scholarly journals MID-SHAFT CLAVICLE FRACTURES;

2013 ◽  
Vol 20 (06) ◽  
pp. 1006-1009
Author(s):  
KASHIF KHURSHID QURESHI ◽  
ZULFIQAR AHMED ◽  
IMRAN ASIF BAJWA ◽  
Saeed Ahmed ◽  
Hassan Moin
Keyword(s):  
Internal Fixation ◽  
Medical Record ◽  
Bone Grafting ◽  
Open Reduction ◽  
Sports Injury ◽  
Non Union ◽  
Small Series ◽  
Clavicle Fractures ◽  
Operative Fixation ◽  
Grafting Procedure

Objectives: To study the time to union and complications after open reduction and internal fixation of mid-shaft claviclefractures. Design: Retrospective. Settings: Midlands Orthopedic/ Sports Injury Clinic, Bahawalpur. Study Period: 2003 to December2012. Material and Methods: The medical record of the patients operated for mid-shaft clavicle fractures was searched to find out thetime to union and occurrence of complications during this period. Results: The time to union was 4.6 months and there were twocomplications. A prominent implant had to be removed and one non-union required additional bone grafting procedure. Conclusions:This small series shows that the rate of complications is low and a larger study is needed to expand the indications for operative fixation ofclavicle fracture safely.

scholarly journals Protocol of BRICS: Brazilian multicentric pragmatic randomised trial of surgical interventions for displaced diaphyseal clavicle fracture study: MIPO versus ORIF for the treatment of displaced midshaft clavicle fractures

BMJ Open ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. e052966
Author(s):  
Adriano Fernando Mendes Jr. ◽  
Rodrigo Fleury Curado ◽  
Jair Moreira Dias Jr. ◽  
José Da Mota Neto ◽  
Oreste Lemos Carrazzone ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Minimally Invasive ◽  
Internal Fixation ◽  
Open Reduction ◽  
Skin Irritation ◽  
Randomised Trial ◽  
Implant Failure ◽  
Minimally Invasive Osteosynthesis ◽  
Non Union ◽  
Clavicle Fractures

IntroductionFractures of the diaphysis of the clavicle are common; however, treatment guidelines for this condition are lacking. Surgery is associated with a lower risk of non-union and better functional outcomes but a higher risk of complications. Open reduction and internal fixation with plates and screws are the most commonly performed techniques, but they are associated with paraesthesia in the areas of incisions, extensive surgical exposure and high rates of implant removal. Minimally invasive techniques for treating these fractures have a lower rate of complications. The aim of this study is to evaluate which surgical treatment option (minimally invasive osteosynthesis or open reduction and internal fixation) has better prognosis in terms of complications and reoperations.Methods and analysisThe study proposed is a multicentric, pragmatic, randomised, open-label, superiority clinical trial between minimally invasive osteosynthesis and open reduction and internal fixation for surgical treatment of patients with displaced fractures of the clavicle shaft. In the proposed study, 190 individuals with displaced midshaft clavicle fractures, who require surgery as treatment, will be randomised. The assessment will occur at 2, 6, 12, 24 and 48 weeks, respectively. The primary outcome of the study will be the number of complications and reoperations. For sample size calculation, a moderate effective size between the techniques was considered in a two-tailed test, with 95% confidence and 90% power. Complications include cases of infection, hypertrophic scarring, non-union, refracture, implant failure, hypoesthesia, skin irritation and shoulder pain. Reoperations are defined as the number of surgeries for pseudoarthrosis, implant failure, infection and elective removal of the implant.Ethics and disseminationStudy approved by the institutional ethics committee (number 34249120.9.0000.5505—V.3). The results will be disseminated by publications in peer-reviewed journals and presentations in medical meetings.Trial registration numberRBR-3czz68)/UTN U1111-1257-8953.

scholarly journals Functional and radiological assessment of displaced midshaft clavicle fractures treated through open reduction and internal fixation surgery using pre-contoured locking compression plates

2020 ◽  
Vol 7 (7) ◽  
pp. 2261
Author(s):  
Rohil Singh Kakkar ◽  
Deepak Mehta ◽  
Ankit Sisodia
Keyword(s):  
Internal Fixation ◽  
Functional Outcomes ◽  
Open Reduction ◽  
Radiological Assessment ◽  
Fracture Union ◽  
Contact Loading ◽  
Non Union ◽  
Locking Compression Plates ◽  
Clavicle Fractures

Background: Fractures of the clavicle constitute approximately 2.6% of all the fractures and nearly 44-66% of fractures around shoulder.Methods: This particular study is intended to assess the functional and radiological outcomes in a series of 32 patients with closed displaced midshaft clavicle fractures treated through open reduction and internal fixation surgery using pre-contoured clavicle locking compression plates.Results: All 32 patients achieved fracture union within 6 months follow up period. As per Constant-Murley scoring, 56.25% cases had excellent results, 34.37% cases had good, 6.25% cases had fair and 3.12% of the cases had poor results respectively.Conclusions: Open reduction and internal fixation surgery with pre-contoured locking compression plates in the displaced midshaft clavicle fractures restores the anatomy, biomechanics and contact loading characteristics of the clavicle and significantly reduces the incidence of non-union with improved functional outcomes resulting in better patient satisfaction.

DISI DEFORMITY AND POST-OPERATIVE SYMPTOMS OF SCAPHOID NON-UNION

Hand Surgery ◽  
1999 ◽  
Vol 04 (02) ◽  
pp. 117-124 ◽  
Author(s):  
T. Wada ◽  
M. Aoki ◽  
M. Usui ◽  
S. Ishii
Keyword(s):  
Internal Fixation ◽  
Grip Strength ◽  
Bone Grafting ◽  
Open Reduction ◽  
Average Duration ◽  
Bone Screw ◽  
Non Union ◽  
Significant Difference ◽  
Corticocancellous Bone Grafting

The correlation between the residual dorsal intercalated segmental instability (DISI) deformity and symptoms of the wrist was investigated in 20 patients with healed scaphoid non-union who had open reduction and bone grafting. In seven patients, inlay corticocancellous bone grafting (modified Russe procedure) was performed. In four of the seven patients, an additional Herbert bone screw was used for internal fixation. The remaining 13 patients were treated with open reduction, anterior bone grafting, and internal fixation with Herbert bone screw. Average duration of follow-up period after operation was 20 months (range, 6 to 57 months). The average extension-flexion arc of the injured wrists was 129°, which was 31° less than that of the uninjured wrists. The average grip strength of the injured wrists was 89% of that of the uninjured wrist. Before the operation, all 20 patients were symptomatic and complained of wrist pains. Post-operatively, three patients experienced mild pains and only one complained of moderate wrist pains. Post-operative radiolunate angle ranged from 0° to 34° (average 10°). DISI deformity remained uncorrected in eight patients. Post-operative symptoms were compared amongst the eight patients who had DISI deformity and 12 patients who had no deformity. There was no significant difference in range of motion, grip strength, and incidence of pain between these two groups of patients. The presence of DISI deformity after bone grafting for a symptomatic scaphoid non-union was not predictive of post-operative symptoms of the wrist.

scholarly journals Operative Fixation of Displaced Middle Third Clavicle (Edinburg Type 2) Fracture with Superior Reconstruction Plate Osteosynthesis

2012 ◽  
Vol 9 (4) ◽  
pp. 286-290 ◽  
Author(s):  
D Dhoju ◽  
D Shrestha ◽  
N P Parajuli ◽  
R Shrestha ◽  
V Sharma
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Clavicle Fracture ◽  
Frozen Shoulder ◽  
Reconstruction Plate ◽  
Small Series ◽  
Superior Surface ◽  
Operative Fixation ◽  
One Year

Background Conservative management of middle third clavicle fracture has been recently reported with suboptimal outcomes. Despite higher nonunion rates in initial open reduction and internal fixation, understanding the problem better and taking in accounts of previous shortcomings, such fractures can be optimally treated by open reduction and internal fixation with reconstruction plate. Objective To study the outcome of middle third clavicle fracture treated with superior reconstruction plating in terms of function using Constant shoulder score, union time and rate, complications and patient satisfaction. Methods Twenty patients with displaced middle third clavicle fracture (Edinburg type 2) treated with open reduction and internal fixation with reconstruction plate implanted in superior surface were prospectively followed for at least one year after surgery. Results There were 20 patients, 16 males and 4 females. The mean age of the patients was 31.5 years with SD 11.5 years (range 15-60 years) and 5 patients (25%) had associated injuries. All fractures united in 16 weeks or less in near anatomic position with complication in 2 (5%) patients, one deep infection and one frozen shoulder which on subsequent management recovered well. There was no nonunion or implant failure. The average Constant score was 97.45 in one year follow up and the patients were relatively satisfied with the treatment.The most common indication (25%) for hardware removal was young age of the patient, hardware prominence and occasional discomfort Conclusion This small series shows that displaced midshaft clavicle fracture can be optimally treated with operative fixation implanting the reonstruction plate in superior surface with six cortical purchases on either side and supervised physiotherapy, although subsequent surgery for implant removal might be necessary.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6346 Kathmandu Univ Med J 2011;9(4):286-90

scholarly journals Near-Complete Supraglottic Transection of the Larynx after a Motorbike Accident

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Sang Hwang ◽  
Samuel McGinness ◽  
Sim Choroomi ◽  
Ian Jacobson
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Surgical Intervention ◽  
Viable Alternative ◽  
Laryngeal Trauma ◽  
Operative Fixation ◽  
Sydney Australia

Severe laryngeal trauma is rare in the civilian environment and requires appropriate and timely surgical intervention. We report a case from Sydney, Australia, which was managed with open reduction and internal fixation of the larynx with resorbable plates. The use of resorbable plates for operative fixation of the larynx has rarely been reported in literature but may be a viable alternative.

scholarly journals Non -Union of Lateral Hoffa Fracture - A Case Report

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Amit Supe ◽  
Shubham Atal ◽  
Neetin P Mahajan ◽  
Prasanna Kumar. G S ◽  
Amey Sadar ◽  
...  
Keyword(s):  
Case Report ◽  
Internal Fixation ◽  
Open Reduction ◽  
Femoral Condyle ◽  
Left Knee ◽  
X Rays ◽  
Non Union ◽  
Hoffa Fracture ◽  
History Of ◽  
Missed Diagnosis

Introduction: Hoffa is a coronal fracture of the femoral condyle. It is an uncommon injury easily missed on X-rays, which later presents as a non-union. Computed tomography (CT) scan knee helps in diagnosing undisplaced fractures and planning the management. Case Report: A 24-year-old male patient presented to us with complaints of pain, decreased range of knee movements, difficulty in walking and clicking sound at the left knee for 9 years. The patient had a history of trauma 9 years back. X-ray of the left knee showed the non-union of left lateral Hoffa fracture, which was managed with open reduction and internal fixation with CC screws using the lateral para patellar approach. At present 1.5 years follow-up, the patient is comfortable with no pain and having a complete knee range of motion. Conclusion: Although Hoffa fracture is rare, clinical suspicion, along with radiological investigations, is essential to diagnose Hoffa fracture. A missed diagnosis can lead to malunion or non-union, which predisposes to knee arthritis. Timely and proper management of Hoffa non-union with open reduction, stable internal fixation and early knee mobilization help in getting a better outcome. Keywords: Lateral Hoffa fracture, non-union, internal fixation, functional outcome.

scholarly journals The Outcome of Using a Jamshidi Biopsy Trocar Needle in a Novel Technique for Bone Grafting in Percutaneous Internal Fixation of Scaphoid Non-Union

2018 ◽  
Vol 6 (3) ◽  
pp. 506-510
Author(s):  
Syed Bokhari ◽  
Saifullah Hadi ◽  
Fahad Hossain ◽  
Bernd Ketzer
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
Bone Grafting ◽  
Proximal Pole ◽  
Union Rate ◽  
Non Union ◽  
Novel Technique ◽  
Grafting Technique ◽  
Percutaneous Internal Fixation ◽  
Time From Injury

INTRODUCTION: We report the outcome of using a novel technique of minimally invasive internal fixation and distal radius bone grafting using the Jamishidi Trephine needle and biopsy/graft capture device.METHODS: The technique utilises a 8 mm incision at the distal pole of the scaphoid. The non-union is excavated using the standard Acutrak drill. An 8 gauge Jamshidi trephine needle is used to harvest bone graft from the distal radius which is impacted into the scaphoid and fixed with an Acutrak screw. Fifteen patients were available for retrospective review, 14 male, age mean 29.5 (15-56). Average time from injury to surgery was 167 days (45-72). Fractures classified according to Herbert giving 7 D1 and 8 D2 fractures, 14 waist and 1 proximal pole fractures, all of which had no humpback deformity.RESULTS: Sixty-six percentages of the fractures went onto unite, 4/7 D1 and 6/8 D2 united (p > 0.05). Seventy-five percentages of fracture that had surgery in less than 3 months from time of injury went onto unite, whereas only 63% united in patients who had surgery later than 3 months (p > 0.05). DASH outcome for all patients improved from 86 down to 32 (p < 0.05). With those that united going down from 90 to 6. Those that did not unite went from 81 to 61.CONCLUSION: The Jamshidi bone grafting technique shows comparable results (union rate 66%) to other techniques published in the literature (27-100%) providing the surgeon with an alternative and less demanding procedure than open scaphoid non-union surgery.

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