scholarly journals Results of internal fixation and anterior muscle pedicle bone grafting in old femoral neck fracture

2012 ◽  
Vol 43 (1-2) ◽  
pp. 10-11 ◽  
Author(s):  
MI Khalil ◽  
A Rahman
Keyword(s):  
Internal Fixation ◽  
Bone Grafting ◽  
Rectus Femoris ◽  
Fracture Site ◽  
Easy Access ◽  
Bone Block ◽  
Range Of Movement ◽  
College Hospital ◽  
Non Union ◽  
Fracture Neck Femur

Sixteen cases of old fracture neck femur were treated by internal fixation and anterior muscle pedicle bone grafting of rectus femoris, sartorius bone block from anterior superior iliac spine. The treatment period were from January 2000 to December 2009 at Khulna Medical College Hospital and some private hospital. Different methods of fixation and bone grafting procedure were reported. We did this procedure by open reduction and internal fixation by cannulated hip screws and muscle pedicle bone grafting. Additional cancellous bone grafting were done in every cases. Follow up period was 2 to 7 years (average 5 years). Evaluation parameter were union, non union. collapse of neck, avascular necrosis of femoral head (AVN) coxavara, shortening, pain, range of movement and functional activities and over all satisfaction of patient. The results of fracture healing rate was good (9), fair (4) and poor (3). The technique is simple, rewarding and easy access of fixation and muscle pedicle bone grafting. Bone graft was placed by making a gutter at fracture site and maintained by a screw or prolin suture. DOI: http://dx.doi.org/10.3329/bmjk.v43i1-2.13016 Bang Med J (Khulna) 2010; 43: 10-11

Orthopaedic management of congenital pseudarthrosis of the tibia

2021 ◽  
pp. 655-660
Author(s):  
Fergal Monsell
Keyword(s):  
Bone Grafting ◽  
Fracture Site ◽  
Important Condition ◽  
Non Union ◽  
Congenital Pseudarthrosis ◽  
Vascularized Fibula ◽  
Affected Tissue

Congenital pseudoarthrosis of the tibia is an uncommon but important condition, often associated with neurofibromatosis, in which the tibia has a region of abnormal bone prone to fracture and subsequent non-union with a fibrocartilaginous pseudoarthrosis forming at the fracture site. The limb is prone to malalignment and distal deformity. Management requires correction and stabilization of the deformity with excision of the affected tissue of the tibia and reconstruction either with bone grafting, transport, or transfer of vascularized fibula.

Cannulated cancellous screws fixation in intracapsular fracture neck femur: a study with an emphasis on result of osteosynthesis

2016 ◽  
Vol 2 (3) ◽  
pp. 180
Author(s):  
Varun Vijay ◽  
Naveen Srivastava
Keyword(s):  
Scoring System ◽  
Screw Fixation ◽  
Fracture Site ◽  
Cancellous Screw ◽  
Intracapsular Fracture ◽  
Neck Of Femur ◽  
Non Union ◽  
Fracture Neck Of Femur ◽  
Post Surgery ◽  
Fracture Neck Femur

<p class="abstract"><strong>Background:</strong> Fracture neck of femur has always presented a great challenge to the orthopaedic surgeons. It is rightly called as “unsolved fracture” as far as treatment and results are concerned. Results generally depend upon time period elapsed from fracture to surgery, adequacy of reduction and fixation. Fixation with cannulated cancellous screw is usually adequate for femoral neck fractures. The aim of the study was to analyse the results of treatment of fracture neck of femur with cannulated cancellous screw fixation and to compare the results with others in the literature using the same modality.  </p><p class="abstract"><strong>Methods:</strong> 25 patients with intra capsular neck of femur fracture were followed for a period of two years post-surgery and their functional outcome was assessed based upon harris hip scoring system.<strong></strong></p><p class="abstract"><strong>Results:</strong> According to harris hip scoring system, we had excellent results in 72% cases, good in 16% cases, fair in 8% and poor in 4%. One patient went into non-union and two developed avascular necrosis of femoral head.</p><p><strong>Conclusions:</strong> Management of intracapsular fracture neck of femur with cannulated cancellous screw fixation is a very good method of treatment being a surgically easy procedure. Use of multiple cannulated cancellous screw have a compression effect at the fracture site. It also avoids re displacement and rotation.</p>

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.

A 22-year-old chronic scaphoid non-union treated with arthroscopic percutaneous scaphoid fixation – A case report and review of literature

2020 ◽  
Vol 0 ◽  
pp. 1-4
Author(s):  
Syed Shumon ◽  
Moin Durrani ◽  
Karthikeyan P. Iyengar ◽  
William Y. C. Loh
Keyword(s):  
Conservative Treatment ◽  
Internal Fixation ◽  
Bone Grafting ◽  
Scaphoid Fracture ◽  
Carpal Bone ◽  
Non Union ◽  
Scaphoid Fractures ◽  
First Case ◽  
Vascularized Bone ◽  
Little Finger

Scaphoid fractures are the most common fractures of the carpal bone. Most heal with adequate conservative treatment, but reports of non-union after conservative treatment have been up to 50%. Symptomatic non-union of a scaphoid fracture remains a common disabling problem. It is known that the scaphoid non-union will inevitably progress to the scaphoid non-union advance collapse over time. Surgical management of chronic non-union of scaphoid fracture includes vascularized bone grafting or non-vascularized bone grafting with or without internal fixation. A 36-year-old male presented with a hyperextension injury to the left little finger. An X-ray showed left little finger distal interphalangeal joint dislocation and an incidental 22-year-old chronic non-union scaphoid fracture. To date, incidental discovery of non-union is at the rate of 0.14%. The patient underwent arthroscopic non-vascularized bone grafting with internal fixation after the natural course of the condition was explained to him. He made a good recovery with a complete union of his scaphoid and resolution of his wrist pain. Our case describes the first case of arthroscopic repair of a chronic non-union scaphoid fracture of 22-year duration and demonstrates union of scaphoid fracture and resolution of symptoms can be achieved with good surgical fixation even extremely prolonged chronic non-union.

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.

Repeat Russe Bone Grafting after Failed Bone Graft Surgery for Scaphoid Non-Union

1995 ◽  
Vol 20 (3) ◽  
pp. 373-378 ◽  
Author(s):  
E. B. BYNUM ◽  
R. W. CULP ◽  
T. J. BONATUS ◽  
C. E. ALEXANDER ◽  
H. R. McCARROLL
Keyword(s):  
Internal Fixation ◽  
Bone Grafting ◽  
Surgical Procedure ◽  
Full Employment ◽  
Salvage Procedure ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Non Union ◽  
Low Rate

We report the long-term outcome of repeat Russe bone grafting after failure of a previous Russe graft for scaphoid non-union. 15 patients were followed for a mean of 71 months after their last surgical procedure. 11 patients had undergone a single previous Russe graft and four patients had two previous graft attempts. Internal fixation was used in only three patients. Eight out of 15 (53%) patients achieved union after a single repeat graft and one out of four united after a third attempt. When union was achieved, range of motion was unchanged, grip strength was increased 10%, and pain was slight to none, allowing return to full employment in seven out of the nine patients. All patients who did not achieve union have either undergone a salvage procedure or are contemplating one. Based on the literature and our relatively low rate of union without internal fixation (53%), we recommend supplementary internal fixation if repeat Russe bone grafting is undertaken. When union is achieved, satisfactory results can be expected.

Collateral Ligament Avulsion Fractures from the Heads of the Metacarpals of the Fingers

2006 ◽  
Vol 31 (5) ◽  
pp. 537-541 ◽  
Author(s):  
D. J. SHEWRING ◽  
R. H. THOMAS
Keyword(s):  
Conservative Treatment ◽  
Internal Fixation ◽  
Full Range ◽  
Metacarpophalangeal Joint ◽  
Collateral Ligament ◽  
Range Of Movement ◽  
Dorsal Approach ◽  
Avulsion Fractures ◽  
Non Union ◽  
Full Flexion

Nineteen patients with collateral ligament avulsion fractures from the metacarpal heads of the fingers were treated during a 6 year period. Seven undisplaced fractures were initially treated conservatively. Four united with full movement. Three required internal fixation for symptomatic non-union and healed without problems. Eleven patients with displaced fractures were treated by primary internal fixation using a single lag screw through a dorsal approach. Seven of these achieved a full range of movement of the injured digit by 3 months. Four patients failed to regain full flexion of the metacarpophalangeal joint. One patient with a displaced and comminuted fracture was treated with internal fixation at 8 weeks when the fragment had consolidated. As with similar fractures from the proximal phalangeal bases, these fractures are prone to non-union when treated conservatively, even when undisplaced. If fixation becomes necessary, the delay of a trial of conservative treatment does not appear to affect the outcome. Internal fixation of displaced fractures allows gentle mobilisation and facilitates union.

scholarly journals Result of Internal Fixation of Femoral Shaft Nonunion with Implant Failure by SIGN Interlocking Nail at Rajshahi Medical College Hospital

2018 ◽  
Vol 30 (1) ◽  
pp. 11-16
Author(s):  
Mohd Alamgir Hossain ◽  
Mosammat Nargis Shamima ◽  
Ahmed Asif Iqbal ◽  
Md Enamul Haque ◽  
Md Qumruzzaman Parvez ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Bone Graft ◽  
Femoral Shaft ◽  
High Energy ◽  
Fracture Site ◽  
Medical College Hospital ◽  
Implant Failure ◽  
College Hospital ◽  
Interlocking Nail ◽  
Medical College

This prospective study on result of internal fixation of femoral shaft nonunion with implant failure by SIGN interlocking nail was carried out during the period of January 2009 to December 2016at Rajshahi Medical College Hospital, Bangladesh. Mean age of the patient was 34 years (11-70 years), majority of the patients were male (76%), injury was due to high energy trauma (88%), right side involvement was more (68%).Closed exchange nailing was done in 28 cases (56%) and open nailing was done in 22 cases (44%). In the open cases previous implants were removed, refreshening of the fracture ends was done. Antegrade or retrograde SIGN interlocking nailing depend on the site involvement. Reaming materials were used as internal bone graft in all the cases. Autogenouscancellous bone graft was given in 5 cases due to comminution at fracture site (2 cases) and severe osteoporosis (3 cases). The final outcome satisfactory result was found in 44 (88%) cases and unsatisfactory result in 6 (12%) cases.TAJ 2017; 30(1): 11-16

scholarly journals Proximal And Distal Femur Replacement For Patient With Non Union Fracture Of Intertrochanteric And Supracondylar Of Femur In A District Hospital

2020 ◽  
Vol 8 (5_suppl5) ◽  
pp. 2325967120S0011
Author(s):  
SL Chin ◽  
H Umar ◽  
A Zaharul
Keyword(s):  
Internal Fixation ◽  
Alternative Treatment ◽  
Bone Grafting ◽  
Distal Femur ◽  
Pain Patient ◽  
Unstable Fracture ◽  
Salvage Procedure ◽  
Non Union ◽  
Comminuted Fracture ◽  
Distal Femur Replacement

Introduction: Non-union of intertrochanteric and supracondylar fractures of femur are uncommon which results in pain and functional disability, presenting major surgical challenge. We wish to report on two cases regarding endoprosthesis as management for non-union. Case Presentation: Patient A is 54 years old lady sustained closed comminuted intertochanteric fracture of right femur (31A2.3). She underwent open reduction, intramedullary nail with cerclage wire on day 3 post trauma. At 6 months, there is sign of avascular necrosis of femur head with non-union fracture site. Patient still complaining of pain, on non-weight bearing ambulation. At 1 year, patient underwent right proximal femur replacement. At 3 months post replacement, she is able to full weight bear with walking cane without pain. Patient B is 56 years old gentleman sustained Grade IIIa open comminuted fracture of right supracondylar with intercondylar split (33C2.2). He underwent emergency wound debridement, screw fixation with high tibial pin insertion. At 4 months, he underwent distal locking plate of right femur with synthetic bone grafting. At 8 months post fixation, there is non-union comminuted fracture of supracondylar, still unable to weight bear. At 1.5 year post trauma, patient underwent right distal femur replacement. At 3 weeks post replacement, he is able to full weight bear without aid. Discussion: Most failures of treatment occur in unstable fracture patterns of hip. (1) Endoprosthesis may provide as alternative treatment if internal fixation are recognized to be suboptimal, amount and quality of remaining distal bone stock and level of the non-union. (2,3) In both our cases, patient experienced marked improvement in functional capacity and pain free, which are the hallmarks of a successful salvage procedure. (4) Conclusion: Endoprosthesis can be consider as alternative treatment for non-union intertrochanteric and supracondylar fracture of femur, hence providing stable joint, pain free and early return to daily activities. References: 1) Dhammi, I., Singh, A., Mishra, P., Jain, A., Rehan-Ul-Haq, & Jain, S. (2011). Primary nonunion of intertrochanteric fractures of femur: Analysis of results of valgization and bone grafting. Indian Journal of Orthopaedics, 45(6), 514.doi:10.4103/0019-5413.87122 2) Outcomes of modular proximal femoral replacement in thetreatment of complex proximal femoral fractures: A caseseries: Andrew J. Schoenfeld, Mark C. Leeson, Gregory A. Vrabec, Joseph Scaglione,Matthew J. Stonestreet. International journal of surgery 6 (2008) 140–146 3) Chapman MW. Nonunions and malunions of the femoral shaft and patella. In: Chapman MW, editor. Operative orthopedics. 2nd ed. Philadelphia: J.B. Lippincott; 1993. p. 841 4) Haidukewych, G. J., Springer, B. D., Jacofsky, D. J., & Berry, D. J. (2005). Total KneeArthroplasty for Salvage of Failed Internal Fixation or Nonunion of the Distal Femur. The Journal of Arthroplasty, 20(3), 344–349. doi:10.1016/j.arth.2004.03.026

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.

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