scholarly journals Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire

2020 ◽  
Author(s):  
Alvin Chao-Yu Chen ◽  
Yi-Hsuan Lin ◽  
Chun-Jui Weng ◽  
Chun-Ying Cheng
Keyword(s):  
Treatment Outcomes ◽  
Surgical Complication ◽  
Patient Characteristics ◽  
Tension Band ◽  
Suture Fixation ◽  
Ulnar Styloid ◽  
Tension Band Wire ◽  
Group A ◽  
Group B ◽  
Anchor Suture

Abstract Background Limited reference is available regarding surgical management in symptomatic ulnar styloid fractures with small bony avulsion. The study goal is to report the surgical outcomes using anchor suture fixation with comparison to traditional tension band wire fixation.Methods We retrospectively reviewed the medical records in patients who underwent surgical repair for unilateral ulnar styloid fractures with distal radioulnar instability between 2004 and 2017. A total of 31 patients were enrolled including two kinds of fixation methods. Anchor suture fixation plus distal radioulnar joint pinning was performed in ten patients with tiny avulsion bony fragments (group A); tension band wire fixation was performed in 21 patients with big styloid fracture fragments (group B). Patient characteristics and 2-year treatment outcomes were compared between two groups based on Mayo Modified Wrist Score (MMWS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), visual analog scale (VAS) and surgical complication. Descriptive statistics were used for calculation of key variables; a p-value of < 0.05 was considered statistically significant.Results Based on Gaulke classification, there were five subtypes in group A and three subtypes in group B. Incidence of concomitant distal radius fractures was significantly higher in group B; other patient characteristics including age, sex, injury side, and time to surgery showed no significant difference. Outcome assessment regarding MMWS, QuickDASH and VAS was comparable between two groups. Bone-related complications including nonunion, DRUJ subluxation and styloid resorption were analyzed; the difference was not significant. Incidence of implant-related complications including migration and secondary removal surgery was significantly higher in group B (p = 0.021).Conclusion Surgical fixation in symptomatic ulnar styloid fractures yields comparable treatment outcomes in both fracture patterns. Implant-related complication with secondary removal surgery is more common in tension band wire group. Anchor suture fixation is a feasible option for tiny styloid avulsion fragments with limited surgical complication.

scholarly journals Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire

2020 ◽  
Author(s):  
Alvin Chao-Yu Chen ◽  
Yi-Hsuan Lin ◽  
Chun-Jui Weng ◽  
Chun-Ying Cheng
Keyword(s):  
Treatment Outcomes ◽  
Surgical Complication ◽  
Patient Characteristics ◽  
Tension Band ◽  
Suture Fixation ◽  
Ulnar Styloid ◽  
Tension Band Wire ◽  
Group A ◽  
Group B ◽  
Anchor Suture

Abstract Background: Limited reference is available regarding surgical management in symptomatic ulnar styloid fractures with small bony avulsion. The study goal is to report the surgical outcomes using anchor suture fixation with comparison to traditional tension band wire fixation.Methods: We retrospectively reviewed the medical records in patients who underwent surgical repair for unilateral ulnar styloid fractures with distal radioulnar instability between 2004 and 2017. A total of 31 patients were enrolled including two kinds of fixation methods. Anchor suture fixation plus distal radioulnar joint pinning was performed in ten patients with tiny avulsion bony fragments (group A); tension band wire fixation was performed in 21 patients with big styloid fracture fragments (group B). Patient characteristics and 2-year treatment outcomes were compared between two groups based on Mayo Modified Wrist Score (MMWS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), visual analog scale (VAS) and surgical complication. Descriptive statistics were used for calculation of key variables; a p-value of < 0.05 was considered statistically significant. Results: Based on Gaulke classification, there were five subtypes in group A and three subtypes in group B. Incidence of concomitant distal radius fractures was significantly higher in group B; other patient characteristics including age, sex, injury side, and time to surgery showed no significant difference. Outcome assessment regarding MMWS, QuickDASH and VAS was comparable between two groups. Bone-related complications including nonunion, DRUJ subluxation and styloid resorption were analyzed; the difference was not significant. Incidence of implant-related complications including migration and secondary removal surgery was significantly higher in group B (p = 0.021). Conclusion: Surgical fixation in symptomatic ulnar styloid fractures yields comparable treatment outcomes in both fracture patterns. Implant-related complication with secondary removal surgery is more common in tension band wire group. Anchor suture fixation is a feasible option for tiny styloid avulsion fragments with limited surgical complication.

scholarly journals Surgical management of ulnar styloid fractures: comparison of fixation with anchor suture and tension band wire

2020 ◽  
Author(s):  
Alvin Chao-Yu Chen ◽  
Yi-Hsuan Lin ◽  
Chun-Jui Weng ◽  
Chun-Ying Cheng
Keyword(s):  
Surgical Complication ◽  
Patient Characteristics ◽  
Tension Band ◽  
Suture Fixation ◽  
Ulnar Styloid ◽  
Tension Band Wire ◽  
Wire Fixation ◽  
Group A ◽  
Group B ◽  
Anchor Suture

Abstract Background Limited reference is available regarding surgical management in symptomatic ulnar styloid fractures with small bony avulsion. The study goal is to report the surgical outcomes using anchor suture fixation with comparison to traditional tension band wire fixation. Methods We retrospectively reviewed the medical records in patients who underwent surgical repair for unilateral ulnar styloid fractures with distal radioulnar instability between 2004 and 2017. A total of 31 patients were enrolled including two kinds of fixation methods. Anchor suture fixation plus distal radioulnar joint pinning was performed in ten patients with tiny avulsion bony fragments (group A); tension band wire fixation was performed in 21 patients with big styloid fracture fragments (group B). Patient characteristics and 2-year treatment outcomes were compared between two groups based on Mayo Modified Wrist Score (MMWS), Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH), visual analog scale (VAS) and surgical complication. Descriptive statistics were used for calculation of key variables; a p-value of < 0.05 was considered statistically significant. Results Based on Gaulke classification, there were five subtypes in group A and three subtypes in group B. Incidence of concomitant distal radius fractures was significantly higher in group B; other patient characteristics including age, sex, injury side, and time to surgery showed no significant difference. Outcome assessment regarding MMWS, QuickDASH and VAS was comparable between two groups. Bone-related complications including nonunion, DRUJ subluxation and styloid resorption were analyzed; the difference was not significant. Incidence of implant-related complications including migration and secondary removal surgery was significantly higher in group B (p = 0.021). Conclusion Surgical fixation in symptomatic ulnar styloid fractures yields comparable treatment outcomes in both fracture patterns. Implant-related complication with secondary removal surgery is more common in tension band wire group. Anchor suture fixation is a feasible option for tiny styloid avulsion fragments with limited surgical complication.

scholarly journals Multiple stents are not superior to single stent insertion for pain relief in patients with chronic pancreatitis: a retrospective comparative study

2019 ◽  
Vol 07 (12) ◽  
pp. E1595-E1604 ◽  
Author(s):  
Lavrentios Papalavrentios ◽  
Carmen Musala ◽  
Paraskevas Gkolfakis ◽  
Jacques Devière ◽  
Myriam Delhaye ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Clinical Outcome ◽  
Treatment Outcomes ◽  
Endoscopic Treatment ◽  
Patient Characteristics ◽  
Median Number ◽  
Stent Insertion ◽  
Group A ◽  
Group B

Abstract Background and study aims Patients with painful chronic pancreatitis (CP) and distal main pancreatic duct (MPD) stricture are considered candidates for treatment using a single plastic stent insertion. Multiple side-by-side stents have been proposed as an alternative treatment but comparative studies are lacking. The aim of this retrospective study is to assess differences in characteristics and treatment outcomes in patients with CP and MPD strictures treated with a different number of stents during the stenting period. Patients and methods Patients with painful CP and distal MPD obstruction requiring endoscopic treatment (01.2004 – 12.2012) were considered. The study population was divided in three groups: Patients treated with (A) exclusively one stent; (B) one or two stents; and (C) exclusively two stents during the stenting period. Patient characteristics and treatment outcomes were retrospectively assessed. Results Among 284 patients, 85 were selected according to inclusion criteria (Group A: 18, Group B: 35, Group C: 32). Median follow-up duration was 84 months. The median number of endoscopic procedures needed was higher for group B [3 (A) vs. 3 (C) vs. 4 (B), P = 0.001]. Regarding outcome, successful endoscopic treatment was lower in Group C (50 % vs. 88.2 % and 74.2 % for groups A and B, respectively; P = 0.02). This difference was attributed to better clinical outcome in Group A compared to Group C patients [OR(95%CI): 7.50 (1.46 – 38.70); P = 0.04]. Moreover, group C patients experienced higher levels of pain at the end of follow-up period [median Izbicki Score 0 (group A) vs. 0 (group B) vs. 6 (group C), P = 0.03]. Conclusions In patients with painful CP and distal MPD obstruction, treatment with a single stent is associated with better clinical outcome compared to treatment with exclusively two stents during the stenting period.

scholarly journals Best technique for fixation of displaced transverse olecranon fractures: tension band wiring or plate fixation?

2020 ◽  
Vol 6 (5) ◽  
pp. 1012
Author(s):  
Lokesh Kumar Yogi ◽  
Gagandeep Mahi ◽  
C. R. Thorat ◽  
Moti Janardhan Naik
Keyword(s):  
Functional Outcome ◽  
Large Scale ◽  
Plate Fixation ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Clinical Event ◽  
Dash Score ◽  
Group A ◽  
Group B ◽  
Olecranon Fractures

<p><strong>Background:</strong> Fractures of olecranon are common fractures in upper limb. Tension band wiring (TBW) and plate fixation (PF) are mostly used techniques but choice is based on type of fracture and surgeon’s preference.</p><p><strong>Methods:</strong>  A study assessed functional results in 28 patients that were enrolled after the clinical event of trauma has occurred. Patients were divided into two groups- Group (A) for TBW and Group (B) for PF; here gender, age and side of fracture were ignored. Post-operative functional outcome were evaluated by using the Mayo Elbow Performance (MEP) and the Disabilities of the Arm, Shoulder and Hand (DASH) score parameters.</p><p><strong>Results:<em> </em></strong>Mean (SD) union time as determined by postoperative radiographs was 8.5 (1.48) weeks for group (A) and 9 (2.08) weeks for group (B). Mean (SD) MEP score at 9 months in group (A) 84.28 (7.28) and 80.71 (10.92) in group (B). Mean (SD) DASH at 9 months in group (A) 12.2 (8.8) and 11.7 (10.4) in group (B). Complications were reported in group (A) 6 patient (42.85%) out of 14 patients and in group (B) 1 patient (7.14%) out of 14 patients.</p><p><strong>Conclusions:<em> </em></strong>The current study shows that there are no significant differences in functional outcome between both the study groups. Due to lesser complications, we recommend the plate fixation approach as the better choice for transverse displaced olecranon fractures. More large scale studies are required to further confirm our results.</p>

scholarly journals Abdominal Wound Closure in Gynaecological or Obstetrical Surgery with Vicryl® (Polyglactin910) Versus Vicryl Plus® (Polyglactin910 with Triclosan Added): A Comparative Study

2019 ◽  
Vol 17 (1) ◽  
pp. 10-12
Author(s):  
Binod Kumar Mahaseth
Keyword(s):  
Surgical Site Infection ◽  
Surgical Complication ◽  
College Teaching ◽  
Controlled Study ◽  
Skin Closure ◽  
Site Infection ◽  
Comparative Efficacy ◽  
Group A ◽  
Group B ◽  
Johnson Company

Background: Surgical site infection is the most common post-surgical complication in surgical patients. The incidence of surgical site infection varies from 3-20% (or even more) in different part of the world. To date, the best method and material for skin closure has not been recommended by anybody. Triclosan is an antiseptic agent used for coating a suture material to prevent the infections. This case-controlled study was carried out to determine the comparative efficacy of sutures; Objective: This case-controlled study was carried out to determine the comparative efficacy of sutures: vicryl® and vicryl plus® (triclosan, an antiseptic incorporated with suture), in reducing surgical site infection in laparotomy for clean Gyn/Obs operations. Material and method: This case-controlled study was carried out in Dept. Of Gynae/Obs at Nepalgunj Medical College Teaching Hospital, Kohalpur. The period of the study was from Jan 2018 to January 2019. A total of 50 participants were enrolled in the study, who met the inclusion criteria. The patients were divided into two groups A and B, each consisting of 25 patients. The patients were allocated in the groups alternately to remove bias. The Group A consisted of patients where Vicrylplus® (Ethicon, Johnson & Johnson Company, Ahmadabad, India) polyglactin910 with triclosan) was used and Group B consisted of patients where vicryl ® (Ethicon, Johnson & Johnson Company, Ahmadabad, India) polyglactin910 alone) was used. Patients whose abdominal wounds were found infected, pus swab for culture were taken and sent for aerobic culture and sensitivity. All patients received ceftriaxone and metronidazole single dose before operations prophylactically. Result: Surgical site infection ingroup A was 3 cases out of 25 (12%) and in group B it was 6 cases out of 25(24%). Triclosan added polyglactin910 suture found to be statistically non significant concerning prevention of SSI as compared to polyglactin910 (p=0.472). The mean age of the study population was in group A was (29.76±7.47) and in group B was (27.12±7.42).

scholarly journals Medial Humeral Epicondylar Fracture in Children and Adolescents

2007 ◽  
Vol 15 (2) ◽  
pp. 170-173 ◽  
Author(s):  
D Ip ◽  
WL Tsang
Keyword(s):  
Treatment Outcomes ◽  
Mayo Clinic ◽  
Kirschner Wire ◽  
Young Patients ◽  
Tension Band ◽  
Kirschner Wires ◽  
Range Of Movement ◽  
Cubitus Valgus ◽  
Tension Band Wire ◽  
Displaced Fracture

Purpose. To assess treatment outcomes of young patients with medial epicondylar fracture of the elbow using standard operative protocols. Methods. 24 consecutive patients with medial humeral epicondylar fracture underwent surgery by one of the 3 methods: (1) 2 parallel Kirschner wires, (2) 2 parallel Kirschner wires plus a tension-band wire, and (3) a screw plus an anti-rotation Kirschner wire. Fractures displaced less than 5 mm were treated conservatively (casting for 3 weeks). Outcome was assessed clinically and radiologically. The Mayo Clinic Elbow Performance Index was measured. Results. The 3 patients with undisplaced fractures had good radiological results and scores. One patient with a displaced fracture refused surgery and subsequently developed pseudarthrosis and cubitus valgus. All operatively treated patients had good scores, but 2 treated with 2 parallel Kirschner wires alone developed pseudarthrosis. Patients in this group needed longer rehabilitation to attain a functional range of movement than those in other groups (treated together with a tension-band wire or screw). Conclusion. Surgery is recommended for children with displaced medial epicondylar fractures of more than 5 mm. The use of a tension-band wire, instead of a screw, together with Kirschner wires is the preferred treatment for younger children.

scholarly journals Clinical Features and Treatment Outcomes of Vulvar Sarcoma: A Single-Institution Review of 21 Cases

2020 ◽  
Author(s):  
Haifeng Gu ◽  
Guochen Liu ◽  
Lili Liu ◽  
Zhimin Liu ◽  
Junyun Li ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Clinical Features ◽  
Epithelioid Sarcoma ◽  
Pelvic Mass ◽  
Adjuvant Chemoradiotherapy ◽  
Wide Resection ◽  
Cancer Center ◽  
Group A ◽  
Group B

Abstract BackgroundValvar sarcoma is an extremely rare disease in which the data for treatment and prognosis are scarce. The aim of this study was to analysis the clinical features and treatment outcomes of initial and recurrent valvar sarcoma.MethodThe medical records of patients with initial or recurrent vulvar sarcoma treated at Sun Yat-sen University Cancer Center between January 2005 and April 2019 were retrospectively reviewed.Results A total of 21 patients with vulvar sarcoma were identified. The median age of them was 43 years (range: 16 to 71). The histological subtypes were epithelioid sarcoma, leiomyosarcoma, dermatofibrosarcoma protuberans, rhabdomyosarcoma, and angiosarcoma in 9, 4, 4, 3 and 1 patients, respectively. None of the patients received wide resection when they were initially treated at communities. Thirteen patients were referred immediately after initial managements (Group A), whereas 8 patients were referred with recurrent disease (Group B). Wide resections were performed with pathologically negative margins in 20 patients, of whom 9 also received lymphadenectomy and 3 showed metastases. One patient in Group B only received chemoradiotherapy for unresectable pelvic mass. Adjuvant chemoradiotherapy were performed for 12 patients evaluated to have high risk of recurrence. The median follow-up time was 39 months (range: 11 to 174) for Group A and 107 (range: 2 to 139) for Group B. During the follow-up, relapse occurred in 3 patients in Group A and 5 in Group B. The 3- and 5-year survival rates were 92.3% and 76.9% for Group A, 50.0% and 37.5% for Group B, respectively.ConclusionsVS is usually resected as benign disease at initial management. Immediate extended resection with negative margins provided favorable outcomes for most of the patients. The prognosis for recurrent cases were poor, however there remained survival opportunities if aggressive treatments were carried out.

Association of bevacizumab-free interval with efficacy of anti-EGFR therapy in patients with metastatic colorectal cancer.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 610-610
Author(s):  
Azusa Komori ◽  
Hiroya Taniguchi ◽  
Yukiya Narita ◽  
Shiori Uegaki ◽  
Sohhei Nitta ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Short Interval ◽  
Progression Free Survival ◽  
Patient Characteristics ◽  
Free Interval ◽  
Significant Difference ◽  
Group A ◽  
Group B

610 Background: Both bevacizumab (Bev) and anti-EGFR agents are sequentially used for metastatic colorectal cancer (mCRC). Some basic studies reported the interaction between Bev and anti-EGFR agents in vivo. Therefore we hypothesized the shorter Bev-free interval may lead to poor outcome of anti-EGFR therapy. The aim of this study is to examine the association of the interval between last Bev administration and initial anti-EGFR agents with efficacy of anti-EGFR therapy. Methods: We retrospectively reviewed consecutive mCRC patients who underwent combination therapy of anti-EGFR agents and irinotecan after failure of fluoropyrimidines, oxaliplatin, irinotecan, and Bev at a single institution. We divided patients in two groups (group A: the interval between Bev and anti-EGFR agents <6M, group B: ≥6M). Results: A total of 114 patients constituted the cohort of analysis. The median age was 63; 78 (68%) patients were male. Most patients (N=100, 88%) were treated with cetuximab, and 14 patients were panitumumab. Seventy-four patients were group A and 40 patients group B, respectively. There was no significant difference in patient characteristics. Response rate was 24.7% in group A, and 50.0% in group B (p=0.0072). The patients in group B have significantly longer progression free survival (4.2 vs. 6.6 M, HR 0.65, 95% CI 0.43- 0.98, p=0.042) and longer overall survival (11.6 vs. 14.3 M, HR 0.62, 95% CI 0.39- 0.97, p=0.038). Conclusions: The short interval (<6M) between last Bev and anti-EGFR agents may interfere with the efficacy of anti-EGFR therapy.

scholarly journals Real world experience from 1000 patients. Preprocedural DOAC interruption impacts detectable DOAC serum levels but not adverse events after catheter ablation of atrial fibrillation

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Konstantinou ◽  
S Bordignon ◽  
T Tohoku ◽  
S Chen ◽  
F Bologna ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Adverse Events ◽  
Real World ◽  
Patient Characteristics ◽  
Af Ablation ◽  
Patient Profile ◽  
Significant Difference ◽  
Single Pill ◽  
Group A ◽  
Group B

Abstract Introduction Direct oral anticoagulation (DOAC) therapy represents the standard of care in patients with atrial fibrillation (AF) and increased stroke risk. In a real world setting withholding DOAC medication before elective AF ablation is considered to reduce procedural bleeding risks. The aim of this study was to determine the individual DOAC level prior to the ablation procedure, to identify predisposing factors affecting traceable DOAC levels and to screen for associated severe adverse events. Methods Between September 2016 and March 2019 blood samples were obtained from patients on DOAC before an elective AF ablation. Per institutional standard all patients have been instructed to pause DOAC medication prior ablation for one or two doses depending on the patient profile and type of medication. The time interval between ablation and last DOAC intake was calculated in hours. Patient characteristics, procedural data and in-hospital complications were noted from all patients. Results A total of 1000 patients (60% male, age: 68y, GFR 83.25: BMI: 28, CHADSVASC score 3) undergoing AF ablation were included. Two groups were defined. Group A (n=416, 41.6%): patients treated with “single pill” DOAC (Rivaroxaban (n=288, 28.8%) and Edoxaban (n=128, 12.8%)). Group B (n=584, 58.4%): patients treated with twice a day DOAC (Apixaban (n=505, 50.5%) and Dabigatran (n=79, 7.9%)). The only difference in patient characteristics was an increased prior bleeding history in group B. The DOAC pause was significantly longer in group A (mean 40h) compared to group B (mean 32h), p=0.026. In a total of 217 patients (21.7%) DOAC levels where traceable prior to AF ablation. Traceable DOAC levels were significantly more common in group B (n=144/584, 24.7%) compared to group A (n=73/416, 17.5%). Adverse events occurred in 5.7% of patients (0.4% stroke, 0.3% tamponade, 2.5% hematoma, 1.9% AV-fistel, 0.7% pseudoaneurysma). T-Test analysis showed no significant difference in the occurrence of adverse events between both groups. Conclusion Despite of interrupting DOACs before an elective AF ablation therapeutic substance levels can be detected in &gt;20% of patients. The rate of adverse events was not different between “single pill” vs. twice a day DOAC intake. Funding Acknowledgement Type of funding source: None

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