scholarly journals Surgical treatment of patients with extra-articular fractures of the distal humerus

TRAUMA ◽  
2021 ◽  
Vol 22 (6) ◽  
pp. 32-38
Author(s):  
A.I. Bodnya ◽  
S.L. Dubovik
Keyword(s):  
Surgical Treatment ◽  
Treatment Outcomes ◽  
Comparison Group ◽  
Distal Humerus ◽  
Humeral Fractures ◽  
Study Group ◽  
Clinical Use ◽  
Performance Score ◽  
Mayo Elbow Performance Score ◽  
Articular Fractures

Background. The article deals with extra-articular fractures of the distal humerus, according to the АО/ASIF classification, which includes types 12A–C, depending on the plane of the fracture and the nature of the fragment displacement. The purpose was to study the features of the lower third humeral fractures and to conduct a comparative analysis of the outcomes of surgical treatment. Material and methods. One hundred and twenty-seven patients with extra-articular fractures of the distal humerus were under observation. For retrospective analysis, they were divided into a comparison group (n = 92) who underwent traditional bone osteosynthesis and a study group (n = 35) in whom a rod-type external fixation device developed by us was used. The short- and long-term functional results were studied using the Mayo Elbow Performance Score. Results. Various indicators, established by us for comparison, and treatment outcomes were analyzed in 101 patients (comparison group — 68 people, study group — 33). Many values of these parameters were quite comparable in terms of the age, gender, hospitalization terms, duration of surgeries, etc., but the revealed differences in indicators still did not reach the level of statistical reliability (p > 0.05). Evaluation of the clinical use of the device proposed by us showed restoration of the humeral anatomy, quite comparable to that in bone osteosynthesis, and the achievement of the final result of treatment. However, the number of complications by type and by total number was significantly higher (4.5 times; p ˂ 0.001) in the comparison group, where it accounted for the largest share of cases of neuropathies (16.18 %), nonunions (8.82 %), elbow contractures (8.82 %) and heterotopic ossification (4.42 %). The final score on the Mayo Elbow Performance Score in the comparison group was 84.9 ± 10.2 points, in the study group — 92.6 ± 3.7 points. At the same time, the total number of positive treatment outcomes after bone osteosynthesis was 66.18 %, after transosseous osteosynthesis — 81.82 %. Conclusions. The analysis of the data obtained allows us to recommend a method of minimally invasive osteosynthesis with a rod device of external controlled fixation as a method of choice for wider clinical use in the treatment of patients with lower third humeral fractures.

scholarly journals THE TREATMENT OF EXTRA- AND INTRA-ARTICULAR FRACTURES THE DISTAL HUMERUS

2010 ◽  
Vol 16 (3) ◽  
pp. 96-102
Author(s):  
V. V. Klyuchevsky ◽  
Hassan Ben El Hafi
Keyword(s):  
Soft Tissues ◽  
Functional Results ◽  
Distal Humerus ◽  
Distal Segment ◽  
Rigid Fixation ◽  
Performance Score ◽  
Mayo Elbow Performance Score ◽  
Articular Fractures ◽  
Active Mobilization ◽  
Violent Acts

From 2005 to 2009 we treated 112 patients with fractures of distal segment of the humerus, 83 (74,10%) of them were injured when falling from the height of its own growth, 8 (7,14%) - in an accident, 6 (5,35%) - a fall from a height, 13 (11,6%) - in sports, and two - as a result of violent acts. In 97 (87%) cases the fractures were closed, in 15 (13%) - open. 19 patients were treated conservatively and 93 - operatively. Functional results were evaluated using the Mayo elbow performance score (MEPS) in 78,37% of patients. Results of the conservative method: excellent and good - 46,66%, and in all patients with type A without displacement - in 100%. The fair results - in 33% and the poor in 20% - with type В and C. The results of operative treatment: excellent and good - 90,41%, the fair results - in 9,58%, no poor results. Initial prevent the oedema and bleeding into joints and soft tissues, adequate rigid fixation of fractures with the maximal restoration of the elbow joint congruent without additional immobilization and early active mobilization is essential to prevent the elbow stiffness and achieve a good outcomes.

scholarly journals Evaluation of functional outcome after osteosynthesis of intra articular distal humerus fracture with pre contoured locking compression plates

2020 ◽  
Vol 6 (6) ◽  
pp. 1215
Author(s):  
Faisal S. Mohammed ◽  
Akshay B. Ingale
Keyword(s):  
Functional Outcome ◽  
Distal Humerus ◽  
Distal Humerus Fracture ◽  
Performance Score ◽  
Mayo Elbow Performance Score ◽  
Locking Compression Plates ◽  
Humerus Fractures ◽  
Distal Humerus Fractures ◽  
Extensor Lag

<p><strong>Background:</strong> Intra articular distal humerus fractures are challenging and cumbersome to treat. Therefore osteosynthesis of such fractures is required. The aim of our study was to evaluate the functional outcome of intra articular distal humerus fractures AO type  13C by osteosynthesis using olecranon osteotomy with pre contoured locking compression plates in orthogonal plate configuration.</p><p><strong>Methods:</strong> Thirty patients were included in our study comprising of 18 males and 12 females. Mean age was 39.63 years with mean follow up of 34 weeks. 7 were AO type 13C1, 9 were AO type 13C2 and 14 were AO type 13C3. Osteosynthesis was done for all fractures by olecranon osteotomy approach. Functional outcome was assessed using mayo elbow performance score.</p><p><strong>Results:</strong> Mean flexion attained at the end of follow up was 127.56 degrees with mean extensor lag of 7.16 degrees. Mean arc of motion was 120.4 degrees. Mean mayo elbow performance score at the end of follow up was 80.36. Mayo elbow performance score in patients aged less than 40 years of age was not statistically significant as compared to patients more than 40 years of age. Functional outcome was also dependent on fracture subtype.</p><p><strong>Conclusions:</strong> Osteosynthesis of distal humerus fractures AO type 13C using pre contoured locking compression plates in orthogonal plate configuration by olecranon osteotomy provides excellent visualization of fracture and better functional outcome.</p>

scholarly journals Coronal shear fractures of the distal humerus: Current concepts and surgical techniques

2019 ◽  
Vol 12 (2) ◽  
pp. 124-135 ◽  
Author(s):  
Jay J Watson ◽  
Simon Bellringer ◽  
Joideep Phadnis
Keyword(s):  
Clinical Experience ◽  
Surgical Techniques ◽  
Distal Humerus ◽  
Humeral Fractures ◽  
Articular Fractures ◽  
Distal Humeral Fractures

Coronal shear fractures of the distal humerus are a unique subset of distal humeral fractures which entail partial or complete articular fractures of the distal humerus without involvement of the columns. The very distal nature of these fragments, their small size and propensity for comminution render them challenging to treat surgically. The purpose of this article is to describe the classification, outcomes and surgical techniques currently used for the treatment of these fractures using the available literature and authors' clinical experience.

scholarly journals Surgical correction of the chronic liver purulent-septic lesions

2019 ◽  
Vol 41 part 2 (2) ◽  
pp. 12-18
Author(s):  
O. G. Kotenko ◽  
A. V. Gusev ◽  
O. O. Popov ◽  
A. V. Grinenko ◽  
M. S. Grigoryan ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Comparison Group ◽  
Abdominal Cavity ◽  
Chronic Liver ◽  
Study Group ◽  
Anatomical Resection ◽  
Duration Of Treatment ◽  
Surgical Interventions ◽  
Liver Abscesses ◽  
Resection Of The Liver

Purpose of the study. The purpose of the study is to improve the results of surgical treatment of patients with purulent-septic lesion of the liver substantiating the indication for resection method use. Material and methods. The work is based on a comparative analysis of the results of examination and treatment of 64 patients aged 10 to 81 years old, with chronic liver abscesses in the department of surgery and liver transplantation during the 1995–2016 periods. According to the tasks of the study patients are divided into two groups. In 30 (46,8%) patients (the study group), various types of anatomical resection of the liver with a purulent lesion were performed without its dissection during the operation; in 34 (53,2%) patients (group of comparison) they performed the disclosure, sanation, drainage of purulent cavity. The majority of patients with chronic liver abscesses treated the abscess with a puncture or drainage method under the control of ultrasound in other medical institutions of Ukraine. Results. The results of diagnosis and treatment of 64 patients for chronic liver abscesses from 1995 to 2016 are analyzed. In the study group, the patients performed anatomical resection of the liver, in the comparison group – standard surgical interventions – the disclosure and drainage of the abscess of the liver. The duration of antibiotic therapy after surgery in the comparison group is significantly higher than in the study group, respectively, 22 ± 3,4 and 5,75 ± 1,6 days; p < 0,001. Second-line antibacterial drugs after draining operations were used more often (p < 0,001) than after resection interventions, respectively, in 94,1 and 6,6% of cases. The duration of treatment of patients in the hospital after surgery in the study group was less than in the comparison group, according to 15,1 ± 0,7 and 27,3 ± 3,05 days; total 25,9 ± 1,4 and 45,7 ± 3,45 days (p < 0,001). After drainage operations, drainages from the abdominal cavity were removed later than after resection interventions, respectively, 17,1 ± 2,8 and 6,35 ± 1,1 days (p < 0,001), through. Conclusion. Resection for chronic purulentseptic lesions of the liver is the priority methods of surgical treatment. The analysis of the obtained results allows us to conclude that resection technologies contribute to the rapid normalization of physical and social rehabilitation of patients with septic liver damage. Keywords: liver abscess, liver resection, chronic, purulent-septic.

ANTITUMOR CHEMOTHERAPY IN COMBINED TREATMENT OF PATIENTS WITH CANCER OF THE LARYNX AND HYPOPHARYNX

2018 ◽  
Vol 64 (5) ◽  
pp. 607-611
Author(s):  
Yuliya Belevich ◽  
Yelena Simolina ◽  
Vitalina Vysotskaya ◽  
Nataliya Popova ◽  
Denis Kulbakin ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Neoadjuvant Chemotherapy ◽  
Comparison Group ◽  
Combined Treatment ◽  
Study Group ◽  
Complete Regression ◽  
Partial Regression ◽  
Patients With Cancer ◽  
Carcinoma Of The Larynx ◽  
Antitumor Chemotherapy

Preliminary results of the evaluation of the effectiveness of combined treatment of 116 patients with morphologically verified squamous cell carcinoma of the larynx and hypopharynx II-IV (T2-4N0-2M0) stages of the tumor process for the period from 2006 to 2017 are presented in the article. Patients of the study group (n=20) underwent 2 courses neoadjuvant chemotherapy according to the scheme: docetaxel + cisplatin, followed by radiotherapy in the mode of multifraction of a dose of 1,3 Gy 2 times a day and surgical treatment (according to indications). Patients included in the comparison group (n=96) underwent 2 courses of neoadjuvant chemotherapy according to the scheme: paclitaxel + carboplatin, followed by radiotherapy in the mode of multifractionation of a dose of 1,3 Gy 2 times a day and surgical treatment (according to indications). The overall effectiveness of the treatment in the study group was 90,3 ± 3,1% (complete regression - 49,4 ± 4,0%, partial regression - 40,9 ± 5,2%), in the comparison group - 81,3 ± 4,0% (complete regression - 34,4 ± 4,8%, partial regression - 46,9 ± 5,1%). Differences between groups are statistically significant (p = 0,001).

scholarly journals Rationale for use of osteoplastic material Bio Ost in surgical dentistry clinic

2019 ◽  
Vol 2 (11) ◽  
pp. 11-14
Author(s):  
E. Yu. Efimova ◽  
D. V. Stomatov ◽  
Yu. V. Efimov ◽  
A. V. Stomatov ◽  
D. V. Smolentsev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Bone Defect ◽  
Comparative Evaluation ◽  
Comparison Group ◽  
Study Group ◽  
Osteoplastic Material

A comparative evaluation of the effectiveness of surgical treatment of 63 patients with periapical cysts of the jaws with the filling of a bone defect with osteoplastic material Osteo Biol (the comparison group) and Bio Ost (the study group) was carried out. The results obtained in patients of the study group indicate a predominance of the rate of osteogenesis processes over the rate of resorption processes, which characterizes the osteo-substituting material Bio-Ost as meeting modern requirements for such materials.

scholarly journals Differentiated approach to radical surgical treatment of elderly patients with tumor diseases of the pancreatoduodenal zone

2021 ◽  
Vol 13 (2) ◽  
pp. 49-56
Author(s):  
Badri V. Sigua ◽  
Vyacheslav P. Zemlyanoy ◽  
Alexey V. Gulyaev ◽  
Malkhaz Yu. Tsikoridze ◽  
Evgeny A. Zakharov
Keyword(s):  
Surgical Treatment ◽  
Postoperative Complications ◽  
Comparison Group ◽  
Main Group ◽  
Control Group ◽  
Study Group ◽  
Tumor Diseases ◽  
Results Of Treatment ◽  
Repeated Surgery ◽  
Pancreatic Fistulas

BACKGROUND: In recent years, there has been a widespread increase in the incidence of tumors of the pancreatoduodenal zone, especially noticeable in the older age group. A decrease in the incidence of postoperative complications and mortality after pancreatoduodenal resection made it possible to expand the indications for surgical treatment of elderly and senile patients. AIM: Improvement of the immediate results of pancreatoduodenal resection in the treatment of elderly and senile patients suffering from tumor diseases of the pancreatoduodenal zone. MATERIALS AND METHODS: Pancreatoduodenal resection was performed in 61 elderly and senile patients with tumors of the pancreatoduodenal zone. The main group consisted of 32 patients, whose treatment was carried out in accordance with the developed algorithm for choosing a method for forming a pancreatodigestive anastomosis based on a scale for assessing the risk of developing pancreatic fistulas. The comparison group consisted of 29 patients in whom the method of forming a pancreatodigestive anastomosis was carried out in accordance with the preferences of the operator without taking into account the risk of developing a pancreatic fistula. RESULTS: In the main group, compared with the control group, pylorus-saving interventions were performed significantly more often 27 (84.4%) and 14 (48.3%) (p 0.01). There was also a decrease in the frequency of performing pancreaticojejunostomy 16 (50%) and 22 (75.9%) (p 0.05), due to the use of reservoir terminolateral pancreatojejunostomy 8 (25%) and 0, respectively (p 0.01). Postoperative complications were observed in 14 (43.8%) of the study group and in 21 (72.4%) patients of the comparison group (p 0.05). There was also a decrease in the incidence of postoperative pancreatic fistulas from 8 (27.6%) to 2 (6.2%) (p 0.05) in the study group. Repeated surgery was required in 5 (15.6%) patients of the main group and 11 (37.9%) in the comparison group (p 0.05). The lethal outcome was recorded in 3 (9.4%) patients of the main group and in 7 (24.1%) in the comparison group (p 0.05). CONCLUSIONS: The results of performing pancreatoduodenal resection in the treatment of elderly and senile patients can be comparable with the results of treatment of the general population. The use of the developed algorithm made it possible to reliably reduce the incidence of complications from 72.4 to 43.8% (p 0.05), postoperative pancreatic fistulas from 27.6 to 6.2% (p 0.05), as well as the frequency of repeated interventions. from 37.9 to 15.6 % (p 0.05). In addition, a downward trend in mortality was achieved from 24.1% to 9.4%.

scholarly journals Outcome of Dual 90-90 Plating in Intercondylar Fractures of Distal Humerus in Adults

2018 ◽  
Vol 16 (2) ◽  
pp. 23-26
Author(s):  
Dinesh Shrestha ◽  
Merina Shrestha
Keyword(s):  
Good Method ◽  
Distal Humerus ◽  
Anatomic Reconstruction ◽  
Rigid Fixation ◽  
Performance Score ◽  
Mayo Elbow Performance Score ◽  
Ao Classification ◽  
Study Evaluation ◽  
Dual Plating

Background: Intercondylar fracture of distal humerus are very difficult to manage. It needs proper anatomic reconstruction and rigid fixation. Aims and Objectives of study: Evaluation of outcome of dual bicolumnar 90-90 plating of AO type 13C fractures of distalhumerus in adult. Material and method: In a prospective hospital based study on 16 patients with a mean age of 33.37 years ± SD8.30, who presented with intercondylar fracture of distal hummers were studied between July 2015 to December 2017. All patients were graded according to AO classification. Out of 16 patients 5 were in 13C1, 6 were in 13C2 and 5 were in 13C3 subgroup. All patients underwent open reduction through Chevron olecranon osteotomy and fixation was done with dual plating in 90-90 fashioni.e.; 3.5 reconstruction plate posterior and 1/3 tubular plate from medial border. We used the Mayo elbow performance score system for evaluating our results. Results: The mean follow up period was 9.38 months. All fractures healed uneventfully. Two of five patients with 13C3 fractures and two of six patients with 13C2 fractures has flexion deformity of less than 30*. Average range of motion was 95*(range 60*-130*). The Mayo elbow performance score was excellent in 7, good in 7 and fair in 2 patients. Conclusion: Dual 90-90 plating technique through Chevron olecranon osteotomy is a good method for intercondylar reconstruction with rigid fixation like AO 13C fractures.

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