scholarly journals Pilon Fractures of Middle Phalanx Managed with Lag Screw and Early Mobilisation

2018 ◽  
Vol 08 (01) ◽  
Author(s):  
Chandan Jadhav N
Keyword(s):  
Early Mobilisation ◽  
Middle Phalanx ◽  
Lag Screw ◽  
Pilon Fractures

Secondary Fractures Following Internal Fixation in Two Horses

1989 ◽  
Vol 02 (03) ◽  
pp. 125-128
Author(s):  
E. M. Gaughan ◽  
N. G. Duchar
Keyword(s):  
Internal Fixation ◽  
Sagittal Plane ◽  
Proximal Phalanx ◽  
Fracture Repair ◽  
Fracture Line ◽  
Carpal Bone ◽  
Fracture Plane ◽  
The Third ◽  
Lag Screw ◽  
Secondary Fractures

SummaryImplant associated fractures have not been reported in horses. Two horses were evaluated for fractures in the fore limbs, occurring subsequent to previous fracture repair. Previously, the horses had sustained fractures of unusual configurations which were repaired using internal fixation. Following repair and healing of the fractures, secondary fractures occurred in the same bone, but in a different (more common) configuration. The first horse was evaluated ten months following lag screw fixation of a longitudinal fracture of the proximal phalanx in a frontal plane. This horse presented with a more typical comminuted fracture in the sagittal plane with the screws from the first fixation lying in the fracture line. This fracture was successfully treated with a cast. The second horse was examined eightteen months after repair of a medial sagittal slab fracture of the third carpal bone. The horse presented with a more typical dorsal slab fracture of the third carpal bone with the previously placed lag screw lying in the fracture line. The screw was removed and a lag screw was placed perpendicular to the new fracture plane through the dorsal surface of the third carpal bone to repair the fracture.

scholarly journals The The Effectiveness of Early Mobilization Time on Balance and Functional Ability after Ischemic Stroke

2019 ◽  
Vol 7 (7) ◽  
pp. 1088-1092
Author(s):  
Umi Budi Rahayu ◽  
Samekto Wibowo ◽  
Ismail Setyopranoto
Keyword(s):  
Randomized Controlled Trial ◽  
Ischemic Stroke ◽  
Functional Ability ◽  
Controlled Trial ◽  
Early Mobilization ◽  
Berg Balance Scale ◽  
Early Mobilisation ◽  
Inclusion Criteria ◽  
Randomized Controlled ◽  
Significant Difference

BACKGROUND: Early mobilisation (EM) after-ischemic stroke is a motor learning intervention aimed to restore nerve cells and to improve balance and functional ability. Unfortunately, the study of when this intervention began has not been widely studied. AIM: On this study was compared the effect of EM started at 24 hours and 48 hours after an ischemic stroke on balance and functional ability. MATERIAL AND METHODS: Randomized controlled trial involving 40 patients on 2 groups meeting predefined inclusion criteria. The levels of balance were measured using the Berg Balance Scale, and the functional ability was measured using the Barthel Index, at 5th and 7th day. RESULTS: A significant difference was observed in both balance (p = 0.038) and functional ability (p = 0.021) obtained on the 7th day of assessment between both groups. A significant difference on the 5th day was observed only in the functional ability (p = 0.002) and not in the balance (p = 0.147), between the groups. CONCLUSION: EM started at 24 hours after the ischemic stroke has been found to have a better impact on balance and functional ability compared to that at 48 hours.

scholarly journals Anatomy of the Distal End of Flexor Digitorum Longus Tendon and Percutaneous Release Technique: A Cadaveric Study

2019 ◽  
Vol 4 (4) ◽  
pp. 247301141988427
Author(s):  
Baofu Wei ◽  
Ruoyu Yao ◽  
Annunziato Amendola
Keyword(s):  
Distal Phalanx ◽  
Neurovascular Bundle ◽  
Middle Phalanx ◽  
Flexor Digitorum Longus ◽  
Longus Tendon ◽  
Pull Out ◽  
Percutaneous Release ◽  
Significant Difference ◽  
Distal Interphalangeal ◽  
Flexor Digitorum

Background: The transfer of flexor-to-extensor is widely used to correct lesser toe deformity and joint instability. The flexor digitorum longus tendon (FDLT) is percutaneously transected at the distal end and then routed dorsally to the proximal phalanx. The transected tendon must have enough mobility and length for the transfer. The purpose of this study was to dissect the distal end of FDLT and identify the optimal technique to percutaneously release FDLT. Methods: Eight fresh adult forefoot specimens were dissected to describe the relationship between the tendon and the neurovascular bundle and measure the width and length of the distal end of FDLT. Another 7 specimens were used to create the percutaneous release model and test the strength required to pull out FDLT proximally. The tendons were randomly released at the base of the distal phalanx (BDP), the space of the distal interphalangeal joint (SDIP), and the neck of the middle phalanx (NMP). Results: At the distal interphalangeal (DIP) joint, the neurovascular bundle begins to migrate toward the center of the toe and branches off toward the center of the toe belly. The distal end of FDLT can be divided into 3 parts: the distal phalanx part (DPP), the capsule part (CP), and the middle phalanx part (MPP). There was a significant difference in width and length among the 3 parts. The strength required to pull out FDLT proximally was about 168, 96, and 20 N, respectively, for BDP, SDIP, and NMP. Conclusion: The distal end of FDLT can be anatomically described at 3 locations: DPP, CP, and MPP. The tight vinculum brevis and the distal capsule are strong enough to resist proximal retraction. Percutaneous release at NMP can be performed safely and effectively. Clinical Relevance: Percutaneous release at NMP can be performed safely and effectively during flexor-to-extensor transfer.

Lag screw and tension band wire arthrodesis of the scapulohumeral joint in a miniature bull calf

2016 ◽  
Vol 4 (2) ◽  
Author(s):  
Elizabeth Cypher ◽  
Sarel Amstel ◽  
Rachel Lyons ◽  
David E Anderson
Keyword(s):  
Tension Band ◽  
Bull Calf ◽  
Lag Screw ◽  
Tension Band Wire

Strength of Lag‐Screw Connections

1992 ◽  
Vol 118 (10) ◽  
pp. 2855-2871 ◽  
Author(s):  
Thomas E. McLain
Keyword(s):  
Lag Screw

scholarly journals Biomechanical Evaluation of Tarsometatarsal Fusion Comparing Crossing Lag Screws and Lag Screw With Locking Plate

2021 ◽  
pp. 107110072110335
Author(s):  
Sarah Ettinger ◽  
Lisa-Christin Hemmersbach ◽  
Michael Schwarze ◽  
Christina Stukenborg-Colsman ◽  
Daiwei Yao ◽  
...  
Keyword(s):  
Locking Plate ◽  
Screw Fixation ◽  
Operative Procedure ◽  
Fixation Technique ◽  
Lag Screw ◽  
Group 15 ◽  
Fresh Frozen ◽  
Biomechanical Evaluation ◽  
The Stability ◽  
End Stage

Background: Tarsometatarsal (TMT) arthrodesis is a common operative procedure for end-stage arthritis of the TMT joints. To date, there is no consensus on the best fixation technique for TMT arthrodesis and which joints should be included. Methods: Thirty fresh-frozen feet were divided into one group (15 feet) in which TMT joints I-III were fused with a lag screw and locking plate and a second group (15 feet) in which TMT joints I-III were fused with 2 crossing lag screws. The arthrodesis was performed stepwise with evaluation of mobility between the metatarsal and cuneiform bones after every application or removal of a lag screw or locking plate. Results: Isolated lag-screw arthrodesis of the TMT I-III joints led to significantly increased stability in every joint ( P < .05). Additional application of a locking plate caused further stability in every TMT joint ( P < .05). An additional crossed lag screw did not significantly increase rigidity of the TMT II and III joints ( P > .05). An IM screw did not influence the stability of the fused TMT joints. For TMT III arthrodesis, lag-screw and locking plate constructs were superior to crossed lag-screw fixation ( P < .05). TMT I fusion does not support stability after TMT II and III arthrodesis. Conclusion: Each fixation technique provided sufficient stabilization of the TMT joints. Use of a lag screw plus locking plate might be superior to crossed screw fixation. An additional TMT I and/or III arthrodesis did not increase stability of an isolated TMT II arthrodesis. Clinical Relevance: We report the first biomechanical evaluation of TMT I-III arthrodesis. Our results may help surgeons to choose among osteosynthesis techniques and which joints to include in performing arthrodesis of TMT I-III joints.

Hemi-hamate Arthroplasty for Base of Middle Phalanx Fracture: A Systematic Review

Hand ◽  
2021 ◽  
pp. 155894472110146
Author(s):  
Harrison Faulkner ◽  
David J. Graham ◽  
Mark Hile ◽  
Richard D. Lawson ◽  
Brahman S. Sivakumar
Keyword(s):  
Systematic Review ◽  
Symptomatic Relief ◽  
Donor Site ◽  
Functional Restoration ◽  
Interphalangeal Joint ◽  
Posttraumatic Arthritis ◽  
Middle Phalanx ◽  
Weighted Mean ◽  
True Incidence ◽  
Fracture Dislocations

Intra-articular fracture dislocations of the base of the middle phalanx are complex and debilitating injuries that present a management conundrum when nonreconstructable. Hemi-hamate arthroplasty (HHA) is a treatment modality of particular use in the setting of highly comminuted fractures. This systematic review aims to summarize the reported outcomes of HHA in this context. A literature search was conducted using MEDLINE, Embase, and PubMed, yielding 22 studies with 235 patients for inclusion. The weighted mean postoperative range of movement at the proximal interphalangeal joint was 74.3° (range, 62.0°-96.0°) and at the distal interphalangeal joint was 57.0° (range, 14.0°-80.4°). The weighted mean postoperative pain Visual Analog Scale was 1.0 (range, 0.0-2.0). The weighted mean postoperative grip strength was 87.1% (range, 74.5%-95.0%) of the strength on the contralateral side. Posttraumatic arthritis was reported in 18% of cases, graft collapse in 4.2%, and donor site morbidity in 3.0%, with a mean follow-up period of 28.4 months (range, 1-87 months). Hemi-hamate arthroplasty is a reliable and effective technique for the reconstruction of intra-articular base of middle phalangeal fracture dislocations, affording symptomatic relief and functional restoration. Further research is required to assess the true incidence of long-term complications.

scholarly journals 34 Discharge After Hip Fracture Surgery by Mobilisation Timing: Secondary Analysis of the UK National Hip Fracture Database

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i7-i11
Author(s):  
A Goubar ◽  
O Almilaji ◽  
F C Martin ◽  
C Potter ◽  
G D Jones ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Average Rate ◽  
Small Sample Size ◽  
Small Sample ◽  
Competing Risk ◽  
Hospital Death ◽  
Early Mobilisation ◽  
Hip Fracture Surgery ◽  
Risk Of Death ◽  
Fracture Surgery

Abstract Background To maximise the benefits of hip fracture surgery the National Institute for Health and Care Excellence Clinical Guideline recommends mobilisation on the day after hip fracture surgery based a low to moderate quality trial with a small sample size. There is a need to generate additional evidence to support early mobilisation as a new UK Best Practice Tariff (BPT). Objective To determine whether mobilisation timing was associated with the cumulative incidence of hospital discharge by 30-days after hip fracture surgery, accounting for potential confounders and the competing risk of in-hospital death. Method We examined data for 135,105 patients 60 years or older who underwent surgery for nonpathological first hip fracture between January 2014 and December 2016 in any hospital in England or Wales. We tested whether the cumulative incidences of discharge differed between those mobilised early (within 36 hours of surgery) and those mobilised late accounting for potential confounders and the competing risk of in-hospital death. Results 106,722 (79%) of patients first mobilised early. The average rate of discharge was 60.1 (95% CI 59.8–60.5) per 1,000 patient days, varying from 65.2 (95% CI 64.8–65.6) among those who mobilised early to 44.5 (95% CI 43.9–45.1) among those who mobilised late, accounting for the competing risk of death. By 30-days postoperatively, the crude and adjusted odds ratios of discharge were 2.26 (95% CI 2.2–2.32) and 1.93 (95% CI 1.86–1.99) respectively among those who first mobilised early compared to those who mobilised late, accounting for the competing risk of death. Conclusion Early mobilisation led to a near two fold increase in the adjusted odds of discharge by 30-days postoperatively. We recommend inclusion of mobilisation within 36 hours of surgery as a new UK BPT to help reduce delays to mobilisation currently experienced by one-fifth of patients surgically treated for hip fracture.

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