Short-term Outcomes of Herbert Screw Fixation for Isolated Olecranon Fractures in Children: a Single-institution Retrospective Study

2021 ◽  
Author(s):  
Yang Li ◽  
Kelai Wang ◽  
Dong Sun ◽  
Yakun Liu ◽  
Jingwei Liu ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Closed Reduction ◽  
Screw Fixation ◽  
Young Patients ◽  
Ossification Center ◽  
Fixation Method ◽  
Short Version ◽  
Herbert Screw ◽  
Fractures In Children ◽  
Olecranon Fractures

Abstract Background: Although various fixation methods can be used for the treatment of displaced olecranon fractures, there are no clear indications in the current literature regarding which surgical technique should be adopted. In this study, we evaluated the clinical and radiological outcomes of closed reduction with percutaneous Herbert screw fixation in children with isolated olecranon fractures.Methods: We retrospectively reviewed the records of children treated at our center for isolated olecranon fractures (Mayo type IIA) with closed reduction and percutaneous Herbert screw fixation between January 2016 and December 2018. Radiographic assessment of fracture healing was performed 6–8 months postoperatively and included assessment for loss of reduction and maximum length of the ulna. Clinical outcomes included elbow flexion and extension, forearm pronation and supination, short version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, and complications. The Herbert screws were removed by a second operation.Results: A total of 14 patients with an average age at the time of injury of 11.36 (range, 10–14) years were included. All patients had good radiological and clinical outcomes at 6–8 months postoperatively; all had normal elbow ranges of motion and showed complete bone healing on radiographs. There were no cases of foreign body irritation, implant migration, or osteoarthritis. Premature epiphyseal closure was noted in six patients. The average QuickDASH score was 1.58. Conclusions: Fixation of olecranon fractures with Herbert screws is a safe and easy fixation method in young patients, leading to good functional and radiological results. Nonetheless, determination of the effects of this treatment method on the olecranon ossification center requires long-term follow-up.

scholarly journals Closed Reduction And Cannulated Screw Fixation For Pediatric Femoral Neck Fractures: A Case Series

2021 ◽  
Author(s):  
Hakan Cici ◽  
Sabahaddin Kiliç
Keyword(s):  
Femoral Neck ◽  
Closed Reduction ◽  
Screw Fixation ◽  
Case Series ◽  
Femoral Neck Fractures ◽  
Cannulated Screw ◽  
Fixation Method ◽  
Coxa Vara

Objective: Pediatric femoral neck fractures are uncommon injuries. Accurate early reduction and fixation is recommended to avoid serious long-term complications. The aim of this study was to analyze the clinical and radiological outcomes of 12 children with femoral neck fractures who were treated with closed reduction and cannulated screw fixation. Method: Between November 2015 and December 2019, 12 children (4 males,8 females) with an average age of 9.7 were operated by closed reduction and cannulated screw fixation for femoral neck fractures. We evaluated the medical records of all patients, including age, gender, injury mechanism, fracture type, initial displacement, postoperative reduction, follow-up roentgenograms and Ratliff’s scores. Results: The mean follow-up was 22.3 months (range 12–47 months). Six Delbett type 2, five Delbett type 3 and one Delbett type 4 fractures were operated with an avarage time to surgery of 12.5 (range: 1-75 hours). Satisfactory outcomes according to Ratliff’s criteria were obtained in 10 (%83.3) children. Coxa vara occurred in 2 cases. Any avascular necrosis was not seen during the follow-up period. Conclusion: Early closed reduction and cannulated screw fixation may be effective to avoid long-term complications in pediatric femoral neck fractures. Keywords: Femoral neck fracture, Pediatric, Closed reduction

Trans-metacarpal Screw Fixation for Extra-articular Proximal Phalangeal Base Fractures

2017 ◽  
Vol 22 (01) ◽  
pp. 35-38 ◽  
Author(s):  
Eichi Itadera ◽  
Takahiro Yamazaki
Keyword(s):  
Screw Fixation ◽  
Proximal Phalanx ◽  
Metacarpophalangeal Joint ◽  
Fixation Method ◽  
Compression Screw ◽  
Metacarpal Head ◽  
Headless Compression Screw ◽  
Articular Fractures ◽  
Intramedullary Canal ◽  
Cannulated Drill

We developed a new internal fixation method for extra-articular fractures at the base of the proximal phalanx using a headless compression screw to achieve rigid fracture fixation through a relatively easy technique. With the metacarpophalangeal joint of the involved finger flexed, a smooth guide-pin is inserted into the intramedullary canal of the proximal phalanx through the metacarpal head and metacarpophalangeal joint. Insertion tunnels are made over the guide-pin using a cannulated drill. Then, a headless cannulated screw is placed into the proximal phalanx. All of five fractures treated by this procedure obtained satisfactory results.

scholarly journals Effect of oblique headless compression screw fixation for metacarpal shaft fracture: a biomechanical in vitro study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yung-Cheng Chiu ◽  
Tsung-Yu Ho ◽  
Yen-Nien Ting ◽  
Ming-Tzu Tsai ◽  
Heng-Li Huang ◽  
...  
Keyword(s):  
Articular Cartilage ◽  
Screw Fixation ◽  
Shaft Fracture ◽  
Metacarpal Bone ◽  
Entry Point ◽  
Fixation Method ◽  
Exit Point ◽  
Compression Screw ◽  
Headless Compression Screw ◽  
Metacarpal Shaft

Abstract Background Metacarpal shaft fracture is a common fracture in hand trauma injuries. Surgical intervention is indicated when fractures are unstable or involve considerable displacement. Current fixation options include Kirschner wire, bone plates, and intramedullary headless screws. Common complications include joint stiffness, tendon irritation, implant loosening, and cartilage damage. Objective We propose a modified fixation approach using headless compression screws to treat transverse or short-oblique metacarpal shaft fracture. Materials and methods We used a saw blade to model transverse metacarpal neck fractures in 28 fresh porcine metacarpals, which were then treated with the following four fixation methods: (1) locked plate with five locked bicortical screws (LP group), (2) regular plate with five bicortical screws (RP group), (3) two Kirschner wires (K group), and (4) a headless compression screw (HC group). In the HC group, we proposed a novel fixation model in which the screw trajectory was oblique to the long axis of the metacarpal bone. The entry point of the screw was in the dorsum of the metacarpal neck, and the exit point was in the volar cortex of the supracondylar region; thus, the screw did not damage the articular cartilage. The specimens were tested using a modified three-point bending test on a material testing system. The maximum fracture forces and stiffness values of the four fixation types were determined by observing the force–displacement curves. Finally, the Kruskal–Wallis test was adopted to process the data, and the exact Wilcoxon rank sum test with Bonferroni adjustment was performed to conduct paired comparisons among the groups. Results The maximum fracture forces (median ± interquartile range [IQR]) of the LP, RP, HC, and K groups were 173.0 ± 81.0, 156.0 ± 117.9, 60.4 ± 21.0, and 51.8 ± 60.7 N, respectively. In addition, the stiffness values (median ± IQR) of the LP, HC, RP, and K groups were 29.6 ± 3.0, 23.1 ± 5.2, 22.6 ± 2.8, and 14.7 ± 5.6 N/mm, respectively. Conclusion Headless compression screw fixation provides fixation strength similar to locked and regular plates for the fixation of metacarpal shaft fractures. The headless screw was inserted obliquely to the long axis of the metacarpal bone. The entry point of the screw was in the dorsum of the metacarpal neck, and the exit point was in the volar cortex of the supracondylar region; therefore the articular cartilage iatrogenic injury can be avoidable. This modified fixation method may prevent tendon irritation and joint cartilage violation caused by plating and intramedullary headless screw fixation.

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