scholarly journals Comminuted intra-articular fractures of distal humerus treated with minimal fixation: One of treatment options

2008 ◽  
Vol 55 (4) ◽  
pp. 61-67
Author(s):  
V.R. Cvetkovic ◽  
A.R. Lesic ◽  
M.Z. Bumbasirevic
Keyword(s):  
Treatment Options ◽  
Distal Humerus ◽  
Patient Treatment ◽  
Treatment Result ◽  
Minimal Amount ◽  
Permanent Disability ◽  
Type Iv ◽  
Articular Fractures ◽  
Score Result

Fractures of distal humerus on humen skeleton are rare and intraarticular fractions of distal part of humerus occur even less frequently, they comprise about 3% of fractures of humerus. However, these fractures can result in a functional deficiency of elbow joint and permanent disability. The main goal if our work was to present one of the surgical treatment options of this kind of fracture with minimal amount of fixation material. Treatment result were evaluated by Broberg-Morrey score system. Pilot study consisted of eight patient with comminuted type IV fracture of distal humerus during 2004-2005 time period. Comminuted fracture was fixed with minimal amount of material: a Kirchner needle and a screw. Patient treatment progress was evaluated initially and followed up after four, nine and twenty four months by B-M score after removal of cast and bone fixing material. The results of the B-M score after four months were: excellent in 0 patient, good in 2 patients, fair in 4 patients and poor in 2 patients. After physical therapy and follow up check- up at the end of nine months the result were: excellent in 3 patients, good in 3 patients, fair in 2 patients and no patients had shown poor result. This B-M score result was identical after 24 months follow up with minor deviations in range of motions of elbow, which did not influence the final result of B-M score.

A simulation study of loss to follow up: The impact on time to event and prevention.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e14097-e14097
Author(s):  
Donna Elise Levy ◽  
Bingyan Wu ◽  
Daniel Quinn ◽  
Sophie Jentzsch ◽  
Christine Lusk ◽  
...  
Keyword(s):  
Treatment Options ◽  
Patient Treatment ◽  
Future Research ◽  
Time To Event ◽  
Loss To Follow Up ◽  
Study Results ◽  
Patient Attrition ◽  
The Impact ◽  
Future Patient

e14097 Background: Patient attrition during study follow up is a concern in all clinical trials, although its impact on study results has rarely been assessed. In oncology, in particular, where studies are lengthier and may be extended into longitudinal studies, there is an increased likelihood of loss to follow up (LTFU) (Gill et al., 2018). This creates a heightened need to understand how it affects the trial’s validity. The loss of data from patients who have been LTFU can reduce a study’s precision and power. This imprecision not only impacts the results of the current study but can also affect future research as well as future patient treatment options. Studies have found that participant characteristics differ in individuals LTFU as compared to those who remain in follow up (Childs et al., 2011; Geng et al., 2008; Hochheimer et al., 2016). This further emphasizes how attrition can skew study results and their interpretation and supports the need to minimize patient attrition during follow up in order to reduce bias and generate robust study estimates. Methods: This study assessed the impact of LTFU rates on the study estimates through simulations using SAS software. While all endpoints can be affected by LTFU, this study assessed time-to-event endpoints. Exponential distribution was assumed with varying rates of LTFU. In addition, the work covered suggestions for reducing LTFU. Results: Even for low rates of LTFU, biases are introduced in time-to event endpoints. Conclusions: Researchers should make every effort to minimize the extent of LTFU in the design and of and conduct of their trials.

Treatment of supra- and intra-articular fractures of the distal humerus with the LCP Distal Humerus Plate: a 2-year follow-up

2011 ◽  
Vol 20 (2) ◽  
pp. 206-212 ◽  
Author(s):  
Timm Kaiser ◽  
Alexander Brunner ◽  
Bernd Hohendorff ◽  
Benjamin Ulmar ◽  
Reto Babst
Keyword(s):  
Distal Humerus ◽  
Articular Fractures

scholarly journals Assessment of outcome of distal radius inta-articular fractures using wrist-spanning mini-fixator in distraction

2019 ◽  
Vol 5 (4) ◽  
pp. 594
Author(s):  
Saurin J. Patel ◽  
KirtiDhavaj I. Merawat ◽  
Harpreet Singh ◽  
Parth B. Bhavsar
Keyword(s):  
Range Of Motion ◽  
Distal Radius ◽  
Upper Limb ◽  
Social Life ◽  
Treatment Options ◽  
Personal Life ◽  
Articular Fractures ◽  
Mayo Wrist Score ◽  
K Wires

<p class="abstract"><strong>Background:</strong> The distal radius fractures are complex injuries. There are many treatment options for these fractures. The benefits of external fixation with mini fixator have been seen in many studies. In our study, the distal radius fracture belonging to type B and C of AO classification were treated with wrist spaning mini extrernal fixator with/without additional k wires. We wish to analyse the functional outcome and to determine any complications of this procedure.</p><p class="abstract"><strong>Methods:</strong> 20 patients were included in this study and were followed up for up to 6 months postoperatively. We assessed pain using VAS score at 6 weeks follow-up and the outcome of each patient was assessed using Mayo wrist score post-operatively on follow-up at 3 months and 6 months.<strong></strong></p><p class="abstract"><strong>Results:</strong> Predominance towards males and left upper limb was observed in our study. At the end of six months, the range of motion as assessed according to the criteria given by Mayo wrist score, excellent results (MWS&gt;=90) were seen in 4 patients (20%), good results (MWS 80-89) were seen in 12 patients (60%),and fair (MWS 70-79) in 4 patient (20%). At the end of result, significant reduction in terms of pain, wellbeing, personal life, social life, lifting, travelling and sleeping was seen.</p><p class="abstract"><strong>Conclusions:</strong> Predominance towards males and left upper limb was observed in our study. At the end of six months, the range of motion as assessed according to the criteria given by Mayo Wrist Score, excellent results (MWS&gt;=90) were seen in 4 patients (20%), good results (MWS 80-89) were seen in 12 patients (60%),and fair (MWS 70-79) in 4 patient (20%). At the end of result, significant reduction in terms of pain, wellbeing, personal life, social life, lifting, travelling and sleeping was seen. </p>

scholarly journals Functional results of AO 13C fractures managed with bicolumnar plating in a tertiary care centre of North India

2021 ◽  
Vol 9 (2) ◽  
pp. 413
Author(s):  
Gagandeep Singh Raina ◽  
Sanjeev Gupta ◽  
Neeraj Mahajan ◽  
Rahul Mahajan ◽  
Zubair A. Lone
Keyword(s):  
Tertiary Care ◽  
Functional Results ◽  
Distal Humerus ◽  
North India ◽  
Osteoporotic Bone ◽  
Tertiary Care Centre ◽  
Articular Fractures ◽  
Flexion Extension ◽  
Distal Humerus Fractures

Background: Distal humerus fractures are associated with many problems like fracture comminution and complex fracture anatomy. Achieving a good functional range of motion at the elbow with stability are the primary objectives in managing a comminuted distal humerus fracture.Methods: 25 consecutive patients were operated with bicolumnar plating for fracture distal humerus AO type 13C. The patients were kept in follow up for at least six months. Mayo elbow performance (MEP) score and flexion extension arc was calculated to study the outcome.Results: All patients achieved fracture union with mean MEP score of 73.2 and mean flexion extension arc of 93º. This was within the functional range of elbow. Stiffness was observed to be most common complication.Conclusions: Our study concluded that internal fixation with bicolumnar plating offers good functional results in comminuted intra-articular fractures even in osteoporotic bone with negligible complications.

scholarly journals K. wire fixation versus conservative treatment of closed displaced intra-articular calcaneal fractures

2019 ◽  
Vol 15 (1) ◽  
pp. 86-94
Author(s):  
Mohammed Sh. Al-Edanni
Keyword(s):  
Minimally Invasive ◽  
Minimally Invasive Technique ◽  
Treatment Result ◽  
Invasive Technique ◽  
Calcaneal Fractures ◽  
Articular Fractures ◽  
Subtalar Arthritis ◽  
Wire Fixation ◽  
One Year

Background: Calcaneus is a spongy cancellous bone with rich blood supply , its fracture heals more rapidly providing no occurrence of infection and soft tissue injury around ,no gross malposition of fragments. The associated pain leads to a major impairment in life quality. The aim of treatment for calcaneal fractures is the decrease of pain and rebuilding of walking ability for patients with normal foot shape and the ability to wear normal foot wear. To reduce complications, a minimally invasive technique for the treatment of displaced intra-articular fractures of the calcaneus was preferred to use. The purpose of this study was to determine whether the closed reduction and percutaneous K. wire fixation of displaced intra-articular calcaneal fractures results in better functional outcome at a minimum one year follow up after the injury compared with those after non-operative management. Methods: One hundred and eleven displaced closed intra-articular calcaneal fracture in 105 patients (six were bilateral) were seen at the orthopedic department of Al-Kindy teaching hospital and Shaih Zaid hospital , only 45 cases included in this study and prospectively evaluated with an average follow-up time of minimum  of one year (1–3years follow-up). For radiographic evaluation, plain radiographs and CT scans were obtained. The Maryland Foot Score was used for clinical estimate. Sanders type II, III and IV fractures were diagnosed. Results: The incidence of subtalar arthritis was correlated with the severity of fracture. Böhler’s angle was restored in 70.1% (47 of 67) of the cases. The majority (77.7%) of patients were content with their treatment result. The rate of significant complications was 6.5%. Discussion: Percutaneous K. wire fixation of displaced intra-articular calcaneal fractures presented minimally invasive technique which showed comparable results with a low rate of serious complications and is a viable alternative for the treatment of intra-articular, dislocated calcaneal fractures. Conclusions: the functional results after K. wires fixation of displaced intra-articular calcaneal fractures were better than those after non-operative care.

Treatment of Distal Humerus Articular Fracture with Pin-and-Plate Technique

2020 ◽  
Vol 25 (03) ◽  
pp. 332-339
Author(s):  
Abbas Abdoli ◽  
Amir Reza Farhoud ◽  
Reza Shahryar Kamrani
Keyword(s):  
Plate Fixation ◽  
Distal Humerus ◽  
Kirschner Wires ◽  
Stable Fixation ◽  
Articular Fracture ◽  
Plate Technique ◽  
Articular Fractures ◽  
Flexion Extension ◽  
The Mean

Background: Distal Humerus Articular Fracture (classified by Arbeitsgemeinschaft für Osteosynthesefragen/Orthopedic Trauma Association as 13-B3) is an uncommon fracture with significant complications. We report results of 14 patients treated by open reduction and pin-and-plate fixation technique. Methods: In this retrospective study, we applied pin-and-plate fixation to 14 distal humerus articular fractures, in which screw fixation alone was inefficient or inadequate to provide stable fixation. After anatomical reduction of articular fragments, multiple Kirschner wires were inserted through the fragments. To prevent migration of Kirschner wires a small plate was placed proximally on the bent end of the pins. Results: The average age of 14 patients (8 males and 6 females) was 36.4 years (range: 16–57) and the mean follow up period was 43 months (range: 12–80). At last follow up the average quick Disabilities of the Arm, Shoulder and Hand score was 18.9 (range: 2.3–42.5) and the mean points for Mayo Elbow Performance Index was 75.3 (range: 50–100). Mean final arc of flexion-extension was 97° (range: 40–131). Conclusions: Distal humerus articular fracture is sometimes difficult to fix with conventional methods. We used pin-and-plate technique that could make a stable fixation and allow early range of motion with acceptable results.

scholarly journals Randomised prospective comparative analysis of functional outcome of osteosynthesis of intra-articular distal humerus fracture using triceps reflecting and transolecrenon approach

2020 ◽  
Vol 6 (4) ◽  
pp. 722
Author(s):  
Nuthan Jagadeesh ◽  
Nibin Sanil ◽  
Vishwanath M. S.
Keyword(s):  
Functional Outcome ◽  
Distal Humerus ◽  
Articular Fractures ◽  
Complex Anatomy ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Approach Group

<p class="abstract"><strong>Background:</strong> Intra articular fractures of distal humerus is one of the demanding injuries to manage due to its complex anatomy. Open reduction internal fixation is able to achieve painless, stable and mobile joint. This study is aimed at comparing functional outcome of patients treated with triceps reflecting and olecranon osteotomy approach.</p><p class="abstract"><strong>Methods:</strong> A hospital based randomized comparative study of 40 patients who diagnosed with distal humerus intraarticular fracture admitted in our hospital from April 2017 to March 2019. Triceps reflecting approach (group A) was used in 20 patients and olecranon osteotomy approach (group B) in 20 patients. Elbow range of movements and Mayo elbow performance score (MEPS) was used to compare outcome.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean elbow range of motion is 95.8±13.5 degree at 1 year follow up in group A and 94.5±9.3 degree in 1 year follow up at 1 year follow up in group B. The mean MEP score at end of 1 year in group A was 93.8±2.9 and in group B was 91.5±3.2 shows excellent results but there was no statistically significant difference between MEP scores of two groups. We observed 6 patients developed extension lag less than 10 degree in group A which was clinically insignificant to patients and 7 patients developed hardware prominence in group B.</p><p class="abstract"><strong>Conclusions:</strong> Triceps reflecting Bryan Morrey approach is equally effective as olecranon osteotomy approach in treatment of distal humerus intra articular fracture with less complication and operative time.</p>

scholarly journals Outcome analysis of extraarticular distal humerus locking plate for fresh fractures of humerus shaft

2020 ◽  
Vol 7 (8) ◽  
pp. 2593
Author(s):  
Anand Saurabh ◽  
Abhijeet Kunwar ◽  
G. N. Khare ◽  
Shubhashu Shekhar ◽  
Anil Kumar Rai ◽  
...  
Keyword(s):  
Radial Nerve ◽  
Plate Osteosynthesis ◽  
Distal Humerus ◽  
Trauma Centre ◽  
Outcome Analysis ◽  
Radial Nerve Palsy ◽  
Hole Density ◽  
Articular Fractures ◽  
Complex Anatomy

Background: The complex anatomy of distal humerus with proximity of radial nerve make the exposure and fixation of these fractures difficult. The standard technique of plate osteosynthesis consider at least eight cortices hold in both distal and proximal ends. Obeying these principles becomes difficult in distal humerus fractures. These difficulties have been overcome with the use of anatomical extra-articular distal humerus plate which has more hole density in the distal part with 3.5 mm screws for greater hold in distal part.Methods: A prospective study was carried out at Institute of Medical Sciences BHU Trauma Centre for 19 cases of distal third fracture excluding open fractures of patients between 18-68 years who attended our OPD or Emergency from June 2017 to July 2019. All patients were operated with the triceps-reflecting modified posterior approach. Regular follow-up was done to evaluate elbow functionality, fracture union, secondary displacement, non-union, implant failure and any complications; Mayo Elbow Performance score (MEPS) was used for the final functional assessment.Results: Fourteen 73.6% male and 5 (26.3%) female patients with mean age 41 years constituted the study group, who had an average follow-up of 17.1 months. Preoperatively one patient had radial nerve palsy (neuropraxia) who recovered completely 3 months after surgery. Overall, 18 (94.7%) patients were adjudged to have complete radiological union within 14 weeks; Mean flexion achieved was 134±11.5 (range 90–140). Average MEPS at the latest follow-up was 94.7±7.5.Conclusions: Extra-articular fractures of distal humerus can be satisfactorily treated with the use of single anatomically pre-contoured locking compression plate with excellent elbow functional range of motion and union rates.

Antiretroviral Treatment-Associated Labia Majora Lipohypertrophy: A Rare Case and Plastic Surgical Treatment Options

2017 ◽  
Vol 2 (1) ◽  
pp. 43
Author(s):  
Akmal Hisham ◽  
Devananthan Ilenghoven ◽  
Wan Syazli Wan Ahmad Kamal ◽  
Salina Ibrahim ◽  
Shah Jumaat Mohd Yussof
Keyword(s):  
Highly Active Antiretroviral Therapy ◽  
Daily Living ◽  
Treatment Options ◽  
Hiv Positive ◽  
Highly Active ◽  
Labia Majora ◽  
The Face ◽  
Central Fat

The emergence of highly active antiretroviral therapy (HAART) has revolutionized the prognosis of HIV-infected patients. However, the extended use of HAART is associated with a disfiguring complication termed lipodystrophy, a disorder of body fat maldistribution causing peripheral fat loss (lipoatrophy) and central fat accumulation (lipohypertrophy). Lipoatrophy commonly affects the face, legs, buttocks and arm, whilst lipohypertrophy frequently favours the abdomen, breast and dorsocervical region. To our knowledge, we present only the second documented case in the literature of a labia majora lipohypertrophy in a HIV-positive patient receiving long-term HAART. The severity of labial abnormality caused significant physical and functional morbidities. Labiaplasty with dermolipectomy of the labia majora and excisional lipectomy of the mons pubis was successfully performed. At a 6-month follow-up, patient had no recurrence with resolution of symptoms and resumption of normal activities of daily living (ADL).

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