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.

Clinical Value of Computer-Assisted Taylor Three-dimensional External Fixation in the Treatment of Tibiofibular Fracture (Preprint)

2020 ◽  
Author(s):  
Hongfeng Sheng ◽  
Weixing Xu ◽  
Bin Xu ◽  
Hongpu Song ◽  
Di Lu ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Internal Fixation ◽  
External Fixation ◽  
External Fixator ◽  
Theoretical Basis ◽  
New Technology ◽  
Three Dimensional ◽  
Computer Assisted ◽  
Clinical Value

UNSTRUCTURED The retrospective study of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures provides a theoretical basis for the application of this technology. The paper collected 28 patients with tibiofibular fractures from the Department of Orthopaedics in our hospital from March 2015 to June 2018. After the treatment, the follow-up evaluation of Taylor's three-dimensional external fixator for the treatment of tibiofibular fractures and concurrency the incidence of the disease, as well as the efficacy and occurrence of the internal fixation of the treatment of tibial fractures in our hospital. The results showed that Taylor's three-dimensional external fixator was superior to orthopaedics in the treatment of tibiofibular fractures in terms of efficacy and complications. To this end, the thesis research can be concluded as follows: Taylor three-dimensional external fixation in the treatment of tibiofibular fractures is more effective, and the incidence of occurrence is low, is a new technology for the treatment of tibiofibular fractures, it is worthy of clinical promotion.

A Biomechanical Evaluation of Three Forms of Internal Fixation Used in Ankle Arthrodesis

1994 ◽  
Vol 15 (6) ◽  
pp. 297-300 ◽  
Author(s):  
Michael P. Dohm ◽  
James B. Benjamin ◽  
Jeffrey Harrison ◽  
John A. Szivek
Keyword(s):  
Internal Fixation ◽  
Plate Fixation ◽  
Ankle Arthrodesis ◽  
Biomechanical Study ◽  
The Other ◽  
Fixation Failure ◽  
Plate Group ◽  
Biomechanical Evaluation ◽  
The Stability ◽  
Fibular Strut

A biomechanical study was undertaken to evaluate the relative stability of three types of internal fixation used for ankle arthrodesis. Crossed screw fixation, RAF fibular strut fixation, and T-plate fixation were tested in 30 cadaver ankles using an MTS machine. T-plate fixation consistantly provided the stiffest construct when compared with the other types of fixation. Failure occurred by distraction of bony surfaces, posterior to the plane of fixation, in the crossed screw and RAF groups. In contrast, failure in the T-plate group occurred through compression of bone anterior to the midcoronal plane of the tibia. Although the stability of fixation is only one factor in determining the success or failure of ankle arthrodesis, the results of this study would support T-plate fixation over the other forms tested.

scholarly journals Arthroscopic fixation of humeral greater tuberosity fracture using a W-shaped suture

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Xiaocong Lin ◽  
Xiuxi Huang ◽  
Kaibin Fang ◽  
Zhangsheng Dai
Keyword(s):  
Internal Fixation ◽  
Range Of Motion ◽  
Shoulder Arthroscopy ◽  
Healing Time ◽  
Fixation Failure ◽  
Greater Tuberosity ◽  
Vas Score ◽  
Constant Murley Score ◽  
Significant Difference

Abstract Background Patients with greater tuberosity fractures of the humerus often require surgery. Therefore, there is a need to find a minimally invasive and effective surgical procedure with great patient outcomes. Aim To evaluate the clinical outcomes of the W-shaped suture technique under shoulder arthroscopy in the treatment of greater tuberosity fractures of the humerus. Methods In this retrospective study, a total of 17 patients were included. The fractures were closed, and there was no neurovascular injury. These patients underwent arthroscopically assisted reduction and internal fixation of the greater tuberosity fractures. Fixation was performed using sighting nails combined with a W-shaped suture. The imaging data of the patients were collected, and the ASES score, Constant-Murley score, and VAS score were used to evaluate the patient’s outcome. At the last follow-up (at least 1 year), the range of motion in the affected shoulder was compared with that of the contralateral side. Results The operation was successful in all the patients. The average follow-up time was 13 months. There were no reported complications such as fracture displacement, nonunion, and internal fixation failure during the follow-up period. Post-operative X-ray examinations revealed good function recovery, with a healing time of between 10 and 12 weeks, and an average healing time of 11.5 weeks. Following the operation, patients reported reduced shoulder joint pain that no longer influenced their activity or caused discomfort in their daily life. The patient’s VAS score ranged from 0 to 3, with an average of 0.52 ± 0.73, while at the last follow-up, the Constant-Murley score ranged from 83 to 97, with an average of 92.33 ± 7.55. The ASES score ranged from 81 to 98, with an average of 93.15 ± 6.93. At the last follow-up, there was no significant difference in the overall range of motion with the unaffected limb. Conclusion This study demonstrates that the W-shaped suture can be used to effectively fix the fractures of the greater tuberosity of the humerus, by increasing the fixed area to promote healing.

scholarly journals Comparison of Percutaneous Kyphoplasty with or without Pedicle Screw Fixation in Osteoporotic Thoracolumbar Vertebral Fractures: A Retrospective Study

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Dichao Huang ◽  
Jichong Ying ◽  
Dingli Xu ◽  
Jianming Chen ◽  
Jianlei Liu ◽  
...  
Keyword(s):  
Back Pain ◽  
Retrospective Study ◽  
Pedicle Screw ◽  
Vertebral Fractures ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Fixation Failure ◽  
Percutaneous Kyphoplasty ◽  
Significant Difference

Background. Osteoporotic thoracolumbar compression fractures have become a great social burden due to the aging tendency of population. This study is aimed at comparing the clinical and radiological outcomes of percutaneous kyphoplasty with or without pedicle screw fixation in patients with osteoporotic thoracolumbar fractures. Hypothesis. There is a difference in clinical outcomes between percutaneous kyphoplasty with pedicle screw fixation and percutaneous kyphoplasty. Methods. This retrospective study included 87 patients who received percutaneous kyphoplasty with or without pedicle screw fixation between October 2015 and October 2017 at Ningbo No.6 Hospital and were followed for 2 years. A total of 40 patients received percutaneous kyphoplasty with pedicle screw fixation (PKPF group), and the other 47 patients had percutaneous kyphoplasty only (PKP group). The outcomes were measured using the visual analogue scale (VAS), Oswestry Disability Index (ODI), Cobb angle (CA), and anterior vertebra height rate (AVHr), which were calculated at preoperative admission and each follow-up visit. Complications including postoperative back pain, refracture, and fixation failure were collected from medical records. Results. There was no significant difference in baseline characteristics or preoperative data between the two groups ( p < 0.05 ) but significantly better improvements in VAS, ODI, CA, and AVHr at 12- and 24-month follow-up visits in the PKPF group compared with those of the PKP group. 23 (48.9%) patients in the PKP group had complications, whereas only 5 (12.5%) patients in the PKPF group presented complications including 2 postoperative back pain and 1 fixation failure ( p = 0.04 ). Conclusions. PKPF obtained longer correction and better improvement in VAS, ODI, and CA in patients with osteoporotic thoracolumbar vertebral fractures than PKP.

scholarly journals  Subacromial Erosion after Hook Plate Fixation in Acute Acromioclavicular Joint Dislocation

2020 ◽  
Author(s):  
Jung Youn Kim ◽  
Yong Girl Rhee ◽  
Young Wan Ko ◽  
Sung Min Rhee
Keyword(s):  
Risk Factors ◽  
Computed Tomography ◽  
Acromioclavicular Joint ◽  
Plate Fixation ◽  
Hook Plate ◽  
Unaffected Side ◽  
Ct Findings ◽  
Ucla Score ◽  
The Mean

Abstract Background: This study was to analyze the clinical results of locking hook plate fixation for acute acromioclavicular joint (ACJ) injury and to find out the incidence of subacromial erosion, carry out quantitative analysis and identify risk factors. Methods: The study was conducted on 35 patients who underwent the locking hook plate fixation for acute ACJ joint injury. The clinical outcomes were evaluated measuring the visual analog scale (VAS) for pain, and the University of California at Los Angeles (UCLA) score. The computed tomography (CT) was conducted to measure the subacromial erosion. The acromioclavicular slope (AC slope) of the unaffected side, the acromion-hook angle (AH angle), the acromioclavicular anteroposterior distance (AC-AP distance), and the preoperative acromioclavicular interval (ACI) of the affected side were analyzed to identify the risk factors of subacromial erosion. Results: The mean preoperative VAS score was 7.6 points, which improved by a significant level of 0.3 at the final follow-up (P <0.001). The UCLA score at the last follow-up was 32.3 points, which was higher than the preoperative average of 15.2 points (P = 0.003). According to the computed tomography (CT) findings, subacromial erosion was found in all cases, and the mean value was 5.0mm, which is 53% of the entire acromion thickness. The AC slope (B=-0.159, P<0.001) and AC-AP distance (B=0.233, P=0.004) were found to have a significant influence on postoperative subacromial erosion. The AC slope showed a negative correlation with the amount of erosion, while the AC-AP distance showed a positive correlation with erosion. onclusion: The study was able to obtain satisfactory clinical and radiological results after locking hook plate fixation for acute ACJ injury. The CT findings revealed that subacromial erosion occurred in all cases, and the mean erosion depth was about 50% of the acromial thickness. If the preoperative AC slope of the unaffected side was more acute and the AC-AP distance was larger, the incidence of subacromial erosion was higher. Level of evidence: Therapeutic Level IV Retrospectively registered study: This study was retrospective in nature, and final approval of informed consent exemption by the institutional review board was obtained (KHUH IRB 2019-04-079)

scholarly journals Comparative Outcome of Loop Suspensory Reconstruction and Hook Plate Fixation for Acute Type III-V Acromioclavicular Joint Dislocation

2020 ◽  
Author(s):  
Yu-Jui Chang ◽  
Wen-Yi Chou ◽  
Jih-Yang Ko ◽  
Hao-Chen Liu ◽  
Ya-Ju Yang ◽  
...  
Keyword(s):  
Plate Fixation ◽  
Hook Plate ◽  
Ac Joint ◽  
Joint Dislocation ◽  
Constant Murley Score ◽  
Group I ◽  
Ac Joint Dislocation ◽  
Group Ii ◽  
Reconstruction Group

Abstract Background Treatment options of acromioclavicular (AC) joint dislocation depend on the injury severity and the functional demand of the patient. Common surgical options include fixation across the AC joint, coracoclavicular (CC) fixation, and AC joint or CC reconstruction. However, the clinical superiority of these various procedures is controversial. This study aimed to compare the clinical and radiological outcomes of loop suspensory reconstruction and hook plate fixation for acute unstable AC joint dislocation.Methods We retrospectively included patients with acute unstable AC joint dislocation who were treated with loop suspensory reconstruction (group I, 23 cases) or hook plate fixation (group II, 14 cases) in our hospital from January 2010 to December 2016 with a minimum follow-up period of 1 year after surgery. We assessed the clinical outcomes of blood loss during surgery, surgical duration, duration of medication required for pain relief after the primary operation, occurrence of complications, and the Constant-Murley score; radiological analysis included postoperative arthritic change and the CC distance discrepancy ratio (CCDR) on preoperative and final follow-up plain films.Results The average follow-up duration was17.0±6.1 months. The mean duration of pain-control medication usage was 121.7±174.1 and 235.4±251.8 days in groups I and II, respectively, significantly lower in the CC reconstruction group (p=0.031). Group I revealed a superior Constant-Murley score at the final outpatient follow-up as compared with group II (71.7±15.8 vs 61.1±6.7, p=0.009). Regarding radiographic analysis, the hook plate group had a superior residual CCDR (group I vs II = 30% vs 80±40%, p<0.001). In addition, there were 9 cases of subluxation noted in group I and 2 cases in group II; however, 4 cases of acromion osteolysis were observed in group II.Conclusions The principle finding of the present study was that hook plate fixation was superior to loop suspensory reconstruction in terms of CC distance maintenance. However, the loop suspensory reconstruction group demonstrated superior clinical functional outcomes and less painkiller usage. A further randomized controlled trial with a long-term follow-up period is required.

Addition of an Oblique Interfragmentary Screw to T-plate Fixation Decreases Nonunion Rate in Trapeziometacarpal Arthrodesis

Hand ◽  
2020 ◽  
pp. 155894472093736
Author(s):  
Lacey R. Pflibsen ◽  
Shelley S. Noland ◽  
Annica C. Eells ◽  
Anthony A. Smith
Keyword(s):  
Surgical Technique ◽  
Plate Fixation ◽  
Complete Healing ◽  
Dominant Hand ◽  
Popular Method ◽  
Novel Technique ◽  
Clinical Healing ◽  
Mean Time ◽  
Radiographic Union

Background: T-plate fixation is a popular method for trapeziometacarpal arthrodesis in patients with osteoarthritis. Previous studies report an 8% to 18% rate of symptomatic nonunion and a 26% rate of radiographic nonunion. In this study, we present our surgical technique of trapeziometacarpal arthrodesis using the addition of an oblique interfragmentary screw to T-plate fixation on the rate of symptomatic and radiographic nonunion. Methods: A retrospective review of all trapeziometacarpal arthrodeses for osteoarthritis was completed by a single surgeon between 2010 and 2018. Preoperative demographics, pain, and Eaton classification were included. The technique was identical in all surgical cases, using a T-plate and oblique interfragmentary screw across the arthrodesis site from the metacarpal to the trapezium. Postoperative nonunion rate and time to clinical healing (absence of pain) and radiographic union were reviewed. Results: A total of 22 trapeziometacarpal arthrodeses were performed on 17 patients using the above technique. The average age was 53 years, 71% were women, and 53% involved the dominant hand. Mean preoperative Eaton classification was 2.74 (±0.73). Mean time to clinical healing was 34 days (±12 days), and mean time to radiographic union was 55 days (±23 days). Mean follow-up was 9 months, and no patients were found to have symptomatic or radiographic nonunion. Hardware removal was required bilaterally in 1 patient after complete healing. Conclusions: The addition of an oblique interfragmentary screw to T-plate fixation is a novel technique in trapeziometacarpal arthrodesis, resulting in no symptomatic or radiographic nonunion.

scholarly journals Aesthetic Treatment of Tillaux-Chaput fractures

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0022
Author(s):  
Shi-Ming Feng
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Weight Bearing ◽  
Ankle Arthroscopy ◽  
X Rays ◽  
The Mean ◽  
American Orthopaedic ◽  
Ankle Function ◽  
Primary Healing

Category: Arthroscopy Introduction/Purpose: This study aim to investigate the clinical result of treating Tillaux-Chaput fractures using the all-inside ankle arthroscopy technique. Methods: We retrospectively evaluated 23 Tillaux-Chaput fractures patients who underwent all-inside ankle arthroscopy technique and were follow-up from May 2013 to June 2016. There were 15 males and 8 females, with the mean age of 30.4 years (range, 10-57 years). Right ankle was involved in 15 patients and left ankle in 8 patients. Eighteen patients had single Tillaux-Chaput fractures and 5 patients had combined proximal fibular fractures. While 20 cases were diagnosed by X-rays and 3 cases by CT. Ankle arthroscopy was used through the anterolateral and anteriormedal approaches for closed reduction and internal fixation using Herbert screw(s). The joints function was performed using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot scale score. Results: Operative incisions of 23 cases were primary healing without complications of nerve, vessel and tendon injuries. The period of follow-up was 19.6 months (range, 12-25 months) and the time of Fracture union was 23.3 weeks (range, 12-36 weeks). At the time of last follow-up, none of the patients had any restriction in the ankle function and range of motion, with the ankle pain and weight-bearing walking pain. AOFAS score was changed from preoperative 53.3 points to 92.1 points, with the excellent-good rate of 100%. Conclusion: All-arthroscopy teatment by the anterolateral and anteriormedal approaches is a precise and effective method for closed reduction and internal fixation of Tillaux-Chaput fractures and deserves clinical application.

scholarly journals Antibiotic cement plate composite structure internal fixation after debridement of bone infection

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xiaohua Wang ◽  
Shulin Wang ◽  
Jianzhong Xu ◽  
Dong Sun ◽  
Jie Shen ◽  
...  
Keyword(s):  
Infection Control ◽  
Internal Fixation ◽  
Composite Structure ◽  
Bone Infection ◽  
Control Effect ◽  
Fixation Failure ◽  
Infection Control Rate ◽  
Antibiotic Cement ◽  
Epidermal Necrosis

AbstractAn internal fixation composite structure of antibiotic cement plates was created. The aim of this study was to analyse the infection control effect of this structure when applied to treat a bone infection. We retrospectively analysed patients with bone infection admitted to our hospital between January 2013 and June 2019. After debridement, an antibiotic cement plate composite structure was used to fill and stabilize the defects. The treatment effect was evaluated at six months after surgery, and the infection control rate, factors associated with the recurrence of infection, and complications were analysed. If the patients had bone defects, the defect was repaired after infection control, and the infection control rate of all of the patients was re-evaluated at 12 months after surgery. A total of 548 patients were treated with this technique, including 418 men and 130 women. The infection sites included 309 tibias, 207 femurs, 16 radii and ulnae, 13 humeri, and 3 clavicles. After at least 6 months of follow-up, 92 patients (16.79%) had an infection recurrence and needed further treatment. The recurrence rate of the tibia was higher than that of the femur (P = 0.025). Eighty-nine out of 92 patients who relapsed underwent a second debridement with the same method, and the infection control rate after the second debridement was 94.71%. Complications included 8 cases of epidermal necrosis around the incision, 6 cases of internal fixation failure, and 30 cases of lower limb swelling. By the follow-up time of 12 months, another 6 patients had experienced recurrence of infection, and 4 cases were controlled after debridement. Finally, among all 548 cases, 7 patients remained persistently infected, and 6 underwent amputation. The infection control rate was 97.6% at the 1-year follow-up. The clinical efficacy of this new antibiotic cement plate composite structure for internal fixation after debridement of bone infection is stable and reliable.

scholarly journals Retrospective study about the postoperative stability of zygomaticomaxillary complex fracture

2021 ◽  
Vol 43 (1) ◽  
Author(s):  
Seoghwan Yang ◽  
Jin-yong Cho ◽  
Woo-chul Shim ◽  
Sungbeom Kim
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Internal Fixation ◽  
Open Reduction ◽  
Complex Fracture ◽  
Significant Difference ◽  
Zygomaticomaxillary Complex Fracture ◽  
The Difference ◽  
Zygomaticomaxillary Complex

Abstract Background The aim of this study is to evaluate the postoperative stability of zygomaticomaxillary complex (ZMC) fractures according to the number of fixation sites and to investigate the direction of postoperative displacement of the unfixed part of the fractured segment. Methods This study was retrospectively performed on 38 patients who were treated by open reduction and internal fixation of ZMC fractures and were taken postoperative computed tomography (CT) between February 2012 and July 2019. The patients were classified into 3 groups: 1-point fixation, 2-point fixation, 3-point fixation according to the number of fixations. The postoperative displacement of the fractured segment was evaluated by the superimposition between postoperative CT and follow-up CT, and the postoperative stability according to the fixation sites was investigated through the amount of postoperative displacement. In addition, it was investigated in which direction the location of the fractured segment was changed in the unfixed fractured segment according to the fixation sites. Results The amount of postoperative displacement of the fractured segment was 0.75 ± 1.18 mm on average. In the postoperative displacement of the distal area according to the number of fixation of the fracture, there was no statistically significant difference in the amount of displacement of the fracture (p = 0.574). As for the direction of the change in the location of the fractured segment, 12 patients among 38 patients with the change in the location of the fractured segment were investigated, and the displacement in the medial direction (n = 11, 91.67%) was the most common in all three fixation methods. Conclusion In patients with a ZMC fracture who were treated by open reduction and internal fixation, the number of fixations did not make the difference in the postoperative displacement of the fracture. In addition, the fractured segment mainly changes in the medial direction after surgery, and this fact can be used as a reference for the reduction direction during surgery for the stable prognosis.

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