A STUDY ON STABILIZATION OF COMPOUND SMALL BONE FRACTURES OF HAND AND FOOT WITH JESS FIXATOR

Background : The fractures of small bones of hand and foot should not be more complicated and damaging compared to the damage caused by the injury itself. The goal is to achieve good stability of the bone and joint, which allows early motion without resulting in the residual instability and malunion. These fractures of small bones of hand and foot can be treated with an external xator that allows fracture reduction attaining normal alignment. we took up the study with an aim to access the overall function and complications in treating open small bones of hand and foot with JESS xator. Methods: We performed a prospective study on 20 adult patients (14 males and 6 females) with small bone fractures of hand and foot, who attended outpatient or admitted in inpatient in the department of orthopaedics, government general hospital, Kakinada from October 2017 to august 2019. We excluded closed fractures and severely crushed fractures with neurovascular and tendon injuries. Results: 5 Results are recorded based on Duncan et al. criteria for ngers. For toes, the results are graded based on a total active range of movements. Most of the cases (n=17) showed radiological union within 12 weeks. Two cases took more than 20 weeks to heal. Whatever be the radiological union, the frame is removed mostly by 15 days postop (n=18) and by a maximum period of 21 days (n=6). the results are found to be excellent in 40% of cases, good in 44% cases, fair in 8% and poor results are seen in 8% cases. We had extensor lag as the most common complication (60%, n=15), 2 cases with malunion (8%) and one case (4%) with supercial infection. Conclusion: Hand serves many functions of precise movement, grip, grasp, touch etc. though these are small bones their fracture are not to be neglected and should be managed with utmost care. Jess is simple to operate, cheap, easily available, and has less complication rate. It makes the postoperative management simple and effective. It allows early mobilization, which prevents joint stiffness. Removing the frame at end of second postoperative week allows good functional results and doesn't compromise the stability of fracture.

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Management Of Recent Elbow Dislocations: Functional Treatment Versus Immobilization; A Prospective Study About 60 Cases

The Open Orthopaedics Journal ◽

10.2174/1874325001711010452 ◽

2017 ◽

Vol 11 (1) ◽

pp. 452-459 ◽

Cited By ~ 5

Author(s):

Ndeye Fatou Coulibaly ◽

Niane Mouhamadou Moustapha ◽

Hamadi Hadji Djoumoi ◽

Sarr Lamine ◽

Gueye Alioune Badara ◽

...

Keyword(s):

Prospective Study ◽

Elbow Dislocation ◽

Early Mobilization ◽

Functional Results ◽

Functional Treatment ◽

Functional Rehabilitation ◽

Dislocation Reduction ◽

Group 3 ◽

Group 2 ◽

A Prospective Study

Objective: To determine our therapeutic posture trough a comparison of functional treatment results versus immobilization in two different periods. Introduction: For years, the treatment of recent elbow dislocations consisted of reduction and immobilization during 21 days. Given the frequency of stiffness other methods have been tried out. Method: A prospective study was carried out from January 2010 to December 2014. Sixty patients averaging 28.3 years of age underwent elbow dislocation reduction. They were categorized into three separate groups. Patients in the first group had their elbow immobilized for 21 days whereas Group 2 patients were immobilized for 10 days. Group 3 patients were applied a functional treatment followed by a functional rehabilitation. Patients were evaluated according to the Mayo Clinic Elbow Performance Index and the results analyzed with statistical software (SPSS, version 18). Results: During the first month, the functional results of the patients were excellent and good in 19%, 94.7% and 90% respectively for Groups 1, 2 and 3. The pain was intense (10 on the visual analogue scale) in group 3 associated with swelling. At day 90, the results of the patients in Groups 2 and 3 were excellent in 100% of the cases versus 90% for Group 1. At 6 months, all the results were the same. We have not noted any instability, or recurrence or periarticular ossification in our patients. Conclusion: The treatment of stable elbow dislocations remains orthopedic. The risk of instability and pain motivates a short 10-day immobilization period followed by early mobilization.

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Treatment of bilateral ankylosis of the temporomandibular joint with temporalis superficial fascia interpositional flap

Padjadjaran Journal of Dentistry ◽

10.24198/pjd.vol19no1.14188 ◽

2007 ◽

Vol 19 (1) ◽

Author(s):

Harmas Yazid Yusuf ◽

Alwin Kasim ◽

Tis Karasutisna

Keyword(s):

Temporomandibular Joint ◽

Bone Fractures ◽

Mandibular Condyle ◽

Mouth Opening ◽

Early Mobilization ◽

Sports Injury ◽

Functional Results ◽

Superficial Fascia ◽

Skull Trauma ◽

Base Of The Skull

Ankylosis of the temporomandibular joint (TMJ) involves fusion of the mandibular condyle to the base of the skull. Trauma and infection are the leading causes of ankylosis. A case of true bilateral ankylosis of the temporomandibular joint is presented. A 21-year-old male patient had a multiple bone fractures history at the age of 13 due to a sports injury. A TMJ injury might not be detected at that time resulting in a progressive restriction of his mouth opening. He presented with almost complete lack of mobility of the mandible. Surgical treatment was a resection of the ankylotic bone mass, interposition temporalis superficial fascia flaps, and early mobilization and aggressive physiotherapy. The functional results showed good remarks.

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A prospective comparative study of internal fixation of diaphyseal forearm fractures with LCP and DCP in above 50 year age group

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20181807 ◽

2018 ◽

Vol 4 (3) ◽

pp. 395

Author(s):

P. Amarnath Reddy ◽

C. Dinesh Reddy

Keyword(s):

Internal Fixation ◽

Functional Results ◽

Vital Role ◽

Age Group ◽

Forearm Fractures ◽

Prospective Comparative Study ◽

Both Bones ◽

A Prospective Study ◽

Type Of Injury ◽

Radiological Union

Background: In orthopedic practice forearm bone fracture is commonly encountered fracture. Forearm plays a vital role in day to day activities without which a person is unable to perform his role in his own life. It has been estimated that around 31% of the total fractures of the upper limb are of forearm fractures. The objective of the study was to study and compare internal fixation of diaphyseal forearm fractures with LCP and DCP in above 50 year age groupMethods: Present study was hospital based study. This was a prospective study. A total of 50 patients with fracture of both bones in the forearm were included in the present study. They were divided randomly as 25 patients in each group. They were followed for about eight months.Results: Both the groups in the present study were found to be comparable in terms of age, sex, mode of injury, type of injury and level of fracture. It took only 13.83 weeks for radiological union in LCP group and it took a longer in DCP group of 15.33 weeks. This difference was found to be statistically significant. Overall functional results were almost same in both the groups. Excellent in 36 cases (19 in LCP, 17 in DCP), Good in 10 cases (4 in LCP, 6 in DCP), fair in 4 cases (2 in each group).Conclusions: It has been concluded from the present study that union of fracture after LCP had taken significantly lesser time as compared to the DCP technique. Hence especially in persons above 50 years, LCP should be used.

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Study of surgical fixation of extra-articular distal third humerus fractures with a posterolateral locking compression plate

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20190520 ◽

2019 ◽

Vol 5 (2) ◽

pp. 216

Author(s):

Ravi Kumar ◽

Ajay Karwasra ◽

Kishore Kunal

Keyword(s):

Early Mobilization ◽

Functional Results ◽

Distal Humerus ◽

Fracture Site ◽

Locking Compression Plate ◽

Compression Plate ◽

Surgical Fixation ◽

Humerus Fractures ◽

Distal Humerus Fractures ◽

A Prospective Study

Background: Fractures of the adult distal humerus account for approximately 2% of all fractures and represent a third of all humerus fractures. Fractures of the distal third of the humerus are challenging injuries due to their peri-articular location, small size of the distal bone fragments, and the osteopenic quality of the bone in older adults. Aim of our study was to evaluate the clinical, radiographic and functional outcomes of posterolateral locking compression plate for extra-articular distal third humerus fractures through posterior triceps splitting approach.Methods: This is a prospective study done at All India Institute of Medical Sciences, Patna in which 30 consecutive skeletally mature, closed extra-articular distal humerus fractures underwent fixation with posterolateral locking compression plate and outcome evaluated in terms of radiological evidence of healing, functional outcome and complications if any.Results: Use of posterolateral plate results in predictably good union rates and excellent results terms of patient outcome without any implant related complications.Conclusions: We recommend using this posterolateral plate for these humerus fractures, because of its consistent results with respect to fracture union, stability across the fracture site and early mobilization for better functional results.

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Osteotomy for Correction of Premature Growth Plate Closure in 24 Dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1633134 ◽

1994 ◽

Vol 07 (03) ◽

pp. 129-135 ◽

Cited By ~ 8

Author(s):

C.W. Miller ◽

P.W. Morgan

Keyword(s):

Corrective Osteotomy ◽

Functional Results ◽

Degenerative Joint Disease ◽

Joint Disease ◽

Angular Deformity ◽

Dynamic Correction ◽

Age At Surgery ◽

Limb Deformities ◽

The Mean ◽

A Prospective Study

SummaryTwenty-four dogs (27 limbs) were evaluated after surgery for correction of forelimb angular limb deformities. Partial ulnar ostectomies or definitive corrective osteotomies were performed depending upon the age of the dog. According to owner assessment nine of fourteen limbs were considered functionally good, or excellent, after partial ulnar ostectomies. Younger dogs appeared to have better functional results after dynamic correction with the mean age at surgery of dogs with good to excellent results being 6.5 months contrasted to the mean age at surgery of dogs with fair to poor results being 9.75 months. Ten of fourteen limbs were considered functionally good or excellent after definitive corrective osteotomy. One dog had definitive osteotomy after partial ulnar ostectomy in order to further correct a residual angular deformity. However, 58% of the limbs with radiographic follow-up had signs of degenerative joint disease (DJD). There were not significant differences between neither degree of angulation remaining after surgery and the functional result nor the degree of angulation remaining after surgery and the development of DJD. A prospective study is warranted to more objectively assess the efficacy of surgical correction of angular limb deformities in dogs.Twenty-four dogs were evaluated after surgery for correction of forelimb angular limb deformities. The results are described.

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Prosthetic Replacement of the Scaphoid Proximal Pole: Should It Be the Future?

Hand ◽

10.1177/1558944720974120 ◽

2020 ◽

pp. 155894472097412

Author(s):

Matteo Ferrero ◽

Enrico Carità ◽

Francesco Giacalone ◽

Julien Teodori ◽

Alberto Donadelli ◽

...

Keyword(s):

Avascular Necrosis ◽

Early Mobilization ◽

Functional Results ◽

Good Alternative ◽

Proximal Row Carpectomy ◽

Proximal Pole ◽

Subjective Outcomes ◽

Clinical Worsening ◽

Pyrocarbon Implant ◽

Over Time

Background Scaphoid proximal pole fractures with avascular necrosis represent a complex surgical problem. Many reconstruction techniques are based on osteosynthesis with a vascularized or nonvascularized bone graft. These procedures do not allow early mobilization and therefore sometimes lead to unsatisfying functional results. In some cases, it is possible to perform a scaphoid hemiarthroplasty using a pyrocarbon implant (adaptive proximal scaphoid implant [APSI]) in place of the necrotic proximal pole, allowing an early mobilization and delaying palliative treatments such as 4-corner arthrodesis or proximal row carpectomy. Methods In this study, we reviewed all patients who had undergone a scaphoid hemiarthroplasty using APSI in our institutions from 1999 to 2017; the F.U. was performed through radiographic, clinical, and subjective (Disabilities of the Arm, Shoulder, and Hand) analysis. Results The performances of scaphoid proximal pole implants are encouraging; radiographic, clinical, and subjective outcomes were good, and the functional recovery proved to be fast and reliable over time. Conclusions This study reports our experience in the use of APSI implants, which proved to be a good alternative to traditional techniques for treating avascular necrosis of the proximal pole, still allowing further surgical steps in case of clinical worsening over time (wrist osteoarthritis). These patients are usually young and present high functional demands. Our experience is promising, but we believe that further evaluation over time will be needed.

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A PROSPECTIVE STUDY TO EVALUATE THE SURGICAL MANAGEMENT OF PROXIMAL HUMERUS FRACTURES BY LOCKING PLATES

10.36106/ijsr/0406283 ◽

2021 ◽

pp. 10-12

Author(s):

Anurag Rathore ◽

Garvita Solanki

Keyword(s):

External Rotation ◽

Functional Results ◽

Average Score ◽

Prospective Clinical Study ◽

Locking Plates ◽

Statistical Parameters ◽

Functional Scores ◽

Minimum Score ◽

Comminuted Fractures ◽

A Prospective Study

BACKGROUND: This prospective clinical study was performed to evaluate the efcacy and functional outcome in proximal humeral fractures following surgery with locking plates. MATERIAL & METHODS: from August 2013 to April 2015, 32 patients were enrolled in this study following exclusion and inclusion criteria. The evaluation parameters included Time taken for fracture union, functional scores, radiographs of the shoulder and ROM (Range of motion- exion, abduction, internal and external rotation etc.). Patients were followed up regularly at 6 weeks, 12 weeks, 24 weeks and 12 months. Functional results were evaluated using Neer's score. All data were collected and analyzed with the help of suitable statistical parameters. RESULTS: The nal results were evaluated by using NEER'S Score. In our study, the minimum score was 65 and maximum was 94. The average score was 83.9 (Mean ± S.D. : 83.875 ± 6.73). We had excellent results in 6(18.75%) patients, 19(59.375%) had satisfactory results, 7(21.875%) patients had unsatisfactory results but none of the case is failure in our study. CONCLUSION: Open reduction and internal xation with Locking Compression Plates, has given good results and it is the implant of choice now-a-days particularly in comminuted fractures and in osteoporotic bones in elderly patients.

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Treatment of Phalangeal Joint Stiffness Related to Proximal Phalangeal Bone Fractures: Therapeutic Effects on the Range of Motion and Finger Pain

Archives of Hand and Microsurgery ◽

10.12790/ahm.21.0123 ◽

2021 ◽

Author(s):

Dongkeun Jun ◽

Minkyoung Jeong ◽

Donghyeok Shin ◽

Hyungon Choi ◽

Jeenam Kim ◽

...

Keyword(s):

Range Of Motion ◽

Bone Fractures ◽

Joint Stiffness ◽

Operative Procedures ◽

Metacarpophalangeal Joints ◽

Elastic Resistance ◽

Group 2 ◽

Phalangeal Bone ◽

Swan Neck Deformity ◽

Group 1

Purpose: Proximal phalangeal bone fractures with displacement are treated using operative procedures. These fractures can cause stiffness of the interphalangeal or metacarpophalangeal joints, which can be relieved using various operative and nonoperative techniques. This study analyzed the range of motion (ROM) and pain after a combination therapy to treat finger stiffness following proximal phalangeal fractures.Methods: Fifty-two patients who underwent operative procedures for proximal phalangeal fractures and showed finger stiffness from March 2015 to January 2021 were included in this retrospective study. The patients in group 1 (n=24) performed elastic resistance exercises, while those in group 2 (n=28) underwent conventional exercise. ROM and pain score were measured at 5, 8, and 12 weeks postoperatively. Furthermore, a patient with a swan-neck deformity and intractable stiffness was treated using partial translocation of the extensor apparatus, and the postoperative outcome is presented.Results: Group 1 showed a larger ROM and less pain than group 2 at 12 weeks postoperatively (p<0.05). Patients in both groups exhibited notable improvements with regard to ROM and pain during the study period (p<0.05). In addition, the swan-neck deformity accompanying hyperextension of the proximal interphalangeal joint was significantly relieved.Conclusion: Proximal phalangeal bone fractures can lead to stiffness of the interphalangeal and metacarpophalangeal joints. Joint stiffness was relieved using an elastic resistance exercise protocol in the early postoperative period. Intractable stiffness showing a fixed joint angle can be treated with thorough tenolysis and corrective surgery.

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Study of outcome of knee joint in patients with fracture distal femur versus fracture ipsilateral femur and tibia

International Journal of Research in Pharmaceutical Sciences ◽

10.26452/ijrps.v12i2.4651 ◽

2021 ◽

Vol 12 (2) ◽

pp. 1174-1181

Author(s):

Ravindra B Gunaki ◽

Chitresh Mehta ◽

Rahul Sharma ◽

Swapnil Chitnavis

Keyword(s):

Knee Joint ◽

Distal Femur ◽

Weight Bearing ◽

Early Mobilization ◽

Bony Union ◽

Fracture Femur ◽

Articular Fractures ◽

Stay Time ◽

A Prospective Study ◽

Type Of Fracture

The posture on the two wheeler at the speed we travel, makes knee the vulnerable joint of all in any of the mishaps. We as orthopedic surgeons see the fractures around the knee joint as one of the most studied concept in the subject. This is a prospective study conducted, over 2 years, in Krishna Institute of Medical Sciences, Deemed to be University, Karad. In this study, 20 cases of fracture distal femur and 20 cases of ipsilateral fracture femur and tibia were studied to evaluate outcome of knee joint and post surgical stabilization of fractures. The fractured limb was stabilized with splinting the limb in Thomas splint or plaster slab. The type of fracture, type of fracture fixation, duration of hospital stay, time of union and time to start weight bearing are evaluated. According to Neer’s score, Good outcome was found in both Fracture Distal femur and Ipsilateral Fracture Femur and tibia. The functional outcome was found to be better in diaphyseal fractures femur and tibia treated with intramedullary interlock nailing which allowed early mobilization and weight bearing than in intra-articular fractures treated with plating. Bony union occurred early in closed, diaphyseal and simple transverse or oblique fractures and delayed in open, intraarticular and comminuted fractures.

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Definite management of bilateral lower leg nonunion fractures by Ilizarov apparatus in polytraumatized patient: Case report

Medicinski pregled ◽

10.2298/mpns1504137l ◽

2015 ◽

Vol 68 (3-4) ◽

pp. 137-142

Author(s):

Ivica Lalic ◽

Mirko Obradovic ◽

Mirka Lukic-Sarkanovic ◽

Vladimir Djan

Keyword(s):

Case Report ◽

Joint Stiffness ◽

Functional Results ◽

Shaft Fracture ◽

Lower Leg ◽

Negative Effects ◽

Lower Leg Fracture ◽

Ilizarov Apparatus ◽

Fracture Nonunions ◽

The Right

Introduction. Nonunion of long bones may often be associated with significant function loss of affected extremity, joint stiffness, and even extremity amputation or systemic manifestations in the case of infection. The aim of this case report is to highlight the possibilities of Ilizarov apparatus in the treatment of fracture nonunions of both lower legs treated by different operative methods and to show that it is not necessary to remove osteosynthetic material (intramedullary nail) in every case when nonunion occurs to achieve its recovery. Case Report. A 62 year-old man was injured in a traffic accident as a pedestrian in April 2012, when he experienced polytrauma, including shaft fracture of the right femur, and segmental open fractures of the right (Gustillo-Anderson grade I) and left (Gustillo-Anderson grade II) lower leg. The fractures of right femur and right tibia were stabilized initially with intramedullary nails, while the left lower leg fracture was treated by unilateral external fixator. After 5 months, there were no clinical and radiographic signs of union on lower legs, therefore the patient underwent re-surgery. Ilizarov apparatus was applied on both lower legs. The patient was early verticalized and both apparatus were removed after 4 months. According to the modified protocol of the Association for the Study and Application of Methods of Ilizarov, the lower leg bony results were good and excellent, and the functional results were excellent on both sides. Conclusion. Nonunion fracture of the right lower leg initially treated by the method of intramedullary osteosynthesis and afterwards by placing Ilizarov apparatus shows that in some cases it is not indicated to remove fixative material in order to achieve full recovery of fracture, thus eliminating the danger of all negative effects resulting from the classical extensive surgical treatment.

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