Orthogonal Plating of Vancouver B1 and C-Type Periprosthetic Femur Fracture Nonunions

2017 ◽  
Vol 27 (6) ◽  
pp. 578-583 ◽  
Author(s):  
Christopher E. Birch ◽  
Michael Blankstein ◽  
Jesse D. Chlebeck ◽  
Craig S. Bartlett 3rd
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Femur Fracture ◽  
Plate Osteosynthesis ◽  
Perioperative Complications ◽  
Femoral Shaft ◽  
Open Reduction Internal Fixation ◽  
Fixation Method ◽  
Periprosthetic Femur Fracture ◽  
Fracture Nonunions

Background Periprosthetic femoral shaft fractures are a significant complication after total hip arthroplasty (THA). Plate osteosynthesis has been the mainstay of treatment around well-fixed stems. Nonunions are a rare and challenging complication of this fixation method. We report the outcomes of a novel orthogonal plating surgical technique for Vancouver B1 and C-type periprosthetic fractures that previously failed open reduction internal fixation (ORIF). Methods A retrospective review identified all patients with Vancouver B1/C THA periprosthetic femoral nonunions from 2010 to 2015. Exclusion criteria included open fractures and periprosthetic infections. The technique utilised a mechanobiologic strategy of atraumatic exposure, resection of necrotic tissue, bone grafting with adjuvant bone morphogenetic protein (BMP) and revision open reduction internal fixation with orthogonal plate osteosynthesis. Results 6 Vancouver B1/C periprosthetic femoral nonunions were treated. 5 patients were female with an average age of 80.3 years (range 72-91 years). The fractures occurred at a mean of 5.8 years (range 1-10 years) from their initial arthroplasty procedure. No patients underwent further revision surgery; there were no perioperative complications. All patients had a minimum of 11 months follow-up (mean 18.6, range 11-36 months). All fractures achieved osseous union, defined as solid bridging callus over at least 2 cortices and pain free, independent ambulation, at an average of 24.4 weeks (range 6.1-39.7 weeks). Conclusions This is the 1st series describing orthogonal locked compression plating using modern implants for periprosthetic femoral nonunions. This technique should be considered in periprosthetic femur fracture nonunions around a well-fixed stem.

scholarly journals Comparison of Minimally Invasive Percutaneous Plate Osteosynthesis and Open Reduction Internal Fixation on Proximal Humeral Fracture in Elder Patients: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Wei Zhao ◽  
Yuhui Zhang ◽  
Dongni Johansson ◽  
Xingyu Chen ◽  
Fang Zheng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Minimally Invasive ◽  
Internal Fixation ◽  
Open Reduction ◽  
Proximal Humeral Fracture ◽  
Plate Osteosynthesis ◽  
Meta Analysis ◽  
Humeral Fracture ◽  
Open Reduction Internal Fixation ◽  
Elder Patients

Objective. The study aims to compare minimally invasive percutaneous plate osteosynthesis (MIPO) and open reduction internal fixation (ORIF) in the treatment of proximal humeral fracture in elder patients. Method. PubMed, Medline, EMbase, Ovid, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wangfang, and VIP Database for Chinese Technical Periodicals were searched to identify all relevant studies from inception to October 2016. Data were analyzed with Cochrane Collaboration’s Review Manage 5.2. Results. A total of 630 patients from 8 publications were included in the systematic review and meta-analysis. The pooled results showed that MIPO was superior to ORIF in the treatment of proximal humeral fracture in elder patients. It was reflected in reducing blood loss, operation time, postoperative pain, or fracture healing time of the surgery and in improving recovery of muscle strength. Concerning complications, no significant difference was seen between MIPO and ORIF. Conclusion. The MIPO was more suitable than ORIF for treating proximal humeral fracture in elder patients.

scholarly journals Early Experience with Low Profile Plate Osteosynthesis for Metacarpal Fractures

1970 ◽  
Vol 7 (1) ◽  
pp. 19-24
Author(s):  
A Joshi ◽  
BR K.C. ◽  
P Chand ◽  
BB Thapa
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Open Reduction Internal Fixation ◽  
Complication Rates ◽  
Metacarpal Fractures ◽  
Active Flexion ◽  
Early Return ◽  
Early Results ◽  
Low Profile

Background: Among various fixation methods for metacarpal fractures, plate osteosynthesis is the most rigid and allows early rehabilitation leading to early return to work. Many authors have reported high complication rates and most of them were because of thick plate. The aim of this study was to report early results of plate osteosynthesis of metacarpal fractures with low profile miniplate. Methods: This was a hospital based prospective study. Unstable and irreducible fractures were managed by open reduction and internal fixation with low profile miniplate and were followed up for 6 months. The functional outcome after fracture treatment was assessed by ability to perform acts of daily life and calculating American Society for Surgery of the Hand Total Active Flexion (ASSH TAF) score. Results: There were 16 patients with 17 metacarpal fractures, 87.5% were male with mean age of 31.50±9.02 years. Fourteen (87.5%) patients could perform their activities of daily living at four weeks. The mean Total Active Flexion was 261.76±24.87 at final follow up. Fourteen (87.5%) patients had excellent, one (6.25%) good and one (6.25%) poor out come at the end of 6 months. Conclusion: Low severity metacarpal fractures can be treated successfully by open reduction internal fixation with low-profile miniplate, allowing early and safe mobilization. Key words: low-profile plate, metacarpal fractures, plate osteosynthesis   DOI: 10.3126/jnhrc.v7i1.2274 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 19-24

scholarly journals Evaluation of functional outcome of distal tibial fractures stabilized with distal tibial locking plate

2020 ◽  
Vol 7 (1) ◽  
pp. 39
Author(s):  
Naveen Kumar ◽  
Manoj Thakur ◽  
Sandeep Kashyap
Keyword(s):  
Minimally Invasive ◽  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Open Reduction Internal Fixation ◽  
Tibial Fractures ◽  
P Value ◽  
Minimally Invasive Plate Osteosynthesis ◽  
Distal Tibial Fractures

<p class="abstract"><strong>Background:</strong> The present study is an attempt to evaluate the results of locking compression plate for distal tibia in lower tibial fractures using open reduction internal fixation and minimally invasive plate osteosynthesis technique.</p><p class="abstract"><strong>Methods: </strong>Prospective and retrospective study was conduct on patients attending the outpatient department (OPD)/Emergency OPD in Indira Gandhi Medical College, Shimla during September 2015 to August 2016 with distal tibial fractures. The patients treated with locking compression plates using minimally invasive plate osteosynthesis (MIPO) or open reduction internal fixation (ORIF) are reviewed for inclusion and exclusion criteria. All data were collected and analyzed by Epi-info software.</p><p class="abstract"><strong>Results: </strong>Out of 52 patients, 48.4% patients undergo open reduction internal fixation had excellent results and 28.6% patients undergo surgery by MIPPO technique had excellent results. p value is 0.352 which is not significant. Overall, 40.4% patients had excellent results. In our study, 32.6% patients having AO/OTA type A fractures had excellent score while type B and C had 1.9% excellent score. This is attributed to more comminution and involvement of ankle joint. Overall, 40.4% patients had excellent score. P value is 0.863 which is insignificant.</p><p class="abstract"><strong>Conclusions: </strong>We observed excellent/ good functional outcome in 65.3% of patients.</p>

scholarly journals Comparison between minimally invasive plate osteosynthesis and open reduction–internal fixation for proximal humeral fractures: a meta-analysis based on 1050 individuals

2019 ◽  
Author(s):  
Feilong Li ◽  
Tao Nie ◽  
Xuqiang Liu ◽  
Fuqiang Wang ◽  
Zhiping Gu ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Internal Fixation ◽  
Nerve Injury ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Meta Analysis ◽  
Axillary Nerve ◽  
Open Reduction Internal Fixation ◽  
Humeral Fractures ◽  
Minimally Invasive Plate Osteosynthesis

Abstract Background This meta-analysis aimed to compare the clinical outcomes and complications of minimally invasive plate osteosynthesis (MIPO) and open reduction–internal fixation (ORIF) in patients with proximal humeral fractures. Methods We searched PubMed, EMBASE, Ovid, and the Cochrane Library to identify all relevant studies from inception to April 2019. Cochrane Collaboration’s Review Manage 5.3 was used for meta-analysis. Results Sixteen studies involving 1050 patients (464 patients in the MIPO group and 586 patients in the ORIF group) were finally included. According to the meta-analysis, MIPO was superior to ORIF in operation time, blood loss, postoperative pain, fracture union time, and constant score. However, MIPO was associated with more exposure to radiation and axillary nerve injury. No significant differences were found in length of hospital stays and complication except for axillary nerve injury. Conclusion The present evidence indicates that MIPO offers superior outcomes in comparison to ORIF. However, surgeons should pay attention to reducing radiation exposure and avoiding axillary nerve injury.

scholarly journals Short term Functional outcome of Harris HIP Score from Open Reduction Internal Fixation action (ORIF Intertrochanter)

2020 ◽  
Vol 13 (2) ◽  
pp. 35-39
Author(s):  
Charles Meliala ◽  
Pranajaya Dharma Kadar ◽  
Husnul Fuad Akbar
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Femur Fracture ◽  
Open Reduction Internal Fixation ◽  
Harris Hip Score ◽  
Control Group ◽  
Functional Evaluation ◽  
Fracture Femur ◽  
Femur Fractures ◽  
Healthy Side

Background- Intertrochanter fracture is commonly found in geriatric and young active patient and it can affects the overall health system. The death rate of intertrochanter fracture has increased by 1 person in 1 year with mortality rate of around 14-36%.Objective- To find out the functional evaluation by Harris hip score from the action of open reduction internal fixation (ORIF) on the intertrochanter femur fractures. Material and Methods-A total of 42subjects were used in the study. The study wasanobservationalanalytic study with no retrospective pairing and with a crossectional approach, whichaimedtoanalyzetheclinical outcomeoftheHarris HipScore after performed ORIF intertrochanter femurfracture. In thiscase, the control group are healthy femur from the same patient. Unpaired T-Test is use if normal distributed data aquired, otherwise Mann-Whitney is the option. The affordable populationofthe study waspatientswho were operated using internal fixation due to intertrochanter femur fracture measures in January 2012 - June 2018.Results-In this case the distribution of the number of intertrochanter femur fracture samples was 42 subjects with 14 women (33.3%) and 28 men (66.7%). The youngest age of the study subjects was 17 years and the oldest age of the research subjects was 82 years with a mean and standard deviation of 60.77 ± 18.23 years, there were significant differences in outcomes of the clinical score of the hip score of the action Open reduction internal fixation (ORIF ) in the case of intertrochanter fracture femur, with a significance value of 0.0001 (<0.05).Conclusion-From the results of the statistical analysis of the outcome of the clinical hip score score of ORIF compared to the healthy side in the case of intertrochanter femur fractures, there is a significant result (15.1%) between ORIF actions compared to the healthy side in the case of intertrochanter fracture femur, with p value <0,0001.

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