Study of functional outcome of displaced intra-articular fractures of the calcaneum treated with open reduction, bone grafting, and plate fixation

Background: Distal radius fractures are a common injury and without proper treatment leads to high functional impairment and frequent complications. Objective: The aim of this study was to see the functional outcome in patients with comminuted distal radius fractures treated with combined external fixation and open reduction with volar plating. Materials and methods: All comminuted distal radius fractures classified as type C in AO/OTA classification were enrolled for the study from 2005 till 2008. The clinical scoring chart modified by Cooney was used to evaluate the functional outcome. Results: There were twenty-two patients with the average age of 42.18 years (range 19-60) with 15 male and 7 females. The follow-up period was from 14 to 46 months. Accordingly, there were 11 (50%) excellent, 7 (31%) good, 2 (9%) fair and 2 (9%) poor results. There were very few complications in our series. In three patients additional K-wire supplementation was necessary along with external and open internal fixation. Conclusions: Comminuted intra-articular fractures of distal radius should be treated by open reduction and combined internal and external fixation to achieve a high rate of patient satisfaction and satisfactory functional outcome. Key words: distal radius fractures; volar plating; external fixationDOI: 10.3126/kumj.v7i4.2756 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 369-373

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Mid-term outcome of volar plate fixation for scaphoid nonunion

The Bone & Joint Journal ◽

10.1302/0301-620x.102b12.bjj-2019-1160.r3 ◽

2020 ◽

Vol 102-B (12) ◽

pp. 1697-1702

Author(s):

Philip Marcel Jozef Schormans ◽

Maria A. Kooijman ◽

Jan A. Ten Bosch ◽

Martijn Poeze ◽

Pascal F. W. Hannemann

Keyword(s):

Functional Outcome ◽

Cancellous Bone ◽

Bone Grafting ◽

Locking Plate ◽

Plate Fixation ◽

Ct Scans ◽

Scaphoid Nonunion ◽

Cancellous Bone Grafting ◽

The Mean

Aims Fixation of scaphoid nonunion with a volar locking plate and cancellous bone grafting has been shown to be a successful technique in small series. Few mid- or long-term follow-up studies have been reported. The aim of this study was to report the mid-term radiological and functional outcome of plate fixation for scaphoid nonunion. Methods Patients with a scaphoid nonunion were prospectively enrolled and treated with open reduction using a volar approach, debridement of the nonunion, and fixation using a locking plate and cancellous bone grafting, from the ipsilateral iliac crest. Follow-up included examination, functional assessment using the patient-rated wrist/hand evaluation (PRWHE), and multiplanar reformation CT scans at three-month intervals until union was confirmed. Results A total of 49 patients with a mean age of 31 years (16 to 74) and a mean duration of nonunion of 3.6 years (0.4 to 16) were included. Postoperatively, the nonunion healed in 47 patients (96%) as shown on CT scans. The mean time to union was 4.2 months (3 to 12). Due to impingement of the plate on the volar rim of the radius and functional limitation, the hardware was removed in 18 patients. At a median follow-up of 38 months in 34 patients, the mean active range of motion (ROM) improved significantly from 89° to 124° (SD 44°; p = 0.003). The mean grip strength improved significantly from 52% to 79% (SD 28%; p < 0.001) of the contralateral side. The mean PRWHE score improved significantly from 66 to 17 points (SD 25; p < 0.001). Conclusion Locking plate fixation supplemented with autologous cancellous bone grafting is a successful form of treatment for scaphoid nonunion. Functional outcomes improve with the passage of time, and mid-term results are excellent with a significant improvement in ROM, grip strength, and functional outcome as measured by the PRWHE. Cite this article: Bone Joint J 2020;102-B(12):1697–1702.

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Distal, metaphyseal radius fractures. Results after open reduction, internal plate fixation and cortico-cancellous iliac bone grafting

Der Unfallchirurg ◽

10.1007/s001130050335 ◽

1998 ◽

Vol 101 (10) ◽

pp. 762-768 ◽

Cited By ~ 4

Author(s):

R. Zimmermann ◽

M. Gabl ◽

S. Pechlaner ◽

R. Sailer ◽

A. Kathrein ◽

...

Keyword(s):

Bone Grafting ◽

Open Reduction ◽

Plate Fixation ◽

Iliac Bone ◽

Radius Fractures ◽

Internal Plate Fixation

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Operative versus Conservative Treatment for the Management of Displaced Midshaft Clavicle Fractures in Adults

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v13i1.41030 ◽

2017 ◽

Vol 13 (1) ◽

pp. 81-85

Author(s):

Md Maksudul Haque ◽

Masud Ahmed ◽

Md Zakir Hossain ◽

Md Ali Faisal ◽

Mohammad Saiful Islam ◽

...

Keyword(s):

Conservative Treatment ◽

Functional Outcome ◽

Open Reduction ◽

Plate Fixation ◽

Major Complication ◽

Armed Forces ◽

Operative Management ◽

Cross Sectional Study ◽

Cross Sectional ◽

Non Union

Introduction: Displaced fractures of mid third clavicle are common in young athletic population and choice of management is still controversial. Recent studies have shown that these fractures do not have favourable outcomes with non-operative management and nonunion rates could be as high as 20%, in addition, there is symptomatic malunion with shortening. Objective: To compare the results of the operative versus that of conservative treatment for the management of displaced midshaft clavicular fractures. Materials and Methods: This prospective cross-sectional study was carried out in Orthopaedic and Trauma center, CMH, Dhaka, from the period of January 2014 to December 2016 to compare results of open reduction and internal fixation by plating with that of conservative management. Total 60 patients (30 in each group) were analyzed in terms of fracture union and functional outcome. Patients in the non-operative group were managed by triangular sling with or without strapping whereas in the operative group fractures were reduced and fixed with a contoured reconstruction plate. Patients were actively followed up for 12 months and functional outcome was measured by Rowe and Oxford shoulder scoring system. Complications were monitored clinically and radiologically. Results: All fractures in the operated group united compared with thirteen cases of symptomatic malunion (43.33%) in the non-operated group which is statistically significant. Rowe and Oxford scores was significantly higher in the operated group than the non-operated group in every occasion of follow-up. There was no major complication of surgery. In one patient (3.33%) plate had to be removed for hardware irritation and prominence. Conclusion: Open reduction and internal plate fixation in acute displaced midshaft clavicular fractures resulted in improved outcome decreased rate of non-union and symptomatic mal-union compared with non-operative treatment Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 81-85

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Outcome following management of unstable lateral end clavicle fractures with locking plate and coracoid anchor augmentation

Shoulder & Elbow ◽

10.1177/1758573220981708 ◽

2021 ◽

pp. 175857322098170

Author(s):

Karthik Karuppaiah ◽

Ahmad Bilal ◽

Toby Colegate-Stone ◽

Joydeep Sinha ◽

Ramon Tahmassebi ◽

...

Keyword(s):

Functional Outcome ◽

Locking Plate ◽

Plate Fixation ◽

Open Reduction Internal Fixation ◽

Implant Removal ◽

Dash Score ◽

Articular Fractures ◽

Clavicle Fractures ◽

Ligament Disruption

Background Management of complex lateral end clavicle fractures with coraco-clavicular ligament disruption can be challenging. Methods We prospectively analysed 19 (17 M:2F) patients from January 2014 to June 2016. Six patients had intra-articular fractures (Edinburgh-3B2) and the remaining were extra-articular (3B1). All patients had open reduction internal fixation with lateral end locking plate augmented with a coracoid anchor. All patients were evaluated at the final follow-up by American Shoulder and Elbow Surgeon score (ASES), Disabilities of the Arm, Shoulder and Hand (DASH), Oxford Shoulder Score (OSS), return to work, sports and radiographs. Results At a mean follow-up of 54 months (range 37–64), 19 patients were available for analysis. Mean age of patients was 34 years (range 24–65). At final follow-up DASH score was 1.66 (range 0–5); ASES score was 98.14 (93.3–100) and OSS was 46.6 (42–48). There was no difference in the functional outcome between 3B1 and 3B2 fractures (DASH – p(0.51); ASES – p(0.44); OSS – p(0.69)). All patients returned to preinjury level of function, sports and work. Five patients needed implant removal and three developed capsulitis that resolved with conservative treatment. Conclusion Locking plate fixation, augmented with coracoid anchor is an effective option in the management of these complex injuries. The need for implant removal is reduced (26%) and there is no difference in the functional outcome between 3B1 and 3B2 fractures.

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Reduction and functional outcome of open reduction plate fixation versus minimally invasive reduction with percutaneous screw fixation for displaced calcaneus fracture: a retrospective study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-019-1162-5 ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Ye Peng ◽

Jianheng Liu ◽

Gongzi Zhang ◽

Xinran Ji ◽

Wei Zhang ◽

...

Keyword(s):

Retrospective Study ◽

Minimally Invasive ◽

Functional Outcome ◽

Open Reduction ◽

Screw Fixation ◽

Plate Fixation ◽

Percutaneous Screw Fixation ◽

Calcaneus Fracture ◽

Minimally Invasive Reduction

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Functional Outcome of Intra-Articular Fractures of the Distal Humerus Treated with Open Reduction and Internal Fixation with Distal Humeral Locking Plates and Screws

Journal of Medical Science And clinical Research ◽

10.18535/jmscr/v6i8.201 ◽

2018 ◽

Vol 6 (8) ◽

Author(s):

Dr Vikaas Ethanur Thuppale ◽

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Distal Humerus ◽

Locking Plates ◽

Articular Fractures

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Results of open reduction and fixed angle locked volar plate fixation for fracture lower end of radius

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20194246 ◽

2019 ◽

Vol 5 (6) ◽

pp. 1055

Author(s):

Gaurav Kumar ◽

Varun Vijay

Keyword(s):

Functional Outcome ◽

Distal Radius ◽

Open Reduction ◽

Locking Plate ◽

Plate Fixation ◽

Volar Plate ◽

Volar Locking Plate ◽

Radius Fractures ◽

Fixed Angle ◽

Volar Plate Fixation

Background: The fracture of lower end radius is the most common fracture of upper extremity encountered in practice. Intra-articular fractures of distal radius present a challenging task to the operating surgeon. Open reduction and internal fixation using volar fixed-angle plates has shown to be a valid treatment option for unstable, dorsally displaced distal radial fractures. The present study was undertaken to evaluate the functional outcome of unstable distal radius fractures treated with fixed angle volar locking plate.Methods: The current study aimed at using fixed angle volar locking plate to treat unstable distal radius fractures. A total of 25 patients records were studied comprising of 19 males and 6 females with a mean of 44.5 years and followed up for a maximum of 1.5 year. Fractures were classified using the AO classification. The interpretation of functional outcome was done according to Mayo Wrist Score.Results: At final functional assessment, according to the Mayo wrist score, the scores of 6 patients were excellent, 10 patients good, 8 patients satisfactory and 1 patient poor. No non-union was reported in any patients. 3 patients developed minor complications in the form of superficial infection, hypertrophic scar and reflex sympathetic dystrophy and 1 patient developed major complication in the form of deep infection.Conclusions: Primary volar plate fixation of unstable distal radius fracture provides a stable construct that helps in early mobilization, better functional outcome and minimizes chances of complications and thereby is the treatment of choice for fracture distal end of radius.

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