scholarly journals To determine frequency of union with orthogonal double locking plate in distal humeral fracture.

2020 ◽  
Vol 27 (05) ◽  
pp. 1059-1064
Author(s):  
Muhammad Javaid Iqbal ◽  
Shahzad Mahmood Shahid ◽  
Afzal Javid ◽  
Anoosh Qayyum ◽  
Usman Akmal ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Locking Plate ◽  
Callus Formation ◽  
Case Series ◽  
Humeral Fracture ◽  
Radiographic Evaluation ◽  
Locking Plates ◽  
Non Union ◽  
Distal Humeral Fracture ◽  
Articular Fractures

Objectives: To determine frequency of union with orthogonal double locking plate in distal humeral fracture. Study Design: Descriptive, case series. Setting: Orthopedic department Punjab Medical College. Period: From April 2, 2017 to October, 2017. Material & Methods: 75 consecutive patients with distal humeral fractures were managed by open reduction of internal fixation with double locking plates in orthogonal configuration. Radiographic evaluation was done to see the callus formation after 12 weeks of treatment. Results: There were 54 (72%) males and 21 (28%) female patients having the average age 43.5±15.9 years. Union was seen in 71 (94.7%) patients. In 4 (5.3%) patients there was non-union. Conclusion: Anatomically pre-contoured distal humeral locking plates are useful in providing stable internal fixation for complex distal articular fractures, and hence allowing early rehabilitation.

Mechanical Failure of Angle Locking Plates in Distal Comminuted Tibial Fractures

2016 ◽  
Vol 695 ◽  
pp. 118-122 ◽  
Author(s):  
Razvan Ene ◽  
Zsombor Panti ◽  
Mihai Nica ◽  
Marian Pleniceanu ◽  
Patricia Ene ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Bone Healing ◽  
Tibial Fracture ◽  
Weight Bearing ◽  
Healing Process ◽  
Biomechanical Properties ◽  
Implant Failure ◽  
Locking Plates ◽  
Non Union ◽  
Tibial Pilon

Distal comminuted tibial fracture with or without intra-articular involvement is a very common injury of the lower limb, especially in younger patients due to high energy trauma. The anatomical and biomechanical properties of this segment of tibia, makes this pathology a major surgical challenge with a preserved clinical outcome. The aim of this study is to present different outcome of tibial fracture, treated with open reduction and internal fixation (ORIF) with titanium angle locking plates (ALP) and to underline the physiological and non-physiological bone healing effects on implants. In this study we included 48 patients with tibial pilon fracture who underwent to ORIF, applying ALP in the Orthopedics and Trauma department of the University Emergency Hospital in Bucharest. Due to preserved biomechanical properties of ALP and this anatomical region, weight bearing is not allowed till 6 to 8 weeks. Comminuted fracture of this part of tibia often have de-vascularized bony fragments which leads to delayed union or non-union. These complications often lead to implant failure, improper bone healing or non-union. Internal fixation with angle stable screws, offers a good stability of reduction in the early postoperative period. Titanium angle locking plates offers good anatomical reduction and stable fixation in the early period of healing process. Due to its rigid, fixed position of the screws in the plates, bone remodelling during healing process and early weight bearing, increases the mechanical failure of implant.Keywords: tibial pilon fractures, angle locking plates, implant failure.

Distal femoral osteotomy for genu valgum deformity caused by malunited Hoffa fracture

2021 ◽  
Vol 14 (2) ◽  
pp. e238615
Author(s):  
Taiga Oda ◽  
Akira Maeyama ◽  
Tetsuro Ishimatsu ◽  
Takuaki Yamamoto
Keyword(s):  
Internal Fixation ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Young Patients ◽  
Femoral Osteotomy ◽  
Posterior Aspect ◽  
Distal Femoral Osteotomy ◽  
Non Union ◽  
Hoffa Fracture ◽  
Articular Fractures

Hoffa fractures are unstable intra-articular fractures of the femoral condyle that occur in the coronal plane.Insufficient anatomical reduction and internal fixation may lead to non-union or malunion. A 39-year-old man was involved in a traffic accident while riding a motorcycle and was diagnosed with left Hoffa fracture and avulsion fracture of the femoral attachment of the medial collateral ligament. Open reduction and internal fixation were performed 5 days after injury. The patient experienced intermittent knee pain, joint contracture and deformity, and attended our hospital for further treatment 18 months after surgery. CT revealed depression and malunion of the posterior aspect of the lateral femoral condyle, and weight-bearing X-ray showed valgus deformity due to malunion. Distal femoral osteotomy (DFO) was performed and good functional and radiographic results were obtained. This report suggests that DFO is a reasonable treatment for young patients suffering from malalignment due to malunited Hoffa fracture.

scholarly journals Reverse distal femoral locking plate for subtrochanter femur fracture

2018 ◽  
Vol 27 (2) ◽  
Author(s):  
Peter Giarso ◽  
Ismail H. Dilogo
Keyword(s):  
Distal Femur ◽  
Locking Plate ◽  
Femur Fracture ◽  
Case Series ◽  
Subtrochanteric Fracture ◽  
Locking Compression Plate ◽  
Non Union ◽  
Functional Scores ◽  
The Right ◽  
Subtrochanteric Femur Fracture

In these case series, we used titanium locking compression plate-distal femur (LCP-DF) plate (Synthes) 9–11 hole using less invasive stabilization system or open reduction technique. This case series aims to determine the functional scores on reverse distal femoral locking plate for subtrochanteric femur fracture. A 34-year-old male with closed subtrochanteric fracture of the right femur (Seinsheimer 2B) with Harris hip scores (HHS) of 17, 96, and 97 obtained consecutively in 0, 6, and 12 months, respectively. A 24-year-old male with closed comminuted subtrochanteric fracture of the right femur (Seinsheimer V) with HHS of 13, 93, and 97 at 0, 6, and 12 months respectively. A 39-year-old male with non-union, left subtrochanteric femur fracture (Seinsheimer 2C) yielded HHS of 38, 73, and 77 at 0, 6, and 12 months, respectively. A 35-year-old female with close subtrochanteric fracture of the right femur (Seinsheimer IIB) yielded HHS of 23, 40, and 73 at 0, 6, and 12 months, respectively. Mean initial HHS and scores at 6 and 12 months reached 22, 75, and 86, respectively.

scholarly journals Evaluation of open reduction and internal fixation of proximal humerus fractures using a locking plate with smooth pegs – A retrospective study

2018 ◽  
Vol 11 (6) ◽  
pp. 411-418
Author(s):  
Frida Hansson ◽  
Magdalena Riddar ◽  
Anders Ekelund
Keyword(s):  
Quality Of Life ◽  
Retrospective Study ◽  
Internal Fixation ◽  
Avascular Necrosis ◽  
Open Reduction ◽  
Locking Plate ◽  
Constant Score ◽  
Humeral Fracture ◽  
The Mean

Background Optimal treatment of displaced proximal humeral fractures is controversial. This retrospective study aims to identify complications and clinical outcomes using a locking plate with smooth pegs instead of screws (S3 plate). Method Eighty-two patients with displaced proximal humeral fracture classified with 2–4 fragments (Neer’s classification) treated with open reduction and internal fixation (ORIF) with S3 plate were studied retrospectively. Clinical outcome according to constant score; Single Shoulder Value; Disabilities of Arm, Shoulder and Hand; and European Quality of life-5 dimensions and complication rate defined radiologically including peg penetration, avascular necrosis, and loss of reduction was assessed minimum 2.5 years after surgery. Results A total of 11 peg penetrations were identified (13.6%). Avascular necrosis was seen in 8.5% (n = 7). Mean constant score at follow-up was 64.4 with a relative constant score of 87% (standard deviation 18%) compared to the contralateral uninjured side. The mean Disabilities of Arm, Shoulder and Hand score was 12.7 and mean European Quality of life-5 dimensions score 0.83. The mean Single Shoulder Value was 78.3. No cases of deep infection were seen. Conclusions Fixation with S3 plate shows a proper osteosynthesis and the functional outcome is good. Symptomatic peg penetrations are rare and the incidence is lower compared to what has been reported with locked screws.

Screw/Plate Stability in Universal Locking Plate: A Novel Internal Fixator

2007 ◽  
Author(s):  
Mehul A. Dharia ◽  
Micah A. Forstein ◽  
Rick C. Compton ◽  
Danny L. Levine
Keyword(s):  
Internal Fixation ◽  
Locking Plate ◽  
Recent Trend ◽  
Internal Fixator ◽  
Locking Plates ◽  
Fixation Device ◽  
Biological Fixation ◽  
Threaded Connection ◽  
Plate Stability ◽  
Frictional Forces

The recent trend in internal fixation of fractures puts a greater emphasis on biological fixation, which involves the use of locking plates and screws [1]. While conventional plates rely on frictional forces between the plate and the bone, locking plates utilize a threaded connection between screw and plate for fixation and stability [2]. Surgeons choose either type of fixation device in treatments for specific fractures and injuries.

scholarly journals Iatrogenic postoperative brachial plexus compression secondary to hypertrophic non-union of a clavicle fracture

2013 ◽  
Vol 95 (3) ◽  
pp. e1-e3 ◽  
Author(s):  
D Thavarajah ◽  
J Scadden
Keyword(s):  
Internal Fixation ◽  
Brachial Plexus ◽  
Callus Formation ◽  
Clavicle Fracture ◽  
Brachial Plexopathy ◽  
Rigid Internal Fixation ◽  
Non Union

The brachial plexus is related intimately to the clavicle such that injury can occur primarily and most commonly at the time of trauma through traction or it can occur secondarily, mainly owing to hypertrophic non-union with exuberant callus formation, causing compression of the plexus. The movement-dependent rearrangement of the subclavicular space is restricted with rigid internal fixation, thereby placing inappropriate pressure on the plexus from the deep hypertrophic tissue. This case highlights another cause of brachial plexopathy of which to be aware.

scholarly journals Fixation of proximal humerus fracture in adult by locking plate: Clinical study

2020 ◽  
Vol 6 (5) ◽  
pp. 325-332
Author(s):  
Dr. Vivek Amritbhai Patel ◽  
◽  
Dr. Vishal A. Pushkarna ◽  
Dr. Dhruvin J. Patel ◽  
◽  
...  
Keyword(s):  
Functional Outcome ◽  
Proximal Humerus Fracture ◽  
Locking Plate ◽  
Proximal Humerus ◽  
Plate Fixation ◽  
Humeral Fracture ◽  
Humerus Fracture ◽  
Functional Evaluation ◽  
Locking Plates ◽  
Radiological Union

p>Aim: The present study aimed to examine the functional outcome of the locking plate in theproximal humerus fracture treatment. Material and Methods: The study consists of 20 patientsdiagnosed with NEER’s 2 – part, 3- part, and 4 – part proximal humerus fracture. All the includedpatients were treated with internal locking plates. Based on the functional evaluation by Constant-Murley shoulder score and the assessment of radiological union foundation. Results: Excellentresults were obtained in 45% of the patients, a good result was seen in 25%, 20% of the patientshad fair results and the poor result was seen in 10% of the patients. The mean Constant-Murleyshoulder score that was obtained in the present study was 75.04. Conclusion: It’s concluded thatthere is a satisfactory functional outcome with the fixation of the proximal humerus fracture withlocking plates. While using the plate fixation for fracture the plate position is of the utmostimportance. Due to angular stability, the locking plates are the advantageous implants in case ofproximal humeral fracture.

scholarly journals Pitfalls and Remedial Technique of Intramedullary Nail for Subtrochanteric Femur Fractures: A Case Series

2021 ◽  
Author(s):  
Botao Chen ◽  
Xiaohong Fan
Keyword(s):  
Internal Fixation ◽  
Intramedullary Nailing ◽  
Intramedullary Nail ◽  
Locking Plate ◽  
Case Series ◽  
Trochanteric Fracture ◽  
Subtrochanteric Fracture ◽  
Chinese Patients ◽  
Good Reduction ◽  
Subtrochanteric Fractures

Abstract Background: Intraoperative technical complications are occasionally encountered while implanting intramedullary nails for subtrochanteric fractures. Surgeons must pay attention to the pitfalls and remedial technique of this operation.Methods: We report on three cases in which intraoperative difficulties occurred during the implantation of an intramedullary nail among Han Chinese patients from mainland China. In Case 1, during an operation on a 57-year-old man, a seinsheimer type V in a right subtrochanteric fracture was not fully realized, and the dislocation of intertrochanteric fracture was aggravated after reduction of the subtrochanteric fracture. The intramedullary nail fixation was completed with the aid of an additional anterolateral plate. Case 2 involved a transverse subtrochanteric fracture. The surgeon neglected the coronal dislocation when considering good sagittal reduction. Although an auxiliary reduction device was used during the operation, there was unacceptable coronal dislocation after the intramedullary nail was inserted. A temporary anterolateral locking plate fixation was used to complete the intramedullary nail fixation. Case 3 involved an old trochanteric fracture combined with a new subtrochanteric fracture in an 81-year-old woman. After reducing the subtrochanteric fractures, the intramedullary nail fixation was successfully completed by releasing the poorly healed intertrochanteric fractures and fixing the anterior lateral plate.Results: With the development of techniques, reliable results can be obtained with fewer complications. Of the various internal fixation methods, we favor using a trochanteric start intramedullary nail.Conclusions: The treatment of subtrochanteric fractures presents challenges. Good reduction and reliable temporary fixation are key to completing the intramedullary nailing. If percutaneous joysticks, finger reduction tools, blocking screws, clamps, and Schanz pins cannot be used for effective auxiliary reduction or temporary reliable fixation, reduction after intramedullary nailing will not be satisfactory. The temporary addition of a reconstruction locking plate can achieve good reduction and temporary stability, and an extra reconstruction locking plate should be retained when the temporary fixation device is removed to reduce the risk of internal fixation failure during fracture healing.

scholarly journals Surgical treatments of patients with periprosthetic humeral fracture and comorbidities

2021 ◽  
Vol 13 (1) ◽  
pp. 1-4
Author(s):  
Jiayong Liu ◽  
Logan J Roebke ◽  
Josh W Vander Maten ◽  
Meaghan Tranovich ◽  
Nabil A Ebraheim
Keyword(s):  
Shoulder Arthroplasty ◽  
Locking Plate ◽  
Rare Complication ◽  
Case Series ◽  
Humeral Fracture ◽  
Humeral Fractures ◽  
Outcome Analysis ◽  
Level Of Evidence ◽  
Significant Difference ◽  
Cerclage Wiring

Background: Periprosthetic humeral fractures represent a complex and rare complication. Currently, there is no standardized procedure for management or classification of these fractures. Questions/purposes: This unique case series purpose was to look at surgical outcomes and comorbidity profiles of 10 PHF patients. Subsequent analysis looked at whether these outcomes could add to the discussion of a proposed standard of care in a patient cohort with significant comorbidities. Patients and methods: All patients with humeral fractures from 2008-2019 were analyzed for inclusion. A total of ten patients met the inclusion criteria; humeral fracture concurrent with a shoulder arthroplasty. Each patient was managed surgically using a locking plate with or without cerclage wiring. Outcome analysis was then performed for each patient. Humoral fractures managed conservatively were removed from the dataset along with periprosthetic fractures around an elbow arthroplasty, IM nail, or supracondylar fracture after shoulder arthroplasty. Results: The average union time in all patients was 13.27±2.90 (9.86-17.29) weeks. There was no significant difference between patients treated with cerclage wiring or without. All patients had successful union except for a patient with Osteogenesis Imperfecta. There were two radial nerve palsies. The average Deyo-Charlson score and BMI was 7.1±.84 (4-13) and 29.89 respectively. Conclusion: The treatment of PHFs using the technique of ORIF with locking plate with or without cerclage wiring provides satisfactory outcomes in a patient population that usually includes significant comorbidities. Level of evidence: Therapeutic Study Level IV Retrospective Review.

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