scholarly journals Sciatic-obturator-femoral technique versus spinal anesthesia in patients undergoing surgery for fixation of open tibial fractures using Ilizarov external fixator: A randomized trial

2019 ◽  
Author(s):  
Hoda Shokri ◽  
Amr Kasem
Keyword(s):  
Back Pain ◽  
Adverse Events ◽  
Nerve Block ◽  
Spinal Anaesthesia ◽  
External Fixator ◽  
Tibial Fractures ◽  
Ilizarov External Fixator ◽  
Open Tibial Fractures ◽  
Significant Difference ◽  
Analgesic Dose

Abstract Background Peripheral nerve block is an ideal choice for lower limb surgery because of the peripheral site of the surgical procedure and the ability to block pain pathways at multiple levels. The aim of this study was to assess the efficacy and safety of SOFT block (sciatic-obturator-femoral nerve block technique) compared with spinal anaesthesia in patients undergoing surgery for fixation of open tibial fractures using Ilizarov external fixatorMethods This study was conducted over 107 patients ASA I, II scheduled for fixation of open tibial fractures using Ilizarov external fixator. The patients were randomly allocated to receive either spinal anaesthesia or SOFT block. In spinal anaesthesia group, patients received spinal anaesthesia with hyperbaric bupivacaine 0.5% (7.5-10mg). In SOFT group, patients received SOFT block with bupivacaine 0.25%. Primary endpoint included the duration of analgesia. The secondary endpoints included patient satisfaction scores, time of first analgesic dose, visual analogue scale scores, incidence of adverse events as back pain, postural -puncture headache, vomiting, systemic toxicity from local anesthetic, parathesia observed within 48 hours of the block.Results The duration of soft block and time to first analgesic dose in SOFT group was significantly longer (p<0.001). The incidence of headache (p=0.028) and back pain (p=0.012) was significantly higher in spinal group. There was no significant difference between the study groups regarding satisfaction scores, the incidence of cardiovascular collapse, seizures and parathesia. Pain scores were significantly lower in SOFT group at 3,6,12 hours postoperative (p<0.001).Conclusion SOFT block is a feasible technique for control of postoperative pain with unremarkable adverse events compared with spinal anaesthesia, in patients undergoing fixation of tibial fractures using Ilizarov external fixator.

scholarly journals Sciatic obturator femoral technique versus spinal anesthesia in patients undergoing surgery for fixation of open tibial fractures using Ilizarov external fixator: A randomised trial

2019 ◽  
Author(s):  
Hoda Shokri ◽  
Amr Kasem
Keyword(s):  
Adverse Events ◽  
Nerve Block ◽  
Spinal Anaesthesia ◽  
External Fixator ◽  
Randomised Trial ◽  
Tibial Fractures ◽  
Ilizarov External Fixator ◽  
Open Tibial Fractures ◽  
Significant Difference ◽  
Analgesic Dose

Abstract Background Peripheral nerve block is an ideal choice for lower limb surgery because of the peripheral site of the surgical procedure and the ability to block pain pathways at multiple levels. The aim of this study was to assess the efficacy and safety of SOFT (sciatic-obturator-femoral nerve block technique) compared with spinal anaesthesia in patients undergoing surgery for fixation of open tibial fractures using Ilizarov external fixatorMethods This study was conducted over 107 patients ASA I, II scheduled for fixation of open tibial fractures using Ilizarov external fixator. The patients were randomly allocated to receive either spinal anaesthesia or SOFT block. In spinal anaesthesia group, patients received spinal anaesthesia with hyperbaric bupivacaine 0.5% (7.5-10mg). In SOFT group, patients received SOFT block with bupivacaine 0.25%. Primary endpoint included the duration of analgesia. The secondary endpoints included patient satisfaction scores, time of first analgesic dose, visual analogue scale scores, incidence of adverse events as vomiting, systemic toxicity from local anaesthetic, paresthesia observed within 48 hours of the block.Results The duration of soft block and time to first analgesic dose in SOFT group was significantly longer (p<0.001). The incidence of headache (p=0.028) and back pain (p=0.012) was significantly higher in spinal group. There was no significant difference between the study groups regarding satisfaction scores, the incidence of cardiovascular collapse, seizures and parathesia. Pain scores were significantly lower in SOFT group at 3,6,12 hours postoperative (p<0.001).Time to the first effect was significantly longer in SOFT (P<0.001).Conclusion Our results showed that SOFT is a feasible technique of local anaesthesia for control of postoperative pain with unremarkable adverse events compared with spinal anaesthesia, in patients undergoing elective fixation of tibial fractures using Ilizarov external fixator.

scholarly journals Sciatic obturator femoral technique versus spinal anaesthesia in patients undergoing surgery for fixation of open tibial fractures using Ilizarov external fixator. A randomised trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hoda Shokri ◽  
Amr A. Kasem
Keyword(s):  
Adverse Events ◽  
Spinal Anaesthesia ◽  
External Fixator ◽  
Randomised Trial ◽  
Study Groups ◽  
Tibial Fractures ◽  
Hyperbaric Bupivacaine ◽  
Ilizarov External Fixator ◽  
Open Tibial Fractures ◽  
Significant Difference

Abstract Background Peripheral nerve block is preferable for lower extremity surgery because it sufficiently blocks pain pathways at different levels providing excellent anaesthesia at the site of surgery. We designed this study to compare the efficacy and safety of SOFT block (sciatic-obturator-femoral technique) compared with spinal anaesthesia in patients undergoing surgery for fixation of open tibial fractures using Ilizarov external fixator. Methods One hundred and seven patients ASA I, II scheduled for fixation of open tibial fractures using Ilizarov external fixator. The patients were randomly allocated to receive either spinal anaesthesia or SOFT block. In spinal anaesthesia group, patients received spinal anaesthesia with hyperbaric bupivacaine 0.5% (7. 5-10mg). In SOFT group, patients received SOFT block with bupivacaine 0.25%. Primary endpoint included the duration of analgesia. The secondary endpoints included patient satisfaction scores, visual analogue scores, incidence of adverse events as vomiting, systemic toxicity from local anaesthetic drug and time to first effect of the techniques. Results The duration of SOFT block and time to first analgesic dose in SOFT group was significantly longer (p < 0.001). There was no significant difference between the study groups regarding satisfaction scores, the incidence of cardiovascular collapse, seizures and paraesthesia. Pain scores were significantly lower in SOFT group at 3,6,12 h postoperative (p < 0.001). The time to the first effect was significantly longer in SOFT group (p < 0.001). Conclusion SOFT is a feasible technique of local anaesthesia for control of postoperative pain with unremarkable adverse events compared with spinal anaesthesia, in patients undergoing fixation of tibial fractures using Ilizarov external fixator. Trial registration This trial was retrospectively registered at ClinicalTrials.gov. registry number: NCT03450798 on February 20, 2018.

scholarly journals Sciatic obturator femoral technique versus spinal anaesthesia in patients undergoing surgery for fixation of open tibial fractures using Ilizarov external fixator. A randomised trial

2019 ◽  
Author(s):  
Hoda Shokri ◽  
Amr Kasem
Keyword(s):  
Adverse Events ◽  
Spinal Anaesthesia ◽  
External Fixator ◽  
Randomised Trial ◽  
Study Groups ◽  
Tibial Fractures ◽  
Hyperbaric Bupivacaine ◽  
Ilizarov External Fixator ◽  
Open Tibial Fractures ◽  
Significant Difference

Abstract Background Peripheral nerve block is preferable for lower extremity surgery because it sufficiently blocks pain pathways at different levels providing excellent anaesthesia at the site of surgery. We designed this study to compare the efficacy and safety of SOFT block (sciatic-obturator-femoral technique) compared with spinal anaesthesia in patients undergoing surgery for fixation of open tibial fractures using Ilizarov external fixator Methods One hundred and seven patients ASA I, II scheduled for fixation of open tibial fractures using Ilizarov external fixator. The patients were randomly allocated to receive either spinal anaesthesia or SOFT block. In spinal anaesthesia group, patients received spinal anaesthesia with hyperbaric bupivacaine 0.5% (7.5-10mg). In SOFT group, patients received SOFT block with bupivacaine 0.25%. Primary endpoint included the duration of analgesia. The secondary endpointsincluded patient satisfaction scores, visual analogue scores, incidence of adverse events as vomiting, systemic toxicity from local anaesthetic drug and time to first effect of the techniques. Results The duration of SOFT block and time to first analgesic dose in SOFT group was significantly longer (p<0.001). There was no significant difference between the study groups regarding satisfaction scores, the incidence of cardiovascular collapse, seizures and paraesthesia. Pain scores were significantly lower in SOFT group at 3,6,12 hours postoperative (p<0.001). The time to the first effect was significantly longer in SOFT group (p<0.001). Conclusion: SOFT is a feasible technique of local anaesthesia for control of postoperative pain with unremarkable adverse events compared with spinal anaesthesia, in patients undergoing fixation of tibial fractures using Ilizarov external fixator.

scholarly journals Operative Choice for Open Tibial Shaft Fracture in Children: A Comparative Study of External Fixator Vs. Elastic Stable Intramedullary Nail

2021 ◽  
Author(s):  
Pan Hong ◽  
Saroj Rai ◽  
Xin Tang ◽  
Ruikang Liu ◽  
Jin Li
Keyword(s):  
Clinical Outcomes ◽  
External Fixator ◽  
Intramedullary Nail ◽  
Shaft Fracture ◽  
Tibial Fractures ◽  
Tibial Shaft Fracture ◽  
Tibial Shaft ◽  
Elastic Stable Intramedullary Nail ◽  
Open Tibial Fractures ◽  
Significant Difference

Abstract IntroductionExternal fixator (EF) is a preferred choice for open tibial fractures, but pin tract infection (PTI) and refracture are common complications. Elastic stable intramedullary nail (ESIN) has been reported in the treatment for open tibial fractures. This study aims to compare the clinical outcomes of EF vs. ESIN in the treatment for open tibial shaft fracture in children retrospectively.Material and methodsPatients aged 5-11 years old with Gustilo-Anderson II and IIIA tibial shaft fracture treated at our institute from January 2008 to January 2018 were reviewed retrospectively and categorized into EF (n = 55) and ESIN (n = 37) group. Patients with pathological fracture, neuromuscular disorder, metabolic disease, previous tibial fracture or instrumentation, and polytrauma were excluded. Patients with follow up less than 24 months or incomplete medical records were also excluded. ResultsIn all, fifty-five patients (33 males, 22 females) were included in the EF group, whereas 37 patients (21 males, 16 females) were included in the ESIN group. There was no significant difference between the two groups concerning sex, age, body weight, duration from injury to surgery, Gustilo-Anderson (GA) classification, and concomitant injuries. There was no patient of nonunion and malunion in either group. The incidence of implant prominence was higher in the ESIN group (16%) than those in the EF group (0), P < 0.001. The angulation was higher in the EF group than ESIN group in coronal and sagittal plane, P < 0.001. The radiological union was faster in the ESIN group (7.0 ± 0.9, weeks) than those in the EF group (9.0 ± 2.2), P < 0.001. Limb length discrepancy (LLD) was significantly longer in the EF group (12.1 ± 4.4, mm) than those in the ESIN group (7.3 ± 4.3, mm), P < 0.001. ConclusionESIN is a viable option in selected patients of GA grade II and IIIA open tibial fractures with comparable clinical outcomes as external fixator, but with less complications including superficial infection, residual angulation and refracture after hardware removal.

scholarly journals Treatment of Open Tibial Fractures with Ilizarov External Fixator

2004 ◽  
Vol 53 (3) ◽  
pp. 664-668
Author(s):  
Takashi Miyamoto ◽  
Noboru Yamamoto ◽  
Yoshifumi Nagatani ◽  
Kenji Miyahara ◽  
Yoshiaki Makino
Keyword(s):  
External Fixator ◽  
Tibial Fractures ◽  
Ilizarov External Fixator ◽  
Open Tibial Fractures

Management of 30 infected nonunited tibial fractures by Ilizarov external fixator with acute shortening distraction technique with consideration of the causative organism

2017 ◽  
Vol 28 (4) ◽  
pp. 416-423
Author(s):  
Ahmed Samir Barakat ◽  
Ahmed Elguindy ◽  
Mohamed Elazab ◽  
Mohamed Hegazy ◽  
Kamal M.S. Abdel-Meguid ◽  
...  
Keyword(s):  
External Fixator ◽  
Tibial Fractures ◽  
Causative Organism ◽  
Ilizarov External Fixator ◽  
Acute Shortening

scholarly journals A COMPARATIVE STUDY OF IN VIVO EFFECT OF PERCUTANEOUS BONE MARROW INJECTION VS WITHOUT INJECTION ON UNION OF OPEN TIBIAL SHAFT FRACTURES WITH EXTERNAL FIXATOR

2020 ◽  
pp. 1-2
Author(s):  
Hrishikesh Desai ◽  
Kirtiraj G ◽  
Abhay P
Keyword(s):  
Bone Marrow ◽  
External Fixator ◽  
Autologous Bone Marrow ◽  
Tibial Fractures ◽  
External Fixators ◽  
Open Tibial Fractures ◽  
Autologous Bone ◽  
Group 2 ◽  
Radiological Union

Background : Open tibial fractures are notorious fractures because the open wound leaves us with limited options and means multiple operations with long intervals for the patient. The usual method of treatment of contaminated, late presenting and complicated fractures is a temporary external fixator followed by conversion into a costly definitive procedure once the wound has healed. The secondary definitive procedure also means extra cost in an already economically stressed patient.In our set up we have to often let patients leave with a plaster cast after removing the external fixator for economic constrains. Per cetaceous autologous bone marrow injection while the patient is on external fixator is one alternative that we have tried to deal with this problem hoping for a primary union without any costly intervention. Materials and methods : We had 42 cases of open tibial fractures which were treated with external fixator and per cutaneous bone marrow injection while 38 other cases which were used as control with only the external fixator and no injections. We included open fractures of only Gustilo Anderson type II,IIIA and B for our study. Study was conducted between period of June 2012 and December 2013 at SBKS medical college . Results : In group one, 34 of the 42 patients had a radiological union before 12 weeks while another 2 in 16 weeks. For group 2 , only 16 of the 38patients had radiological union at 12 weeks and no more at 16 weeks. The average time of union for group 1 was 10 weeks while of group 2 was 12 weeks .Function of the union cases of both the groups was similar in all aspects including distance of walking and ability to carry out daily activities. Conclusion : Per cutaneous autologous bone marrow injections are cheap , easily available and successful alternative to a secondary procedure for open tibial fractures on external fixators.

Management of segmental tibial fractures by an Ilizarov external fixator

2016 ◽  
Vol 29 (3) ◽  
pp. 680
Author(s):  
Ahmad Samy ◽  
Taher Abdelsatar ◽  
Mohammad Elsawy ◽  
Ahmad Zayda
Keyword(s):  
External Fixator ◽  
Tibial Fractures ◽  
Ilizarov External Fixator
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