Outcome of Two Ring Hybrid Ilizarov Fixator in the Management of Proximal Tibial Fractures in Adults

Objective: The aim of this study is to determine the outcomes of using two ring hybrid ilizarov fixator for the management of proximal tibial fractures in adult patients. Study Design: Descriptive Study Place and Duration: Methods: There were 60 patients of both genders were presented in this study. Patients were aged between 25-65 years. Informed written consent was taken from all the patients for detailed demographics age, sex, body mass index and cause of fracture. All the patients had proximal tibial fractures were included, type of fractures were assessed by schatzker technique. Outcomes were assessed by using Rasmussen score in terms of excellent, good and fair. Radiological outcome was measured by fracture healing on radiography. Student t-test and chi square test was used. SPSS 24.0 was used to analyze all of the data. Results: There were 45 (75%) patients were males and 15 (25%) were female patients. Mean age of the patients was 42.3±7.43 years with mean BMI 25.07±6.29 kg/m2. Falling was the most common cause of fracture found in 33 (55%), followed by road traffic accidents in 17 (28.3%) and 10 (16.7%) fractures by assault. Majority of the patients were schatzker type VI fractures 34 (56.7%) followed by schatzker type V fractures in 11 (18.3%), metaphyseal fractures found in 8 (13.3%) cases and proximalone third shaft fractures in 7 (11.7%) cases. Mean surgery time was 4.2±6.17 hours and mean union time of fractures was 19.8±6.61 weeks. According to Rasmussen score 39 (65%) cases showed excellent results with knee flexion more than 90 degree, good results found in 17 (28.3%) patients and fair results in 4 (6.7%) cases. Pin tract infection was the most common complication found in 12 (20%) cases, followed by compartment syndrome in 4 (6.7%) and delayed union in 3 (5%). No any poor outcome was assessed in this study. Conclusion: We concluded in this study that the use of two ring hybrid ilizarov fixator in the management of proximal tibial fractures were effective and useful in terms of excellent and good outcomes of knee flexion. The ilizarov approach allowed for early definitive treatment with a low rate of complications and a favourable clinical outcome. Keywords: Proximal Tibial fracture, Ilizarov Fixator, Shatzker, Rasmussen score, Outcomes

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Unreamed Intramedullary Nailing with Oblique Proximal and Biplanar Distal Interlocking Screws for Proximal Third Tibial Fractures

Journal of Orthopaedic Surgery ◽

10.1177/230949900901700106 ◽

2009 ◽

Vol 17 (1) ◽

pp. 23-27 ◽

Cited By ~ 5

Author(s):

VK Singh ◽

Y Singh ◽

PK Singh ◽

RK Goyal ◽

H Chandra

Keyword(s):

Compartment Syndrome ◽

Intramedullary Nailing ◽

Functional Outcomes ◽

Knee Flexion ◽

Delayed Union ◽

Tibial Fractures ◽

Entry Point ◽

Implant Failure ◽

Distal Locking ◽

Distal Interlocking

Purpose. To assess the outcome of unreamed intramedullary nailing through the lateralised entry point using oblique proximal and biplanar distal interlocking screws. Methods. 15 men and 3 women aged 25 to 58 (mean, 37) years underwent unreamed intramedullary nailing with oblique proximal and biplanar distal interlocking screws for proximal third metaphyseal tibial fractures. The entry point was kept proximal to the tibial tuberosity and slightly lateral to midline. Proximal locking was at 45° to the coronal and sagittal planes. Biplanar distal locking was in the coronal and sagittal planes. Results. 16 patients had bone union within 20 (mean, 17; range, 14–27) weeks; 2 underwent dynamisation for delayed union. Three patients had valgus angulation of <5°; 2 had a loss of terminal knee flexion; 3 had a loss of ankle dorsiflexion; and 3 had shortening of >0.5 cm. Functional outcomes were excellent in 13, good in 4, and fair in one patient. No patient endured neurovascular injury, compartment syndrome or implant failure. Conclusion. Unreamed intramedullary nailing with oblique proximal and biplanar distal interlocking screws for proximal third tibial fractures was effective in preventing malalignment.

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Investigating the Association between Orthopedic Fractures and Head Injury due to Road Traffic Accidents

Applied Bionics and Biomechanics ◽

10.1155/2021/2430090 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Mubarak Ali Algahtany

Keyword(s):

Head Injury ◽

Hospital Stay ◽

Traffic Accidents ◽

Road Traffic ◽

Road Traffic Accidents ◽

Traumatic Head Injury ◽

Chi Square ◽

Duration Of Hospital Stay ◽

Orthopedic Injury ◽

Tertiary Center

Background. Traumatic head injury (THI) due to road traffic accidents (RTAs) is a global health problem. Studies exploring the association between RTA-related THI and concurrent orthopedic fractures are lacking. We aim to provide a detailed analysis of this association and its impact on inhospital outcomes. Methods. Retrospective analysis of RTA-related THI associated with orthopedic fractures admitted to a large tertiary center, Southwest, Saudi Arabia, over ten years. Descriptive statistics for participant demographics and clinical outcomes were represented by percentages. The associations between head injury diagnosis or orthopedic fractures region and patient demographics are analyzed using the Chi-square test. Post hoc analysis for the significant Chi-square values was carried out by calculating the significant adjusted residuals. Adjust p value was obtained by using the Benjamini-Hochberg procedure to control for multiplicity testing. A p value less than 0.05 was considered statistically significant. Results. Concurrent orthopedic fractures are present in one-tenth of RTA-related THI. The cohort was dominated by young males, with 46.5% of the population between 18 and 29 years old. There was a significant association between the head injury diagnosis and the region of orthopedic fracture ( p = 0.028 ). The type of head injury had significant associations with mortality and duration of hospital stay ( p = 0.039 and p = 0.037 , respectively). The region of orthopedic fracture significantly ( p = 0.018 ) affected the duration of hospital stay, with fractures in the clavicle/shoulder region significantly ( p = 0.035 ) having a short course of hospital admission. Conclusion. Orthopedic fractures concomitant with RTA-related THI are common. The associations between the two injuries tend to happen in specific patterns. The inhospital stay duration and mortality significantly correlated with the site of the head or orthopedic injury. Knowledge of these patterns improves the care of THI victims, triaging, and resource allocations.

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Human Injury causing Road Traffic Accident at Debre Markos Town

10.21203/rs.3.rs-101705/v1 ◽

2020 ◽

Author(s):

Wubetie Habtamu Tilaye

Keyword(s):

Road Traffic Accident ◽

Traffic Accident ◽

Traffic Accidents ◽

Road Traffic ◽

Weather Condition ◽

Vehicle Ownership ◽

Contributing Factors ◽

Chi Square ◽

Education Status ◽

Human Injury

Abstract Objective: A Road traffic accident (RTA) is when in a road Vehicle collides with another Vehicle, pedestrian, animal or geographical or architectural obstacle. The RTAs can result in human injury, property damage and death. RTA result in the deaths of 1.2 million people worldwide each year and injuries about 4 times this number. The objective of this study is to identify the main causing-factors that contribute to road traffic accidents involving human injuries. Literature suggested factors considered for analysis are: Driver's Age, Driver’s Education status, Driver's experience, Vehicle type, Driver Vehicle Ownership, Vehicle year of service, Road type, Road division, Road condition, Problem with car, Weather condition, and accident time (day or night). Results: Among the candidate variables, Pearson Chi-Square method identified weather condition, driver’s experience, Vehicle year of service; Road division, Driver Vehicle Ownership, and accident time (day or night ) as significantly associated variables. Furthermore, percentage is used to describe the magnitude of associated variable. The result from Poisson regression analyses revealed that low driver experience, high Vehicle year of service (old cars), and Road division (one way road) are the significant contributing factors for increment of human injuries accidents.

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Evaluation of the functional outcome in open tibial fractures managed with an Ilizarov fixator as a primary and definitive treatment modality

International Journal of Orthopaedics Sciences ◽

10.22271/ortho.2017.v3.i2d.35 ◽

2017 ◽

Vol 3 (2d) ◽

pp. 436-440

Author(s):

Dr. SK Irfan Ali ◽

Dr. Sujai S ◽

Dr. HK Md Junied ◽

Dr. Chethan M H ◽

Dr. Ganesh H ◽

...

Keyword(s):

Functional Outcome ◽

Treatment Modality ◽

Tibial Fractures ◽

Definitive Treatment ◽

Open Tibial Fractures ◽

Ilizarov Fixator

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Maxillofacial Injuries Related to Road Traffic Accidents: A Five Year Multi Center Analysis

Craniomaxillofacial Trauma & Reconstruction Open ◽

10.1055/s-0039-1694708 ◽

2019 ◽

Vol 3 (1) ◽

pp. s-0039-1694708

Author(s):

Utsav Singh Gurung ◽

Gaurav Singh ◽

Madan Mishra ◽

Shubhamoy Mondal ◽

Amit Gaur

Keyword(s):

Traffic Accidents ◽

Road Traffic ◽

Bone Fractures ◽

Treatment Protocol ◽

Care Program ◽

Epidemiological Data ◽

Road Traffic Accidents ◽

Maxillofacial Injuries ◽

Chi Square ◽

Periodic Evaluation

The purpose of this study was to assess the epidemiological data on maxillofacial injuries related to road traffic accidents from two multispecialty medical centers in India, and then evaluate their incidence and pattern. Data were extracted from the medical records of all road traffic accident victims with maxillofacial injuries who reported to the centers between January 2013 and December 2017. Descriptive statistics and chi-square test were used for statistical analysis; significance was set at p < 0.05. Out of 1,110 patients, highest incidence of injuries was observed in the males of age group 20 to 29 years with mean age of 25.95 years (standard deviation, 9.35 years). Head injury, laceration, and tooth luxation were the most common forms of associated injuries. The use of protective helmets and seatbelts was extremely low which was associated to higher risk of facial bone fractures. Violation of traffic rules was the most common etiology behind these accidents. These findings were statistically significant ( p < 0.05). The ever increasing incidence of maxillofacial injuries related to road traffic accidents suggests the need to deal with them promptly and wisely. Keeping an update on the changing pattern of these injuries by continuous recording and periodic evaluation of epidemiological data is helpful in the primary prevention of trauma by evolving a better trauma care program and effective treatment protocol focused on the target groups. The updated data can guide treating physicians in anticipating and diagnosing maxillofacial injuries.

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Prevalence and Pattern of Road Traffic Accidents among Commercial Motorcyclists in the Central Tongu District, Ghana

The Scientific World JOURNAL ◽

10.1155/2020/9493718 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Kennedy Diema Konlan ◽

Abdul Razak Doat ◽

Iddrisu Mohammed ◽

Roberta Mensima Amoah ◽

Joel Afram Saah ◽

...

Keyword(s):

Traffic Accidents ◽

Road Traffic ◽

Head Injuries ◽

World Health Organisation ◽

Cross Sectional Study ◽

World Health ◽

Chi Square ◽

Cross Sectional ◽

Traffic Crashes ◽

Road Traffic Crashes

Background. The World Health Organisation estimates that 1.35 million people die as a result of road traffic crashes. Motorcycles as a means of transport are increasingly becoming the preferred and easiest means of transportation for most people in developing countries despite the associated risk. This study determined the prevalence and pattern of motorcycle crashes in Adidome among commercial motorcyclists. Methods. A descriptive, cross-sectional study design was used as 114 commercial motorcyclists were recruited to respond to a pretested research questionnaire in the Adidome district of the Volta Region. Data were analyzed using SPSS, version 22.0. Data were presented as simple descriptive statistics. A chi-square relationship was determined using the demographic variables, and the history of accident at a 95% confidence interval with 0.05 was considered as statistically significant. Results. The prevalence of road traffic crashes at Adidome was 64.0%. Motorcyclists (74.0%) were reported to have been involved in crashes in the past one year prior to the study. Motorcyclists attributed the last accident to excessive speeding (31.5%) and bad roads (23.3%), this accident as a result of colliding with another motorcycle (50.7%), and slippery surfaces (24.7%). The majority (63.0%) of the respondents had an accident once. The consumption of alcohol was associated with the occurrence of an accident as 34.2% occurred among cyclists who drank alcohol, compared with 29.8% who did not (p<0.05). Conclusion. There should be strict implementation of current road traffic regulations of Ghana by the MTTD of the Ghana Police Service, and penalties should be awarded against anybody caught riding a motorcycle under the influence of alcohol. Helmet and other protective devices must be made compulsory for motorcycle riders to prevent injuries, especially head injuries, if an accident occurs.

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Neurotrauma in Old Aged: A Study from India

Indian Journal of Neurosurgery ◽

10.1055/s-0037-1598092 ◽

2017 ◽

Vol 06 (01) ◽

pp. 004-009

Author(s):

Ashok Munivenkatappa ◽

Vineet Kumar ◽

Prashant Bhandarkar ◽

Nobhojit Roy ◽

Jyoti Kamble ◽

...

Keyword(s):

Ct Scan ◽

Traffic Accidents ◽

Brain Injuries ◽

Road Traffic ◽

Age Groups ◽

Indian Government ◽

Chi Square ◽

Aged Patients ◽

Significance Level ◽

Chi Square Test

Introduction Traumatic brain injury (TBI) is common in all the age groups. In India with increased life expectancy and more active old-aged population, basic details of neurotrauma in old aged are limited. The aim of the present study is to determine injury pattern and factors influencing outcome of the neurotrauma in old-aged patients, and also to contribute to national trauma data. Methods The study is based on prospective observational registry Towards Improved Trauma Care Outcomes (TITCO) database collected from four Indian government hospitals during October 1, 2013 to September 30, 2015. Data of neurotrauma patients aged 60 years or older were considered for analysis. SPSS version 24.0 was used for statistical analysis. The chi-square test was used for comparison of categorical data with significance level of p < 0.05. Results Old-aged patients contributed for 1,629 (10.2%) of total neurotrauma data. Men were 2.4 times higher than women, but mortality was almost same in both the sexes. Approximately 860 (53%) of injuries were due to falls and 490 (30%) due to road traffic accidents (RTA). Approximately 708 (44%) of subjects patients had moderate to severe brain injuries. Approximately 1,136 (70%) of patients required CT scan and 435 (27%) of patients underwent brain surgery. Approximately 588 (36%) of patients expired during study period. There was significant (p = 0.0001) difference between mortality of old-aged and productive age group (19–59 years). The deaths between the two groups differed significantly (p = 0.0001) among sex, injury cause, severity, requirement of CT scan, and surgery. Conclusion Our study highlights that geriatric TBI is a significant phenomenon and reflects our national data. Possible risk factors associated with deaths are identified in our population. More research is needed to develop specific management and preventive protocols.

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Study on the Impact of “Gerayo Amahoro Policy” on Road Traffic Accidents Reduction in Rwanda

Brilliant Engineering ◽

10.36937/ben.2022.4197 ◽

2021 ◽

Vol 3 (1) ◽

pp. 1-9

Author(s):

JEAN DE DIEU GATESI

Keyword(s):

Traffic Accidents ◽

Road Traffic ◽

Secondary Data ◽

Status Report ◽

Road Traffic Accidents ◽

Chi Square ◽

Road Traffic Crashes ◽

Global Status ◽

Inclusive Analysis ◽

The Impact

The global status report on road safety declared that the number of annual road traffic deaths has reached 1.35 million. In Rwanda, considering the raising number of vehicles in line with the economy growth and the above 48.90/000 ratio of deaths per registered vehicles; the lives of people are therefore increasingly exposed to road traffic crashes. This study therefore aims to utilize statistical methods for assessing the impact of Gerayo Amahoro policy on Road Traffic Accidents reduction in Rwanda and propose counter measures that could help the decision makers in minimizing the losses caused by Road Traffic Accidents. secondary data related to road traffic accidents have been collected by using questionnaire from Rwanda National Police with the study period from 2016 up to 2020 inclusive. Analysis was done by using graphics and chi-square methods in excel and SPSS software. The results indicated that GERAYO AMAHORO policy plays the greatest role in reduction of RTAs in Rwanda due to the number of RTAs happened before the implementation of GERAYO AMAHORO which was high as compared to the total number of RTAs after implementation of GERAYO AMAHORO policy. This research conclude that negligence, over speed, bad maneuver and over drunk are mostly causes and responsible for the occurrence of RTAs in Rwanda; indicated that Vehicle types mostly related to RTAs were moto-cycles, cars and 4 wheel vehicles and the mostly victims related to RTAs were moto-cyclists, passengers and pedestrians.

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A STUDY ON FRACTURE OF FEMUR SHAFT TREATMENT WITH INTRAMEDULLARY INTERLOCKING NAILING

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i12.2333 ◽

2021 ◽

Vol 5 (12) ◽

Author(s):

Ashok Meena ◽

D S Meena ◽

Narendra Saini ◽

Poonam Meena

Keyword(s):

Traffic Accidents ◽

Femoral Shaft Fracture ◽

Road Traffic ◽

Femoral Shaft ◽

Shaft Fracture ◽

Delayed Union ◽

Interlocking Nailing ◽

Shaft Fractures ◽

Femur Diaphysis ◽

Femur Shaft

Background: Rigid interlocking nailing for femoral shaft fracture is ideal for use in adolescents in terms of stability of the fracture and convenience for the patient. Closed reduction and intramedullary interlocking nailing is the surgical treatment of choice for the closed shaft fractures of femur. Present study conducted to study the principles of intramedullary interlocking nailing and to assess the outcome of the patient. Methods: The present study comprises of 30 cases of fracture shaft of the femur in adults about >20 years old. All the fractures, which were included in the study were traumatic in origin, most of them are due to road traffic accidents. Results: The delayed union rate in our series was 6.67%. There were no non-unions. Conclusions: It is concluded that closed intramedullary interlocking nailing method given good result in treatment of shaft fractures of femur. Keywords: Intramedullary nailing, Femur, Diaphysis fractures, Interlocking

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Surgical management of proximal tibial fractures with locking compression plate

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20172549 ◽

2017 ◽

Vol 3 (4) ◽

pp. 756

Author(s):

Girisha B. A. ◽

Rajesh P. ◽

Satish Kumar C. ◽

Muralidhar N.

Keyword(s):

Knee Joint ◽

Road Traffic ◽

Plate Osteosynthesis ◽

Weight Bearing ◽

Locking Compression Plate ◽

The Body ◽

Tibial Fractures ◽

Minimally Invasive Plate Osteosynthesis ◽

Proximal Tibial Fractures ◽

Compression Plate

Background: Incidence of proximal tibial fractures is increasing due to increasing incidence of road traffic accidents (RTA). Knee joint being one of the major weight bearing joint of the body, appropriate management of fracture around it will be of paramount importance in maintaining mobility. The recent development of locking compression plate (LCP) has revolutionized the treatment of proximal tibial fractures by overcoming the few drawbacks of conventional buttress plate.Methods: We studied 30 patients involving proximal tibial fracture manged using LCP [23 patients with minimally invasive plate osteosynthesis, (MIPO) technique and 7 patients with Open reduction and internal fixation (ORIF) technique]. We followed up all the patients until complete union of fractures.Results: The average time for union of fracture was 14 weeks (range: 12-24 weeks). Overall 96.7% patients had acceptable outcome (70% excellent and 26.7% good). Patients treated with MIPO technique healed earlier and more frequently had excellent results than those treated with ORIF. A total of four patients had complications (knee joint stiffness in 1, postoperative loss of reduction in 1, infection in 1 and knee instability in 1). Conclusions: Locking compression plate system acts as a good biological fixation for proximal tibial fractures even in difficult fracture situations. MIPO technique offers faster healing and better outcome than ORIF in patients with proximal tibial fractures.

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