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.

COMPARATIVE STUDY OF FUNCTIONAL OUTCOME OF OLECRANON FRACTURE TREATED WITH TENSION BAND WIRING AND CANNULATED COMPRESSIVE SCRE

2021 ◽  
pp. 71-72
Author(s):  
Ranjeet Kumar ◽  
Shambhu Prasad ◽  
Shailendra Kumar
Keyword(s):  
Functional Outcome ◽  
Operation Time ◽  
Cancellous Screw ◽  
Fracture Union ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Intramedullary Screw ◽  
Orthopaedic Injuries ◽  
Olecranon Fractures

Olecranon fractures are one of the most commonly seen orthopaedic injuries in the emergency room. There are various types of management including non-operative, TBW using k wire, TBW using Cancellous screw, plating, intramedullary screw xation, olecranon excision (1). Our study is to compare functional outcome of two operative methods namely TBW and intramedullary CCS xation. 25 patients were retrospectively analysed and divided into two groups. Group A (n=13) patients were treated by TBW and group B (n=12) by CCS. All the cases were followed up and the results were analysed by using a Mayo Elbow Performance Index. The mean operation time in group Awas 46.63 minutes and 35.40 minutes in group B .The mean fracture union time in group A was 15.62 weeks (range 8–24 weeks), and 14.24 weeks in group B. Excellent results were achieved with 6.5mm CCS in 8(66.6%) patients while with TBW K wire 7(53.8%) patients, good results were achieved with 6.5mm CCS with Washer in 3(25%) patients while with TBW K wire 4(30.7%) patients fair results were achieved 6.5mm CCS in 1(8.33%) patients while with TBWK wire 2(15.38%) patients. The technique of close reduction and internal xation with CCS is as effective as open reduction and internal xation with T

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.

Outcomes of Thoracolumbar Burst Fracture in Patients With Osteoporosis Without Neurologic Symptoms: Analysis of Three Different Surgical Approaches

2019 ◽  
Vol 9 (8) ◽  
pp. 1052-1057
Author(s):  
Tao Li ◽  
Yonghong Zheng ◽  
Zhengwei Xu ◽  
Dingjun Hao ◽  
Lixiong Qian
Keyword(s):  
Blood Loss ◽  
Internal Fixation ◽  
Hospital Stay ◽  
Burst Fracture ◽  
Surgical Approaches ◽  
Intraoperative Blood Loss ◽  
Thoracolumbar Burst Fracture ◽  
Neurologic Symptoms ◽  
Group A ◽  
Group B

This study aimed to compare the outcomes of thoracolumbar burst fractures in patients with osteoporosis without neurologic symptoms according to the surgical approach. The patients in group A underwent percutaneous balloon kyphoplasty, those in group B underwent minimally invasive percutaneous reduction and internal fixation, and those in group C underwent open reduction with bone graft fusion and internal fixation. Fracture reduction was assessed by X-ray. The operative time in group A was shorter than that in groups B and C, with less intraoperative blood loss and shorter hospital stay. The intraoperative blood loss was less in group B than in group C, with shorter hospital stay. The postoperative visual analog scale scores were lower than the preoperative scores in each group. Cobb's angle of the injured vertebra in the last follow-up was larger in group A than in groups B and C. Regarding complications, in group A, nine patients developed postoperative bone cement leakage that required no specific treatment. In group B, one patient developed subcutaneous hematoma that healed well after treatment. The screw channel was loosened in two patients without symptoms; the screws were removed 1 year later. In group C, delayed incision healing was found in five patients. All three surgical approaches safely and effectively relieved the lower back pain in patients with thoracolumbar burst fracture with osteoporosis but without neurologic symptoms.

scholarly journals Lumbodorsal flap for repair of meningomyelocele- a procedure matched controlled study

2017 ◽  
Vol 4 (5) ◽  
pp. 1678
Author(s):  
Gungi Raghavendra Prasad ◽  
Deepak Sharma ◽  
J. V. Subba Rao ◽  
P. Siva Kumar ◽  
Amtul Aziz
Keyword(s):  
Soft Tissue ◽  
Neural Tube ◽  
Wound Dehiscence ◽  
Csf Leak ◽  
Controlled Study ◽  
Skin Closure ◽  
Fascial Flap ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Background: Open neural tube defects have been approached by innumerable surgical techniques. Hitherto, excision of the exposed neural tube component, water tight closure of dura, approximation of paraspinal soft tissue and skin closure repair was stressed. Support of vertebral defect was not adequately addressed. Objectives were to introduce lumbodorsal/thoraco dorsal fascial flap as an effective answer to the vertebral defect component of MMC. To compare conventional paraspinal soft tissue closure with lumbodorsal/ thoracodorsal fascial flap.Methods: This was a procedure matched controlled study conducted from 1984-2015. A total of 121 procedures were performed by the same team formed the cohort of the study. Conventional muscle mobilization group A (n=50) and lumbodorsal flap group B (n=71) were the two groups. Demographic data, CSF leak, CSF collection, wound dehiscence, duration of drain and duration of surgery were the parameters evaluated with statistically blinded method.Results: The series mostly constituted lumbar (28%) and lumbo-sacral meningomyelocele (56%). Most of the children in both the groups are either at birth or <1 month. Only few patients in group B with lipo-meningocele presented beyond the age of 5 years (7%). 12% in group A had hydrocephalus, whereas 15.4% had in group B. The patients underwent similar technique at all sites of MMC. Grossly it appears that there is less wound dehiscence, less CSF leak, less hygroma formation in group B cases. Duration of surgery is similar in both the groups, most of them requiring 60 to 120 minutes. The duration of drainage was more than 7 days in group A (34%) as compared to group B (20%).Conclusions: Lumbodorsal/thoraco dorsal fascial flap adequately supports the vertebral defect and skin flaps. They seem to be superior in addressing the vertebral defect component.

scholarly journals Comparative study of tension band wiring and pre contoured locking compression plate fixation in olecranon fractures in adults

2021 ◽  
Author(s):  
Mohit Mahoviya ◽  
Pradeep Choudhari ◽  
Divyanshu Patel ◽  
Arpit Choyal
Keyword(s):  
Comparative Study ◽  
Internal Fixation ◽  
Plate Fixation ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Improvement Rate ◽  
Articular Fractures ◽  
Group A ◽  
Group B ◽  
Olecranon Fractures

<p class="abstract"><strong>Background:</strong> Olecranon fractures are about 10% of all proximal forearm fractures.Mostly intra articular fractures, require anatomical reduction and internal fixation for satisfactory clinical outcomes. The most commonly used techniques are still tension band wiring (TBW) and plate fixation (PF). The aim of the current study is to discuss whether TBW or PF technique of internal fixation is better in the treatment of olecranon fractures.</p><p class="abstract"><strong>Methods:</strong> This is a comparative study including 30 adult patients of olecranon fracture classified by Mayo classification and operated upon by tension band plating (group A) and tension band wiring (group B) at Department of Orthopaedics, Sri Aurobindo Medical College and PG Institute, Indore. All operated cases between the period of January 2018 to August 2019 with follow up of 1 year were assessed on the basis of functional outcome using Mayo elbow performance score<strong> </strong>(MEPS).<strong></strong></p><p class="abstract"><strong>Results:</strong> The MEPS, 73% of the patients in group A achieved a good to excellent results in comparison to 60% in group B. no significant differences between the two groups could be detected regarding the clinical and radiographic outcome.</p><p class="abstract"><strong>Conclusions:</strong> Both TBW and PF interventions had treatment benefit in OFs. The current study reveals that there are no significant differences in MEPS, improvement rate and ROM between TBW and PF for OFs. More high-quality studies are required to further confirm our results as most of the cases included in study belonged to Mayo type IIA category.</p>

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.

scholarly journals Efficacy of Intraperitoneal Bupivacaine on Pain Relief After Laparoscopic Cholecystectomy

PRILOZI ◽  
2018 ◽  
Vol 39 (1) ◽  
pp. 123-129 ◽  
Author(s):  
Marija Toleska ◽  
Andrijan Kartalov ◽  
Biljana Kuzmanovska ◽  
Milcho Panovski ◽  
Mirjana Shosholcheva ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Local Anesthetic ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Intraperitoneal Instillation ◽  
Group A ◽  
Vas Scores ◽  
Group B

Abstract Introduction: Patients undergoing laparoscopic cholecystectomy do experience postoperative pain, especially in the abdomen. Postoperative pain management remains a major challenge after laparoscopic procedures. Administration of intraperitoneal local anesthetic (IPLA) after surgery is used as a method of reducing postoperative pain. In this study, we evaluated the effect of intraperitoneal infiltration of local anesthetic (bupivacaine) for pain relief after laparoscopic cholecystectomy. Material and methods: In this prospective, controlled, and randomized study were included 50 patients aged 25-60 years (35 female and 15 male), scheduled to laparoscopic cholecystectomy with ASA classification 1 and 2. Patients were classified randomly into two groups: group A, which included 25 patients who received intraperitoneal instillation of bupivacaine 0.5% 20 ml; and group B, which included 25 patients who didn’t receive any intraperitoneal instillation. Postoperative pain was recorded using the visual analogue scale (VAS) for 24 hours after laparoscopic cholecystectomy. Results: There was no significant difference with respect to age, weight, and sex; duration of surgery; and anesthesia time. VAS scores at different time intervals were statistically significantly lower at all times in group A compared to group B. There were statistically significant differences in VAS scores between group A and group B at all postoperative time points - 1hr,4 hr,8 hr,12hr and 24hr (p < 0.00001). Conclusion: Intraperitoneal instillation of bupivacaine provides good analgesia in the postoperative period after laparoscopic cholecystectomy.

scholarly journals Microsurgical unilateral laminotomy for bilateral decompression of degenerative lumbar canal stenosis: a comparative study

2019 ◽  
Vol 55 (1) ◽  
Author(s):  
Mohamed I. Refaat ◽  
Amr K. Elsamman ◽  
Adham Rabea ◽  
Mohamed I. A. Hewaidy
Keyword(s):  
Patient Satisfaction ◽  
Blood Loss ◽  
Minimally Invasive ◽  
Invasive Technique ◽  
Decompression Surgery ◽  
Microsurgical Decompression ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Group A ◽  
Group B

Abstract Background The quest for better patient outcomes is driving to the development of minimally invasive spine surgical techniques. There are several evidences on the use of microsurgical decompression surgery for degenerative lumbar spine stenosis; however, few of these studies compared their outcomes with the traditional laminectomy technique. Objectives The aim of our study was to compare outcomes following microsurgical decompression via unilateral laminotomy for bilateral decompression (ULBD) of the spinal canal to the standard open laminectomy for cases with lumbar spinal stenosis. Subjects and methods Cases were divided in two groups. Group (A) cases were operated by conventional full laminectomy; Group (B) cases were operated by (ULBD) technique. Results from both groups were compared regarding duration of surgery, blood loss, perioperative complication, and postoperative outcome and patient satisfaction. Results There was no statistically significant difference between both groups regarding the improvement of visual pain analogue, while improvement of neurogenic claudication outcome score was significant in group (B) than group (A). Seventy-three percent of group (A) cases and 80% of group (B) stated that surgery met their expectations and were satisfied from the outcome. Conclusion Comparing ULBD with traditional laminectomy showed the efficacy of the minimally invasive technique in obtaining good surgical outcome and patient satisfaction. There was no statistically significant difference between both groups regarding the occurrence of complications The ULBD technique was found to respect the posterior spinal integrity and musculature, accompanied with less blood loss, shorter hospital stays, and shorter recovery periods than the open laminectomy technique.

scholarly journals Monopolar Diathermy Tonsillectomy Versus Dissection Method Tonsillectomy

KYAMC Journal ◽  
2019 ◽  
Vol 10 (1) ◽  
pp. 21-24
Author(s):  
Md Abdus Salam ◽  
Md Mahbub Alam ◽  
Rezwan Ahmed ◽  
Md Sultan Mahmud
Keyword(s):  
Postoperative Pain ◽  
Postoperative Bleeding ◽  
Throat Pain ◽  
Medical College ◽  
Advantages And Disadvantages ◽  
Case Surgery ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Dissection Method

Background: Tonsillectomy is one of the most common surgical procedures performed worldwide by otorhinolaryngologists for different indications. Tonsillectomy is often performed as day-case surgery, which increases the demands of a satisfactory postoperative pain control and a low risk of early postoperative bleeding. Objective: The aim of the study was to compare the Monopolar diathermy and Dissection methods of tonsillectomy and evaluate their advantages and disadvantages during surgery, convalescence. Materials and Methods: Two hundred children were recruited for this study during the period of five years from January, 2014 to December, 2018 at Otolaryngology department of Khwaja Yunus Ali Medical College and Hospital (KYAMCH). Subjects between the age of 5 and 25 years listed for tonsillectomy were included. Subjects were recommended not to have aspirin within the 2 weeks before surgery. Results: The mean duration of operation was found 10.6±0.4 minutes in group A and 17.0±0.7 minutes in group B. The difference was statistically significant (p<0.05) between two groups. At 1st day, 11(11.0%) patients had throat pain in group A and 23(23.0%) in group B. At 2nd day, 14(14.0%) patients had throat pain in group A and 25(25.0%) in group B. Which were statistically significant (p<0.05) between two groups. Conclusion: The monopolar diathermy tonsillectomy appears to cause less bleeding, postoperative pain and less time consuming in compare with the dissection tonsillectomy although patients experience slightly more pain than dissection Method. KYAMC Journal Vol. 10, No.-1, April 2019, Page 21-24

scholarly journals Non-locking buttress plate in distal tibial metaphyseal fractures

2018 ◽  
Vol 1 (2) ◽  
pp. 87-91
Author(s):  
Norman Lamichhane ◽  
Bhogendra Bahadur KC ◽  
Chandra Bahadur Mishra ◽  
Sabita Dhakal
Keyword(s):  
Soft Tissue ◽  
Weight Bearing ◽  
Delayed Union ◽  
Full Weight Bearing ◽  
Distal Fibula ◽  
Fibula Fracture ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Metaphyseal Fractures

Background: Treatment of distal tibial metaphyseal fractures is often challenging and no single technique has been unanimously advocated. Open reduction and internal fixation with plates and screws allows better restoration of anatomical alignment but with more soft tissue complication. Simultaneous fixation of the fibula is not universally carried out. This study aims at evaluation of the outcome of plating technique and the effect of fixation of fibula fracture in treatment of distal tibial metaphyseal fractures. Material and methods: Thirty-one cases (14 cases in Group A with concomitant distal fibula fracture and 17 cases in Group B without distal fibula fracture) were analyzed retrospectively for the mean duration of full weight bearing, mean union time and complications, and compared. Results: The mean time for full weight bearing and radiological union in our study was 14.2 weeks (15.9 in Group A and 13.1 in Group B) and 23.8 weeks (26.6 in Group A and 21.5 in Group B) respectively. 16.1% of cases had post-operative complications including one case of deep infection and malalignment of 6 degree varus (following delayed union) was seen in one case of Group A. Range of motion (ROM) at ankle was not problem in any of the cases except the one delayed union which had 5 degrees of dorsiflexion and 15 degrees of plantiflexion. Conclusion: Open reduction and internal fixation with plate and screws in distal tibial metaphyseal fracture is more economic means of treatment modality with comparable incidence of post-union malalignment and union time,though more soft tissue complications compared to other modalities. Fixation of fibula fracture aids in reducing the incidence of malalignment.

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