scholarly journals A retrospective comparative study of open reduction and cannulated screw fixation and Kirschner wire fixation in the treatment of fracture of lateral condyle of humerus in children

2021 ◽  
Author(s):  
XIANYONG LUO ◽  
XINRANG CHEN ◽  
JIAXIANG WANG
Keyword(s):  
Internal Fixation ◽  
Kirschner Wire ◽  
Operation Time ◽  
Distal Humerus ◽  
Fixation Time ◽  
Lateral Condyle ◽  
Surgical Methods ◽  
Group A ◽  
Elbow Function ◽  
Group B

Abstract Objective To evaluate the clinical efficacy of two surgical methods in the treatment of fracture of lateral condyle of humerus in children and the application value of two kinds of internal fixation materials.Methods A total of 32 children with fracture of lateral condyle of humerus were treated in our hospital from June 2015 to June 2018, with an average age of 5.6 years, including 18 males and 14 females. The patients were divided into two groups: group A (n = 12) and group B (n = 20). By comparing the operation time, removal of internal fixation time, Dhillon elbow function evaluation, HHS elbow function score, X-ray measurement of postoperative carrying angle, Baumann angle and distal humerus anteversion angle, the operation-related complications were recorded in detail.Results The operation time was 0.9 ±0.2 hours in group A, 0.8 ±0.2 hours in group B, P > 0.05. The removal internal fixation time was 91 ±8 days in group A, 59 ±10 days in group B (P < 0.05). The Dhillon elbow function score was 8.2 ±0.6 in group A, 8.0 ±0.8 in group B, and 93 ±5 in group A and 89 ±4 in group B (P > 0.05). The carrying angle was 10 °±1 °in group A and 10 °±2 °in group B (P > 0.05). The Baumann angle was 15 °±4 °in group A and 16 °±3 °in group B (P > 0.05). The anteversion of distal humerus was 33 °±3 °in group A and 33 °±4 °in group B (P > 0.05). In the last follow-up, the excellent and good rate of elbow joint function in group A was excellent in 8 cases and good in 4 cases, and the excellent and good rate in group B was 100%. In group B, 13 cases were excellent, 6 cases were good, and 1 case was moderate, with an excellent and good rate of 95%. The postoperative complications were observed in group A, including avascular necrosis of lateral condyle in 1 case, premature closure of epiphysis in 1 case, skin irritation in 5 cases, needle exudation and incision infection in 2 cases, hyperplasia of lateral condyle in 3 cases, and loss of extension and flexion in 1 case.Conclusions There was no significant difference in operation time, elbow function recovery and imaging measurement between the two surgical methods in the treatment of lateral condylar fracture of humerus. Kirschner wire group had a certain advantage over cannulated cancellus screw group in fracture healing and removal of internal fixation. however, the clinical observation screw group has advantages in postoperative nursing and early exercise.

COMPARISION BETWEEN MINIMALLY INVASIVE VERSUS OPEN REDUCTION PLATING IN MID TO DISTAL THIRD HUMERAL SHAFT FRACTURES

2021 ◽  
pp. 69-70
Author(s):  
Ranjeet Kumar ◽  
Shambhu Prasad ◽  
Shailendra Kumar
Keyword(s):  
Minimally Invasive ◽  
Radial Nerve ◽  
Open Reduction ◽  
Operation Time ◽  
Radial Nerve Palsy ◽  
Fracture Union ◽  
Group A ◽  
Elbow Function ◽  
The Mean ◽  
Group B

This study compares the functional outcomes of osteosynthesis of fracture shaft of humerus by minimally invasive plating and open reduction plating technique.25 patients were retrospectively analysed and divided into two groups. Group A(n=13) patients were treated by MIPO and group B (n=12) by conventional plating. The mean operation time in group A was 86.63 minutes and 111.40 minutes in group B. Iatrogenic radial nerve palsy in group Awas 0% (0/13) and 3 in group B 33.33% (4/12). The mean fracture union time in group Awas 15.62 weeks (range 8–24 weeks), and 37.14 weeks (range 10–58 weeks) in group B. The mean UCLAend-result score in group Awas 35.54points (range 33–35), and 31.23 points (range 30–35) in group B. When compared to the conventional plating techniques, MIPO offers advantages in terms of reduced incidence of iatrogenic radial nerve palsies and accelerated fracture union and a similar functional outcome with respect to shoulder and elbow function.

scholarly journals The Improved TBW Versus the Standard TBW for Olecranon Fractures in the Aged: a Retrospectively Comparative Study

2021 ◽  
Author(s):  
Xiaoyong Lin ◽  
Hai Liao
Keyword(s):  
Postoperative Pain ◽  
Soft Tissue ◽  
Internal Fixation ◽  
Intraoperative Blood Loss ◽  
Fracture Union ◽  
Duration Of Surgery ◽  
Group A ◽  
Elbow Function ◽  
Group B ◽  
Olecranon Fractures

Abstract Objectivession: Olecranon fractures of the aged are traditionally managed operatively with Tension Band Wire (TBW). We compared clinical outcomes of treatment of the improved TBW versus the standard TBW for the treatment of the senile Olecranon fractures patients. Methods: A retrospective study was conducted on senile olecranon fractures patients in our hospital from June 2016 to January 2019. After appropriate exclusion, 62 olecranon fractures patients (29 patients in group A of the improved TBW, 33 patients in group B of the standard TBW) were reviewed in this study. All reviewed patients underwent preoperative immobilization and detumescence, open reduction and internal fixation, and postoperative function exercise. Duration of surgery, intraoperative blood loss, times of fluoroscopy intraoperatively, postoperative pain score, fracture union time, soft tissue irritation, failure of fixation and Broberg Morrey score of elbow function were recorded and compared.Results: The duration of surgery, intraoperative blood loss, postoperative pain score, Broberg Morrey score of elbow function had no significant difference between the two groups. The improved TBW (group A) was better than the standard (group B) in terms of the fixation loosening, fracture union time, the skin irritation, and the difference was significant ( all p< 0.05) .Conclusions: On the basis of no additional surgical trauma, the improved TBW was not only benefit for the fracture union, but also benefit for reducing the incidence of internal fixation loosening and soft tissue irritation. This improved internal fixation is not an unattractive option for senile olecranon fractures patients.

Comparison of Outcome of two different Methods for the treatment of Intra-articular fracture of Distal Radius

2021 ◽  
Vol 17 (1) ◽  
pp. 66-70
Author(s):  
Zaigham Habib ◽  
Shuja Uddin ◽  
Riaz Qadeer Niazi ◽  
Muneeb Ur Rehman ◽  
Abdul Qadir ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
Open Reduction ◽  
Controlled Trial ◽  
Kirschner Wire ◽  
Study Groups ◽  
Fixation Method ◽  
P Value ◽  
Group A ◽  
Group B

Objective: It is to compare the radiological and functional outcome of two different fixation methods for displaced intra articular distal radius fracture (DRF): open reduction and internal fixation with anatomical plate and closed reduction with percutaneous K-wires. Methodology: A randomized controlled trial was conducted in Orthopaedics department, Shaikh Zayed Hospital, Lahore for one year; from April 2017 to March, 2018. Total 90 patients were selected in the study by ‘non-probability, consecutive sampling technique’ with 45 patients in each group of the study; Group-A (fixation method: Open reduction with internal fixation with volar plate) and Group-B (Fixation method: Kirschner-wire known as K-wire). Results: The mean age in the group A and group B was 53.7 ± 11.8 years and 55.2 ± 12.3 years respectively. There were 58 male and 32 females in the study. The differences in volar tilt, radial inclination, radial length and modified Mayo score were significantly better in group A than group B (p-value < 0.05). The differences were not significantly different for articular step off in the two study groups (p-value > 0.05). Conclusion: Open reduction with internal fixation using volar locking plates yielded significantly better radiological and functional outcomes than percutaneous fixation using K-wire in the 6 months’ postoperative period.

scholarly journals A comparison between remaining and resecting the posterior longitudinal ligament in percutaneous endoscopic transforaminal discectomy for disc herniation: A retrospective cohort study

2020 ◽  
Author(s):  
Wenhao Hu ◽  
Fanqi Hu ◽  
Chao Liu ◽  
Weibo Liu ◽  
Yi Jiang ◽  
...  
Keyword(s):  
Accurate Determination ◽  
Operation Time ◽  
Posterior Longitudinal Ligament ◽  
Surgical Methods ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Endoscopic Lumbar Discectomy ◽  
Surgical Duration

Abstract Background Nowadays, percutaneous endoscopic lumbar discectomy (PELD) has become a popular surgical option for the management of LDH, On the basis of the approach to the herniation disc materials, PELD could be classified into percutaneous endoscopic transforaminal discectomy (PETD) and percutaneous endoscopic interlaminar discectomy (PEID). During PETD procedure, especially in in-and-out approach, accurate determination of whether the posterior longitudinal ligament is needed resection seems particularly important.In the study, we tried assessing comparative clinical outcome, surgical duration and complications between the two different surgical methods of LDH treated by PETD via inside-and-out approach. Methods A total of 135 symptomatic LDH patients who were treated by PETD resecting the posterior longitudinal ligament (68 patients) or remaining the posterior longitudinal ligament (67 patients) during the surgery were included in the study. Visual analog scale (VAS) score, Oswestry disability index (ODI) and modified MacNab criteria were used to evaluate clinical outcomes. Operation time, blood loss, recurrence of LDH and other complication such as dural tear, nerve injury, intervertebral infection, etc. of these two groups were recorded. Clinical evaluation was performed preoperatively, immediately postoperatively, and at each follow-up visit (1 month, 3 months, and final follow-up). Results There were 38 males and 30 females in the group A that resecting the posterior longitudinal ligament (mean age = 52.40 ± 8.73 years) and 35 males and 32 females in the group B that remaining the posterior longitudinal ligament (mean age = 53.50 ± 9.24 years). The mean operation time of the group A and the group B respectively, were 82.7 ± 18.5 min and 115.6 ± 24.6 min (P < 0.01). The postoperative VAS scores and ODI were significantly higher than those before surgery in two groups (P < 0.01). The differences in the results were not significant between the two groups (P > 0.05). There was no significant difference in the complication rate, the excellent/good ratio and the recurrence rate between the two groups (P > 0.05). Conclusion Whether the posterior longitudinal ligament is resected do not make any difference on curative effect in PETD via inside-and-out approach, and remaining the ligament when it’s intact is preferred because of its shorter operation time.

scholarly journals Infective complications after percutaneous nephrolithotomy in relation to preoperative urine culture status

2019 ◽  
Vol 6 (1) ◽  
pp. 8-13
Author(s):  
Birendra Kumar Yadav ◽  
Robin Bahadur Basnet ◽  
Anil Shrestha ◽  
Parish Mani Shrestha
Keyword(s):  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Urine Culture ◽  
Operation Time ◽  
Group A ◽  
One Year ◽  
Group B ◽  
Stone Characteristics ◽  
Negative Urine Culture ◽  
Infective Complications

Introductions: Fever and sepsis after percutaneous nephrolithotomy (PCNL) secondary to urinary tract infection is a major determinant of overall post PCNL complications. This study aims to analyse infective complications after PCNL in relation to pre-operative urine culture status. Methods: A comparative analysis of post PCNL infective complications in pre-operative urine culture positive (Group A) and negative (Group B) was done for one year during June 2017 to May 2018 in department of urology, Bir Hospital, National Academy of Medical Sciences, Kathmandu, Nepal. Demographics, stone characteristics, mean operative time, post-operative hospital stay and post-operative complications as per Modified Clavien classification were compared between the two groups. Results: Out of total 136 PCNL patients, 51 were in Group A and 85 in Group B. Infective complications were significantly high, 28 (54.90%) in group A compared to 20 (23.53%) in group B, p=0.004. The most common isolate was Escherichia coli 19 (37.25%), sensitive to amikacin 37 (72.55%). The mean operation time, transfusion and hospital stay was not statically different in two groups. Morality occurred in 1 (1.96%) in group A. Conclusions: Infective complications were significantly high after PCNL in patients with preoperative positive urine culture, even when it was treated to sterile with sensitive antibiotics, compared to patients with preoperative negative urine culture.

Laparoscopic versus open partial nephrectomy for the management of highly complex renal tumors with PADUA score ⩾10: A single center analysis.

2021 ◽  
pp. 039156032110016
Author(s):  
Francesco Chiancone ◽  
Marco Fabiano ◽  
Clemente Meccariello ◽  
Maurizio Fedelini ◽  
Francesco Persico ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Operation Time ◽  
Renal Tumors ◽  
Open Partial Nephrectomy ◽  
Estimated Blood Loss ◽  
Significant Difference ◽  
Operative Complications ◽  
Group A ◽  
Group B ◽  
Post Operative Complications

Introduction: The aim of this study was to compare laparoscopic and open partial nephrectomy (PN) for renal tumors of high surgical complexity (PADUA score ⩾10). Methods: We retrospectively evaluated 93 consecutive patients who underwent PN at our department from January 2015 to September 2019. 21 patients underwent open partial nephrectomy (OPN) (Group A) and 72 underwent laparoscopic partial nephrectomy (LPN) (Group B). All OPNs were performed with a retroperitoneal approach, while all LPNs were performed with a transperitoneal approach by a single surgical team. Post-operative complications were classified according to the Clavien-Dindo system. Results: The two groups showed no difference in terms of patients’ demographics as well as tumor characteristics in all variables. Group A was found to be similar to group B in terms of operation time ( p = 0.781), conversion to radical nephrectomy ( p = 0.3485), and positive surgical margins ( p = 0.338) while estimated blood loss ( p = 0.0205), intra-operative ( p = 0.0104), and post-operative ( p = 0.0081) transfusion rates, drainage time ( p = 0.0012), pain score at post-operative day 1 (<0.0001) were significantly lower in Group B. The rate of enucleation and enucleoresection/polar resection was similar ( p = 0.1821) among the groups. Logistic regression analysis indicated that preoperative factors were not independently associated with the surgical approach. There was a statistically significant difference in complication rate (<0.0001) between the two groups even if no significant difference in terms of grade ⩾3 post-operative complications ( p = 0.3382) was detected. Discussion: LPN represents a feasible and safe approach for high complex renal tumors if performed in highly experienced laparoscopic centers. This procedure offers good intraoperative outcomes and a low rate of post-operative complications.

scholarly journals Importance of initial fracture crack width in minimally dislocated fractures of humeral lateral condyle in children for evaluation of fracture stability and treatment choice

2009 ◽  
Vol 137 (3-4) ◽  
pp. 179-184
Author(s):  
Zoran Rakonjac ◽  
Radivoj Brdar
Keyword(s):  
Crack Width ◽  
Lateral Condyle ◽  
Intraarticular Fracture ◽  
Number Of Children ◽  
Fracture Crack ◽  
Choice Of Treatment ◽  
Group A ◽  
Group B ◽  
Fracture Stability ◽  
Selection Of

Introduction. The fracture of the external condyle is the most common fracture of the distal end of the humerus. This is an intraarticular fracture, which, if not properly treated, can cause serious complications, difficult to treat. Objective. To define the importance of the initial width of the fracture crack for the evaluation of stability of the minimally dislocated fractures of the humeral lateral condyle and for the selection of the method of treatment. Methods. The target group included the children with minimally dislocated fractures or fractures of uncertain stability. The number of children was 35. On the grounds of the initial width of the fracture crack, two groups were formed. Group A comprised 25 (71.4%) examinees with the initial width 2-2.9 mm. Group B comprised 10 (28.6%) examinees with the initial width 3-3.9 mm. Measuring was performed on the PA and profile radiographies. A higher value was taken for analysis. The control of fracture crack width was done by systematic radiographies in the following time intervals: the first, third, seventh and the fourteenth day in group A, and the first and third day (1B and 3B) in group B, since the fracture occurrence. Results. The analysis of the results in group A showed the following: the enlargement of dislocation between 1-3 days was significant (p<0.05). Between 3-7 and 7-14 days, there was no significant enlargement of dislocation (p>0.05). Fractures were stable and treated nonsurgically. In group B, the enlargement of dislocation was significant until the third day (p<0.05). These fractures were unstable, there was a great risk for secondary dislocations and they were to be duly fixed. Initial widths of these groups varied significantly (p<0.05). Conclusion. The initial width of the fracture crack is important for the evaluation of the fracture stability, the evaluation of the risk for the creation of secondary dislocations and for the choice of treatment. The upper limit of the fracture crack width which influenced the selection of the method of treatment was 2.5 mm.

scholarly journals Surgery for thoracolumbar junction (T12-L1) tuberculosis a multicentre, retrospective study

2019 ◽  
Author(s):  
Yanping Zeng ◽  
Peng Cheng ◽  
Jiulin Tan ◽  
Zhilin Li ◽  
Yuan Chen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Posterior Approach ◽  
Spinal Tuberculosis ◽  
Surgical Techniques ◽  
Operation Time ◽  
Thoracolumbar Junction ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Approach Group

Abstract Purpose A multicentre, retrospective study was conducted to evaluate the safety and efficacy of different surgical techniques for thoracolumbar junction (T12-L1) tuberculosis. Methods The medical records of thoracolumbar junction tuberculosis patients (n = 257) from January 2005 to January 2015 were collected and reviewed. A total of 45 patients were operated on by an anterior approach (Group A), 52 by a combined anterior and posterior approach (Group B) and 160 by a posterior approach (Group C). Anti-tuberculosis therapy was performed both before and after surgery. Clinical outcomes, laboratory indexes and radiological results of the three groups were compared. Results All three surgical approaches achieved bone fusion, pain relief and neurological recovery. The mean loss of correction in group A at last follow-up was higher than in groups B and C (P < 0.05), and the difference between groups B and C was not significant (P > 0.05). The mean operation time and blood loss in group B were greater than in groups A and C. Conclusions For patients with thoracolumbar junction (T12-L1) tuberculosis, the posterior-only approach is superior to the anterior-only approach in the correction of kyphosis and maintenance of spinal stability. The posterior-only approach is recommended because it achieves the same efficacy as the anterior-only or combined approach but with shorter operation times, less trauma and less blood loss. Keywords Spinal tuberculosis; Thoracolumbar junction; Three approaches.

scholarly journals The Impact of Unilateral or Bilateral Cataract Surgery on Visual Acuity and Life Quality of Elderly Patients

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Lei Zuo ◽  
Haidong Zou ◽  
Xinfeng Fei ◽  
Weiqi Xu ◽  
Jianhong Zhang
Keyword(s):  
Visual Acuity ◽  
Elderly Patients ◽  
Cataract Surgery ◽  
Life Quality ◽  
Weighted Average ◽  
Bilateral Cataract ◽  
Surgical Methods ◽  
Group A ◽  
Group B ◽  
The Impact

In the current study, the CLVQOL was used to assess VRQOL before unilateral or bilateral cataract surgery and at the end of the follow-up period in order to determine the greater beneficial mode of surgery for patients, if one of the two surgical methods is more beneficial over the other. The patients were classified as receiving unilateral (group A) and bilateral cataract surgery (group B). There were no significant differences between groups A and B before the operation in terms of life quality scores, binocular weighted average LogMAR BCVA, age, educational level, gender, systematic and ocular comorbidities, and the complications of the operation. It was shown that visual acuity improved more significantly with bilateral cataract surgery than with unilateral surgery in elderly patients with a high preoperative disease burden in Shanghai city. However, the improvement in life quality was not different in patients receiving either bilateral or unilateral cataract surgery.

PS01.063: THE EFFECT OF DISEASE DURATION ON SURGICAL OUTCOMES FOR PATIENTS WITH EROSIVE GERD TREATED BY LAPAROSCOPIC SURGERY

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 67-67
Author(s):  
Kazuto Tsuboi ◽  
Nobuo Omura ◽  
Fumiaki Yano ◽  
Masato Hoshino ◽  
Se-Ryung Yamamoto ◽  
...  
Keyword(s):  
Los Angeles ◽  
Surgical Outcomes ◽  
Disease Duration ◽  
Conflicts Of Interest ◽  
Operation Time ◽  
Acid Reflux ◽  
Los Angeles Classification ◽  
Patients Satisfaction ◽  
Group A ◽  
Group B

Abstract Background Erosive gastro-esophageal reflux disease (e-GERD) is associated with various symptoms caused by reflux of acid and gastric contents from the stomach to the esophagus. In general, it seems that as the duration of the disease is longer, surgical outcomes are inferior because of disease progression. The aim of this study is to evaluate the relationship between the disease duration and surgical outcomes of laparoscopic fundoplication (LF). Methods Two hundred and fifty-one (mean age was 53.4 years, male in 166) patients with e-GERD who underwent LF as an initial operation at our institution were extracted from the database. E-GERD was defined as equal to or more than grade A esophagitis by Los Angeles classification. These patients were divided into three groups by the length of disease duration: less than two years in Group A (n = 104), two to 5 years in Group B (n = 68) and equal to or more than 5 years in Group C (n = 79). We analyzed patients’ background, pre-operative symptoms, surgical outcomes, patients’ satisfaction and post-operative course. Before surgery, a standardized questionnaire was used to assess the degree of frequency and severity of symptoms (heartburn, regurgitation, dysphagia, vomiting and chest pain). Moreover, satisfaction with the operation was evaluated using the standardized questionnaire. Results Age and degree of acid reflux by pH-metry were significantly different among the three groups (P = 0.0054 and 0.0345, respectively). As to the pre-operative symptom score, the severity score of heartburn and the frequency score of regurgitation were significantly lower in Group A (P = 0.0225 and 0.031, respectively). Although operation time was significantly difference among the three groups (P = 0.0423), there were no differences in intraoperative blood loss, occurrence of peri-operative complications, post-operative course and patients’ satisfaction. Conclusion Although the patients who suffered equal to or over two years had more severe heartburn and regurgitation because of prolonged acid reflux, the duration of the disease does not seem to affect the surgical outcomes. Disclosure All authors have declared no conflicts of interest.

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