scholarly journals Efficacy and Sagittal Parameters of Debridement and Bone Grafting using Internal Fixation in the Treatment of Kyphotic Cervical Tuberculosis: A Case Series

2021 ◽  
Author(s):  
Haopeng Luan ◽  
Kai Liu ◽  
Qiang Deng ◽  
Weibin Sheng ◽  
Maierdan Maimaiti ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Bone Grafting ◽  
Case Series ◽  
Cervical Vertebra ◽  
Fixation Group ◽  
Post Operation ◽  
Group A ◽  
Sagittal Parameters ◽  
Radiographic Data

Abstract Background: To evaluate the efficacy of debridement and bone grafting using internal fixation in the treatment of kyphotic cervical tuberculosis, and analyze the changes of pre-operation and post-operation sagittal parameters, which related to the surgical indications.Methods: Clinical and radiographic data of patients with kyphotic cervical TB treated by debridement and BGIF at our hospital from January 2010 to December 2017 were analyzed retrospectively. The sagittal parameters of the cervical vertebra at the pre-operation, post-operation, and last follow-up were documented and were compared. Results: Eighteen patients of simple anterior approach debridement and fusion with internal fixation (group A), and 5 patients underwent anterior debridement and fusion, combined with posterior internal fixation (group AP). In the comparison of preoperative sagittal parameters, significant improvement after surgery was observed in both groups, included Cobb angle, SCA, C2-C7SVA, and CG-SVA (P < 0.05). There were no significant differences in T1 Slope, NT, and TIA (P > 0.05).Conclusions: In the treatment of kyphotic cervical TB, the characteristics of the lesion, the degree of kyphosis and spinal cord nerve compression damage can be presented clearly by the radiographic sagittal parameters, which does a favor to individualize the choice of surgical approach safely and effectively.

scholarly journals INTER-TROCHANTERIC FRACTURES;

2019 ◽  
Vol 26 (03) ◽  
Author(s):  
Farhad Alam ◽  
Mudassar Jabeen
Keyword(s):  
Internal Fixation ◽  
Case Series ◽  
Deep Infection ◽  
Dynamic Hip Screw ◽  
Intertrochanteric Fractures ◽  
Superficial Infection ◽  
Group A ◽  
Hip Screw ◽  
Group B

Introduction: Hip fractures are a leading cause of death and disability among elderly. Approximately half of these injuries are intertrochanteric fractures and the incidence is continuously increasing. These fractures are the most common injuries around the hip region and are more common in elderly people. Different types of implants were tried at different times for internal fixation of these fractures, of which dynamic hip screw has remained the most popular one. But with the advent of some newer implants, the efficacy of dynamic hip screw is being questioned. Objectives: To determine the results of dynamic hip screw as a method of internal fixation in closed stable as well as unstable intertrochanteric fractures of femur in adults. Design: Descriptive case series. Setting: The study was conducted in orthopedic department Allied Hospital Faisalabad. Period: 11months (from 26th, march, 2015 to 25th Feb, 2016). Subjects and Methods: Sixty cases of intertrochanteric fractures were included and operated for internal fixation with dynamic hip screw under fluoroscopic guidance. Pre, per and post-operative findings during hospital stay and follow-up period were recorded. Results: We had a total 60 cases, 20 patients in group A stable intertrochanteric fractures and 40 patients in group B unstable intertrochanteric fractures. We have reported the follow up study up to 20 weeks. There were 10 (50%) male and 10 (50%) female in group A. In group B 27 (67.5%) males and 13 (32.5%) females. The youngest pt was 25 years in group A and 16 years in group B. The mean age in group A was 59.10 and st/deviation 16.942. In group B mean age was 54.85 and st/ deviation 14.123. Infection rate in group A was 5%. In group B superficial infection was 5% and deep infection was 2.5%. Nonunion in both groups was 5%. The failure rate was 5% in group A and 20% in group B. Conclusion: The use of Dynamic hip screw with aside plate is associated with good results and acceptable complication rate. Dynamic hip screw is implant of choice in both stable and unstable intertrochanteric fractures.

scholarly journals Clinical effect of combined anterior and posterior approach surgery for cervical spondylotic myelopathy

2018 ◽  
Vol 1 (1) ◽  
pp. 7
Author(s):  
Jiang Yanzhou ◽  
Fu Lianchong ◽  
Mu Yushan
Keyword(s):  
Internal Fixation ◽  
Bone Graft ◽  
Clinical Efficacy ◽  
Posterior Approach ◽  
Cervical Vertebra ◽  
Clinical Effectiveness ◽  
Fusion Rate ◽  
Group A ◽  
Pairwise Differences

Objective: To evaluate the clinical efficacy of combined anterior and posterior approach surgery for patients with spinal type. Methods: 96 patients with cervical spondylosis were randomly selected among all patients admitted in our hospital from January 2013 to December 2015. They were evenly assigned to A, B or C group, 32 patients each.  Patients in Group A suffered from cervical myelopathy and were treated by combined anterior and posterior approach. Patients in Group B group suffered from cervical vertebra disease and accepted a cervical corpectomy decompression and a bone graft fusion internal fixation surgery. Patients in Group C accepted conventional posterior decompression and fusion surgery for lateral mass screw fixation. Postoperative follow-up, X-ray intervertebral stability and fusion, neurological function JOA score and clinical efficacy of the effective date were compared. Results: JOA scores of all three groups were improved after 6 months. After a year, patients in Group A, B and C scored (16.3 ± 1.83), (15.7 ± 1.15) and (15.59 ± 1.21), respectively. The pairwise score differences between any two groups were statistically significant (P &lt; 0.05). After one year’s follow-up, the bone graft and internal fixation material had no signs of loosening, displacement or subsidence. The fusion rates of Group A, B and C reached 90.6%, 53.1% and 56.25%, respectively. Similarly, the pairwise differences in fusion rate between any two groups were statistically significant (P &lt; 0.05). The clinical effectiveness was classified as apparent, effective, fair and invalid. The effective rates of Group A, B and C were 87.5%, 50% and 56.2%, respectively. The pairwise differences between any two groups were statistically significant (P &lt; 0.05). Conclusion: Combined anterior and posterior approach surgery significantly improved the clinical efficacy than the other two surgeries.

scholarly journals Management of Isolated Capitate Nonunion: A Case Series and Literature Review

2018 ◽  
Vol 07 (05) ◽  
pp. 419-423 ◽  
Author(s):  
Rishabh Jethanandani ◽  
Schneider Rancy ◽  
Keith Corpus ◽  
Jeffrey Yao ◽  
Scott Wolfe
Keyword(s):  
Literature Review ◽  
Internal Fixation ◽  
Bone Grafting ◽  
Relevant Literature ◽  
Case Series ◽  
Rare Condition ◽  
Vascular Supply ◽  
Autogenous Bone ◽  
Rare Injury ◽  
Autogenous Bone Grafting

Background Isolated capitate nonunion is rare. No consensus on the appropriate treatment for this condition exists. Case Description We reported two cases of capitate fracture nonunion presenting several months after untreated high-impact wrist trauma. Treatment was delayed as both patients' nonunions were missed on conventional radiographs. Both were ultimately diagnosed with advanced imaging and successfully treated with internal fixation and autogenous bone grafting. The relevant literature pertaining to capitate nonunion was reviewed. Literature Review Immobilization and internal fixation with bone grafting for capitate nonunion have been described in the literature. Loss of vascular supply and progression to avascular necrosis is a concern after capitate nonunion. Clinical Relevance We present two cases and review the literature on the diagnosis and treatment of this rare injury to guide management. Internal fixation with autogenous bone grafting could play a role in management for this rare condition.

scholarly journals One-Stage Anterolateral Debridement, Bone Grafting, and Internal Fixation for Treating Lumbosacral Tuberculosis

2017 ◽  
Vol 11 (2) ◽  
pp. 305-313 ◽  
Author(s):  
Tao Zhang ◽  
Lihua Ma ◽  
Xu Lan ◽  
Ping Zhen ◽  
Shiyong Wang ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Erythrocyte Sedimentation Rate ◽  
Sedimentation Rate ◽  
Bone Grafting ◽  
Oswestry Disability Index ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
One Stage ◽  
Erythrocyte Sedimentation

<sec><title>Study Design</title><p>Retrospective case series.</p></sec><sec><title>Purpose</title><p>To investigate the clinical efficacy and feasibility of one-stage anterolateral debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis.</p></sec><sec><title>Overview of Literature</title><p>There has been no consensus regarding the optimal means of treating lumbosacral tuberculosis. The one-stage anterolateral extraperitoneal approach for radical debridement, bone grafting, and internal fixation for treating lumbosacral tuberculosis is rare in literature.</p></sec><sec><title>Methods</title><p>Twenty-one patients with lumbosacral tuberculosis were retrospectively analyzed. All patients underwent the surgery of anterolateral debridement after regularly antituberculous drugs therapy. We evaluated the erythrocyte sedimentation rate, C-reactive protein, radiography, computed tomography, magnetic resonance imaging, visual analogue score, and Oswestry disability index before and after surgery.</p></sec><sec><title>Results</title><p>All patients completed a follow-up survey 9–48 months after surgery. All patients' wounds healed well without chronic infection or sinus formation, and all patients with low-back pain reported relief after surgery. All cases had no tuberculosis recurrence. Solid bony fusion was achieved within 6–12 months. At final follow-up, evaluated the erythrocyte sedimentation rate decreased from 38.1±12.5 to 11.3±7.1 mm/hr, C-reactive protein decreased from 6.2±4.2 to 1.6±1.3 mg/dL, the visual analog scale score decreased from 4.6±1.1 to 1.4±1.0, the Oswestry disability index score decreased from 50.2%±11.9% to 13.0%±6.6%, and the lumbosacral angle increased from 20.0°±4.8° to 29.0°±3.9° (<italic>p</italic>&lt;0.05).</p></sec><sec><title>Conclusions</title><p>One-stage anterolateral debridement, bone grafting, and internal instrument fixation for treating lumbosacral tuberculosis is safe and effective.</p></sec>

scholarly journals Limited Open Reduction and Internal Fixation of Calcaneal Fractures

2019 ◽  
Vol 41 (1) ◽  
pp. 57-62 ◽  
Author(s):  
Anne K. Bremer ◽  
Lukas Kraler ◽  
Lars Frauchiger ◽  
Fabian G. Krause ◽  
Martin Weber
Keyword(s):  
Wound Healing ◽  
Internal Fixation ◽  
Open Reduction ◽  
Case Series ◽  
Functional Results ◽  
High Rate ◽  
Calcaneal Fractures ◽  
Retrospective Case ◽  
Level Of Evidence

Background: The treatment of displaced intra-articular calcaneal fractures remains a challenge and the optimal approach is still controversial. The main reason to avoid the extended lateral approach is the high complication rate due to wound healing problems. We report on 16 years of experience with a standardized limited open reduction and internal fixation technique. Methods: Between 2001 and 2017, we prospectively followed 240 consecutive patients operatively treated for a displaced intra-articular calcaneal fracture. Patients with open, multiple, bilateral, extra-articular, and Sanders IV fractures and those lost to follow-up were excluded. A lateral subtalar approach was used, with a cast for 8 weeks and full weightbearing allowed after 12 weeks. Follow-up examinations were scheduled until 24 months. Subjective and clinical assessment included gait abnormality, subtalar and ankle range of motion, and stability and alignment. The American Orthopaedic Foot & Ankle Society (AOFAS) hindfoot score was calculated. Alignment was analyzed on standard radiographs. In total, 131 patients were excluded. The remaining 109 patients were followed for a minimum of 24 months (34.4 ± 14.2 [range, 24-102] months). Results: The mean AOFAS score was 87 ± 13 (range, 32-100). “Excellent” and “good” results, as well as hindfoot motion with “normal/mild” and “moderate” restrictions, were seen in 80% of patients. Early reoperations were performed for insufficient reduction (2 patients), delayed wound healing (debridement, 3 patients), and hematoma (1 patient). Late revisions were arthrodesis (3 patients), medializing calcaneal osteotomy (1 patient), and implant removal (53 patients; 49%). Conclusion: The presented approach has remained unmodified for 16 years and resulted in consistently good functional results. The main disadvantage was the high rate of heel screw removal. Level of Evidence: Level IV, retrospective case series.

scholarly journals Olecranon Apophyseal Nonunion in Adolescent Judo Players: A Report of Two Cases

2018 ◽  
Vol 2018 ◽  
pp. 1-4
Author(s):  
Kohei Yamaura ◽  
Yutaka Mifune ◽  
Atsuyuki Inui ◽  
Hanako Nishimoto ◽  
Yasuhiro Ueda ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Bone Grafting ◽  
Case Series ◽  
Radiographic Evidence ◽  
Level Of Evidence ◽  
Old Patients ◽  
Elbow Injury ◽  
Autologous Bone Grafting ◽  
Judo Athletes ◽  
Autologous Bone

Olecranon apophyseal nonunion is an elbow injury from overuse that affects adolescent athletes such as baseball pitchers who participate in overhead throwing sports. However, such injury is rare in collision sports. Here, we report two patients with this condition who are Judo athletes. The purpose of this report was to describe three elbows with olecranon apophyseal nonunion in two adolescent patients participating in Judo. This is a case series; the level of evidence is 4. Two 15-year-old patients were evaluated. One suffered from unilateral and the other from bilateral chronic posterior elbow pain. They were diagnosed with olecranon apophyseal nonunion, which was treated using internal fixation and bone grafting. Radiographic evidence of the apophyseal union was observed four months postsurgery. Two elbows were treated with tension band wiring, then they underwent hardware removal six months postsurgery. Both patients returned to their previous levels of activities six months postsurgery. Internal fixation using autologous bone grafting was a useful treatment for these Judo athletes with olecranon apophyseal nonunion.

A Case Series of Successful Repair of Articular Cartilage Fragments in the Knee

2019 ◽  
Vol 47 (11) ◽  
pp. 2589-2595 ◽  
Author(s):  
Jessica L. Churchill ◽  
Aaron J. Krych ◽  
Mark J. Lemos ◽  
Morganne Redd ◽  
Kevin F. Bonner
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Internal Fixation ◽  
Scale Score ◽  
Case Series ◽  
Resonance Imaging ◽  
Patient Reported ◽  
Activity Scale ◽  
Chondral Fracture

Background: It is unclear whether chondral fragments without bone have the potential to heal after fixation. Controversy exists and opinions differ regarding the optimal treatment of chondral defects after pure chondral fracture. Purpose: To determine clinical and radiographic outcomes after internal fixation of traumatic chondral fragments repaired to bone in the knee. Study Design: Case series; Level of evidence, 4. Methods: A retrospective clinical and radiographic evaluation of 10 male patients with a mean age of 14.6 years (range, 10-25 years) at the time of surgery was performed. Eight of 10 patients were skeletally immature. Patients were selected by operating surgeons per the presence of a large displaced pure chondral fragment on magnetic resonance imaging and confirmed on intraoperative inspection. All patients had a diagnosed traumatic displaced pure chondral fracture of the knee (without bone) and underwent internal fixation with minimum 1-year follow-up. Validated patient-reported and surgeon-measured outcomes were collected pre- and postoperatively. All patients were evaluated at a mean 56 months postoperatively. Results: At surgery, the mean defect size that was primarily repaired with the displaced chondral fragment was 1.9 × 2.0 cm. With minimum 1-year follow-up, there were no clinical failures. All 8 patients who had subsequent magnetic resonance imaging follow-up had radiographic evidence of complete healing of the chondral fragment back to bone. At a mean follow-up of 56 months (range, 13-171 months; median, 36 months), patients had a mean International Knee Documentation Committee score of 94.74 (range, 87.4-100), a mean Marx Activity Scale score of 14.4 (range, 8-16), and a mean Tegner Activity Scale score of 7 (range, 5-9). At final follow-up, all patients except 1 returned to sports. Conclusion: The treatment of large traumatic chondral fragments is controversial. In this select series of 10 young patients who underwent primary repair with internal fixation, there were no failures clinically. Patients demonstrated excellent short-term clinical and radiographic results after fixation of these relatively large chondral fragments in the knee.

scholarly journals Outcomes of Hindfoot and Ankle Arthrodesis in Neuropathic Patients

2019 ◽  
Vol 4 (4) ◽  
pp. 2473011419S0028
Author(s):  
David Macknet ◽  
Andrew Wohler ◽  
Carroll P. Jones ◽  
J. Kent Ellington ◽  
Bruce E. Cohen ◽  
...  
Keyword(s):  
Internal Fixation ◽  
External Fixation ◽  
Limb Salvage ◽  
Median Number ◽  
Ankle Arthrodesis ◽  
High Rate ◽  
Hardware Failure ◽  
Radiographic Outcomes ◽  
Fixation Group

Category: Ankle Arthritis, Diabetes, Hindfoot Introduction/Purpose: Charcot neuropathy of the ankle and hindfoot is a progressive and destructive process that can lead to instability and ulceration resulting in significant morbidity which can end with amputation. The foot and ankle surgeon’s aim is to reconstruct the high risk foot with the creation of a stable plantigrade foot, while reducing the risk of ulceration and allowing the patient to mobilize in commercially available footwear. There are numerous techniques for the reconstruction of the neuropathic hindfoot, but the most utilized of these include multiplanar external fixation or internal fixation with a plate or intramedullary nail. It is our goal to further elucidate outcomes of Charcot patients undergoing corrective ankle and hindfoot fusion comparing internal versus external fixation. Methods: We retrospectively collected 377 patients undergoing hindfoot and ankle arthrodesis at our institution from 2006- 2017. 77 patients were identified that underwent arthrodesis for Charcot arthropathy, 56 of which met our inclusion and exclusion criteria. This included 47 who had internal fixation as their primary procedure and 9 patients who underwent external fixation with a multi-planar external fixator. Our median follow up time was 3.4 years (IQR .5 to 12.9). Preoperatively we collected basic demographic variables, reasons for neuropathy, and ulcer status. Postoperatively we collected complications including infection, hardware failure, ulceration, recurrent deformity, and radiographic outcomes including union and hardware backout. Reoperation numbers and indications were also collected. Our primary outcome was limb salvage at final follow up. Secondarily, we collected final ambulatory and footwear status. Results: The limb salvage rate was 82% with 10 patients undergoing amputation, which did not vary between groups (p=.99). The primary reasons for amputation were persistent infection (4 of 10) and nonunion (4 of 10). Thirteen (24%) patients developed an infection. The median number of reoperations per patient was 1 (IQR 0-2) with the patients who underwent amputation undergoing a median of 2 (IQR 2-4) reoperations. The rate of union was 54%, occurring at a median of 26.5 (IQR 12-47) months. 44% (4/9) of patients in the external fixation group had a preoperative ulceration versus 19% (9/47) of the patients in the internal fixation group (p=.19). Preoperative ulceration was not a risk factor for amputation. Forty-two (75%) patients were ambulatory at final follow up. Conclusion: We report on the single largest series of Charcot patients undergoing hindfoot and ankle arthrodesis. The surgical management of this population has a high rate of complications with infection and reoperation being common. Despite a high nonunion rate most patients are able to ambulate in a brace or orthotic. Limb salvage can be expected with either internal or external fixation techniques.

Fractures of the Second Cervical Vertebra

Neurosurgery ◽  
1977 ◽  
Vol 1 (2) ◽  
pp. 125-127 ◽  
Author(s):  
James H. Salmon
Keyword(s):  
Internal Fixation ◽  
Neurological Deficit ◽  
Operative Mortality ◽  
Cervical Vertebra ◽  
Initial Evaluation ◽  
Follow Up Studies

Abstract Fractures of the 2nd cervical vertebra are frequently undetected on initial evaluation. Tomography may be necessary to delineate the fracture. This is a report of 20 patients treated by internal fixation using interlaminar wiring. There was no operative mortality. Follow-up studies, an average of 25 months after operation, demonstrated satisfactory results and no evidence of delayed neurological deficit.

Effects of an on-table Reconstruction Technique Combined With Miniplate Internal Fixation and Prosthesis for the Treatment of Isolated Mason III Radial Head Fractures

2021 ◽  
Author(s):  
Lei HAN ◽  
feng Can Wang ◽  
geng Yun Hu ◽  
li Wei Fang ◽  
Song Zhou-feng
Keyword(s):  
Internal Fixation ◽  
Radial Head ◽  
Point Of View ◽  
Reconstruction Technique ◽  
Consecutive Series ◽  
Radial Head Fractures ◽  
Post Operation ◽  
Elbow Function ◽  
Dash Questionnaire

Abstract Background: In this retrospective study we analyzed a consecutive series of patients affected by isolated radial head Mason III fractures and treated with an on-table reconstruction technique combined with miniplate internal fixation or prosthesis.Methods: This study included 42 patients affected by isolated radial head Mason III fractures and treated between Jan 2012 and Jan 2019. Twenty-four patients (average age 45.6 years) were treated with an on-table reconstruction technique combined with miniplate internal fixation. The remaining 18 (average age 44.5 years) were treated with prosthesis. From a clinical point of view, we evaluated the patients according to the Broberg–Morrey scoring system and the (disabilities of the arm, shoulder, and hand) DASH questionnaire for parameters.Results: We found similar results in both the groups according to Broberg–Morrey score system and the DASH questionnaire at the last follow-up. The scores of the prosthesis group were better than those of the internal fixation group at the 1st, 3rd, and 6th month follow-up post-operation.Conclusion: Both the on-table reconstruction technique combined with the miniplate internal fixation and prosthesis can be effective in treating patients with isolated Mason III radial head fractures. There was no difference in elbow function between the two groups at the last follow-up; however, a prosthesis favors early functional recovery of the elbow.

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