A PROSPECTIVE STUDY OF FUNCTIONAL OUTCOME OF CLOSED DISPLACED MID- SHAFT CLAVICLE FRACTURES TREATED WITH INTRAMEDULLARY TITANIUM ELASTIC NAIL SYSTEM

2021 ◽  
pp. 81-83
Author(s):  
S. Kishore Babu ◽  
Pamu Bala Avinash ◽  
S. Rajeswara Rao
Keyword(s):  
Minimally Invasive ◽  
Clavicle Fracture ◽  
Invasive Procedure ◽  
Routine Work ◽  
Elastic Nail ◽  
Clavicle Fractures ◽  
The Mean ◽  
Average Size ◽  
A Prospective Study

Background: Clavicle fracturesare common injuries in young individuals, mostly related to sports and road trafc accidents. In contrast, in children and elderly, they are related to falls, and account for approximately 2.6% of all fractures. A middle-third shaft clavicle fracture is the most common site( 80% of all clavicle fractures). Methodology: A study was carried out in 30 patients with simple middle third clavicular fractures who weretreated with closed intra-medullary xation with TENS nailing. Postoperatively range ofmovements,ability to get back to routine work were assessed and noted. Results :At the end of the study, 30 patients in the follow-up group with 21 male and 9 femalepatients taken. The mean age was 34.9 years noted. The mean time intervalbetween injury and surgery was 3.55 days (range 1–6 days). For all the patients the clinical andradiological union achieved at a mean of 8.6 weeks (Range, 6-12 weeks). seventeen out of the 30 patients had closednailing while thirteen patients (43%) required open reduction of their fracture. The average size of theexible titanium nail used was 2.5 mm (range, 2 - 3mm). Conclusion :The present study advise the use of minimally invasive antegradetitanium elastic nail for xation of displaced midshaft clavicle fractures as a safe minimally invasive procedure.

scholarly journals A prospective study of functional outcome of closed displaced mid-shaft clavicle fractures treated with intramedullary titanium elastic nail system

2020 ◽  
Vol 6 (4) ◽  
pp. 735
Author(s):  
Mallepogu Kiran Kumar ◽  
Rajana Siva Prasad
Keyword(s):  
Minimally Invasive ◽  
Prospective Study ◽  
High Speed ◽  
Invasive Technique ◽  
Time Interval ◽  
Titanium Elastic Nail ◽  
Elastic Nail ◽  
Clavicle Fractures ◽  
The Mean ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> Clavicle fractures are most common injuries in young and active individuals, especially those who participate in sports where high-speed falls (e.g., bicycling, motorcycles) or violent collisions (e.g., Football, hockey) are frequent. In contrast, in children and elderly, they are related to falls, and they account for approximately 2.6% of all fractures. The most common site of fracture is a middle-third shaft; it accounts for 80% of all clavicle fractures.</p><p class="abstract"><strong>Methods:</strong> This was a prospective study carried in 20 patients with simple mid third clavicular fractures, who were treated with closed intra-medullary fixation with TENS nailing. Post-operatively range of movements, ability to get back to routine work were assessed and noted.  <strong></strong></p><p class="abstract"><strong>Results:</strong> At the end of the study, all the 20 patients in the follow-up group with 14 male and 6 female patients. The mean age was 34.9 years (between 22-55 years) in the group. The mean time interval between injury and surgery was 3.55 days (range 1-6 days). All the patients are achieved clinical and radiological union at a mean of 8.6 weeks (range, 6-12 weeks).</p><p class="abstract"><strong>Conclusions:</strong> Thus, the intramedullary fixation of a displaced midshaft clavicle fracture is a safe minimally invasive technique. The present study advises the use of minimally invasive antegrade titanium elastic nail for fixation of displaced midshaft clavicle fractures. Although, for comminuted fractures plating remains the procedure of choice.</p>

scholarly journals Clinical outcomes of doubled-suture Nice knot augmented plate fixation in the treatment of comminuted midshaft clavicle fracture

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gui Wu ◽  
Yao-qing Chen ◽  
Chun-yong Chen ◽  
Zhang-xiong Lin ◽  
Qi-yang Xie ◽  
...  
Keyword(s):  
Average Length ◽  
Plate Fixation ◽  
Demographic Data ◽  
Clavicle Fracture ◽  
Bone Fragments ◽  
Comminuted Fractures ◽  
Clavicle Fractures ◽  
The Mean ◽  
The Stability

Abstract Background Free bone fragments were difficult to be fixed in many comminuted midshaft clavicle fractures, and the absence of cortical alignment in comminuted fractures had direct influence on the stability of fixation. This survey was performed to assess the efficacy of doubled-suture Nice knot augmented plate fixation in the treatment of comminuted midshaft clavicle fractures. Methods Between 2013 and 2018, all patients with comminuted midshaft clavicle fractures treated with doubled-suture Nice knot augmented plate fixation were retrospectively reviewed and included in this research. Demographic data of the patients, characteristics of the fractures, intraoperative parameters and follow-up data of the patients were evaluated and summarized. Results A total of 56 patients were included in this study. The mean follow-up time was 25.6 months (range, 12–60 months). The number of male patients was 38 (67.9 %) and of the female patients was 18 (32.1 %). The average age of all patients was 47.89 ± 16.5 years. The mean time of surgery was 85.6 ± 24.0 min. The average length of incision was 9.2 ± 1.9 cm. The number of doubled-suture Nice knot applied ranged from 1 to 5 knots. All the patients reached bone union after the treatment. There was no implant failure or neurovascular injury observed. And most of the patients showed good functional outcome. Conclusions The doubled-suture Nice knot could provide reliable fixation for small bone fragments in comminuted clavicle fractures. Combination of the doubled-suture Nice knot and plate screws fixation was a safe and effective method in comminuted midshaft clavicle fractures treatment.

scholarly journals Functional outcome of plating for displaced middle third clavicle fractures in adults

2018 ◽  
Vol 8 (3) ◽  
pp. 57-63
Author(s):  
Jyoti Sitaula ◽  
Ananda Prasad Regmi ◽  
Akesh Prajapati ◽  
Suresh Bahadur Thapa ◽  
Bishnu Dev Sharma ◽  
...  
Keyword(s):  
Functional Outcome ◽  
Constant Score ◽  
Clavicle Fracture ◽  
Reconstruction Plate ◽  
Superior Surface ◽  
Clavicle Fractures ◽  
The Common ◽  
The Mean ◽  
One Year

Introduction: Clavicle fractures are the common fractures around the shoulder. Conservative treatment is as­sociated with higher incidence of nonunion. We conducted this study to assess the functional outcome of plat­ing for displaced middle third clavicle fractures. Methods: This prospective study included 60 patients with displaced middle third clavicle fractures from April 2016 to March 2017. Fixation was done with a 3.5 mm reconstruction plate placed at the superior surface of the clavicle. Patients were followed-up for a minimum of one year. Functional outcome was assessed using Constant shoulder score. Results: There were 48 male and 12 female patients with a mean age of 33.17 years (range 18-74 years). The average follow-up period was 17.82 months. All fractures united at an average of 5.35 months. The mean Constant score at final follow-up was 89.12. There were two superficial infections and three implant failures. Conclusion: We conclude that treat­ment of displaced middle third clavicle fracture with plate gives good results.

Minimally Invasive Transaortic Repair of the Mitral Valve

2011 ◽  
Vol 14 (4) ◽  
pp. 232 ◽  
Author(s):  
Orlando Santana ◽  
Joseph Lamelas
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Mitral Regurgitation ◽  
Aortic Valve Replacement ◽  
Minimally Invasive ◽  
Valve Replacement ◽  
Operative Mortality ◽  
The Mean ◽  
Transaortic Approach

<p><b>Objective:</b> We retrospectively evaluated the results of an edge-to-edge repair (Alfieri stitch) of the mitral valve performed via a transaortic approach in patients who were undergoing minimally invasive aortic valve replacement.</p><p><b>Methods:</b> From January 2010 to September 2010, 6 patients underwent minimally invasive edge-to-edge repair of the mitral valve via a transaortic approach with concomitant aortic valve replacement. The patients were considered to be candidates for this procedure if they were deemed by the surgeon to be high-risk for a double valve procedure and if on preoperative transesophageal echocardiogram the mitral regurgitation jet originated from the middle portion (A2/P2 segments) of the mitral valve.</p><p><b>Results:</b> There was no operative mortality. Mean cardiopulmonary bypass time was 137 minutes, and mean cross-clamp time was 111 minutes. There was a significant improvement in the mean mitral regurgitation grade, with a mean of 3.8 preoperatively and 0.8 postoperatively. The ejection fraction remained stable, with mean preoperative and postoperative ejection fractions of 43.3% and 47.5%, respectively. Follow-up transthoracic echocardiograms obtained at a mean of 33 days postoperatively (range, 8-108 days) showed no significant worsening of mitral regurgitation.</p><p><b>Conclusion:</b> Transaortic repair of the mitral valve is feasible in patients undergoing minimally invasive aortic valve replacement.</p>

scholarly journals A study on the outcome of displaced midshaft non-comminuted clavicle fractures treated with anatomical locking plate versus titanium elastic nail

2020 ◽  
pp. 221049172097518
Author(s):  
Vineet Thomas Abraham ◽  
Chandrasekaran Marimuthu
Keyword(s):  
Functional Outcome ◽  
Locking Plate ◽  
Plate Versus ◽  
Dash Score ◽  
Titanium Elastic Nail ◽  
Constant Murley Score ◽  
Elastic Nail ◽  
Clavicle Fractures ◽  
The Mean ◽  
Quick Dash

Purpose: Fixation of displaced midshaft clavicle is well known to decrease nonunion, malunion and shoulder disability as compared to nonoperative treatment. This study was done to compare the clinical and functional outcome of group 1 clavicle fractures treated with anatomic locking plates (ALP) versus Titanium elastic nail (TEN). Methods: We studied patients presenting with displaced midshaft clavicle fractures treated with ALP or TEN. The study period was from Jan 2013 to Dec 2016. Patients were reviewed and at each visit clinical and radiological progress of union was noted, complications if any were noted, functional assessment was done using the quick Dash score and Constant Murley score. Results: A total of 116 patients met our inclusion criteria. 62 patients were treated with TEN and 54 with ALP. Bony union was achieved at an average of 11.8 weeks in the TENS group and 12.8 weeks in the ALP group post operatively and this was found to be significant. The mean postoperative Constant Murley score in the ALP and the TEN groups were 92.8 (range 80–97), and 93.7 (82–97) respectively. The mean postoperative quick dash score in the ALP and TEN groups were 2.48(range from 0 to 6.8) and 2.1 (range 0–9.1) respectively. Conclusion: Both Anatomical locking plate and TEN are good options for the treatment of non-comminuted mid clavicular fractures as they have a similar functional outcome. TEN nail insertion has the advantage of being minimally invasive, having a faster union time and may be recommended in midshaft clavicle fractures without comminution.

scholarly journals Biological and clinical impact of hemangioblastoma-associated peritumoral cysts in von Hippel-Lindau disease

2016 ◽  
Vol 124 (4) ◽  
pp. 971-976 ◽  
Author(s):  
Kristin Huntoon ◽  
Tianxia Wu ◽  
J. Bradley Elder ◽  
John A. Butman ◽  
Emily Y. Chew ◽  
...  
Keyword(s):  
Clinical Impact ◽  
Anatomical Location ◽  
Von Hippel Lindau ◽  
Study Enrollment ◽  
Common Location ◽  
Younger Age ◽  
The Mean ◽  
A Prospective Study ◽  
Vhl Disease

OBJECT Peritumoral cysts are frequently associated with CNS hemangioblastomas and often underlie neurological morbidity and mortality. To determine their natural history and clinical impact, the authors prospectively analyzed hemangioblastoma-associated peritumoral cysts in patients with von Hippel-Lindau (VHL) disease. METHODS Patients with VHL disease who had 2 or more years of follow-up and who were enrolled in a prospective study at the National Institutes of Health were included. Serial prospectively acquired laboratory, genetic, imaging, and clinical data were analyzed. RESULTS One hundred thirty-two patients (of 225 in the VHL study with at least 2 years of follow-up) had peritumoral cysts that were followed for more than 2 years (total of 292 CNS peritumoral cysts). The mean age at study entrance was 37.4 ± 13.1 years ([mean ± SD], median 37.9, range 12.3–65.1 years). The mean follow-up was 7.0 ± 1.7 years (median 7.3, range 2.1–9.0 years). Over the study period, 121 of the 292 peritumoral cysts (41.4%) became symptomatic. Development of new cysts was associated with a larger number cysts at study enrollment (p = 0.002) and younger age (p < 0.0001). Cyst growth rate was associated with anatomical location (cerebellum cysts grew faster than spine and brainstem cysts; p = 0.0002 and p = 0.0008), younger age (< 35 years of age; p = 0.0006), and development of new neurological symptoms (p < 0.0001). Cyst size at symptom production depended on anatomical location (p < 0.0001; largest to smallest were found, successively, in the cerebellum, spinal cord, and brainstem). The most common location for peritumoral cysts was the cerebellum (184 cysts [63%]; p < 0.0001). CONCLUSIONS Peritumoral cysts frequently underlie symptom formation that requires surgical intervention in patients with VHL disease. Development of new cysts was associated with a larger number of cysts at study enrollment and younger age. Total peritumoral cyst burden was associated with germline partial deletion of the VHL gene.

Endoscopy-Assisted Achilles Tendon Reconstruction With a Central Turndown Flap and Semitendinosus Augmentation

2016 ◽  
Vol 37 (12) ◽  
pp. 1333-1342 ◽  
Author(s):  
Prashant N. Gedam ◽  
Faizaan M. Rushnaiwala
Keyword(s):  
Minimally Invasive ◽  
Achilles Tendon ◽  
Achilles Tendon Rupture ◽  
Wound Complication ◽  
Reconstruction Technique ◽  
Level Of Evidence ◽  
Invasive Approach ◽  
Perioperative Morbidity ◽  
The Mean

Background: The objective of this study was to report the results of a new minimally invasive Achilles reconstruction technique and to assess the perioperative morbidity, medium- to long-term outcomes, and functional results. Methods: Our series was comprised 14 patients (11 men and 3 women), with a mean age of 45.6 years at surgery. Each patient had a chronic Achilles tendon rupture. The mean interval from rupture to surgery was 5.5 months (range, 2-10). The mean total follow-up was 30.1 months (range, 12-78). All patients were operated with a central turndown flap augmented with free semitendinosus tendon graft and percutaneous sutures in a minimally invasive approach assisted by endoscopy. The patients underwent retrospective assessment by clinical examination, the American Orthopaedic Foot & Ankle Society (AOFAS) ankle and hindfoot score, and the Achilles Tendon Total Rupture Score (ATRS). Paired t tests were used to assess the preoperative and postoperative AOFAS scores, ATRS scores, and ankle range of motion. Results: The length of the defect ranged from 3 to 8 cm (mean, 5.1), while the length of the turndown flap ranged from 8 to 13 cm (mean, 10.1). The mean AOFAS score improved from 64.5 points preoperatively to 96.9 points at last follow-up. The mean ATRS score improved from 49.4 preoperatively to 91.4 points at last follow-up. None of the patients developed a wound complication. No patient had a rerupture or sural nerve damage. Conclusion: All patients in our study had a favorable outcome with no complications. We believe that with this triple-repair technique, one can achieve a strong and robust repair such as in open surgery while at the same time reducing the incidence of complications. Level of Evidence: Level III, retrospective comparative study.

Comparison of minimally invasive and non-invasive systems in lengthening total femoral prostheses

2018 ◽  
Vol 100-B (12) ◽  
pp. 1640-1646 ◽  
Author(s):  
M. R. Medellin ◽  
T. Fujiwara ◽  
R. Clark ◽  
L. M. Jeys
Keyword(s):  
Minimally Invasive ◽  
Leg Length Discrepancy ◽  
Implant Survival ◽  
Leg Length ◽  
Range Of Movement ◽  
Musculoskeletal Tumor Society ◽  
Non Invasive ◽  
Length Discrepancy ◽  
The Mean

AimsThe aim of this study was to describe, analyze, and compare the survival, functional outcome, and complications of minimally invasive (MI) and non-invasive (NI) lengthening total femoral prostheses.Patients and MethodsA total of 24 lengthening total femoral prostheses, 11 MI and 13 NI, were implanted between 1991 and 2016. The characteristics, complications, and functional results were recorded. There were ten female patients and ten male patients. Their mean age at the time of surgery was 11 years (2 to 41). The mean follow-up was 13.2 years (seven months to 29.25 years). A survival analysis was performed, and the failures were classified according to the Modified Henderson System.ResultsThe overall implant survival was 79% at five, ten, and 20 years for MI prostheses, and 84% at five years and 70% at ten years for NI prostheses. At the final follow-up, 13 prostheses did not require further surgery. The overall complication rate was 46%. The mean revision-free implant survival for MI and NI prostheses was 59 months and 49 months, respectively. There were no statistically significant differences in the overall implant survival, revision-free survival, or the distribution of complications between the two types of prosthesis. Infection rates were also comparable in the groups (9% vs 7%; p = 0.902). The rate of leg-length discrepancy was 54% in MI prostheses and 23% in NI prostheses. In those with a MI prosthesis, there was a smaller mean range of movement of the knee (0° to 62° vs 0° to 83°; p = 0.047), the flexion contracture took a longer mean time to resolve after lengthening (3.3 months vs 1.07 months; p < 0.001) and there was a lower mean Musculoskeletal Tumor Society (MSTS) score (24.7 vs 27; p = 0.295).ConclusionThe survival and complications of MI and NI lengthening total femoral prostheses are comparable. However, patients with NI prosthesis have more accurate correction of leg-length discrepancy, a better range of movement of the knee and an improved overall function.

scholarly journals Surgical and Postoperative Evaluations of Rectal Adenomas Ecised With a Novel Proctoscope.

2020 ◽  
Author(s):  
Roberta Denise Alkmin Lopes Lima ◽  
Rogerio Serafim Parra ◽  
Marley Ribeiro Feitosa ◽  
Omar Féres ◽  
José Joaquim Ribeiro Rocha
Keyword(s):  
Operative Time ◽  
Average Distance ◽  
Economic Feasibility ◽  
Surgeon Experience ◽  
Average Operative Time ◽  
The Mean ◽  
Average Size ◽  
High Level ◽  
Complex Methods

Abstract Purpose Many transanal endoscopic surgeries require a high level of technical expertise and surgeon experience. Considering the economic feasibility of material acquisition and the technical feasibility of training and experience with complex methods, a simpler technique with available resources is relevant for the excision of rectal adenomas. This study presents the surgical and postoperative results achieved with a novel proctoscope using the transanal endoscopic technique to excise rectal adenomas. The results are compared to the results obtained with other currently employed transanal techniques. Methods We retrospectively investigated the medical records of patients who underwent transanal endoscopic operations from April 2000 to June 2018 at two tertiary referral centers for colorectal cancer. Results This study included 99 patients. The mean age was 65.3 ± 13.3 years. The average size of the adenomas was 4.6 ± 2.3 cm, and their average distance to the anal border was 5.6 ± 3.3 cm. The average operative time was 65.3 ± 41.7 min. In 48.5% of the operations, the specimen was fragmented, and in 59.6% of the cases, the microscopic margins were free. The rates of postoperative complications and relapse were 5% and 19%, respectively. The mean follow-up was 80 ± 61.5 months. Conclusions The described proctoscope proved to be a viable technique with results similar to other techniques, with the advantage that it allowed greater accessibility for surgeons. Therefore, its use could be implemented and become widespread in surgical practice.

scholarly journals Midshaft Clavicular Fractures - Osteosynthesis with Minimally Invasive Technique

2016 ◽  
Vol 4 (4) ◽  
pp. 647-649 ◽  
Author(s):  
Tabet A. Al-Sadek ◽  
Desislav Niklev ◽  
Ahmed Al-Sadek
Keyword(s):  
Minimally Invasive ◽  
Plate Osteosynthesis ◽  
Deep Infection ◽  
Delayed Union ◽  
Minimally Invasive Technique ◽  
Invasive Technique ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Clavicle Fractures ◽  
The Mean ◽  
Mechanism Of Trauma

BACKGROUND: Fractures of the clavicle are one of the most common fractures in modern orthopaedics and traumatology practice. Knowing the mechanism of trauma, and it's pathophysiological elements, it's clear distinction and it's individual features are essential to the development of more new and effective methods for their treatment, and the minimising of postoperative complications.AIM: The aim of this paper was to present the results of our patients treated with minimally invasive plate osteosynthesis (MIPO).MATERIAL AND METHODS: Between January 2011 and March 2013, 12 patients were treated with MIPO technique. The mean age was 47.5 years (range, 16-79 years). Outcomes and complications of clinical treatment were reviewed.RESULTS: All fractures healed within a mean period of 4.9 months (range, 2-10 months). Regarding complications, there was no occurrence of implant failure or deep infection. There were no nonunions, but one 79-year-old man had a delayed union. Almost of all the cases didn’t need bending of the plate. Seven plates were removed by their hopes. And there weren’t any cases that required new incisions.CONCLUSIONS: A pre-contoured plate anatomically configured to fit the clavicle was easier to apply. MIPO technique for midshaft clavicle fractures may be a good option.

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