scholarly journals TREATMENT OF TALAR BODY FRACTURES WITH CLOSED REDUCTION AND PERCUTANEOUS FIXATION AT ORTHOPAEDICS DEPARTMENT OF DMCH, LAHERIASARAI, BIHAR

2020 ◽  
pp. 1-3
Author(s):  
Ramashish Yadav ◽  
Ramsagar Pandit ◽  
Nand Kumar ◽  
Debarshi Jana
Keyword(s):  
Closed Reduction ◽  
Weight Bearing ◽  
Distal Tibia ◽  
Functional Results ◽  
The Body ◽  
Radiographic Evaluation ◽  
Full Weight Bearing ◽  
Medial Malleolus ◽  
Percutaneous Fixation ◽  
Medial Malleolus Fracture

Background: Fractures of the talus have a relatively low incidence accounting for 0.3% of all bone fracturesand 3–6% of all foot fractures. These injuries affect the neck of the talus, more than the head or the body. Talar body fractures of the talus are uncommon accounting for 7–38% of all talus fractures. Patients and Methods: Fifteen patients with fracture of the talus were operated on using closed reductionand percutaneous screws fixation. The patients (Table 1) were followed up for an average of 20 months (range 12-30 months). In 12 patients the talar fracture was an isolated fracture of the talus in the foot and ankle region. Patient no. 2 had ipsilateral fractures of the distal tibia, fibula, and calcaneus. Patient no. 7 suffered from ipsilateral fracture of the fifth metatarsal. Patient 4 had ipsilateral medial malleolus fracture. Results: Radiographic evaluation postoperative showed exact reduction in all cases but three which had astep of 2mm and 1.5 mm displacement. There were no re-displacements of the fractures, and all patients achieved union radiologically and clinically and could walk without external aid with full weight bearing by third to sixth month postoperative. Functional results according to Hawkins were excellent in five patients, good in seven, fair in three, and no poor results. Conclusion: Closed reduction and percutaneous fixation of talar body fractures is a good technique withaccepted clinical and radiological results, and less complications

scholarly journals A New Radiographic Method for Estimating Tibial Malrotation

2020 ◽  
Vol 7 (3) ◽  
pp. 121-128
Author(s):  
Hamidreza Yazdi ◽  
◽  
Mohammad Taher Ghaderi ◽  
Alireza Yousof Gomrokchi ◽  
Parham Pezeshk ◽  
...  
Keyword(s):  
Lower Limb ◽  
Evaluation Method ◽  
Bone Fractures ◽  
Distal Tibia ◽  
Bone Diseases ◽  
The Body ◽  
University Hospital ◽  
Radiographic Evaluation ◽  
Minor Trauma ◽  
Lower Limb Injury

Background: Diaphyseal tibial fractures are the most frequent bone fractures in the body and are usually treated with intramedullary nailing method. However, this approach is responsible for 41% of the rotational deviation.  Objectives: This study aimed to provide a radiographic evaluation method to determine tibial malrotation in closed fixation of tibia bone fractures during or after the operation. Methods: This study was conducted in a university hospital from May 2015 to March 2016. All patients referring to the hospital with the complaints of minor trauma around the ankle and knee requiring radiographic evaluation of both joints were enrolled in the study. The inclusion criteria included being 20 and 50 years old; having normal axial, sagittal, and coronal lower limb alignment; lacking previous lower limb injury (such as fractures of the tibia or fibula), ankle or knee sprain; not having previous lower limb surgery, metabolic or congenital bone diseases, or malignancy. In all cases, a standard Anteroposterior (AP) radiograph of the knee was taken, and then, without changing the limb position or image setting, an AP radiograph of the ankle was obtained. The overlap between the distal tibia and fibula was measured in the PACS program environment.   Results: Fifty cases were included in this study. The Mean±SD ages of males and females were 29.08±2.49 years and 31.46±2.04 years, respectively. The range of distal tibia-fibula overlap one centimeter above the tibiotalar joint line was 7.81 to 9.09 mm (confidence interval of 95%), and its percentage to the fibula shaft width at the same level was 49.43% to 54.35%. Conclusion: According to the results, distal tibia-fibula overlap when the knee is in the true AP position, regardless of the side and gender, is 7.81 to 9.09 mm or 49.43% to 54.35%.

scholarly journals Treatment of pertrochanteric fractures in elderly patients: is dynamic fixation so important?

2021 ◽  
Vol 27 (5) ◽  
pp. 502-507
Author(s):  
I.M. Shcherbakov ◽  
◽  
V.E. Dubrov ◽  
A.S. Shkoda ◽  
Yu.S. Zlobina ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Weight Bearing ◽  
Femoral Fractures ◽  
Early Time ◽  
Functional Results ◽  
Full Weight Bearing ◽  
Pertrochanteric Fractures ◽  
Results Of Treatment ◽  
Bone Fragments ◽  
One Year

Abstract. Introduction The problem of complications after surgical treatment of pertrochanteric fractures in elderly patients is relevant and far from a solution. Materials and methods The retrospective study was based on the analysis of the results of treatment of 129 patients with pertrochanteric femoral fractures (average age 76 years). All fractures in the early time from trauma were fixed with two types of cephalomedullary nails, either dynamic or static. All patients could not limit the load on the operated limb after surgery because of different reasons. Results The results of treatment were evaluated in 109 patients after one year. In dynamic cephalomedullary fixator group (59 patients), there were 7 orthopedic complications with a functional Harris scale result of 68 points (range, 26 to 94 points). In static cephalomedullary fixator group (50 patients), there were 14 orthopedic complications with a functional Harris score of 56.5 points (range, 15 to 92 points). Discussion Higher results of treatment in the group of dynamic fixator in the condition of full-weight bearing on the operated limb may be associated with the possibility of dynamization of the part of fixator in response to bone resorption in the contact area of bone fragments. The use of dynamic cephalomedullary fixators instead of static ones for treatment of pertrochanteric femoral fractures in elderly patients exercising full weight-bearing leads to a decrease in orthopedic complications (from 28 to 11.9 %) and improves the functional results of treatment.

scholarly journals An innovate strategy to treat large metaphyseal segmental femoral bone defect using customized design and 3D printed micro-porous prosthesis: a prospective clinical study

2020 ◽  
Author(s):  
Guojin Hou ◽  
Bingchuan Liu ◽  
Yun Tian ◽  
Zhongjun Liu ◽  
Fang Zhou ◽  
...  
Keyword(s):  
Bone Defect ◽  
Weight Bearing ◽  
Fibrous Tissue ◽  
Radiographic Evaluation ◽  
Full Weight Bearing ◽  
Prospective Clinical Study ◽  
Femoral Bone ◽  
3D Printed ◽  
Partial Weight

Abstract Background Large segmental bone defect at the metaphyseal area is still difficult to treat, nowadays, there is a tremendous level of interest in uses of 3D printing technology in orthopaedic surgery. This study was introduced to prospectively confirm the safety and effectiveness of 3D printed micro-porous prosthesis in clinical bone defect reconstruction application. Methods Patients with segmental irregular-shaped bone defect of the femur were recruited from 2017.12 to 2018.11. The first stage of the treatment involves radical debridement of all infected or non-viable bone and interposed fibrous tissue, and temporary fixation. Once the culture and biopsy results were negative, the PMMA spacer should remain in the defect approximately 6-8 weeks. This period is for the membrane formation, virtual surgery (computed tomography (CT) scan of the lesion area and the contra-lateral parts of the femur, and then design of the implant). The second stage involves reconstruction the defects with the 3D printed micro-porous prosthesis combined with intra-medullar nailwithout bone graft.Routine clinical follow-up and radiographic evaluation were done to assess bone incorporation and complications of internal fixation. The weight-bearing time and the joint function were recorded. Result 5 consecutive patients were included in the study. They were followed up for an average of 16.4 months. The average length of bone defect and the distal residual bone was 12 cm and 6.5 cm. The average time of partial weight-bearing and full weight-bearing was 12.7 days and 2.6 months. X-ray demonstrated good osseous integration of the implant/bone interface. No complications occurred such as implant loosening, subsidence, loss of correctionand infection. At the last follow-up, Harris score of hip joint was excellent in 2 cases, good in 2 cases, fair in 1 case; HSS score of knee joint was good in 4 cases, middle in 1 case. Conclusion Meticulous customized design 3D printed micro-porous prosthesis combined with intramedullary fixation may be a cost-effective and an alternative strategy to treat metaphyseal segmental irregular-shaped femoral bone defect without bone graft, especially for cases with massive juxta-articular bone loss.

scholarly journals Osteosynthesis distal tibial metadiaphyseal fractures with intramedullary nailing versus plating

2017 ◽  
Vol 5 (5) ◽  
pp. 2104
Author(s):  
Deepak Vashisht ◽  
Manjit S. Daroch ◽  
Sanjeev Sreen ◽  
Kuldeep Rathi
Keyword(s):  
Intramedullary Nailing ◽  
Weight Bearing ◽  
Operating Time ◽  
Distal Tibia ◽  
Full Weight Bearing ◽  
P Value ◽  
Operative Care ◽  
Diaphyseal Fractures ◽  
Time Required ◽  
Early Restoration

Background: The management of the tibial fracture remains controversial despite advances in both non-operative and operative care. Plates and intramedullary nails are two well-accepted and effective methods, but each has been historically related to complications. The present study was conducted to compare the results of displaced extra-articular distal tibia meta-diaphyseal fractures OTA/AO Type 42A- C (distal) and 43-A treated with intramedullary nailing versus plating with respect to union of fracture, early Restoration of function, the axial alignment and Complications, if any.Methods: In this study 30 patients of extra-articular distal tibia fracture AO type 42 A-C (distal) and 43 A were randomly selected and 15 were operated with intramedullary nailing and remaining 15 with plating. The patients were regularly followed up for a period of 9 months with radiological and clinical examination. Final assessment was done by Tenny and Wiss clinical assessment criteria.Results: In Interlocking group, average time for union was 20.33 weeks in Interlocking nail group compared to 23.21 weeks in plating group which was significant (p value 0.011). Also, the average time required for partial and full weight bearing in the nailing group was 7.2 weeks and 13.2 weeks respectively which was significantly less as compared to 9.33 weeks and 16.64 weeks in the plating group. Lesser complications in terms of implant irritation, ankle stiffness and infection (superficial and deep) were seen in Interlocking group as compared to plating group.Conclusions: In present study ILN showed better outcome as it offers advantage in terms of mean operating time, less invasive surgery, hospital stay, partial and full weight bearing time and union time.

Pseudarthrosis in fibrous dysplasia treated with bone morphogenetic protein

Open Medicine ◽  
2008 ◽  
Vol 3 (3) ◽  
pp. 377-379
Author(s):  
Johannes Beckmann ◽  
Franz Kock ◽  
Markus Tingart ◽  
Juergen Goetz ◽  
Joachim Grifka ◽  
...  
Keyword(s):  
Bone Morphogenetic Protein ◽  
Fibrous Dysplasia ◽  
Callus Formation ◽  
Weight Bearing ◽  
Femoral Shaft ◽  
Shaft Fracture ◽  
Underlying Disease ◽  
The Body ◽  
Full Weight Bearing ◽  
Morphogenetic Protein

AbstractWe present a case of pseudarthrosis in a patient suffering from polyostotic fibrous dysplasia of the right part of the body that was successfully treated with bone morphogenetic protein. Pseudarthrosis occurred after proximal femoral shaft fracture due to a motorcycle accident initially treated by intramedullary nailing. After revision, the patient was treated by pseudarthrosis debridement and grafting of bone morphogenetic protein-7/osteogenic protein-1, resulting in callus formation that allowed indolent full weight-bearing after 6 weeks. The underlying disease as well as the described treatment is discussed.

scholarly journals Simultaneous traumatic dislocation of the hip knee and ankle joints in an ipsilateral limb, does it happen? A case report

2018 ◽  
Vol 5 (7) ◽  
pp. 2660
Author(s):  
Lokesh Kumar S. N. ◽  
Deepak Kumar ◽  
Sameer Aggarwal
Keyword(s):  
Ankle Joint ◽  
Hip Joint ◽  
Weight Bearing ◽  
Posterior Dislocation ◽  
Fracture Dislocation ◽  
Radiographic Examination ◽  
Medial Malleolus ◽  
Pilon Fracture ◽  
Medial Malleolus Fracture ◽  
Dislocation Of The Hip

Simultaneous dislocation of three joints the hip knee and ankle joint in an ipsilateral limb is a very rare pattern of injury and only a single case has been reported in the literature, but it is associated with acetabulum fracture. A 34-year-old male had met with a road traffic accident involving left lower limb. Radiographic examination revealed (i) Posterior dislocation of the hip joint without any fracture (ii) Posterior dislocation of the knee joint(iii)Open fracture dislocation of the ankle joint with medial malleolus fracture tibial pilon fracture. The patient underwent an immediate closed reduction of the hip joint by Allis method. Simultaneous reduction of the knee and ankle joint was done and appropriate splintage gave. Open wounds were well debrided and trans-articular fixator was placed over knee and ankle joint. At a second stage, the medial malleolus fracture and tibia pilon fracture were fixed. MRI scan was done which revealed an anterior cruciate ligament injury of the knee. At 6-month follow-up, the patient was ambulating with full weight-bearing on both lower extremities without any assistive devices. There always lies a high risk of hemodynamic instability and other serious and life-threatening injuries due to the high velocity of trauma involved in such cases. The outcome of ipsilateral hip knee and ankle dislocation can vary widely depending on the circumstances and other associated injuries.

scholarly journals The circular arc internal fixation for tibio-talo-calcaneal arthrodesis

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0029
Author(s):  
Kaj Klaue
Keyword(s):  
Sagittal Plane ◽  
Weight Bearing ◽  
Distal Tibia ◽  
Vertical Plane ◽  
Neurological Complications ◽  
Full Weight Bearing ◽  
Circular Arc ◽  
Full Contact ◽  
Heel Contact ◽  
Anatomical Alignment

Category: Hindfoot Introduction/Purpose: Stabilizing a tibio-talo-calcaneal arthrodesis in anatomical alignment allowing for weight bearing is a technical challenge. Normal anatomy demonstrates alignment of the heel, the posterior subtalar facet, the talus, the ankle joint and the distal tibia on a circular arc. This arc lies on a vertical plane which is slightly angulated inwards in relation to the sagittal plane. Today’s hindfoot nails do not respect this alignment. Complications include malalignment, primary instability, plantar neuropraxia. Purpose of the study is to optimize the technique to stabilize the hindfoot in anatomical alignment. Methods: An instrumentation was designed to create a circular arc bore hole crossing the heel, the posterior subtalar facet, the tibio-talar joint and the distal tibia metaphysis. At the operation, the desired definitive position of the hindfoot is fixed temporarily with Kirschner wires. A guiding frame is fixed to three critical spots of the hindfoot to drill the central hole. Using an image amplifier the hole is bored using a motor driven end cutting flexible reamer which is seated within a rigid curved hull. The nail has the same shape than the hull and is impacted up to the distal tibia. The nail allows for eventual secondary impaction without losing full contact with the surrounding bone. 30 patients have been treated so far using this technique and evaluated more than 6 months post-operatively. Results: The pathology of the operated patients include post-traumatic, congenital and metabolic (diabetes) conditions. The mean follow-up is 16 months. We did observe 3 ruptures of the tibial locking screw which allowed for more spontaneous impaction. All cases went to consolidation without malunion or other complications. One diabetic patient developed a stable pseudarthrosis at the midfoot joints. The patients were treated for 2 weeks post-op with a closed circular cast allowing heel contact to the floor. After 2 weeks our patients did practise partial to full weight bearing using a cam walker for other 6 weeks. Conclusion: The tibio-talo-calcaneal arthrodesis can be successfully treated using a central circular arc shaped nail allowing for full form fit between implant and bone. The anatomical bony alignment of the hindfoot is corrected or preserved. Due to the safe and limited approaches, the technique prevents complications such as neurological complications and non-unions. We expect a shorter period of time between surgical fixation and full weight bearing.

scholarly journals PO 18220 - Talocalcaneal tibio arthrodesis with percutaneous retrograde intramedullary nail

2019 ◽  
Vol 13 (Supl 1) ◽  
pp. 50S
Author(s):  
Jorge Eduardo De Schoucair Jambeiro ◽  
Tavares Cordeiro Neto ◽  
Fernando Delmonte Moreira ◽  
José Augusto De Oliveira ◽  
Felipe Fernande Leão
Keyword(s):  
Minimally Invasive Surgery ◽  
Minimally Invasive ◽  
Invasive Surgery ◽  
Intramedullary Nail ◽  
Functional Limitations ◽  
Weight Bearing ◽  
Radiographic Evaluation ◽  
Full Weight Bearing ◽  
Percutaneous Technique ◽  
One Year

Introduction: Primary osteoarthritis, post-traumatic lesions, Charcot arthropathy and rheumatoid arthritis are some of the causes of ankle and hind foot osteoarthritis that result in pain and sometimes functional limitations in patients affected by such pathology. The therapeutic options vary from conservative treatment (painkillers, bracing and nonsteroidal anti-inflammatory drugs) and surgical treatment. The objective of this present study is to report three cases of patients with ankle osteoarthritis who had undergone minimally invasive surgery (MIS) for tibio-talocalcaneal arthrodesis with an intramedullary nail, with the use of a retrograde blocked intramedullary nail and screws as fixation. Methods: Clinical and radiographic evaluations were conducted of three cases treated using this technique at our institution in 2017, who were allowed full weight bearing postoperatively The AOFAS questionnaire and radiographic evaluation were employed in two orthogonal incidences of the ankle, evaluated after one year postoperatively. Results: We obtained AOFAS scores between 68 and 86 after one year postoperatively with this study technique, and the radiographic consolidation index was observed in 100% of cases (between 6 and 12 weeks) postoperatively. There were no complications. Conclusion: We obtained good results with minimally invasive surgery (MIS) for tibio-talocalcaneal arthrodesis, with satisfactory consolidation presenting no complications. However, there are an insufficient number of studies in the literature demonstrating superiority of the percutaneous tibio-talocalcaneal arthrodesis technique over the open technique. We believe that the percutaneous technique is a recent method fir study that may be added to the therapeutic arsenal.

scholarly journals Evaluation of mobilization in operated case of fracture tibia

2018 ◽  
Vol 5 (1) ◽  
pp. 61
Author(s):  
Ravi Kant Jain ◽  
Ajay Varun ◽  
Pranav Mahajan ◽  
Mandar Deshpande
Keyword(s):  
Weight Bearing ◽  
Functional Results ◽  
Tibial Fractures ◽  
Full Weight Bearing ◽  
Optimal Method ◽  
Early Weight Bearing ◽  
Pattern Of Injury ◽  
Vas Score ◽  
Fracture Tibia ◽  
A Prospective Study

<p class="abstract"><strong>Background:</strong> In spite of all the advances optimal method of treatment, fractures of the tibia still pose a challenge to the orthopaedic surgeons and thus the management of the fractured tibia requires the widest experience, the greatest wisdom, and the nicest of the clinical judgement in order to choose the most appropriate treatment for particular pattern of injury. Therefore, in this study we evaluated the role of mobilization efficacy and results of nailing and plating compression in management of tibial fractures and its VAS scoring.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of fractures tibia in 150 cases aged from 18-60 years, out of which 109 (72.6%) were males. The left side was involved in 85(56.6%) patients and RTA was the major cause of the tibial fractures 98 (65.3%). Among the patients full weight bearing time was early (&lt;3 weeks) with 90 (60%) and 60 (40%) patients within delay (&gt;3 weeks) of surgery.<strong></strong></p><p class="abstract"><strong>Results:</strong> VAS score was significant better in early (&lt;3 weeks) mobilization and in nailing treatment of tibial fractures in first month (7.8±074 and 7.6±0.81) and (2.1±0.8 and 1.8±0.65) at the final follow-up. Vas score correlation was significant with process and mobilization.</p><p class="abstract"><strong>Conclusions:</strong> We here conclude from our study that interlocking nailing appears to be promising method of treatment of unstable tibia fractures in adults without any external splintage after adequate stabilization and early weight bearing leading to excellent functional results in most of cases.</p>

Sign in / Sign up

Export Citation Format

Share Document