Reverse Contralateral Distal Femoral Locking Compression Plate for Subtrochanteric Femoral Fractures: A Comparative Retrospective Study with Cephalomedullary Nail and Technical Note

2021 ◽  
Vol 104 (12) ◽  
pp. 1913-1919
Keyword(s):  
Surgical Technique ◽  
Blood Loss ◽  
Operative Time ◽  
Femoral Fractures ◽  
Locking Compression Plate ◽  
Safe Procedure ◽  
Cephalomedullary Nail ◽  
Estimated Blood Loss ◽  
Compression Plate ◽  
Fixation Techniques

Background: Cephalomedullary nails (CMN) have been proven to be the implant of choice in Subtrochanteric Femoral Fractures. The reverse contralateral distal femoral locking compression plate (DF-LCP) is an alternative fixation in cases that are unsuitable for nailing. The comparative studies made of these two fixation techniques are inadequate. Objective: To retrospectively analyze and compare the outcomes of these two fixation techniques and demonstrate the apparent surgical technique for applying the reverse contralateral DF-LCP. Materials and Methods: The present study included patients over 18 years of age diagnosed of subtrochanteric fractures and treated with either DF-LCP or CMN. Retrospective comparative analyses of union time, operative times, estimated blood loss, and complications were conducted from their medical records and serial radiographs. The surgical technique for reverse contralateral DF-LCP fixation is also described in the present study. Results: The present study enrolled 106 eligible patients, in which 33 patients were treated with reverse contralateral DF-LCP, and 73 patients with CMN. There were no significant differences in age, gender, type of fracture, or history of smoking between the two groups. However, there were significant differences in the requirements of the open reduction technique with 26 fractures (78.8%) in the DF-LCP group and 17 fractures (23.3%) in the CMN group (p<0.001). The comparative outcomes of the DF-LCP and CMN groups demonstrated the statistically significant difference in the number of malreductions or malunions, comprising four events (12.1%) and 22 events (30.1%), respectively (p=0.036). There were no statistically significant differences in terms of union time, operative time, and the amounts of estimated blood loss. Conclusion: The reverse contralateral DF-LCP fixation technique demonstrated comparable outcomes in terms of union time, operative time, and blood loss, and was deemed a safe procedure for subtrochanteric femoral fracture. Lower occurrences of malreduction or malunion complication were shown in DF-LCP group. Keywords: Subtrochanteric fracture; Reverse contralateral distal femoral locking compression plate; Cephalomedullary nail

scholarly journals Outcome of Ventral Fusion of Two or Three Cervical Vertebrae with a Locking Compression Plate for the Treatment of Cervical Stenotic Myelopathy in Eight Horses

2018 ◽  
Vol 31 (05) ◽  
pp. 356-363 ◽  
Author(s):  
Anton Fürst ◽  
Elisabeth Ranninger ◽  
José Suárez Sánchez-Andrade ◽  
Jan Kümmerle ◽  
Christoph Kühnle
Keyword(s):  
Surgical Technique ◽  
Cervical Vertebrae ◽  
Clinical Results ◽  
Locking Compression Plate ◽  
Surgery Outcome ◽  
Cord Injury ◽  
Compression Plate ◽  
Data History ◽  
Cervical Stenotic Myelopathy

Objectives It was recently shown that biomechanical stability achieved with a locking compression plate (LCP) for ventral cervical fusion in horses is similar to the commonly used Kerf cut cylinder. The advantages of the LCP system render it an interesting implant for this indication. The goal of this report was to describe surgical technique, complications and outcome of horses that underwent ventral fusion of two or three cervical vertebrae with an LCP. Methods Medical records of eight horses were reviewed for patient data, history, preoperative grade of ataxia, diagnostic imaging, surgical technique and complications. Follow-up information was obtained including clinical re-examination and radiographs whenever possible. Results Two (n = 5) or 3 (n = 3) cervical vertebrae were fused in a mixed population with a median age of 9 months, median weight of 330 kg and median grade of ataxia of 3/5. A narrow 4.5/5.0 LCP (n = 6), a broad 4.5/5.0 LCP (n = 1) and a human femur 4.5/5.0 LCP (n = 1) were applied. Two horses were re-operated due to implant loosening. Six patients developed a seroma. Long-term complications included ventral screw migration in four, spinal cord injury in one and plate breakage in two horses at 720 to 1116 days after surgery. Outcome was excellent in three, good in four, poor in one patient. Clinical Significance The use of an LCP for ventral cervical vertebral fusion is associated with good clinical results. However, a careful surgical technique is required to further reduce the complication rate.

scholarly journals Proximal Femoral Locking Compression Plate for Proximal Femoral Fractures

2014 ◽  
Vol 22 (3) ◽  
pp. 287-293 ◽  
Author(s):  
Wei Ting Lee ◽  
Diarmuid Murphy ◽  
Fareed HY Kagda ◽  
Joseph Thambiah
Keyword(s):  
Femoral Fractures ◽  
Locking Compression Plate ◽  
Proximal Femoral Fractures ◽  
Compression Plate

scholarly journals Laparoscopic Risk-Reducing Salpingo-Oophorectomy: The Brigham and Women's Experience

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Melina Shoni ◽  
Taymaa May ◽  
Allison F. Vitonis ◽  
Anjelica Garza ◽  
Michael G. Muto ◽  
...  
Keyword(s):  
Surgical Outcomes ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Admission Rate ◽  
Safe Procedure ◽  
Short Term ◽  
Surgical Morbidity ◽  
Hospital Admission Rate ◽  
Estimated Blood Loss ◽  
Risk Reducing

Objective. To establish short-term surgical outcomes of three-port laparoscopic risk-reducing salpingo-oophorectomy (RRSO) in women with hereditary breast-ovarian cancer syndrome (HBOC). Methods. The medical records of all HBOC women that underwent laparoscopic RRSO between January 2001 and December 2010 were retrospectively reviewed. Demographic data, operative details, and short-term surgical outcomes were obtained and subjected to SAS. Statistical univariate and multivariate analyses were performed. Results. 358 patients met study criteria with 277 (77.4%) carrying a documented BRCA mutation. The predominant technique utilized three ports (two 5 mm and one 10/12 mm), a 5 mm laparoscope and a 5 mm Ligasure pulsatile bipolar device. Mean operative time was 58.3 minutes (SD 22.6, 26.0–197.0), significantly affected by BMI greater than 30 (P<0.0001) and status of adhesions (P=0.001). Estimated blood loss (EBL) was negligible in 96.9% of cases. Seven patients required conversion to laparotomy. No major intraoperative complications were recorded. One-night hospital admission rate was less than 2.0% while postoperative complication rate was 3.1%. Malignancy was revealed in 14 patients (3.9%). Conclusion. In HBOC population, three-port laparoscopic RRSO is a simple, reproducible, and safe procedure with low conversion rate, short operative time, minimal EBL, low surgical morbidity, and rapid postoperative recovery.

scholarly journals Supracondylar fracture of femur: our experience of treatment with locking compression plate from rural Maharashtra

2019 ◽  
Vol 5 (2) ◽  
pp. 232
Author(s):  
Kiran P. Paknikar ◽  
Shekhar Malve ◽  
G. S. Kulkarni ◽  
M. G. Kulkarni ◽  
S. G. Kulkarni ◽  
...  
Keyword(s):  
Femoral Fractures ◽  
Healing Time ◽  
Locking Compression Plate ◽  
Supracondylar Fracture ◽  
Osteoporotic Bone ◽  
Complication Rates ◽  
Compression Plate ◽  
Post Graduate Institute ◽  
Metaphyseal Fractures ◽  
Prospective Longitudinal

<p class="abstract"><strong>Background:</strong> Surgical treatment of supracondylar or intercondylar distal femoral fractures (AO/OTA types 33-A to 33-C) remains a significant surgical challenge with significant complication rates. Supracondylar and intercondylar fractures of femur are very often difficult to treat and they are notorious for many complications. We have studied use of LCP (locking compression plate) in the treatment of metaphyseal fractures. These implants improve fracture healing, especially in osteoporotic bone due to better holding capacity. Objective wass to assess the efficacy of LCP in maintenance of post-operative distal femoral alignment and in preventing post-operative varus collapse in supracondylar fracture of femur.</p><p class="abstract"><strong>Methods:</strong> Prospective Longitudinal observational study Conducted at Post Graduate Institute of Swasthiyog Pratishthan, Miraj, Maharashtra involving 50 patients with supracondylar fracture. The fractures were classified as supracondylar femur fracture (AO/OTA type 33) (A- C). Fractures that were supracondylar with significant proximal fracture extension were classified as an AO/OTA type 33 fracture unless there was a separate diaphyseal fracture. Data was analysed by using SPSS 16.0 version and expressed as percentages.<strong></strong></p><p class="Body"><strong>Results:</strong> Majority of patients were from 30-39 years age group i.e. 32%. Majority of patients were males i.e. 46 (92%). 7 (14%) patients had healing time &lt;4 months. 24 (48%) patients had healing time between 4-6 months. 19 (38%) patients had healing time more than 6 months. To assess the overall results, we used Knee society score. In 38% of patients, we found excellent results. Good and fair results were seen in 32% and 26% of patients.</p><p class="abstract"><strong>Conclusion: </strong>Locking compression plate is an ideal implant for fixation of supracondylar fracture of femur 33 (A-C) especially in C3 type where articular comminution is present.</p>

Regrowth of the adenoids after adenoidectomy down to the pharyngobasilar fascial surface

2015 ◽  
Vol 129 (7) ◽  
pp. 662-665 ◽  
Author(s):  
L Wei ◽  
M Wang ◽  
N Hua ◽  
K Tong ◽  
L Zhai ◽  
...  
Keyword(s):  
Surgical Technique ◽  
Blood Loss ◽  
Success Rate ◽  
Operation Time ◽  
Early Complications ◽  
Estimated Blood Loss ◽  
Endoscopic Guidance ◽  
Pharyngobasilar Fascia

AbstractObjectives:This study aimed to explore adenoid regrowth after transoral power-assisted adenoidectomy down to the pharyngobasilar fascial surface.Methods:Transoral adenoidectomy down to the pharyngobasilar fascia surface was performed on 39 patients under endoscopic guidance, using a power-assisted system. The operation time, amount of blood loss and iatrogenic injury, presence of complications, and success and regrowth rates were recorded to assess the feasibility, safety and effectiveness of our surgical technique.Results:In this adenoidectomy procedure, the pharyngobasilar fascia was left intact. The estimated blood loss was 5–50 ml (mean 15 ml), and the success rate was 97.3 per cent. Early complications occurred in 2.3 per cent of patients, while no long-term complications occurred in the cohort. No regrowth was found in the follow-up assessments, which were performed for 18–36 months after surgery.Conclusion:Adenoid regrowth was rare after adenoidectomy down to the pharyngobasilar fascial surface. The pharyngobasilar fascia can therefore be considered a surgical boundary for adenoidectomy.

A team approach to anterior lumbar spine surgery in the military

Vascular ◽  
2013 ◽  
Vol 22 (4) ◽  
pp. 246-251 ◽  
Author(s):  
Anahita Dua ◽  
Jennifer Fox ◽  
Bhavin Patel ◽  
Eric Martin ◽  
Michael Rosner ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Blood Loss ◽  
Operative Time ◽  
Lumbar Spine Surgery ◽  
Team Approach ◽  
Disc Space ◽  
Estimated Blood Loss ◽  
All Cause Mortality ◽  
The Military ◽  
Median Operative Time

We report a five year military experience with anterior retroperitoneal spine exposure combining vascular and neurosurgical spine teams. From August 2005 through April 2010 (56 months), hospital records from a single institution were retrospectively reviewed. Complications, estimated blood loss, transfusions, operative time and length of stay were documented. Eighty-four patients with lumbar spondylosis underwent primary (63, 75%) or secondary exposure (21, 25%) of a single- (66, 79%) or multilevel disc space (18, 21%). Median operative time and estimated blood loss were 127 minutes (range, 30–331 minutes) and 350 mL (range, 0–2940 mL). The overall complication rate was 23.8%. Postoperative complications included six blood transfusions (7%), three patients with retrograde ejaculation (3.57%) or surgical site infection; two with a prolonged ileus (2.38%) or ventral hernia and one each with a bowel obstruction (1, 1.19%), deep venous thrombosis or lymphocele. All-cause mortality was 1%. In conclusion, a team approach can minimize complications while offering the technical benefits and durability of an anterior approach to the lumbar spine.

scholarly journals Tourniquet Use in Wide-Awake Carpal Tunnel Release

Hand ◽  
2018 ◽  
Vol 15 (1) ◽  
pp. 59-63 ◽  
Author(s):  
Sarah E. Sasor ◽  
Julia A. Cook ◽  
Stephen P. Duquette ◽  
Elizabeth A. Lucich ◽  
Adam C. Cohen ◽  
...  
Keyword(s):  
Blood Loss ◽  
Carpal Tunnel ◽  
Local Anesthetic ◽  
Operative Time ◽  
Carpal Tunnel Release ◽  
Estimated Blood Loss ◽  
Tunnel Syndrome ◽  
Clinically Significant ◽  
Without Tourniquet ◽  
Wide Awake

Background: Carpal tunnel syndrome is a common cause of upper extremity discomfort. Surgical release of the median nerve can be performed under general or local anesthetic, with or without a tourniquet. Wide-awake carpal tunnel release (CTR) (local anesthesia, no sedation) is gaining popularity. Tourniquet discomfort is a reported downside. This study reviews outcomes in wide-awake CTR and compares tourniquet versus no tourniquet use. Methods: Wide-awake, open CTRs performed from February 2013 to April 2016 were retrospectively reviewed. Patients were divided into 2 cohorts: with and without tourniquet. Demographics, comorbidities, tobacco use, operative time, estimated blood loss, complications and outcomes were compared. Results: A total of 304 CTRs were performed on 246 patients. The majority of patients were male (88.5%), and the mean age was 59.9 years. One hundred patients (32.9%) were diabetic, and 92 patients (30.2%) were taking antithrombotics. Seventy-five patients (24.7%) were smokers. A forearm tourniquet was used for 90 CTRs (29.6%). Mean operative time was 24.97 minutes with a tourniquet and 21.69 minutes without. Estimated blood loss was 3.16 mL with a tourniquet and 4.25 mL without. All other analyzed outcomes were not statistically significant. Conclusion: Operative time was statistically longer and estimated blood loss was statistically less with tourniquet use, but these findings are not clinically significant. This suggests that local anesthetic with epinephrine is a safe and effective alternative to tourniquet use in CTR. The overall rate of complications was low, and there were no major differences in postoperative outcomes between groups.

Sign in / Sign up

Export Citation Format

Share Document