scholarly journals Functional Outcome of Displaced Diaphyseal Both Bone Forearm Fracture in Children Treated with Elastic Stable Intramedullary Nails

2018 ◽  
Vol 16 (2) ◽  
pp. 47-49
Author(s):  
Gopal Sagar DC
Keyword(s):  
Functional Outcome ◽  
Intramedullary Nail ◽  
Forearm Fracture ◽  
Diaphyseal Fracture ◽  
Intramedullary Nails ◽  
College Hospital ◽  
Average Hospital ◽  
Elastic Stable Intramedullary Nail ◽  
Minimal Morbidity ◽  
Day Range

Introduction: Pediatric forearm fractures are most commonly managed by closed reduction and above elbow cast. Failure to achieve anatomical initial reduction, tight cast and re-displacement within cast leading to malunion are common complication. Elastic stableintramedullary nailing for such fracture gives more predictable result with minimal morbidity. We studied on functional outcome of such fracture treated operatively with elastic stable intramedullary nail in our center. Methods: This prospective descriptive study was done in Nepalgunj Medical College Hospital, Nepalgunj between January 2015 to May 2017.It included 47 pediatric patients (5-15 years) with displaced both bone forearm diaphyseal fracture. All fractures were fixed with elastic stable intramedullary nails of appropriate size under general anesthesia. Cases were followed up at 1, 2, 4, 6, 8, 10, 12 weeks and at 6 month functional outcome was evaluated using price criteria. Data were entered in structured proforma and statistical analysis was carried out using SPSS 20.0. Results: Out of 47 cases included in our study, mean age of patient was 9.7 years (range 5-15 years). 31(65.9%) cases were male and16 (34.1%) were female. 42(89.4%) cases had closed fracture and 5(10.6%) had grade I open factor. 40(85.1%) cases were operated by closed technique. Average hospital stay was 2.7±1.8 day (range 2-5days). Radiological union was achieved on 6.5±2.7 weeks (range 6-11weeks).Functional outcome in final follow up at 6 month was excellent in 36(76.6%), good in 9(19.1%) and fair in 2(4.3%) cases. Superficial surgical site infection was seen in 3 cases (6.3%) and exposure of nail tip was seen in 2 cases (4.2%). Conclusion: Elastics table intramedullary nail for displaced pediatric both bone forearm diaphyseal fracture is biological osteosynthesis, simple and reproducible treatment with excellent functional outcome with minimal morbidity.

Elastic intramedullary nail treatment of adolescent perihardware radius and ulna refracture

2021 ◽  
Vol 14 (1) ◽  
pp. e236098
Author(s):  
Carah M Griffin ◽  
Jeremy S Somerson
Keyword(s):  
Intramedullary Nailing ◽  
Intramedullary Nail ◽  
Plate Fixation ◽  
Forearm Fracture ◽  
Entire Length ◽  
Hardware Removal ◽  
Intramedullary Nails ◽  
Flexible Intramedullary Nailing ◽  
Additional Protection ◽  
Forearm Bones

A 13-year-old girl presented to the clinic with a midshaft refracture of both forearm bones adjacent to the site of a prior forearm fracture that had been treated with plating. She was treated with hardware removal and placement of elastic intramedullary nails. Flexible intramedullary nailing can be successful for a skeletally mature adolescent in treatment of refracture surrounding plate fixation of a midshaft forearm fracture. This technique allows for additional protection of the entire length of the affected bones, while avoiding the extensive dissection needed for extended plating.

scholarly journals Treatment of Intertrochanteric Femur Fractures with Hip Arthroplasty in Older Patients: A Narrative Review of Indications and Outcomes

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 763
Author(s):  
Tiago Martinho ◽  
Karl Stoffel
Keyword(s):  
High Risk ◽  
Surgical Technique ◽  
Internal Fixation ◽  
Functional Outcome ◽  
Hip Arthroplasty ◽  
Older Patients ◽  
Bipolar Hemiarthroplasty ◽  
Intramedullary Nails ◽  
Fixation Failure ◽  
Femur Fractures

Intertrochanteric femur fractures are common in older patients and often have a significant impact on disability. The treatment aims to achieve a rapid return to the prior functional level with a low rate of complications and mortality. Surgical management by internal fixation is the mainstay of treatment for most of these fractures. Even when treated with intramedullary nails, the overall complication rates are high, especially for unstable or highly comminuted fractures or in the presence of poor bone quality. Hip arthroplasty is an alternative in older patients with intertrochanteric femur fractures at high risk of fixation failure or with concomitant intraarticular pathologies. Especially patients whose condition precludes prolonged bedrest and who are at risk of significant deterioration if their locomotor function cannot be restored rapidly are likely to benefit from hip arthroplasty. The choice of the surgical technique mainly depends on the surgeon’s preferences and the fracture characteristics. Bipolar hemiarthroplasty is the most common type of prosthesis used with primary or revision femoral stems. Compared with intramedullary nails, hip arthroplasty has a better early functional outcome and lower rates of surgical complications as well as reoperations. However, the functional outcome and the mortality rate in the longer term tend to favor intramedullary nails, even though the results are inconsistent, and a statistically significant difference cannot always be obtained. Currently, there are no guidelines that define the role of hip arthroplasty in the treatment of intertrochanteric femur fractures in older patients. The literature only offers an overview of the possibilities of the usage of hip arthroplasty, but methodological limitations are common, and evidence levels are low. Further studies are needed to identify the intertrochanteric fractures that are at high risk of internal fixation failure, the characteristics that determine which patients may benefit most from hip arthroplasty, and the optimal surgical technique.

scholarly journals Development and validation of clinical prediction models for mortality, functional outcome and cognitive impairment after stroke: a study protocol

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e014607 ◽  
Author(s):  
Marion Fahey ◽  
Anthony Rudd ◽  
Yannick Béjot ◽  
Charles Wolfe ◽  
Abdel Douiri
Keyword(s):  
Cognitive Impairment ◽  
Functional Outcome ◽  
Multilevel Models ◽  
Prediction Models ◽  
External Validation ◽  
Model Development ◽  
College Hospital ◽  
Stroke Registry ◽  
Temporal Validation ◽  
Stroke Register

IntroductionStroke is a leading cause of adult disability and death worldwide. The neurological impairments associated with stroke prevent patients from performing basic daily activities and have enormous impact on families and caregivers. Practical and accurate tools to assist in predicting outcome after stroke at patient level can provide significant aid for patient management. Furthermore, prediction models of this kind can be useful for clinical research, health economics, policymaking and clinical decision support.Methods2869 patients with first-ever stroke from South London Stroke Register (SLSR) (1995–2004) will be included in the development cohort. We will use information captured after baseline to construct multilevel models and a Cox proportional hazard model to predict cognitive impairment, functional outcome and mortality up to 5 years after stroke. Repeated random subsampling validation (Monte Carlo cross-validation) will be evaluated in model development. Data from participants recruited to the stroke register (2005–2014) will be used for temporal validation of the models. Data from participants recruited to the Dijon Stroke Register (1985–2015) will be used for external validation. Discrimination, calibration and clinical utility of the models will be presented.EthicsPatients, or for patients who cannot consent their relatives, gave written informed consent to participate in stroke-related studies within the SLSR. The SLSR design was approved by the ethics committees of Guy’s and St Thomas’ NHS Foundation Trust, Kings College Hospital, Queens Square and Westminster Hospitals (London). The Dijon Stroke Registry was approved by the Comité National des Registres and the InVS and has authorisation of the Commission Nationale de l’Informatique et des Libertés.

scholarly journals Intramedullary Nailing for Paediatric Diaphyseal Forearm Bone Fracture

2012 ◽  
Vol 9 (3) ◽  
pp. 198-202 ◽  
Author(s):  
N P Parajuli ◽  
D Shrestha ◽  
D Dhoju ◽  
G R Dhakal ◽  
R Shrestha ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Bone Fracture ◽  
Closed Reduction ◽  
Open Reduction ◽  
Forearm Fracture ◽  
Skin Irritation ◽  
Pediatric Age Group ◽  
Superficial Skin ◽  
Reduction Methods ◽  
Forearm Bone

Background Though most of the pediatric diaphyseal forearm bone fracture can be treated with closed reduction and cast application, indications for operative intervention in pediatric both-bone forearm fractures include open fractures, irreducible fractures, and unstable fractures. Controversy exists as to what amount of angulation, displacement, and rotation constitutes an acceptable reduction. Objective To review union time and functional outcome of pediatric diaphyseal forearm bone fracture managed with intramedullary rush pin by closed or open reduction. Methods Fifty patients with both bone fracture of forearm were treated with intramedullary rush pin by closed or open reduction were included in the study and followed up for minimum six months for radilological and functional outcome. Results Out of 50 patients, 31 underwent closed reduction and 19 underwent open reduction. All fractures maintained good alignment post operatively. Forty seven patients had excellent results with normal elbow range of motion and normal forearm rotation and three patients had good results. In all patients good radiological union was seen in three months time. Eight patients had minor complications including skin irritation over prominent hardware, backing out of ulnar pin, superficial skin break down with exposed hardware. Twenty-three (46%) patients had undergone implant removal at an average of 6 months (range 4-8 months) under regional or general anesthesia Conclusion Fixation with intramedullary rush pin for forearm fracture is an effective, simple, cheap, and convenient way for treatment in pediatric age group. DOI: http://dx.doi.org/10.3126/kumj.v9i3.6305 Kathmandu Univ Med J 2011;9(3):198-202 

scholarly journals Functional Outcome of Intracapsular Femoral Neck Fractures Treated by Bipolar Hemiarthroplasty

2021 ◽  
Vol 15 (5) ◽  
pp. 988-991
Author(s):  
Zamir Hussain Tunioi ◽  
Rizwan Ali Jhatiyal ◽  
M Azeem Akhund ◽  
M Kashif Abbasi ◽  
L Das Maheshwari ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Functional Outcome ◽  
Femoral Neck Fractures ◽  
University Hospital ◽  
Harris Hip Score ◽  
Bipolar Hemiarthroplasty ◽  
Neck Of Femur ◽  
Cross Sectional ◽  
Average Hospital

Aim: To evaluate the functional outcome of bipolar hemiarthroplasty in intracapsular fracture neck of femur. Study design: Descriptive cross sectional study. Place and duration of study: Department of Orthopaedic Surgery & Traumatology, Peoples Medical University Hospital, Shaheed Benazir Abad from 1st December 2017 to 31st December 2020. Methodology: Sixty six cases of intracapsular femoral neck fractures with age ranging from 50 year to 75 year of either gender who were ambulatory before injury were included; while basicervical, younger than 50 years, with neuromuscular disorder, unfit for surgery, open fracture, bilateral injuries, osteoarthritis of hip, Rheumatoid, Gouty, pathological fractures, bedridden & who did not give consent for study, were excluded from the study. Functional outcome assessed by Harris hip score & data analyzed by SPSS version 23. Results: Twenty six (59.09%) were male and 40 (40.91%) were female with mean age of 64.3±7.77 year. Average time from injury to hospital arrival was 14.7±6.8 hours. Average time from hospitalization to surgery was 4.67±2.23 days. Average time of surgery was 55.67±9.9 minutes. Average hospital stay was 9.7±4.3 days. The average time of follow-up was 18.45±7.63 months. Conclusion: Bipolar implant is safe, effective, reliable, stable and cost effective implant for intracpsular fracture of femoral neck in elderly populace. The 66.66% of patients have satisfactory Harris hip score in follow up duration of 18.45±7.63 months. Keywords: Functional, Outcome, Femoral neck fractures, FNF, Bipolar, Hemiarthroplasty, HHS

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