Clinical Outcome of Percutaneous Intramedullary Fixation for Midshaft Clavicular Fractures Using Elastic Stable Nails

2021 ◽  
Vol 23 (1) ◽  
pp. 15-20
Author(s):  
Ahmed Genena ◽  
Amr Abouelela ◽  
Ramy Mohamed ◽  
Ahmed Nagi
Keyword(s):  
Clavicle Fracture ◽  
Skin Irritation ◽  
Elastic Stable Intramedullary Nailing ◽  
Common Complication ◽  
Intramedullary Nails ◽  
Final Score ◽  
The Mean ◽  
Dorsolateral Cortex ◽  
Shoulder Score

Background. This study investigated the clinical outcomes of fixation of displaced middle-third clavicular fractures using percutaneous elastic stable intramedullary nails. Material and methods. This study included sixty patients with a mean age of 26.40 ± 8.91 years (16-53 years) presented with a displaced middle third fracture of the clavicle. According to the Robinson classification, 48 cases (80%) were type 2B1, 9 cases (15%) type 2B2 and 3 case (5%) 2A1. All cases were treated by elastic intramedullary nails and followed up for at least 12 months. Results. At the end of the twelve months’ follow-up period, the mean Constant Shoulder score was 95.70 ± 13.55, ranging from 48 to 100. 54 patients (90%) had excellent results, 3 patients (5%) had an adequate result and 3 patients (5%) had a poor result. There was a statistically significant relationship between the final score and age and associated medical conditions. Conclusions. 1. Elastic Stable Intramedullary Nailing is an image-dependent procedure indicated best for young medically free athletes with simple 2-part middle third clavicle fracture. 2. Hammering is not recommended to avoid dorsolateral cortex perforation. 3. The most common complication is medial skin irritation because of the subcutaneous position of the clavicle as well as the sharp end of the cut nail.

mocowanie implantu, zrost kostny, polyetheretherketone (PEEK), powłoka tytanowa

2020 ◽  
Vol 22 (4) ◽  
pp. 223-232
Author(s):  
Amr Abouelela ◽  
Islam Mubark ◽  
Ahmed Nagi ◽  
Ahmed Genena
Keyword(s):  
Functional Outcomes ◽  
Proximal Humerus ◽  
Radial Nerve Palsy ◽  
Superficial Infection ◽  
Significant Difference ◽  
Operative Complications ◽  
Final Score ◽  
Humerus Fractures ◽  
The Mean ◽  
Shoulder Score

Background. This study examined the clinical outcomes of fixation of displaced fractures of the proximal humerus using a trans-deltoid approach. Material and methods. Twenty patients (13 male and 7 female) were treated with this technique, with a mean age of the patients of 38.85 years (range, 19 to 64 years). All patients were followed up for at least twelve months and were evaluated according to the Constant shoulder score. Results. The mean Constant Shoulder score was 87.45, ranging from 63 to 100. Ten patients (50%) had excellent results, four patients (20%) had good results, three patients (15%) had satisfactory results, and three had adequate results (15%). There was a statistically significant difference between the type of the fracture and the final score (p=0.013), where 3-part fractures with impaction (11-B1), either valgus or varus impaction, showed higher scores than those without impaction. Four patients presented with post-operative complications varying from superficial infection to radial nerve palsy. Conclusions. 1. The trans-deltoid approach was a safe and reliable alternative to the delta-pectoral approach for the treatment of displaced proximal humerus fractures. 2. The impacted (11-B1) fracture type was a signifi­cant contributing factor in terms of good functional outcomes.

scholarly journals Seven-year survival analysis of the Global® CAP® (Conservative Anatomic Prosthesis) shoulder resurfacing

2017 ◽  
Vol 10 (2) ◽  
pp. 87-92
Author(s):  
Helen Ingoe ◽  
Philip Holland ◽  
Emma Tindall ◽  
Raymond Liow ◽  
James L Mcvie ◽  
...  
Keyword(s):  
Survival Analysis ◽  
Confidence Interval ◽  
Medium Term ◽  
Survival Analyses ◽  
Oxford Shoulder Score ◽  
The Mean ◽  
Shoulder Arthroplasties ◽  
Quick Dash ◽  
Shoulder Score

Background Shoulder resurfacings represent approximately one-third of shoulder arthroplasties and have the highest revision rates of any shoulder arthroplasty. We present a survival analysis of the Global CAP hemi-resurfacing implanted by multiple surgeons with up to 10 years of follow-up. Methods A life-table survival analysis of the Global CAP hemi-resurfacing was undertaken in a single site with multiple surgeons. Two survival analyses were performed; first, where failure was defined as component exchange and, second, where failure was defined as re-operation for any reason. Postoperative functional outcome was quantified using the Quick Disability Arm Hand and Shoulder Score (Quick DASH) and Oxford Shoulder Score (OSS). Results Eighty-seven Global CAPs were implanted in 75 patients. At a mean (SD) follow-up of 5.4 years (2.5 years) (range 0.9 years to 10 years), five patients had revision surgery and three patients underwent a reoperation for any reason. Survival at year 7 with component exchange as the endpoint was 80% (95% confidence interval = 93 to 65) and survival with re-operation for any reason as the end point was 62% (95% confidence interval = 82 to 50). The mean OSS and Quick DASH were 35 and 27.6, respectively. Conclusions The Global CAP has similar survivorship in the short to medium term and produces similar clinical outcomes compared to other shoulder resurfacings.

A PROSPECTIVE STUDY OF FUNCTIONAL OUTCOME OF CLOSED DISPLACED MID- SHAFT CLAVICLE FRACTURES TREATED WITH INTRAMEDULLARY TITANIUM ELASTIC NAIL SYSTEM

2021 ◽  
pp. 81-83
Author(s):  
S. Kishore Babu ◽  
Pamu Bala Avinash ◽  
S. Rajeswara Rao
Keyword(s):  
Minimally Invasive ◽  
Clavicle Fracture ◽  
Invasive Procedure ◽  
Routine Work ◽  
Elastic Nail ◽  
Clavicle Fractures ◽  
The Mean ◽  
Average Size ◽  
A Prospective Study

Background: Clavicle fracturesare common injuries in young individuals, mostly related to sports and road trafc accidents. In contrast, in children and elderly, they are related to falls, and account for approximately 2.6% of all fractures. A middle-third shaft clavicle fracture is the most common site( 80% of all clavicle fractures). Methodology: A study was carried out in 30 patients with simple middle third clavicular fractures who weretreated with closed intra-medullary xation with TENS nailing. Postoperatively range ofmovements,ability to get back to routine work were assessed and noted. Results :At the end of the study, 30 patients in the follow-up group with 21 male and 9 femalepatients taken. The mean age was 34.9 years noted. The mean time intervalbetween injury and surgery was 3.55 days (range 1–6 days). For all the patients the clinical andradiological union achieved at a mean of 8.6 weeks (Range, 6-12 weeks). seventeen out of the 30 patients had closednailing while thirteen patients (43%) required open reduction of their fracture. The average size of theexible titanium nail used was 2.5 mm (range, 2 - 3mm). Conclusion :The present study advise the use of minimally invasive antegradetitanium elastic nail for xation of displaced midshaft clavicle fractures as a safe minimally invasive procedure.

Arterial Complications of Thoracic Outlet Syndrome

2009 ◽  
Vol 75 (3) ◽  
pp. 235-239 ◽  
Author(s):  
Lazar B. Davidović ◽  
Igor B. Končar ◽  
Siniša D. Pejkić ◽  
Ilija B. Kuzmanović
Keyword(s):  
Subclavian Artery ◽  
Complete Resolution ◽  
Thoracic Outlet Syndrome ◽  
Clavicle Fracture ◽  
Distal Embolization ◽  
Cervical Rib ◽  
First Rib ◽  
Arterial Complications ◽  
The Mean

Arterial complications of thoracic outlet compression have serious potential implications; however, these complications rarely appear. Between 1990 and 2006, prospectively collected data on 27 patients with arterial complications of thoracic outlet syndrome were analyzed. The causes of arterial compression were cervical rib (20 [74.1%]), abnormalities of the first thoracic rib (three [11.1%]), soft tissue anomalies (two [7.4%]), and hypertrophic callus after clavicle fracture (two [7.4%]). In all cases, a combined supraclavicular and infraclavicular approach was used. Decompression was achieved by cervical rib excision in 13 (48.1%) patients, combined cervical and first rib excision in seven (26%), and first rib excision in six (22.2%). Associated vascular procedures included resection and replacement of the subclavian artery (26 [97.3%]), one subclavian–axillary and one axillary–brachial bypass as well as 17 (63%) brachial embolectomies. The mean follow-up period was 7 years 4 months (range, 1-16 years). Two pleural entries, two transient brachial plexus injuries, and one subclavian artery rethrombosis were found. Complete resolution of symptoms with a return to full activity was noted in all cases. In surgical treatment, a combined anterior supraclavicular and infraclavicular approach is recommended as well as transbrachial embolectomy in all cases with symptoms of distal embolization.

Risk factors affecting the development of nephrocalcinosis, the most common complication of hypophosphatemic rickets

2015 ◽  
Vol 28 (11-12) ◽  
Author(s):  
Melikşah Keskin ◽  
Şenay Savaş-Erdeve ◽  
Elif Sağsak ◽  
Semra Çetinkaya ◽  
Zehra Aycan
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Significant Relationship ◽  
Combined Treatment ◽  
Hypophosphatemic Rickets ◽  
Common Complication ◽  
Factors Affecting ◽  
Significant Difference ◽  
The Mean

AbstractThe aim of the present study was to analyse the effects of combined treatment with calcitriol and phosphate, to find out the incidence of the nephrocalcinosis, and to elucidate the risk factor of nephrocalcinosis in patients with hypophosphatemic rickets. We followed six patients. The median age at diagnosis was 3.25 (0.75–10.5) years. The median follow-up duration was 8.25 (3.5–12.5) years. The mean dose of calcitriol and phosphate treatments was 39.1±8 ng/kg/day, 90.5±57.1 mg/kg/day, respectively. Nephrocalcinosis was detected in three patients (50%). The mean dose of phosphate taken by the patients found to have nephrocalcinosis was detected to be high with a statistically significant difference (p=0.041). No significant relationship was found the mean dose of calcitriol. We found no relationship between the development of nephrocalcinosis and the incidence of hypercalciuria or hypercalcemia episodes. We found the increased phosphate dose administered for treatment to play a role in nephrocalcinosis development.

scholarly journals Arthroscopic Bankart Repair after Anterior Traumatic Shoulder Dislocation in Workers

2018 ◽  
Vol 6 (12_suppl5) ◽  
pp. 2325967118S0020
Author(s):  
Agustín Guala ◽  
Pedro Rial ◽  
Luciano Mendoza ◽  
Walter RIal ◽  
Lucas Perezlindo ◽  
...  
Keyword(s):  
Return To Work ◽  
Shoulder Dislocation ◽  
High Rate ◽  
Bankart Repair ◽  
Anterior Dislocation ◽  
Arthroscopic Bankart Repair ◽  
Previous Level ◽  
The Mean ◽  
Shoulder Score

Objectives: The objective of this study was to evaluate clinical results in workers after Arthroscopic Bankart repair for traumatic unidirectional shoulder dislocation. Methods: A total of 45 patients (42 male- 3 female) meet the inclusion criteria: traumatic anterior dislocation, workers´ compensation patient, minimum of 2 years follow-up and exclusion criteria: bony Bankart >25%, engaging Hill Sachs, previous surgery, rotator cuff injury. Number of dislocations were 1 in 35 patients, 2 in 7 patients and 3 in 3 patients. Artroscopic Bankart repair was performed by a single surgeon. UCLA shoulder Score and ROWE score for shoulder instability were scored for clinical assessment. The mean follow up was 64 (SD+- 21.6) month with a mean age of 30 (SD+-10) years. Type of work and workload was recorded according to Canadian classification and dictionary of occupations. Time to return to work was also recorded. Statistical analysis was performed at the center for biostatistics at Facultad de Ciencias Medicas, Universidad Nacional del Litoral using SPSS 23.0-IBM. Results: The mean UCLA Shoulder Score was 33 (SD+-2) and ROWE Score 95 (SD +-7), none of the patients presented recurrent dislocation at the time of follow up. Time to return to work was mean 123 days (+-60 SD) of whom 52% were heavy workers, 39% medium and 9% light workers. All patients except one could return to his previous level of work. Pearsons bi variate correlation coefficient between days to return to work between heavy and medium/light workers was not significative (p>0,05) but in heavy workers return to work take more days than in medium/light workers. Age and return to work with 35 years as a cut point was not significative either. Conclusion: Workers treated with Arthroscopic Bankart repair after traumatic unilateral dislocation, presents good results and high rate of return to work at the previous level.

scholarly journals Clinical outcomes of doubled-suture Nice knot augmented plate fixation in the treatment of comminuted midshaft clavicle fracture

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Gui Wu ◽  
Yao-qing Chen ◽  
Chun-yong Chen ◽  
Zhang-xiong Lin ◽  
Qi-yang Xie ◽  
...  
Keyword(s):  
Average Length ◽  
Plate Fixation ◽  
Demographic Data ◽  
Clavicle Fracture ◽  
Bone Fragments ◽  
Comminuted Fractures ◽  
Clavicle Fractures ◽  
The Mean ◽  
The Stability

Abstract Background Free bone fragments were difficult to be fixed in many comminuted midshaft clavicle fractures, and the absence of cortical alignment in comminuted fractures had direct influence on the stability of fixation. This survey was performed to assess the efficacy of doubled-suture Nice knot augmented plate fixation in the treatment of comminuted midshaft clavicle fractures. Methods Between 2013 and 2018, all patients with comminuted midshaft clavicle fractures treated with doubled-suture Nice knot augmented plate fixation were retrospectively reviewed and included in this research. Demographic data of the patients, characteristics of the fractures, intraoperative parameters and follow-up data of the patients were evaluated and summarized. Results A total of 56 patients were included in this study. The mean follow-up time was 25.6 months (range, 12–60 months). The number of male patients was 38 (67.9 %) and of the female patients was 18 (32.1 %). The average age of all patients was 47.89 ± 16.5 years. The mean time of surgery was 85.6 ± 24.0 min. The average length of incision was 9.2 ± 1.9 cm. The number of doubled-suture Nice knot applied ranged from 1 to 5 knots. All the patients reached bone union after the treatment. There was no implant failure or neurovascular injury observed. And most of the patients showed good functional outcome. Conclusions The doubled-suture Nice knot could provide reliable fixation for small bone fragments in comminuted clavicle fractures. Combination of the doubled-suture Nice knot and plate screws fixation was a safe and effective method in comminuted midshaft clavicle fractures treatment.

Analysis of Fracture Midshaft Clavicle Treated by Intramedullary Device Versus Conservative

2021 ◽  
Vol 12 (4) ◽  
pp. 2615-2629
Author(s):  
Swapnil Date ◽  
Kiran Saoji ◽  
Kushal Surana
Keyword(s):  
Clavicle Fracture ◽  
Time Interval ◽  
Dash Score ◽  
Female Ratio ◽  
Conservative Group ◽  
Intramedullary Device ◽  
Male Female Ratio ◽  
Clinical And Radiological Outcome ◽  
The Mean

Clavicle fractures account for about 2.6 to 4 % of all fractures. The best method to treat the displaced midshaft fracture of the clavicle remains a topic of debate. Although there is a large number of studies published about this topic, it is still relatively unknown as to which modality provides better long term functional outcomes and low complications rates. In our study, we have analyzed midshaft clavicle fracture treated with intramedullary device versus conservatively in terms of clinical, functional and radiological outcomes. The mean age of the patients in our study was 35.766 years. Male: Female ratio was 5.0:1.0.  The mean time interval between injury and intervention was 2.1 days. Out of 30 patients, 11 patients (36.666%) had left sided fractures, while 19 patients (63.333%) had right sided fractures. Out of 30 patients, 12 patients (40%) had type 2B1 fracture according to Robinson's classification, followed by type 11 patients (36.666%) type 2B2, 6 patients (20%) type 2A1 and 1 patient (3.333%) type 2A2 fracture. Inoperative group, the mean Constant and Murley score before the intervention, at 1 month follow up, 3 months follow up and at 6 months follow up were 47.46, 76.73, 82.8 and 90.73, while in a conservative group, it was 47.53, 71.66, 79.2 and 89.46 respectively. Inoperative group, the mean Q-DASH score before the intervention, at 1 month follow up, 3 months follow up and at 6 months follow up were 29.33, 19.33, 16.86 and 13.8, while in a conservative group, it was 31.266, 22.533, 18.8 and 15.66 respectively. The final outcome, on the basis of the final Constant and Murley score in 13 patients (43.33%), was excellent, 11 patients (36.66%) was good and 6 patients (20%) was fair. Inoperative group, complications were seen in 6 patients (40%), while in the conservative group, complications were seen in 10 patients (66.66%). Thus, the functional, clinical and radiological outcome of the patients managed surgically with an intramedullary device was significantly better when compared with patients treated conservatively.

scholarly journals TREATMENT OF MIDSHAFT CLAVICLE FRACTURE WITH SUPERIOR PLATE PLACEMENT

2020 ◽  
Vol 28 (2) ◽  
pp. 88-91
Author(s):  
BEKIR ERAY KILINC ◽  
YUNUS OC ◽  
RAMAZAN ERDEN ERTURER
Keyword(s):  
Constant Score ◽  
Clavicle Fracture ◽  
Controlled Study ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Superior Surface ◽  
The Mean ◽  
Clinical And Radiological Results ◽  
Anterior Posterior

ABSTRACT Objective: To evaluate the late clinical and radiological results of patients had locking plate anatomically compatible from superior surface and muscle cover on plate due to clavicle mid-region. Materials and Methods: Forty patients were included retrospectively. Patients had a routine right shoulder anterior posterior graph after examination. The results were assessed by returning to the patient's daily activities, Constant score, the Disability of the Arm, and Shoulder and Hand scoring, followed by radiological and clinical examination. Results: Fourteen (35%) patients were female and 26 (65%) were male. The mean age was 36.2 years. Twenty-six patients had right clavicle fracture and 14 patients had left. Twenty-three fractures were type 2B1 and 17 fractures were type 2B2. Mean follow-up time was 36.4 months. Radiologic union was at a mean of 9.1 ± 1.3 weeks. All patients had excellent results. The mean Constant score was 97.2 ± 1.8, the mean Disability of the Arm, and Shoulder and Hand score was 3.8 ± 2.4. Conclusion: It is possible to obtain complete union with high patient satisfaction by avoiding the complications and difficulties of the conservative treatment with the use of the anatomically compatible locking plates in superior fixation and our surgical dissection. Level of Evidence III, Retrospective Case controlled study.

scholarly journals Arthroscopic Management of Scapulothoracic Bursitis: Clinical Outcomes and Assessment of Novel Bony Parameters on Magnetic Resonance Imaging

2021 ◽  
Vol 9 (4) ◽  
pp. 232596712199827
Author(s):  
Gerald Joseph Zeng ◽  
Ken Lee Puah ◽  
Ying Hao ◽  
Denny Tjiauw Tjoen Lie
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Clinical Outcomes ◽  
Rating Scale ◽  
Resonance Imaging ◽  
Arthroscopic Management ◽  
Scapulothoracic Bursitis ◽  
The Mean ◽  
Shoulder Score

Background: Scapulothoracic bursitis is a significant clinical condition that limits day-to-day function. Arthroscopic scapular debridement and resection have provided satisfactory outcomes; however, techniques, approaches, and recommendations remain varied. Novel bony parameters have also gained increasing interest owing to their value in preoperative planning. Purpose: To assess midterm clinical outcomes after the arthroscopic management of scapulothoracic bursitis and to identify and measure novel bony parameters on preoperative magnetic resonance imaging. Study Design: Case series; Level of evidence, 4. Methods: A total of 8 patients underwent arthroscopic scapular debridement and bursectomy; 5 of the 8 patients underwent additional medial scapulectomy. There were 5 male (62.5%) and 3 female (37.5%) patients with a mean age of 30.1 ± 12.3 years (range, 19-58 years). Inclusion criteria for surgery were patients with symptomatic scapulothoracic bursitis for whom extensive nonoperative modalities had been utilized for at least 6 months but failed. Outcome measures included the Oxford Shoulder Score (OSS), University of California Los Angeles (UCLA) shoulder rating scale, Constant Shoulder Score (CSS), and visual analog scale (VAS) for pain. The bony parameters included scapular shape, anterior offset, costomedial angle, and medial scapular corpus angle (MSCA). Results: The follow-up duration was at least 2 years for all patients (mean follow-up, 25.0 ± 4.1 months [range, 24-35 months]). The majority of patients had a concave-shaped scapula (62.5%). The mean anterior offset was 24.3 ± 3.4 mm, and the mean costomedial angle was 132.3° ± 9.6°. Half the patients had a positive MSCA, while the other half had a negative MSCA. A statistically significant improvement was observed in the OSS, UCLA, CSS, and VAS scores from preoperatively to 2-year follow-up ( P < .001 for all). No complications were observed. Conclusion: Arthroscopic scapular debridement and resection provided satisfactory midterm clinical outcomes for the treatment of scapulothoracic bursitis.

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