome and results of treatment of neglected bimalleolar fracture. Materials and Methods. Seventeen neglected bimalleolar fracture patients were treated with open reduction and internal fixation. Patients were followed-up at 1, 2, and 5 years and functional ability was assessed by using the modified Weber Rating Scale. Results. The mean age of patients was 41.4 ± 13.28 years. After 2 year of surgery, 13 out of 17 patients showed excellent results and 4 patients had fair results. Conclusion. Good to excellent functional results were observed after long-term follow-up in neglected bimalleolar fracture treated with open reduction and internal fixation, and we advise surgical intervention in all such patients. Levels of Evidence: Therapeutic, Level III: Retrospective Cohort study


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