scholarly journals An Assessment of 3.5mm Reconstruction Plate Fixation in Olecranon Fractures

2022 ◽  
Vol 8 (1) ◽  
pp. 261-267
Author(s):  
Manpreet Singh
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Plate Fixation ◽  
Posterior Part ◽  
Early Mobilization ◽  
Deep Infection ◽  
Reconstruction Plate ◽  
Superficial Infection ◽  
A Prospective Study ◽  
Olecranon Fractures

Background: Olecranon process is a large, curved eminence comprising of the proximal and posterior part of the ulna. It lies subcutaneously which makes it more vulnerable to injury. Due to intra-articular extension of fractures, anatomical reduction and early mobilization should be achieved in every case and usually managed surgically. Aims and Objectives: To access the results of reconstruction plate in fracture olecranon.Materials &Methods: This was a prospective study consisted of 25 cases of olecranon fractures which were managed by open reduction and internal fixation using 3.5mm reconstruction plate. Patients were followed up every month till 6 months. At each follow up visit clinical and radiological parameters were assessed: Final assessment was done at 6 months using the Mayo Elbow Performance Score.Result: According to the AO classification, Type A-1 – 7 cases, A-3 – 1case, B-1 – 13 cases, B-3 – 1 case, C-1 – 1 case, C-2 – 1 case, C-3 – 1 case. An adequate reduction was maintained in all fractured olecranon until union. Average radiological union time was 12 weeks in 72% cases, 15 weeks in 16% cases, 18 weeks in 8% cases and > 18 weeks in 4% cases. The results were graded as per the criteria laid by Rogers et al as excellent in 84% cases, good in 12% and unsatisfactory in 4% cases. 2 cases developed superficial infection and 1 deep infection and 1 delayed union.Conclusion: Open reduction and internal fixation of fracture of olecranon with 3.5mm reconstruction plate is based on sound biomechanical principle with a good functional outcome and a low incidence of complications.

scholarly journals The role of open reduction and internal fixation in the treatment of the intercondylar fractures of humerus

2019 ◽  
Vol 5 (5) ◽  
pp. 855
Author(s):  
Venkata Sivaram G. V. ◽  
Y. V. S. Prabhakar
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Early Mobilization ◽  
Distal Humerus ◽  
Inclusion Criteria ◽  
Senior Faculty ◽  
Chevron Osteotomy ◽  
Stiff Elbow ◽  
Condylar Fractures

<p class="abstract"><strong>Background:</strong> Inter-condylar fractures represent one of the most complicated and challenging fractures in the upper extremity. The results of managing these fractures non-operatively are limited by failure to get anatomical reduction and early mobilization, which often results in painful stiff elbow and/or pseudo-arthrosis. The objective of this study was to evaluate and analyse the role of open reduction and internal fixation in inter-condylar fractures of distal humerus.</p><p class="abstract"><strong>Methods:</strong><strong> </strong>The present study was done in Malla Reddy Institute of Medical Sciences between June 2014 and June 2017. Out of 34 cases of intercondylar fractures of humerus admitted during the period, 25 patients were selected for the study that satisfied our inclusion criteria. Three patients out of those selected could not be included in the study as one had cardiac issues pre-operatively, one refused surgery and one was lost to follow up.<strong></strong></p><p class="abstract"><strong>Results:</strong> Our study included 22 patients, 14 male and 8 female patients. Their average age was 41.4 years. The fractures were classified as per the AO classification. There were B1-3, B2-1, C1-6, C2-5, C3-7 fractures. Both compound and closed fractures were included. All the patients were operated by posterior olecranon Chevron osteotomy approach by a senior faculty member. Twenty two patients who satisfied our inclusion criteria were treated, followed up and the results analyzed using Cassabaum’s scale of elbow function we had 86% of excellent to good results. Our results are comparable with other similar studies.</p><p class="abstract"><strong>Conclusions:</strong> Posterior olecranon approach was found to be of most satisfactory approach by us. It allows good exposure of the joint and the ulnar nerve.</p>

scholarly journals Two-stage open reduction and internal fixation versus limited internal fixation combined with external fixation: a meta-analysis of postoperative complications in patients with severe Pilon fractures

2018 ◽  
Vol 46 (7) ◽  
pp. 2525-2536 ◽  
Author(s):  
Xueliang Cui ◽  
Hui Chen ◽  
Yunfeng Rui ◽  
Yang Niu ◽  
He Li
Keyword(s):  
Postoperative Complications ◽  
Internal Fixation ◽  
Bone Healing ◽  
Open Reduction ◽  
Lower Risk ◽  
Meta Analysis ◽  
Two Stage ◽  
Superficial Infection ◽  
Tibial Pilon ◽  
Pilon Fractures

Objectives Two-stage open reduction and internal fixation (ORIF) and limited internal fixation combined with external fixation (LIFEF) are two widely used methods to treat Pilon injury. However, which method is superior to the other remains controversial. This meta-analysis was performed to quantitatively compare two-stage ORIF and LIFEF and clarify which method is better with respect to postoperative complications in the treatment of tibial Pilon fractures. Methods We conducted a meta-analysis to quantitatively compare the postoperative complications between two-stage ORIF and LIFEF. Eight studies involving 360 fractures in 359 patients were included in the meta-analysis. Results The two-stage ORIF group had a significantly lower risk of superficial infection, nonunion, and bone healing problems than the LIFEF group. However, no significant differences in deep infection, delayed union, malunion, arthritis symptoms, or chronic osteomyelitis were found between the two groups. Conclusion Two-stage ORIF was associated with a lower risk of postoperative complications with respect to superficial infection, nonunion, and bone healing problems than LIFEF for tibial Pilon fractures. Level of evidence 2.

scholarly journals SURGICAL TREATMENT OF CLAVICULAR FRACTURES IN SPORT

2018 ◽  
Vol 6 (6_suppl3) ◽  
pp. 2325967118S0004
Author(s):  
E Gastaldi Orquin ◽  
GM Gastaldi Llorens
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Open Reduction ◽  
Plate Osteosynthesis ◽  
Platelet Rich Plasma ◽  
Plate Fixation ◽  
Activity Level ◽  
Contact Sports ◽  
Sport Practice ◽  
Shoulder Range Of Motion

Clavicular fractures are common in sport practice, they are easily diagnosed and have a relative good forecast. Nevertheless there is no consensus among orthopedic surgeons regarding treatment for displaced midle-third clavicular fractures (Robinson’s classification 2B2) and lateral-third fractures. The tendency toward operative treatment is increasing due to the earlier sport recovery. Objectives: The aim of the paper is to present the results of treatment of 98 clavicular fractures in the Clinic Gastaldi of Traumatology during the period from 1997 to 2016, analyzing the radiologic and clinical results. Methods: The serie consists of 89 patients, 80 males and 9 females, average age 32.2 years. From them, 89 were agude fractures and 9 nonunion (after conservative treatment). According to the Thomsom classification there were 82 middle-third and 16 lateral-third. Motorbike sport trauma was the cause of 49 patients (55%), bike trauma in 18 (20%), 18 (20%) fractures occurred due to contact sports and 3 other causes. All patients were surgically treated. We used an antero-superior approach, open reduction and internal fixation with antero-superior plate osteosynthesis. In case of nonunion we decorticated the fracture callus, adding intramedullary reaming and graft bone. PRP (Platelet Rich-Plasma) was used in 8/9 patients. Postoperatively, the patients were placed in a sling. After that they began a rehabilitation program that consists of isometrics, pendular and active movements until 45° during 3 weeks. From 4th to 6th week, active movements until 90°. The patients began free movements after the 6th week. Results: Fracture healing mean was 10 weeks. Bikes and motorbikes were able to ride again between 10 to 21 days after surgery (once removed stitches). All patients retrieved full shoulder range of motion and returned to their previous activity level. Complications: we had no nonunion rates after surgical treatment, neither infections. 1 case of insufficient plate fixation and 4 re-fractures which required surgical treatment. Conclusion: We suggest surgical treatment for clavicular fractures in adult patients, contact sports with IIB and IIIB fractures, re-fractures and painful nonunion. Surgical treatment with open reduction and internal fixation (ORIF) of displaced middle-third clavicular fractures achieved shorter time to complete return to sport and earlier bone union.

scholarly journals Surgical management of proximal humerus fracture treated with locking compression plate

2017 ◽  
Vol 3 (6) ◽  
pp. 1165
Author(s):  
Sivakumar Arumugam ◽  
Venkateshwara Arumugam ◽  
V. Raviraman
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Proximal Humerus ◽  
Early Mobilization ◽  
Open Reduction Internal Fixation ◽  
Locking Compression Plate ◽  
Proximal Humerus Fractures ◽  
Compression Plate ◽  
Comminuted Fractures ◽  
Humerus Fractures

<p class="abstract"><strong>Background:</strong> Proximal humerus fractures accounts for about 4 to 5% of all fractures.  Treatment of unstable, displaced, and comminuted fractures of the proximal humerus remain challenging. Significant controversy continues regarding the best methods of treating displaced proximal humerus fractures. Various operative procedures are carried out, the recent trend in internal fixation has moved on to locking plates. The present study is undertaken to evaluate the functional outcome and complication of proximal humerus fractures treated by locking compression plate.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study comprising of 30 patients with fractures of proximal humerus were treated by open reduction and internal fixation with locking compression plate were evaluated at Velammal  Institute Of Medical  Sciences, Madurai from the period of April 2015 to December 2016. Clinical and radiological evaluation was done. Patients will undergo open reduction internal fixation with locking compression plate for the sustained fracture under general anesthesia.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our series, the majority of the patients were males, elderly aged, with RTA being the commonest mode of injury, involving 2 part, 3 part and 4 part fractures of the proximal humerus. Excellent and satisfactory results were found in 76.7% of patients with unsatisfactory results in 23.3 % according to Neer’s criteria. There were 100 % union rates and no failures.</p><p><strong>Conclusions:</strong> In conclusion locking Compression, the plate is an advantageous implant in proximal humeral fractures due to angular stability, particularly in comminuted fractures and in Osteoporotic bones in elderly patients, thus allowing early mobilization.</p>

scholarly journals Comparative analysis between locking compression plate and Joshi's external stabilization system in the management of proximal tibial fractures

2020 ◽  
Vol 7 (1) ◽  
pp. 56
Author(s):  
Amit Dwivedi ◽  
Anupinder Sharma ◽  
Vaibhav Ashta ◽  
Robium Nairobi ◽  
Sunandan Nandi
Keyword(s):  
Plate Osteosynthesis ◽  
Plate Fixation ◽  
Deep Infection ◽  
Open Reduction Internal Fixation ◽  
Tibial Fractures ◽  
Stabilization System ◽  
Superficial Infection ◽  
Bone Consolidation ◽  
Proximal Tibial Fractures ◽  
External Stabilization

<p><strong>Background:</strong> Proximal tibial fractures present with a variety of patterns. They are mostly treated using plate osteosynthesis or Joshi's external stabilization system (JESS) depending upon the injury configuration and surgeon preference. We have compared the efficacy of plate fixation to JESS in the treatment of complex proximal tibial fractures.<strong></strong></p><p><strong>Methods</strong>: 36 patients of proximal tibial fractures with a mean age of 47 years were included in the study, 20 were treated using plate osteosynthesis while the other 16 were treated using JESS, they were followed up at regular intervals till 24 weeks and the progress was recorded in accordance with the knee society score (KSS) parameters<strong></strong></p><p><strong>Results</strong>: 20 patients were treated using plate osteosynthesis, 18 of them had excellent KSS scores, 2 patients recorded good scores, average range of flexion was 126<sup>o</sup>, no incidences of superficial or deep infections were seen in any of them. Bone consolidation was achieved around 12 weeks in plate fixation group of the16 patients treated using JESS, 12 had excellent scores, 4 recorded a good score, average range of flexion was 118<sup>o</sup>, superficial infection was seen in 2 patients, with no incidence of deep infection. Bone consolidation was achieved around 16 weeks in JESS group.</p><p><strong>Conclusions</strong>: Both open reduction internal fixation (ORIF) with plating and JESS appear to be adequate fixation methods for complex proximal tibial fractures, but as per our study plate fixation resulted in earlier bone consolidation and gave a slightly better functional outcome compared to JESS.</p>

scholarly journals Demographic profile and functional outcome following fixation of malleolar fractures in adults

2020 ◽  
Vol 6 (2) ◽  
pp. 313
Author(s):  
Rejo V. Jacob ◽  
Sanjeev Kumar ◽  
Naveen K. Singh ◽  
Prateek Girotra
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Scoring System ◽  
Open Reduction ◽  
External Rotation ◽  
Early Mobilization ◽  
Common Mechanism ◽  
Demographic Profile ◽  
Malleolar Fractures ◽  
Male Preponderance

<p class="abstract"><strong>Background:</strong> Malleolus are important structures which forms part of ankle mortise and provide stability to it. This article underlines the current demographic profile of patients sustaining malleolar fractures in adults. It also discusses the modalities of treatment and functional outcomes following open reduction and internal fixation of these fractures as well as the improvement in functional outcome following early mobilization.</p><p class="abstract"><strong>Methods:</strong> 30 patients sustaining malleolar fractures who attended the Department of Orthopedics were included in the study. The patients were operated as and when the soft tissue condition permitted and were followed up in outpatient department at 6 weeks, 3 months and 6 months where functional outcome based on Baird and Jackson scoring system was assessed.<strong></strong></p><p class="abstract"><strong>Results:</strong> In this study, the average age of patients was 43.8 years with a male preponderance. Supination-external rotation was the most common mechanism of injury following a slip or twisting injury. According to Baird and Jackson scoring system 20% patients had excellent, 50% patients had good results, 20% patients had fair results and 10% patients had poor results.</p><p class="abstract"><strong>Conclusions:</strong> 70% patients had excellent to good results following fixation of malleolar fractures. Early mobilization was started in 5 patients with 80% patients showing excellent results. Open reduction and Internal fixation proved to be an excellent procedure leading to union in all cases, less complication and early resumption of routine activities.</p><p> </p>

scholarly journals In adults, early mobilization may be beneficial for distal radius fractures treated with open reduction and internal fixation: a systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
ZhiBo Deng ◽  
JiangPing Wu ◽  
KaiYing Tang ◽  
Han Shu ◽  
Ting Wang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Internal Fixation ◽  
Open Reduction ◽  
Data Extraction ◽  
Meta Analysis ◽  
Early Mobilization ◽  
Distal Radial Fracture ◽  
Cochrane Central Register ◽  
Dash Score ◽  
Implant Loosening

Abstract Objectives It remains debatable if early mobilization (EM) yields a better clinical outcome than the late mobilization (LM) in adults with an acute and displaced distal radial fracture (DRF) of open reduction internal fixation (ORIF). Therefore, we aimed to perform a systematic review and meta-analysis of randomized controlled trials (RCTs), comparing clinical results with the safety of EM with LM following ORIF. Methods Databases such as Medline, Cochrane Central Register, and Embase were searched from Jan 1, 2000, to July 31, 2021, and RCTs comparing EM with LM for DRF with ORIF were included in the analysis. The primary outcome of study included disabilities of the Arm, Shoulder, and Hand (DASH) score at different follow-up times. Wherever the secondary outcomes included patient-rated wrist evaluation (PRWE), grip strength (GS), visual analog scale (VAS), wrist range of motion (WROM), and associated complications, the two independent reviewers did data extraction for the analysis. Effect sizes of outcome for each group were pooled using random-effects models; thereafter, the results were represented in the forest plots. Results Nine RCTs with 293 EM and 303 LM participants were identified and included in the study. Our analysis showed that the DASH score of the EM group was significantly better than LM group at the six weeks postoperatively (− 10.15; 95% CI − 15.74 to − 4.57, P < 0.01). Besides, the EM group also had better outcomes in PRWE, GS and WROM at 6 weeks. However, EM showed potential higher rate for implant loosening and/or fracture re-displacement complication (3.00; 95% CI 1.02–8.83, P = 0.05). Conclusion Functionally, at earlier stages, EM for patients with DRF of ORIF may have a beneficial effect than LM. The mean differences in the DASH score at 6 weeks surpassed the minimal clinically important difference; however, the potentially higher risk of implant loosening and/or fracture re-displacement cannot be ignored. Due to the lack of definitive evidence, multicenter and large sample RCTs are required for determining the optimal rehabilitation protocol for DRF with ORIF. PROSPERO registration number: CRD42021240214 2021/2/28.

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