scholarly journals Osteosynthesis of intercondylar humerus fracture using Bryan and Morrey approach

1970 ◽  
Vol 8 (2) ◽  
pp. 154-157 ◽  
Author(s):  
S Lakhey ◽  
S Sharma ◽  
RL Pradhan ◽  
BK Pandey ◽  
RR Manandhar ◽  
...  
Keyword(s):  
Fracture Fixation ◽  
Road Traffic ◽  
Articular Surface ◽  
Distal Humerus ◽  
Humerus Fracture ◽  
Surgical Approaches ◽  
Osteotomy Site ◽  
Distal Articular Surface ◽  
The Mean

Background: The olecranon approach has been the gold standard for surgical approaches to fracture fixation of distal articular surface of humerus. Although it provides a good exposure, it also has disadvantages of delayed union, nonunion and implant related complications at the osteotomy site. Objective: The aim of this study was to determine the functional outcome of displaced intra-articular distal humerus fracture fixation using an alternative approach: the Bryan and Morrey approach. Materials and methods: Twenty patients with twenty AO type C1 and C2 intercondylar fractures of the distal humerus had bicolumnar fixation of the distal humerus with two contoured reconstruction plates and screws on the dorsal surface or various combinations of a single reconstruction plate, screws and K-wires using a Bryan and Morrey approach. Twelve of the patients were male and eight were female. The average age of the patients was 44.8 years. Eleven patients had sustained the injury as result of fall and nine of the patients had sustained it in road traffic accidents. Right elbow was involved in fifteen patients and left in five. All patients were followed up for 12 months post operatively. Results: All twenty fractures had united at 4 months follow-up. The mean fixed flexion deformity was 9.0° (range 0°-15°) and the mean arc of motion was 115.0° (range 85°-130°). All patients had grade 4 triceps strength and stable elbows at the end of 12 months follow up. One patient had deep seated wound infection resulting in necrosis of the triceps tendon requiring a second operative procedure. Conclusions: Bryan and Morrey approach is a simpler, easier and better approach as compared to the other posterior approaches to the elbow joint, and therefore, can be used as the approach of choice for fixation of fractures of the distal articular surface of humerus. Key words: Fracture; Intercondylar Humerus; Osteosynthesis DOI: 10.3126/kumj.v8i2.3549 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 154-157  

scholarly journals Osteosynthesis of Intercondylar Humerus Fracture Using Bryan and Morrey Approach

2010 ◽  
Vol 49 (178) ◽  
Author(s):  
S Lakhey ◽  
S Sharma ◽  
RL Pradhan ◽  
BK Pandey ◽  
RR Manandhar ◽  
...  
Keyword(s):  
Fracture Fixation ◽  
Road Traffic ◽  
Articular Surface ◽  
Distal Humerus ◽  
Humerus Fracture ◽  
Surgical Approaches ◽  
Osteotomy Site ◽  
Distal Articular Surface ◽  
The Mean

INTRODUCTION: The olecranon approach has been the gold standard for surgical approaches to fracture fixation of distal articular surface of humerus. Although it provides a good exposure, it also has disadvantages of delayed union, nonunion and implant related complications at the osteotomy site. OBJECTIVE: The aim of this study was to determine the functional outcome of displaced intra-articular distal humerus fracture fixation using an alternative approach: the Bryan and Morrey approach. MATERIALS AND METHODS: Twenty patients with twenty AO type C1 and C2 intercondylar fractures of the distal humerus had bicolumnar fixationof the distal humerus with two contoured reconstruction plates and screws on the dorsal surface or various combinations of a single reconstruction plate, screws and K-wires using a Bryan and Morrey approach. Twelve of the patients were male and eight were female. The average age of the patients was 44.8 years. Eleven patients had sustained the injury as result of fall and nine of the patients had sustained it in road traffic accidents. Right elbow was involved in fifteen patients and left in five. All patients were followed up for 12 months post operatively. RESULTS: All twenty fractures had united at 4 months follow-up. The mean fixed flexion deformity was 9.0º (range 0º-15º) and the mean arc of motion was 115.0 º (range 85 º- 130º). All patients had grade 4 triceps strength and stable elbows at the end of 12 months follow up. One patient had deep seated wound infection resulting in necrosis of the triceps tendon requiring a second operative procedure. CONCLUSIONS: Bryan and Morrey approach is a simpler, easier and better approach as compared to the other posterior approaches to the elbow joint, and therefore, can be used as the approach of choice for fixation of fractures of the distal articular surface of humerus. KEYWORDS: fracture, Humerus, intercondylar, osteosynthesis.

scholarly journals Management of Distal Humerus Fractures With Jess Fixator

2015 ◽  
Vol 3 (4) ◽  
pp. 16-20
Author(s):  
Prakriti Raj Kandel ◽  
Kishor Man Shrestha ◽  
Laxmi Pathak
Keyword(s):  
Distal Humerus ◽  
Humerus Fracture ◽  
Medical Sciences ◽  
Distal Humerus Fracture ◽  
Fixation Technique ◽  
Fixation Techniques ◽  
Humerus Fractures ◽  
The Mean ◽  
Distal Humerus Fractures

INTRODUCTION: Fractures of distal humerus are rare comprising approximately 2% of all fractures and a third of all humerus fractures. Even with the development of newer fixation techniques, the treatment of distal humerus fractures remains a great challenge to any orthopaedic surgeon. Thus this present study was conducted to evaluate the results of Joshi's External Stabilization System (JESS) in the management of distal humerus fracture with or without intercondylar extension. MATERIALS AND METHODS: This retrospective study was conducted by collecting records of thirty two adult patients who sustained distal humerus fracture and were managed with JESS fixation under anaesthesia over a period of two years in Universal College of Medical Sciences Teaching Hospital (UCMSTH) after obtaining permission from Institutional ethical committee. RESULTS: According to AO (Arbeitsgemeinschaft für Osteosynthesefragen) classification, 2 patients had C1 fracture and 30 patients had C2 fractures. The mean duration of JESS application was 16 weeks. The mean follow up was 8 months. The functional outcome was evaluated by using Cassebaum's functional rating system. Among C1 fractures, 50% showed fair and 50% showed good result whereas among C2 fractures, 40% showed good, 46.66% showed fair and 13.33% showed poor results.  CONCLUSIONS: JESS fixation technique represents a viable option in the management of open as well as close intercondylar fractures of the distal humerus.

scholarly journals Clinical Results and MRI Evaluation of Patellar Osteochondral Fracture Fixation following Patellar Dislocation

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Krzysztof Małecki ◽  
Kornelia Pruchnik–Witosławska ◽  
Dominika Gwizdała ◽  
Piotr Grzelak ◽  
Paweł Flont ◽  
...  
Keyword(s):  
Fracture Fixation ◽  
Patellar Dislocation ◽  
Articular Surface ◽  
Clinical Results ◽  
Suture Technique ◽  
Osteochondral Fracture ◽  
Mri Scans ◽  
The Mean ◽  
Reconstructed Surface

Aim. The aim of the study was to analyze the clinical results and MRI scans after transpatellar osteochondral fracture fixation following patellar dislocation. Methods. Our study group comprised 17 patients with patellar dislocation followed by osteochondral fracture of the articular surface of the patella. All patients underwent surgery where the fractured osteochondral fragments of the patella were attached using the transpatellar suture technique. The mean age at the time of surgery was 14.1 years, and the mean follow-up period was 7.5 years. Results. The results of the patellar compression test and the apprehension test were negative in all patients. The mean Lysholm and Kujala scores were 89.2 and 89.6, respectively. The MRI scan revealed healing of the fixed fragment and restoration of the articular surface in all patients. In 16 cases, subchondral bone of the fixed fragment area was described as irregular: its articular cartilage was narrowed and not homogenous. Progressive degenerative changes were observed in the patellofemoral joint at follow-up in three patients. Conclusions. By fixing osteochondral fragments, the patellar articular surface can be restored. The MRI scans show that the cartilage in the reconstructed surface is narrowed after a mean 7.5-year follow-up.

scholarly journals Z-osteotomy in hallux valgus: clinical and radiological outcome after Scarf osteotomy

2009 ◽  
Vol 1 (1) ◽  
pp. 4 ◽  
Author(s):  
Marcus Jaeger ◽  
Michael Schmidt ◽  
Alexander Wild ◽  
Bernd Bittersohl ◽  
Susanne Courtois ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Hallux Valgus ◽  
Metatarsophalangeal Joint ◽  
Mean Value ◽  
Surgical Approaches ◽  
Radiological Outcome ◽  
Scarf Osteotomy ◽  
Post Surgery ◽  
The Mean

Correction osteotomies of the first metatarsal are common surgical approaches in treating hallux valgus deformities whereas the Scarf osteotomy has gained popularity. The purpose of this study was to analyze short- and mid-term results in hallux valgus patients who underwent a Scarf osteotomy. The subjective and radiological outcome of 131 Scarf osteotomies (106 hallux valgus patients, mean age: 57.5 years, range: 22-90 years) were retrospectively analyzed. Mean follow-up was 22.4 months (range: 6 months-5 years). Surgical indications were: intermetatarsal angle (IMA) of 12-23°; increased proximal articular angle (PAA>8°), and range of motion of the metatarsophalangeal joint in flexion and extension >40°. Exclusion criteria were severe osteoporosis and/or osteoarthritis. The mean subjective range of motion (ROM) of the great toe post-surgery was 0.8±1.73 points (0: full ROM, 10: total stiffness). The mean subjective cosmetic result was 2.7±2.7 points (0: excellent, 10: poor). The overall post-operative patient satisfaction with the result was high (2.1±2.5 points (0: excellent, 10: poor). The mean hallux valgus angle improvement was 16.6° (pre-operative mean value: 37.5°) which was statistically significant (p<0.01). The IMA improved by an average of 5.96° from a pre-operative mean value of 15.4° (p<0.01). Neither osteonecrosis of the distal fragment nor peri-operative fractures were noted during the follow-up. In keeping with our follow-up results, the Scarf osteotomy approach shows potential in the therapy of hallux valgus. 筻

scholarly journals Clinical Outcome of Carotid Body Paraganglioma Management: A Review of 10-Year Experience

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Ahmed Elsayed Fathalla ◽  
Mohammad Ahmad Elalfy
Keyword(s):  
Adjuvant Chemotherapy ◽  
Carotid Artery ◽  
Carotid Body ◽  
Ct Scanning ◽  
Surgical Approaches ◽  
R0 Resection ◽  
Primary Malignancy ◽  
Nerve Paralysis ◽  
The Mean

Background. Carotid body paragangliomas are rare neoplasms usually benign, however sometimes presenting as highly aggressive tumors. Surgery is the main line of treatment. Purpose. To study and describe clinical presentations, surgical approaches, postoperative complications, and treatment outcomes. Materials and Methods. A single-institution retrospective analysis of 19 cases with carotid body paragangliomas who were candidates for surgery from January 2009 through January 2019 with a mean follow-up period of 58.8 months. Results. The mean age was 46 years with the female predominance of 63%. The mean size of the tumor was 4.3 cm. All cases were presented with a painless pulsating neck lump located anteriorly at the level of the hyoid bone. Neck US was done in all cases as a primary screening investigation. CT scanning was the second main investigation performed in 17 cases (89.5%) revealing tumors attached to the carotid artery at its bifurcation. Urinary catecholamine metabolites were measured in all cases to rule out familial functioning types. 5 cases (26.3%) were malignant. All cases were surgically approached through transcervical transverse incision. 11, 5, and 3 cases were classified as Shamblin’s type II, III, and I, respectively. All tumors were R0 resected with nodal neck dissection conducted in the malignant group. Major complications occurred in 4 cases (21%) during tumor dissection from the adventitia of carotid bifurcation. ECA ligation was performed in one case (5.3%). 2 patients (10.5%) suffered XII nerve paralysis. Carotid artery blowout occurred in one patient (5.3%) and was immediately controlled. No operative mortality occurred. All patients were free of disease during the follow-up period. 4 malignant cases (21%) suffered a systemic relapse to bone and lung metastasis justifying adjuvant chemotherapy, radiotherapy, or both. Conclusions. Surgery is the treatment of choice for carotid body paragangliomas. Complete R0 resection should be justified especially in case of malignancy. Adjuvant chemotherapy or radiotherapy is an option for patients with primary malignancy or relapse.

scholarly journals Outcome of tibial diaphyseal fracture fixation with Surgical Implant Generation Network (SIGN) nail

2019 ◽  
Vol 6 (2) ◽  
pp. 5-11
Author(s):  
Balakrishnan M. Acharya ◽  
Rojan Tamrakar ◽  
Pramod Devkota ◽  
Abhishek K. Thakur ◽  
Suman K. Shrestha
Keyword(s):  
Road Traffic ◽  
Bone Fractures ◽  
Long Bone ◽  
Fracture Union ◽  
Surgical Implant ◽  
Non Union ◽  
Generation Network ◽  
Diaphyseal Fractures ◽  
The Mean

Introductions: Fractures of diaphyseal region of the tibial bone are amongst the most commonly seen extremity injuries in the developing countries. The surgical implant generation network (SIGN) intramedullary (IM) nail was designed for the treatment of long bone fractures in the developing nations. Methods: From March 2008 to December 2018, a total of 104 patients with 104 tibial diaphyseal fractures were treated with SIGN IM nail. The follow-up visits were arranged at 6, 12, 24 weeks and one-year post operatively. During follow-up visits, the signs of fracture union clinically as well as radiologically and the presence of complications any were recorded and analyzed. Results: The mean age of the patients was 32.81 (16 – 65) years, male 74 (71.2%) and female 30 (28.8%). Majority of the patients 70 (67.3%) had fractures after road traffic accidents. The mean time of surgery was 13.58 (1 – 463) days. Six (5.8%) patients had delayed union and no non-union was detected. We had 10 cases (9.6%) of mal-alignment but were on acceptable range. Conclusions: In the developing country like Nepal, the SIGN nail is an effective surgical implant for the management of the tibial diaphyseal fractures with good result of fracture union and low rates of nonunion, mal-alignment and manageable complications.

Elbow Dislocation and Articular Fracture of the Distal Humerus

2010 ◽  
Vol 2 (2) ◽  
pp. 111-117 ◽  
Author(s):  
Thierry G. Guitton ◽  
Andrew D. Duckworth ◽  
Margaret M. Mcqueen ◽  
Peter Kloen ◽  
David Ring
Keyword(s):  
Medial Collateral Ligament ◽  
Articular Surface ◽  
Present Report ◽  
Elbow Dislocation ◽  
Distal Humerus ◽  
Fracture Dislocation ◽  
Elbow Fracture ◽  
Collateral Ligament ◽  
Articular Fracture

Background The present report describes subluxation and dislocation of the elbow with articular fracture of the distal humerus and injury to the medial collateral ligament, a type of elbow fracture-dislocation about which little is available in the literature. Methods Twenty-two patients with subluxation or dislocation of the elbow (with injury to the medial collateral ligament) and a fracture of the distal humerus articular surface (capitellum/trochlea) were identified. Seventeen patients had a minimum of 12 months follow-up and eight patients returned for a long-term follow-up at a median of 36 months (range 12 months to 154 months) after injury. Results Nine patients had one or more subsequent surgeries. Seven patients had surgery to address complications and two had a planned implant removal. The final median arc of elbow flexion was 120° (range 100° to 145°) and the median arc of forearm rotation was 175° (range 150° to 180°). The median Broberg and Morrey score was 88 points (range 63 points to 100 points) and the median Disabilities of the Arm Shoulder and Hand score was 9 points (range 1 point to 43 points). Discussion Some elbow dislocations and subluxations are associated with osteochondral fractures of the distal humeral articular surface.

An integer programming model for distal humerus fracture fixation planning

2008 ◽  
Vol 13 (3) ◽  
pp. 139-147 ◽  
Author(s):  
Joseph D. Maratt ◽  
Ya-Sin A. Peaks ◽  
Lisa Case Doro ◽  
Madhav A. Karunakar ◽  
Richard E. Hughes
Keyword(s):  
Integer Programming ◽  
Fracture Fixation ◽  
Programming Model ◽  
Distal Humerus ◽  
Humerus Fracture ◽  
Distal Humerus Fracture ◽  
Integer Programming Model

scholarly journals An anterior neurovascular interval approach to coronal shear fractures of the distal humerus: a prospective clinical study with short- to mid-term follow-up

2019 ◽  
Vol 65 (3) ◽  
pp. 355-360
Author(s):  
Xiao-Hua Yang ◽  
Chen Wei ◽  
Guo-Ping Li ◽  
Jian-Ji Wang ◽  
Hai-Tao Zhao ◽  
...  
Keyword(s):  
Shear Fracture ◽  
Articular Surface ◽  
Vascular Complications ◽  
Distal Humerus ◽  
Prospective Clinical Study ◽  
Time Interval ◽  
X Rays ◽  
Interval Approach ◽  
Elbow Function

SUMMARY OBJECT: To explore the treatment effect of the anterior medial neurovascular interval approach to coronal shear fractures of the distal humerus. METHODS: This prospective study included two female patients who were 30-64 years old, with a mean age of 47 years. Fractures were caused by falling from a bicycle. The time between the injury and operation was 1-2 days, with a mean time interval of 1.5 days. Two patients with coronal shear fracture of the distal humerus were treated with open reduction and internal fixation using anterior neurovascular interval approach. RESULTS: There were no intraoperative and postoperative neurological and vascular complications or infections, and the fracture was united. At 12 months after the surgery, the patient returned to work without pain, and with a normal range of motion for elbow and forearm rotation. The X-rays revealed excellent fracture union, no signs of heterotopic ossification, and no traumatic arthritis. According to Mayo's evaluation standards for elbow function, a score of 100 is excellent. CONCLUSIONS: The application of the anterior neurovascular interval approach of the elbow in the treatment of shear fracture of the articular surface of the distal humerus, particularly the trochlea of the humerus, can reduce the stripping of the soft tissue.

scholarly journals Endoscopic Transforaminal Thoracic Foraminotomy and Discectomy for the Treatment of Thoracic Disc Herniation

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Hong-Fei Nie ◽  
Kai-Xuan Liu
Keyword(s):  
Disc Herniation ◽  
Surgical Approaches ◽  
Invasive Technique ◽  
Complication Rates ◽  
Thoracic Disc Herniation ◽  
Blood Patch ◽  
The Mean ◽  
Thoracic Disc ◽  
Rib Head

Thoracic disc herniation is a relatively rare yet challenging-to-diagnose condition. Currently there is no universally accepted optimal surgical treatment for symptomatic thoracic disc herniation. Previously reported surgical approaches are often associated with high complication rates. Here we describe our minimally invasive technique of removing thoracic disc herniation, and report the primary results of a series of cases. Between January 2009 and March 2012, 13 patients with symptomatic thoracic disc herniation were treated with endoscopic thoracic foraminotomy and discectomy under local anesthesia. A bone shaver was used to undercut the facet and rib head for foraminotomy. Discectomy was achieved by using grasper, radiofrequency, and the Holmium-YAG laser. We analyzed the clinical outcomes of the patients using the visual analogue scale (VAS), MacNab classification, and Oswestry disability index (ODI). At the final follow up (mean: 17 months; range: 6–41 months), patient self-reported satisfactory rate was 76.9%. The mean VAS for mid back pain was improved from 9.1 to 4.2, and the mean ODI was improved from 61.0 to 43.8. One complication of postoperative spinal headache occurred during the surgery and the patient was successfully treated with epidural blood patch. No other complications were observed or reported during and after the surgery.

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