FUNCTIONAL OUTCOME OF TIBIAL FRACTURES TREATED BY INTERLOCKING NAILING THROUGH SUPRAPATELLAR APPROACH – A PROSPECTIVE AND RETROSPECTIVE STUDY

2021 ◽  
pp. 54-55
Author(s):  
Dinesh Loganathan ◽  
Shivakumar Jeyarajan ◽  
B. Sivaraman ◽  
M. Venkataraman
Keyword(s):  
Functional Outcome ◽  
Intramedullary Nailing ◽  
Motor Vehicle ◽  
Operating Time ◽  
Tibial Fractures ◽  
Good Reduction ◽  
Vehicle Accidents ◽  
Suprapatellar Approach ◽  
The Mean ◽  
Both Bones

The aim of this prospective study is to analyse the functional and radiological outcome of tibial fractures treated by intramedullary nailing through supra patellar approach.15 patients with tibial fractures were operated by intramedullary nailing through suprapatellar approach. Oxford knee scoring system was done to evaluate the functional outcome. Serial radiographs were taken to assess the fracture union at 2 weeks, 6 weeks and 12 weeks. Fifteen patients (male 11 female 4) with fracture both bones leg i Results : ncluded in our study. The most common cause was motor vehicle accidents (9 cases), self limiting fall (4 cases), assault (2 cases). The mean age was 45 years. All fractures united at a mean period of 3.5 months. To conclude, Suprapatellar tibial nailing has the benets of decreased operating time, good ouroscopy visualisation, minimal blood loss and ability to achieve and maintain good reduction throughout the procedure.

scholarly journals Functional Outcomes in Suprapatellar Intramedullary Nailing for the Treatment of Tibial Shaft Fractures

2021 ◽  
Vol 8 ◽  
Author(s):  
Abhishek Garg ◽  
Ankur Sahu ◽  
Aditya Seth ◽  
Ipanshu Malik ◽  
Rahul Sharma
Keyword(s):  
Intramedullary Nailing ◽  
Functional Outcomes ◽  
Operating Time ◽  
Deep Infection ◽  
Tibial Shaft ◽  
Shaft Fractures ◽  
Suprapatellar Approach ◽  
Safe Technique ◽  
The Mean ◽  
Tibial Shaft Fractures

Introduction: The purpose of this study was to evaluate the functional outcomes of suprapatellar intramedullary nailing for the treatment of tibial shaft fractures.Material and Methods: The present retrospective study included 10 cases aged more than 20 years, who were operated for tibial shaft fractures over last 3 years with suprapatellar tibial nailing. Patients were retrospectively followed up with all their previous surgical records and radiographs.Results: The mean age was 41.57±16.51 with a range of 20-72 years. Mean operating time was 81±10.15 minutes. Mean blood loss was 110±20.5 ml. Mean time for union was 15.15±1.35 weeks. No deep infection was noted. 1 patient had anterior knee pain. The mean Lysholm knee score was 87.91 ± 5.75.Conclusion: The suprapatellar approach is good and safe technique for nailing in the tibial fractures.

scholarly journals TEVAR versus open repair of blunt traumatic descending aortic injury in polytraumatic patients involved in motor vehicle accidents

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Imthiaz Manoly ◽  
Mohamed El Tahan ◽  
Maymoona Al Shuaibi ◽  
Fatimah Adel ◽  
Mohammed Al Harbi ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Hospital Stay ◽  
Open Repair ◽  
Motor Vehicle ◽  
Aortic Injury ◽  
Motor Vehicle Accidents ◽  
Time Interval ◽  
Vehicle Accidents ◽  
Severity Scores ◽  
The Mean

Abstract Background Thoracic endovascular aortic repair (TEVAR) is the standard-of-care for treating traumatic aortic injury (TAI). Few retrospective studies compared TEVAR to open repair in blunt traumatic aortic injury (BTAI). Our objectives were to compare the early outcomes of TEVAR for blunt traumatic descending aortic injury to open repair (OR) in polytraumatic patients involved in motor vehicle accidents (MVA). Results Between February 2005 and April 2017, 71 patients with TAI due to MVA presented to our institution. All patients with descending aortic injuries were considered for open repair (n = 41) or TEVAR (n = 30) if there was no contraindication. The primary outcome was mortality, and secondary outcomes were stroke, paraplegia, intensive care unit (ICU), and hospital stay. The mean age was 28.4 ± 10.1 years in the OR group and 33.3 ± 16.6 years in TEVAR-group (P = 0.13). The injury severity scores were 41 ± 10 in the OR group and 33 ± 17 in the TEVAR group (P = 0.03). Patients in the OR group underwent emergency repair with a mean time of 0.56 ± 0.18 days from arrival. The TEVAR group had a longer time interval between arrival and procedure (2.1 ± 1.7 days, P = 0.001). The OR group had more blood transfusion (24 (58.5%) vs. 8 (27.5%), P = 0.002), renal impairment (6 (14.6%) vs. 1 (5.50%), P = 0.23), and wound infection (21 (51.2%) vs. 3 (10%), P < 0.001). Three TEVAR patients had a perioperative stroke compared to two patients in the OR group (P = 0.64). There was no difference in the mean ICU (6 ± 8.9 vs. 5.3 ± 2.9 days; P = 0.1) or hospital stay (20.1 ± 12.3 vs. 20.1 ± 18.3, P = 0.62) between the two groups. There were four deaths in the OR group and none in the TEVAR group (P = 0.13). Conclusion The results of TEVAR were comparable with the open repair for traumatic aortic injury with good early postoperative outcomes. TEVAR repair could be associated with lower mortality, blood transfusion, and infective complications. However, the complexity of the injury and technical challenges were higher in the open group.

scholarly journals Pilon Fracture: A Case Report of a 45-Year-Old Dental Technician

2014 ◽  
Vol 8 (1) ◽  
pp. 433-436 ◽  
Author(s):  
Pouya Mafi ◽  
James Stanley ◽  
Sandip Hindocha ◽  
Reza Mafi
Keyword(s):  
Lower Extremity ◽  
External Fixation ◽  
Motor Vehicle ◽  
High Energy ◽  
Tibial Fractures ◽  
Pilon Fracture ◽  
Distal Tibial Fractures ◽  
Vehicle Accidents ◽  
Dental Technician ◽  
Fall From Height

Pilon fractures are complex and difficult-to-treat fractures of the lower extremity that account for about 1% of all lower extremity fractures and up to 10% of tibial fractures. The injury is caused by high energy axial load either from motor vehicle accidents or a fall from height. The treatment of these fractures has caused controversy among surgeons due to mixed outcomes. Here we report a case of pilon fracture in a 45 year old male patient who has sustained the injury as a result of a fall from a height of approximately 12 feet. We describe why it is absolutely crucial that the patient is treated with external fixation initially and evaluate its merits and drawbacks as well as ways to minimize the complications associated with external fixation of open intra-articular distal tibial fractures.

Infrapatellar vs. suprapatellar approach to obtain an optimal insertion angle for intramedullary nailing of tibial fractures

2017 ◽  
Vol 44 (6) ◽  
pp. 927-938 ◽  
Author(s):  
Joerg Franke ◽  
Annika Homeier ◽  
Lars Metz ◽  
Thilo Wedel ◽  
Volker Alt ◽  
...  
Keyword(s):  
Intramedullary Nailing ◽  
Tibial Fractures ◽  
Insertion Angle ◽  
Suprapatellar Approach

scholarly journals DETERMINATION OF THE EFFICACY OF SUPRAPATELLAR APPROACH FOR INTRAMEDULLARY NAILING OF PROXIMAL TIBIAL FRACTURES

2020 ◽  
pp. 60-74
Author(s):  
A.V. Kalashnikov ◽  
I.E. Chip ◽  
O.V. Kalashnikov
Keyword(s):  
Intramedullary Nailing ◽  
Efficient Method ◽  
Traditional Approach ◽  
Practical Importance ◽  
Injury Rate ◽  
Tibial Fractures ◽  
Proximal Tibial Fractures ◽  
Significant Difference ◽  
Suprapatellar Approach ◽  
Im Nailing

Summary. The topicality of the research is predetermined by the high frequency of adverse functional results after PTF (proximal tibial fractures) treatment, like deforming osteoarthritis, contractures, knee joint instability developing fairly often in the distant period and occurring in 5.8% to 28% of cases; disability rate up to 5.9-9.1%. The mater of a traditional approach to an intramedullary nail insertion point versus the suprapatellar one for FPRTB intramedullary nailing is still under discussion. Objective: To specify the efficacy of suprapatellar approach for IM nailing in patients with PTF. Materials and methods: prospective and retrospective analysis of the efficiency of 30 PTF patients’ treatment at the clinic of the State Institution “ITO NAMN of Ukraine” and at the traumatology department of KNMP “Globinskaya CRН” within 2016-2017, using both suprapatellar and traditional accesses. Their outcomes have been evaluated after their fractures consolidation (1 year after the start of the treatment) according to the Neer-Grantham-Shelton scale. Results. The IM nailing from the suprapatellar access has shown itself to be the most efficient method for proximal tibial fractures management. The share of excellent results reached 60%, demonstrating statistically significant difference (p ≤ 0.01) from those of patients cured from a traditional access; there were only 20% of satisfactory results. No poor results were reported. Practical importance: the study proves the expediency of suprapatellar access in IM nailing of PTF and the need for wider implementation of the method within the territory of Ukraine. Conclusions. Considering the low injury rate and ensuring potentially better bone fragments reposition, the suprapatellar access in IM nailing is the most efficient method for PTF management.

Injury Characteristics and the Clinical Outcome of Subtalar Dislocations: A Clinical and Radiographic Analysis of 25 Cases

2003 ◽  
Vol 24 (2) ◽  
pp. 158-163 ◽  
Author(s):  
Christopher Bibbo ◽  
Robert B. Anderson ◽  
W. Hodges Davis
Keyword(s):  
Subtalar Joint ◽  
Motor Vehicle ◽  
High Energy ◽  
Aofas Score ◽  
Exact Test ◽  
Subtalar Dislocation ◽  
Vehicle Accidents ◽  
The Mean ◽  
Radiographic Changes

The objective of this study was to determine the mechanisms of injury and pattern of associated foot and ankle injuries and systemic injuries associated with subtalar dislocations, and, correlate these data with the radiographic and clinical/functional outcome of patients after subtalar dislocation. Results: Twenty-five patients with a subtalar dislocation were identified over a seven year period. The mean patient age was 38 years. Males (n=19) comprised 76% of patients, with a mean age of 36 years. High energy mechanisms (motor vehicle accidents, falls) accounted for 68% of subtalar dislocations. Although high energy mechanisms showed a strong trend toward open subtalar dislocations, the association was not statistically significant (p=0.0573, Fisher's exact test). Closed dislocations predominated (75%). Left and right-sided dislocations were nearly equally distributed, even among motor vehicle accidents. Medial dislocations predominated (65%): these were not influenced by mechanism of injury and did not result in statistically lower AOFAS ankle/hindfoot scores. Subtalar dislocation was irreducible (requiring open reduction) in 32%, with higher energy mechanisms of injury being statistically associated with an irreducible subtalar dislocation (p=0.0261, Fisher's exact test). Block to reduction was evenly distributed among soft tissue elements (posterior tibial tendon, flexor hallucis longus tendon, capsule, extensor retinaculum) and osseous elements. Eighty-eight percent of patients incurred concomitant injuries to the foot and ankle (95% of which were closed injuries), namely, the ankle and talus. Systemic injuries occurred in 88% of patients. At a mean follow-up of five years, the mean AOFAS score of the subtalar dislocation side was significantly lower (mean=71 vs. 93, p=0.0007, unpaired Student's t-test). No statistical relation was found between the number of associated extremity injuries and AOFAS score (Spearman correlation coefficient, r=(–)0.236, p=0.331). Radiographic follow-up demonstrated 89% of ankles with radiographic changes (31% symptomatic); however, the majority of these patients (61%) had an associated ankle injury. The subtalar joint demonstrated radiographic changes in 89% of patients, with 63% being symptomatic; 75% of patients with subtalar joint changes incurred a fracture about the subtalar joint at the time of dislocation. Four patients went on to subtalar fusion at an average of 8.8 months post-dislocation. The midfoot showed radiographic changes in 72% of patients, with only 15% of these patients being symptomatic. All patients with midfoot symptoms were well controlled by nonsurgical measures.

scholarly journals The etiology and prognosis of canalicular laceration repair using canalicular anastomosis combined with bicanalicular stent intubation

2020 ◽  
Author(s):  
Hongwei Wang ◽  
Xiuhong Qin ◽  
Jiali Ji ◽  
Yang Lu ◽  
Li Xu ◽  
...  
Keyword(s):  
Success Rate ◽  
Motor Vehicle ◽  
Vehicle Accidents ◽  
Tarsal Plate ◽  
Plate Fracture ◽  
The Mean ◽  
Trauma Injury ◽  
Electric Bike ◽  
Anatomic Success

Abstract Background: To evaluate the etiology of lacrimal canalicular laceration and explore possible risk factors influencing prognosis.Methods: A total of 142 patients (142 eyes) with lacrimal canalicular lacerations were reviewed and surgically repaired using canalicular anastomosis combined with bicanalicular stent intubation between March 2017 and March 2018. The analyzed data contained demographic information, types of trauma, injury location, associated additional ocular injuries and surgerical outcomes at follow-up. The main outcome measures were anatomic success rate, functional success rate, and complications of surgery.Results: The mean patient age was 42.07 years(ranging from 1-75 years) and 112 (78.87%) were men. Upper and lower canalicular lacerations were found in 14 (9.86%) and 112 (78.87%)patients, respectively, and both canalicular lacerations were found in 16 patients (11.27%). Electric bike accidents were the leading cause of injury with 76(53.52%)patients. There were 100 (70.42%)patients who had lid lacerations without tarsal plate fracture and 42 (29.58%)patients who had lid lacerations with tarsal plate fracture. Anatomic success rate was 98.59%, and functional success rate was 83.8%. Functional reconstruction failure rates were higher in patients with indirect injuries, lid lacerations with tarsal plate fracture, and with punctum splitting(P<0.05). Surgical complications were detected in the form of lacrimal punctum ectropion in 3(2.11%)patients, punctum splitting in 2(1.41%)patients, stent extrusion and loss in 2(1.41%)patients. Conclusions: Electric bike accidents have become the leading cause of injury instead of the motor vehicle accidents because of changes in lifestyle. The indirect injuries, lid lacerations with tarsal plate fracture and with punctum splitting, were significantly more likely to lead to a poor prognosis, as comfirmed by the lower functional success rate of surgery.

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