scholarly journals Treatment of midshaft clavicle fracture with anatomical contoured clavicular locking plate

2018 ◽  
Vol 10 (1) ◽  
pp. 92-96
Author(s):  
Pratyenta Raj Onta ◽  
Krishna Sapkota ◽  
Krishna Wahegaonkar ◽  
Niraj Ranjeet ◽  
Pabin Thapa ◽  
...  
Keyword(s):  
Shoulder Joint ◽  
Open Reduction ◽  
Locking Plate ◽  
Plate Osteosynthesis ◽  
Plate Fixation ◽  
Clavicle Fracture ◽  
Shaft Fracture ◽  
Free Movement ◽  
Early Return ◽  
The Mean

Background: Fracture clavicle is a common fracture around the shoulder joint accounting about 2.6% of all fracture and 44% in shoulder region. Mid shaft clavicle fracture accounts about 81% of total clavicle fracture. Open reduction and plate fixation is a good treatment method for displaced mid shaft clavicle fracture with benefit of early pain free movement of shoulder joint and early return to work. The anatomical contoured clavicular plate maintains mechanical strength and has less soft tissue complications. Aims and Objective: The aim of the study was to evaluate the clinical and radiological outcome, time for fracture union and complications in midshaft clavicle fracture managed with anatomical contoured clavicularlocking plate. Material and Methods: This study was done in Manipal Teaching Hospital, Pokhara, Nepal.There were a total of 30 patients (19 male and 11 female) who had displaced mid shaft fracture. All patients underwent plate osteosynthesis with anatomical contoured locking plate. The patients were followed up at 3 weeks, 6 weeks, 3 month and 6 months’ time. Results: There were 30 patients among whom; one patient had bilateral clavicle fracture. The mean age of the patient was 37.19 (11.96) years. The mean time for clinical and radiological union was 8.77 (1.17) weeks and 17.03 (3.06) weeks. All patients in our study had union of fracture with only one patient having superficial surgical site infection. Conclusion: Open reduction and plate fixation is a good option for displaced mid shaft clavicle fracture which help the patient for early pain-free movement of shoulder. Use of anatomical contoured clavicle plate provides fixation of clavicle to its normal contour and provides better fixation and stability.  

scholarly journals A novel surgical approach and technique and short-term clinical efficacy for the treatment of proximal humerus fractures with the combined use of medial anatomical locking plate fixation and minimally invasive lateral locking plate fixation

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Fu Wang ◽  
Yan Wang ◽  
Jinye Dong ◽  
Yu He ◽  
Lianxin Li ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Surgical Approach ◽  
Shoulder Joint ◽  
Locking Plate ◽  
Proximal Humerus ◽  
Plate Fixation ◽  
Anterolateral Approach ◽  
Proximal Humerus Fractures ◽  
Locking Plate Fixation ◽  
Humerus Fractures

Abstract Background and hypothesis The typical anterolateral approach is widely used to treat proximal humerus fractures with lateral locking fixation. However, lateral fixation cannot completely avoid medial reduction loss and varus deformity especially in the cases of an unstable medial column. We present a novel medial surgical approach and technique together with a minimally invasive lateral locking plate to fix proximal humerus fractures with an unstable medial column. Materials and methods We performed an anatomical study and reported 8 cases of proximal humerus fractures with unstable medial columns treated with plate fixation through a minimally invasive anterolateral approach and medial approach. All surgeries were performed by the same single surgeon. Patients were followed clinically and radiographically at 1, 3, 6, and 12 months postoperatively. Results There was a safe region located at the medial part of the proximal humerus just beneath the articular surface. An anatomical medial locking proximal humerus plate could be placed in the medial column and did not affect the axillary nerve, blood supply of the humeral head, or stability of the shoulder joint. Successful fracture healing was achieved in all 8 cases. The function and range of motion of the shoulder joint were satisfactory 24 months postoperatively, with an average Constant score (CS) of 82.8. No reduction loss (≥ 10° in any direction), screw cutout, nonunion, or deep infection occurred. Conclusions The combined application of medial anatomical locking plate fixation and minimally invasive lateral locking plate fixation is effective in maintaining operative reduction and preventing varus collapse and implant failure in proximal humerus fractures with an unstable medial column.

scholarly journals Bone plate fixation ability on the dorsal and lateral sides of a metacarpal shaft transverse fracture

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yung-Cheng Chiu ◽  
Cheng-En Hsu ◽  
Tsung-Yu Ho ◽  
Yen-Nien Ting ◽  
Ming-Tzu Tsai ◽  
...  
Keyword(s):  
Mechanical Strength ◽  
Locking Plate ◽  
Plate Fixation ◽  
Shaft Fracture ◽  
Bone Plate ◽  
Lateral Side ◽  
Lateral Plate ◽  
Fracture Force ◽  
Shaft Fractures ◽  
Metacarpal Shaft

Abstract Background Metacarpal shaft fractures are a common hand trauma. The current surgical fixation options for such fractures include percutaneous Kirschner wire pinning and nonlocking and locking plate fixation. Although bone plate fixation, compared with Kirschner wire pinning, has superior fixation ability, a consensus has not been reached on whether the bone plate is better placed on the dorsal or lateral side. Objective The purpose of this study was to evaluate the fixation of locking and regular bone plates on the dorsal and lateral sides of a metacarpal shaft fracture. Materials and methods Thirty-five artificial metacarpal bones were used in the experiment. Metacarpal shaft fractures were created using a saw blade, which were then treated with four types of fixation as follows: (1) a locking plate with four locking bicortical screws on the dorsal side (LP_D); (2) a locking plate with four locking bicortical screws on the lateral side (LP_L); (3) a regular plate with four regular bicortical screws on the dorsal side (RP_D); (4) a regular plate with four regular bicortical screws on the lateral side (RP_D); and (5) two K-wires (KWs). All specimens were tested through cantilever bending tests on a material testing system. The maximum fracture force and stiffness of the five fixation types were determined based on the force–displacement data. The maximum fracture force and stiffness of the specimens with metacarpal shaft fractures were first analyzed using one-way analysis of variance and Tukey’s test. Results The maximum fracture force results of the five types of metacarpal shaft fracture were as follows: LP_D group (230.1 ± 22.8 N, mean ± SD) ≅ RP_D group (228.2 ± 13.4 N) > KW group (94.0 ± 17.4 N) > LP_L group (59.0 ± 7.9 N) ≅ RP_L group (44.5 ± 3.4 N). In addition, the stiffness results of the five types of metacarpal shaft fracture were as follows: LP_D group (68.7 ± 14.0 N/mm) > RP_D group (54.9 ± 3.2 N/mm) > KW group (20.7 ± 5.8 N/mm) ≅ LP_L group (10.6 ± 1.7 N/mm) ≅ RP_L group (9.4 ± 1.2 N/mm). Conclusion According to our results, the mechanical strength offered by lateral plate fixation of a metacarpal shaft fracture is so low that even KW fixation can offer relatively superior mechanical strength; this is regardless of whether a locking or nonlocking plate is used for lateral plate fixation. Such fixation can reduce the probability of extensor tendon adhesion. Nevertheless, our results indicated that when lateral plate fixation is used for fixating a metacarpal shaft fracture in a clinical setting, whether the mechanical strength offered by such fixation would be strong enough to support bone union remains questionable.

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.

scholarly journals SURGICAL TREATMENT OF CLAVICULAR FRACTURES IN SPORT

2018 ◽  
Vol 6 (6_suppl3) ◽  
pp. 2325967118S0004
Author(s):  
E Gastaldi Orquin ◽  
GM Gastaldi Llorens
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Platelet Rich Plasma ◽  
Plate Fixation ◽  
Activity Level ◽  
Contact Sports ◽  
Sport Practice ◽  
Shoulder Range Of Motion

Clavicular fractures are common in sport practice, they are easily diagnosed and have a relative good forecast. Nevertheless there is no consensus among orthopedic surgeons regarding treatment for displaced midle-third clavicular fractures (Robinson’s classification 2B2) and lateral-third fractures. The tendency toward operative treatment is increasing due to the earlier sport recovery. Objectives: The aim of the paper is to present the results of treatment of 98 clavicular fractures in the Clinic Gastaldi of Traumatology during the period from 1997 to 2016, analyzing the radiologic and clinical results. Methods: The serie consists of 89 patients, 80 males and 9 females, average age 32.2 years. From them, 89 were agude fractures and 9 nonunion (after conservative treatment). According to the Thomsom classification there were 82 middle-third and 16 lateral-third. Motorbike sport trauma was the cause of 49 patients (55%), bike trauma in 18 (20%), 18 (20%) fractures occurred due to contact sports and 3 other causes. All patients were surgically treated. We used an antero-superior approach, open reduction and internal fixation with antero-superior plate osteosynthesis. In case of nonunion we decorticated the fracture callus, adding intramedullary reaming and graft bone. PRP (Platelet Rich-Plasma) was used in 8/9 patients. Postoperatively, the patients were placed in a sling. After that they began a rehabilitation program that consists of isometrics, pendular and active movements until 45° during 3 weeks. From 4th to 6th week, active movements until 90°. The patients began free movements after the 6th week. Results: Fracture healing mean was 10 weeks. Bikes and motorbikes were able to ride again between 10 to 21 days after surgery (once removed stitches). All patients retrieved full shoulder range of motion and returned to their previous activity level. Complications: we had no nonunion rates after surgical treatment, neither infections. 1 case of insufficient plate fixation and 4 re-fractures which required surgical treatment. Conclusion: We suggest surgical treatment for clavicular fractures in adult patients, contact sports with IIB and IIIB fractures, re-fractures and painful nonunion. Surgical treatment with open reduction and internal fixation (ORIF) of displaced middle-third clavicular fractures achieved shorter time to complete return to sport and earlier bone union.

scholarly journals Early Experience with Low Profile Plate Osteosynthesis for Metacarpal Fractures

1970 ◽  
Vol 7 (1) ◽  
pp. 19-24
Author(s):  
A Joshi ◽  
BR K.C. ◽  
P Chand ◽  
BB Thapa
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Open Reduction Internal Fixation ◽  
Complication Rates ◽  
Metacarpal Fractures ◽  
Active Flexion ◽  
Early Return ◽  
Early Results ◽  
Low Profile

Background: Among various fixation methods for metacarpal fractures, plate osteosynthesis is the most rigid and allows early rehabilitation leading to early return to work. Many authors have reported high complication rates and most of them were because of thick plate. The aim of this study was to report early results of plate osteosynthesis of metacarpal fractures with low profile miniplate. Methods: This was a hospital based prospective study. Unstable and irreducible fractures were managed by open reduction and internal fixation with low profile miniplate and were followed up for 6 months. The functional outcome after fracture treatment was assessed by ability to perform acts of daily life and calculating American Society for Surgery of the Hand Total Active Flexion (ASSH TAF) score. Results: There were 16 patients with 17 metacarpal fractures, 87.5% were male with mean age of 31.50±9.02 years. Fourteen (87.5%) patients could perform their activities of daily living at four weeks. The mean Total Active Flexion was 261.76±24.87 at final follow up. Fourteen (87.5%) patients had excellent, one (6.25%) good and one (6.25%) poor out come at the end of 6 months. Conclusion: Low severity metacarpal fractures can be treated successfully by open reduction internal fixation with low-profile miniplate, allowing early and safe mobilization. Key words: low-profile plate, metacarpal fractures, plate osteosynthesis   DOI: 10.3126/jnhrc.v7i1.2274 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 19-24

scholarly journals A Unique Complication after a Routine Operation – Late Pseudoaneurysm of the Brachial Artery after Plate Fixation of Humeral Shaft Fracture. A Case Report and Review of the Literature

Folia Medica ◽  
2020 ◽  
Vol 62 (3) ◽  
pp. 610-614
Author(s):  
Boris Kyurkchiev ◽  
Borislav Zlatev ◽  
Todor Georgiev ◽  
Dian Enchev
Keyword(s):  
Brachial Artery ◽  
Rare Case ◽  
Proximal Humerus ◽  
Plate Osteosynthesis ◽  
Plate Fixation ◽  
Orthopedic Implants ◽  
Shaft Fracture ◽  
Humeral Shaft Fracture ◽  
Review Of The Literature ◽  
Attending Physician

We report an extremely rare case of an 82-year-old woman with pseudoaneurysm of the brachial artery developed 22 months after a plate osteosynthesis with angularly stable locking plates for the proximal humerus. The condition was initially misdiagnosed as a tumor by the attending physician, and the patient was referred to an oncological unit. The case was successfully managed by a multidisciplinary team consisting of orthopedic and vascular surgeons. An up-to-date review of the available literature is also provided. The pseudo-aneurysms of the axillary and the distal peripheral arteries of the upper limb are a rare but potentially dangerous complication because the thromboembolism could lead to gangrene and amputation of the extremity. Despite casuistic, they should be taken into consideration in the differential diagnosis after plate osteosynthesis. Proper operative technique and constant vigilance when orthopedic implants are used are of paramount importance, which is actually the emphasis of this report.

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