scholarly journals Retrospective comparative study of arthroscopy assisted loop-plate suture technique and a Hook plate for the treatment of distal clavicle fractures

2020 ◽  
Author(s):  
Hui Wang ◽  
Guiquan Cai ◽  
De Li ◽  
Chenglong Wang ◽  
Jiahong Zhang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Shoulder Joint ◽  
Hook Plate ◽  
Clinical Effects ◽  
Clavicular Fracture ◽  
Distal Clavicle ◽  
Joint Function ◽  
Plate Group ◽  
Loss Of Reduction

Abstract Abstract Purpose To compare the clinical effects of hook plate and AALS technique in the treatment of acute Neer II distal clavicular fracture. Methods 33 patients with Neer II distal clavicular fracture were included in this study. 15 patients were treated internal fixation with clavicular hook plate. 18 patients underwent fracture reduction with AALS technique. Constant-Murley and VAS scores were used to evaluate shoulder joint function and pain degree during follow-up. Karlsson score and shoulder joint X-ray was used to evaluate patients' satisfaction and the loss of reduction respectively. Results There were significant differences in amount of bleeding, Constant-Murley score and Karlsson score between these two groups (P<0.05). In the AALS group, we observed 3 cases with rotator cuff injury, 1 case with labrum injury during the operation. Two patients in AALS group had slight loss of reduction, but with no requirement of removal of internal fixation owing to discomfort. In hook plate group, 5 patients complained discomfort in shoulder movement and limited function after operation. At the last follow-up, 3 patients suffered from subacromial osteolysis accompanied by acromial impingement pain, and 2 patients with mild reduction loss. Conclusion For patients with Neer IIB distal clavicle fracture, AALS technique is superior to hook plate in shoulder joint function recovery and pain performance after operation, which is probably a novel reliable choice.

scholarly journals Clavicle hook plate versus distal clavicle locking plate for Neer type II distal clavicle fractures

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Liang Li ◽  
Tian-yan Li ◽  
Peichao Jiang ◽  
Guizhen Lin ◽  
Hongxiao Wu ◽  
...  
Keyword(s):  
Shoulder Joint ◽  
Locking Plate ◽  
Meta Analysis ◽  
Hook Plate ◽  
Type Ii ◽  
Distal Clavicle ◽  
Plate Group ◽  
Clavicle Fractures ◽  
Distal Clavicle Fractures ◽  
Clavicle Hook Plate

Abstract Background The purpose of this meta-analysis was to compare clavicle hook plates versus distal clavicle locking plates for the treatment of Neer type II distal clavicle fractures. Methods PubMed (1996 to January 2019), Embase (1980 to January 2019), Web of Science (1990 to January 2019), the Cochrane Library (January 2019), and the China National Knowledge Infrastructure (January 2019) were systematically searched without language restrictions for literature retrieval. The Constant-Murley shoulder joint function score at 3 and 6 months after the operation and the postoperative complications after the operation (shoulder joint pain, abduction restriction, fracture delay healing, subacromial impingement) were the outcomes. Stata 12.0 was used for the meta-analysis. Results A total of 9 clinical trials involving 446 patients were finally included in this meta-analysis. The results showed that the improvement in the Constant-Murley shoulder joint function score in the distal locking plate group was better than that in the clavicle hook plate group at 3 and 6 months after the operation (P < 0.05). There were fewer cases of shoulder joint pain and restricted shoulder abduction range of motion in the distal locking plate group, and the difference was statistically significant (P < 0.05). There were no statistically significant differences in fracture delay healing and subacromial impingement between the two groups (P > 0.05). Conclusion Compared with the clavicular hook plate, the distal clavicle locking plate for the treatment of Neer type II distal clavicle fractures is associated with better shoulder function recovery and fewer complications related to pain and abduction restriction.

scholarly journals Comparison of the efficacy of MIS-TLIF combined with unilateral or bilateral internal fixation on single-segment lumbar degenerative diseases

2019 ◽  
Vol 17 ◽  
pp. 205873921984439
Author(s):  
Lisheng Zhao ◽  
Huijin Yu ◽  
Yan Zhang ◽  
Wenjun Zhen
Keyword(s):  
Internal Fixation ◽  
Lumbar Lordosis ◽  
Clinical Effects ◽  
Degenerative Diseases ◽  
Single Segment ◽  
Tnf Α ◽  
Significant Difference ◽  
Lumbar Degenerative Diseases ◽  
Serum Crp

In this study, to compare the efficacy of minimally invasive surgery transforaminal lumbar interbody fusion (MIS-TLIF) combined with unilateral or bilateral internal fixation for the treatment of single-segment lumbar degenerative diseases, patients with single-segment lumbar degenerative diseases treated with MIS-TLIF combined with unilateral or bilateral internal fixation in Rehabilitation Center, Gansu Province Hospital from January 2014 to November 2015 were retrospectively enrolled, and the related data of 85 patients with 2-year follow-up were obtained. The patients were divided into unilateral group (40 cases) and bilateral group (45 cases) according to the method of internal fixation, and the Oswestry dysfunction index (ODI), visual analogue scale (VAS), lumbar lordosis angle, surgical segmental lordosis angle, lumbar scoliosis angle, surgical segmental scoliosis angle, lumbar lordosis index (LI), intervertebral height index (IHI), fusion rates, and serum inflammatory factors, including C-reactive protein (CRP), interleukin (IL)-6, and tumor necrosis factor alpha (TNF-α), were calculated to evaluate the efficacy of these two surgical methods. The results showed that the VAS and ODI of the two groups at 1 month, 6 months after surgery, and the last follow-up were significantly improved when compared with those before surgery ( P < 0.05). However, there were no significant differences in VAS and ODI between the two groups at preoperative, 1 month, 6 months after surgery, and the last follow-up ( P > 0.05). The lumbar lordosis and LI decreased at 1 month, 6 months, and the last follow-up ( P < 0.05), while the IHI increased when compared with that before surgery ( P < 0.05). Besides, no significant differences were observed in lumbar lordosis, LI, and IHI between the two groups at preoperative, 1 month, 6 months after surgery, and final follow-up ( P > 0.05). In addition, the fusion rates between these two groups had no significant difference ( P > 0.05). The levels of serum CRP, IL-6, and TNF-α at 12 and 24 h after operation in the two groups were higher than those before operation ( P < 0.05), but there was no significant difference in the levels of serum CRP, IL-6, and TNF-α between the two groups at 12 and 24 h after operation ( P < 0.05). In addition, none of the patients of both groups had permanent nerve injury, incision infection, and other complications. These results showed that MIS-TLIF combined with unilateral or bilateral percutaneous internal fixation technique causes less damage to the body tissues of patients with single-segment lumbar degenerative diseases, and they were considered to have similar clinical effects and imaging.

Calcaneal Tuberosity Fracture (Beak Fracture) Fixation Using a Pre-contoured “L-form” Hook Plate: A Retrospective Study

2021 ◽  
Author(s):  
Qiang Zhang ◽  
Chan Zhu ◽  
Zongde Wu
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
Plate Fixation ◽  
Hook Plate ◽  
Fixation Technique ◽  
Fixation Failure ◽  
Clinical Healing ◽  
Ankle Function ◽  
Calcaneal Tuberosity

Abstract Background: The treatment of calcaneal tuberosity fracture (beak fracture) is very tricky. Patients’ ankle function may be badly affected by skin flap necrosis and internal fixation failure. This study presented a simple, and safe internal fixation technique which is to fix the fracture fragment with a pre-contoured “L-form” hook plate.Methods: A retrospective study was done to analyze patients with calcaneal tuberosity fracture who were treated with pre-contoured “L-form” hook plate fixation from January 2015 to February 2020. When the patients could complete single-legged heel raise tests, and when they achieved clinical healing criteria were reviewed. Functional assessment was performed according to the American Orthopaedic Foot and Ankle Society Ankle-Hindfoot (AOFAS-AH) scores and the Visual Analogue Scale (VAS) was recommended for assessment of pain intensity (PI).Results: There were a total of 15 patients of calcaneal tuberosity fracture (beak fracture) treated with the pre-contoured “L-form” hook plate fixation technique, among which eight patients were female and the others were male, with the age ranging from 35 to 69 years (average of 55.3±9.0 years). And the mean duration of follow-up was 22.53±5.78 months (range: 12 to 36 months). 11 cases underwent emergency surgery. After the operation, there were no complications such as wound dehiscence, poor wound healing, infections, or plate exposure, no sural nerve injuries or venous thromboembolic events. Also, there was no loss of reduction or fixation failure in the follow-up. All 15 cases achieved clinical healing at 8-13 weeks (average 10.5±1.4 weeks) postoperatively. They were able to perform the test on their affected leg after 3.7±0.7 months (3-5 months) on average. The preoperative VAS and AOFAS-AH scores were 5.7±0.6 and 24.0±9.9 respectively, while the postoperative VAS and AOFAS-AH scores at the last follow-up were 1.3±0.5 and 93.8±5.2 (p<0.001).Conclusion: Emergency open reduction and internal fixation should be provided as soon as possible. For patients with Beavis type II beak fractures, the pre-contoured “L-form” hook plate fixation technique helps them restore normal ankle function. This simple, safe, and strong internal fixation technique can be one of the treatment options for avulsion fractures of the calcaneal tuberosity.

Anatomic Locking Plate Fixation and Coracoclavicular Stabilisation with Multistrand Titanium Cable for Unstable Distal Clavicle Fracture

2021 ◽  
Vol 11 (5) ◽  
pp. 1477-1480
Author(s):  
Zhong-Guo Liu ◽  
Yue-Wei Yu ◽  
Huang-Lin Xie ◽  
Qing-Xin Xie
Keyword(s):  
Fracture Healing ◽  
Locking Plate ◽  
Clavicle Fracture ◽  
Clinical Effects ◽  
Distal Clavicle ◽  
Distal Clavicle Fracture ◽  
Clavicle Fractures ◽  
Anatomic Locking Plate ◽  
Distal Clavicle Fractures

Objective: The aim of this study was to introduce a modified surgical procedure using anatomic locking plate (ALP) fixation and coracoclavicular (CC) stabilisation with multistrand titanium cable (MTC) to repair unstable distal clavicle fractures, and to estimate clinical effects of these people. Materials and methods: Between July 2016 and April 2018, we treated 7 patients with unstable distal clavicle fracture by ALP fixation and CC stabilisation with MTC. After the surgery, we followed up every patient for at least 24 months and analysed their clinical results. Results: The average term required for fracture healing was 9.9 (range, 9–12 weeks) and all cases are successful in fracture healing. The average Constant score was 94.6 points (range, 92–100) at the last follow-up; the modified University of California, Los Angeles (UCLA) shoulder rating scale was 33.4 points (range, 31–35) at the last follow-up. There was no infection, hardware failure and iatrogenic fracture in all the cases. Conclusions: ALP fixation and CC stabilisation with MTC is a really good method for the treatment of unstable distal clavicle fractures. This surgical technique can provide stable fixation for early functional exercise, and prevent extra shoulder joint damage.

scholarly journals Treatment of distal clavicle fracture of Neer type II with locking plate in combination with titanium cable under the guide

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jun Wang ◽  
Jie Guan ◽  
Minbo Liu ◽  
Yongfeng Cui ◽  
Yuhang Zhang
Keyword(s):  
Locking Plate ◽  
Clavicle Fracture ◽  
Operation Time ◽  
Hook Plate ◽  
Type Ii ◽  
Distal Clavicle ◽  
Distal Clavicle Fracture ◽  
Plate Group ◽  
Clavicle Fractures ◽  
Distal Clavicle Fractures

AbstractTo observe and compare the curative effect of a locking plate plus titanium cable under the Guide device and clavicular hook plate in the treatment of Neer type II distal clavicle fractures. A prospective cohort study was conducted to analyse the clinical data of 36 patients with distal clavicle fractures from January 2016 to January 2019. The results were analysed. According to the random number method, the patients were divided into two groups: the titanium cable group (fixed with a titanium cable in combination with a locking plate) and hook plate group (fixed with a clavicular hook plate only). Under the guidance of a special device (for which a patent was obtained), in the titanium cable group, the coracoclavicular ligament was fixed with tension reduction, and then the distal clavicular fracture was fixed with a locking plate. In the hook plate group, the distal clavicle fracture was fixed with a hook plate. The incision length, operation time, bleeding volume and VAS score before, 1 week after and 1 year after the operation were compared between the two groups. The effect of the operation was evaluated by the Constant-Murley score before and 1 year after the operation. X-ray films were taken 2 days, 3 months, half a year and 1 year after the operation to observe the reduction and healing of fractures. At the same time, complications were recorded. The amount of bleeding was the same in the two groups. The operation time in the hook plate group was relatively short, and the difference was statistically significant (P < 0.05). The VAS score in the titanium cable group was significantly lower than that in the hook plate group one year after the operation. The Constant-Murley score in the titanium cable group and hook plate group was significantly higher 1 year after the operation. The number of postoperative complications in the titanium cable group was significantly lower than that in the hook plate group. The treatment of Neer type II distal clavicle fractures with a titanium cable plus a locking plate has a good curative effect, few complications and good postoperative recovery and thus is worth popularizing.

scholarly journals Neer Type II Distal End Clavicular Fracture: Outcome with Clavicular Hook Plate Fixation

2020 ◽  
Vol 2 (2) ◽  
pp. 1-4
Author(s):  
Sagar Panthi ◽  
Rishiswor Shrestha ◽  
Sabal Krishna Gaihre ◽  
 Angelica Karki ◽  
Suyachha Chettri
Keyword(s):  
Plate Fixation ◽  
Adult Population ◽  
Hook Plate ◽  
Type Ii ◽  
Clavicular Fracture ◽  
Rare Type ◽  
Non Union ◽  
Excellent Outcome ◽  
Clavicular Hook Plate

Background: Distal end clavicular fractures are rare type of injuries seen in adult population. These fractures are unstable because of various deforming forces. Clavicular hook plate aligns the clavicle along with ligaments. The aim of this study is to observe the outcome of displaced distal end clavicular fracture managed with hook plate fixation.Methods: Twenty five patients with displaced distal end clavicular fractures (Neer type II) were evaluated retrospectively from November 2018 to September 2020. Functional outcome were assessed via Constant and Murley score at one year final follow-up.Results: 60% of patient had excellent outcome, 32% of patient had good outcome and 8% of patient had fair outcome at final follow-up. Mean Constant and Murley score was 86. Four patients developed subacromial osteolysis which resolved at final follow-up. One patient had extra-articular ossification whereas none of the patient developed non-union and AC joint arthrosis.Conclusion: Clavicular hook plate provides stable fixation of distal end clavicular fracture with few complications and is cost-effective.Keywords: Clavicular Hook Plate; Complications; Distal End Clavicular Fractures; Subacromial Osteolysis

scholarly journals Motion-preserving treatment of unstable atlas fracture: transoral anterior C1-ring osteosynthesis using a laminoplasty plate

2020 ◽  
Author(s):  
Xiaobao Zou ◽  
Beiping Ouyang ◽  
Binbin Wang ◽  
Haozhi Yang ◽  
Su Ge ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Neurological Complication ◽  
Bone Union ◽  
Clinical Effects ◽  
Reduction Mechanism ◽  
Loss Of Reduction ◽  
Function Range ◽  
Atlas Fractures ◽  
Replacement Operation

Abstract Background C1-ring osteosynthesis is a valid alternative to posterior C1–C2 or C0–C2 fusion to preserve important C1–C2 motion in the treatment of unstable atlas fractures. Nevertheless, the fixation instruments used in current studies for transoral anterior C1-ring osteosynthesis were not suitable for anterior anatomy of the atlas or did not have reduction mechanism. We therefore present this report to investigate preliminary clinical effects of transoral anterior C1-ring osteosynthesis using a laminoplasty plate in unstable atlas fractures. Methods From January 2014 to December 2017, 13 patients with unstable atlas fractures were retrospectively reviewed. All patients were treated with transoral anterior C1-ring osteosynthesis using a laminoplasty plate. Pre- and postoperative images were obtained to assess reduction of the fracture, internal fixation placement, and bone union. Neurological function, range of motion, and pain levels were evaluated clinically on follow-up. Results The surgeries were successfully performed in all cases. The average follow-up duration was 16.6 ± 4.4 months (range 12–24 months). One patient suffered screw loosening after operation and underwent replacement operation subsequently. Satisfactory clinical outcomes were achieved in all patients with ideal fracture reduction, reliable plate placement, well-preserved range of motion, and neck pain alleviation. All patients achieved bone union of fractures without loss of reduction or implant failure or C1–C2 instability during the follow-up. No vascular or neurological complication was noted during the operation and follow-up. Conclusions Transoral anterior C1-ring osteosynthesis using a laminoplasty plate is a effective surgical treatment for unstable atlas fractures. This technique has a ingenious reduction mechanism, and can provide satisfactory bone union and preservation of C1–C2 motion.

Functional outcome of displaced middle third clavicular fractures treated by plate osteosynthesis

2021 ◽  
Vol 7 (2) ◽  
pp. 335
Author(s):  
A. Palanivel
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Locking Compression Plate ◽  
Activity Level ◽  
Clavicular Fracture ◽  
Union Rate ◽  
Compression Plate

<p class="abstract"><strong>Background:</strong> Clavicle fracture is a common traumatic injury around the shoulder girdle due to its subcutaneous position. Recent studies have shown a higher rate of nonunion and shoulder dysfunction in subgroups of patients with clavicle fractures. The purpose of the study was to prospectively analyse the functional outcome of mid-third displaced clavicular fractures treated by open reduction and internal fixation with plate osteosynthesis. To study the outcome of displaced middle-third clavicular fracture streated by plate osteosynthesis.</p><p class="abstract"><strong>Methods:</strong> This was a prospective comparative on-randomized study was conducted in Government District Head Quarters Hospital Nagapattinam with a follow-up ranging from September 2018 to January 2019 5 months. Thirty-four cases of middle third displaced (Robinson type 2b1 and 2b2) clavicular fractures are treated with plate osteosynthesis. We used a reconstruction plate, a locking compression plate, and a 1/3<sup>rd</sup> tubular plate for study.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean time to union was 9.5 weeks. At the latest follow-up, the entire patients returned to the pre-injury activity level. One case had a superficial infection which was treated with intravenous antibiotics. There is no difference between the reconstruction group and the locking compression plate group in terms of functional outcome and union rate. We also noticed that road traffic accident and direct injury to the shoulder causes Robinson type 2b2 fractures.</p><p class="abstract"><strong>Conclusions:</strong> Open reduction and rigid internal fixation of displaced midshaft clavicular fracture have resulted in a good fracture union rate and excellent functional outcome.</p>

scholarly journals Minimally invasive open reduction combined with proximal femoral hollow locking plate in the treatment of Pauwels type III femoral neck fracture

2019 ◽  
Vol 47 (7) ◽  
pp. 3050-3060 ◽  
Author(s):  
Gang Wang ◽  
Yong Tang ◽  
Bin Wang ◽  
Huilin Yang
Keyword(s):  
Femoral Neck ◽  
Minimally Invasive ◽  
Internal Fixation ◽  
Open Reduction ◽  
Locking Plate ◽  
Femoral Neck Fractures ◽  
Harris Hip Score ◽  
Clinical Effects ◽  
Type Iii

ObjectiveThis study was performed to investigate the clinical effects of minimally invasive open reduction and internal fixation with a proximal femoral hollow locking plate on Pauwels type III femoral neck fractures.MethodsThe clinical data of 45 patients aged 32.0 ± 8.1 years (range, 19–45 years) with Pauwels type III femoral neck fractures treated from March 2012 to August 2016 were retrospectively analyzed. All patients underwent anterolateral minimally invasive open reduction and proximal femoral hollow locking plate fixation of the hip joint. Garden’s index was used to evaluate the quality of fracture reduction. Complications and fracture healing were recorded in all patients. At the last follow-up, the functional outcome was recorded using the Harris hip score.ResultsNo complications such as femoral neck shortening, internal fixation loosening, or refracture occurred. However, three patients required reoperation (one with nonunion and two with femoral head necrosis). At the last follow-up, the mean Harris hip score was 92.1 ± 4.5 (range, 76–98). The rate of excellent and good Harris hip scores was 93.3%.ConclusionThe herein-described strategy for Pauwels type III femoral neck fractures is advantageous in terms of high reduction quality, firm fixation, and prevention of neck shortening.

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