Immediate Open Reduction and Internal Fixation in Open Ankle Fractures

2006 ◽  
Vol 96 (2) ◽  
pp. 120-124 ◽  
Author(s):  
Deepak Joshi ◽  
Davindar Singh ◽  
Juned Ansari ◽  
Yadu Lal
Keyword(s):  
Internal Fixation ◽  
Early Mobilization ◽  
Functional Results ◽  
Ankle Fractures ◽  
Anatomical Reduction ◽  
Ankle Stiffness ◽  
Loss Of Reduction ◽  
Superficial Skin ◽  
Grade Ii ◽  
Stable Internal Fixation

In this prospective study, 30 patients (28 men and 2 women) with open ankle fractures were treated with early debridement and immediate stable internal fixation after anatomical reduction to achieve better functional results after early mobilization. The procedure was performed an average of 8 hours (range, 6–15 hours) after injury. According to the classification system of Gustilo and Anderson, 11 fractures (37%) were grade I, 12 (40%) were grade II, 5 (17%) were grade IIIA, and 2 (7%) were grade IIIB. Six complications occurred: four patients had superficial skin necrosis and two had loss of reduction, resulting in residual ankle stiffness. Twenty patients had excellent results, eight had good results, and two had fair results according to the modified criteria of Ketenjian and Shelton. We found that immediate debridement, anatomical reduction, and internal fixation of open ankle fractures leads to better functional results, especially in grade I and grade II injuries. (J Am Podiatr Med Assoc 96(2): 120–124, 2006)

scholarly journals Operative management of tibial plateau fractures: an assessment of functional and radiological outcomes with Rasmusssens scoring system

2017 ◽  
Vol 3 (6) ◽  
pp. 1092
Author(s):  
Yeshwanth Subash ◽  
Ilavarasan M. Dhamu ◽  
Jagadeesh B. ◽  
Preethi N. ◽  
Manoj Jayaram ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Bone Grafting ◽  
Scoring System ◽  
Tibial Plateau ◽  
Articular Surface ◽  
Weight Bearing ◽  
Early Mobilization ◽  
Functional Results ◽  
Tibial Plateau Fractures ◽  
Stable Internal Fixation

<p class="abstract"><strong>Background:</strong> Fractures of the proximal tibia involve a major weight bearing joint and are intra-articular injuries which frequently result in functional impairment. They require an accurate reduction of the articular surface with stable internal fixation. If these fractures are not managed appropriately, they often result in high rates of morbidity in the form of knee stiffness and arthritis. This study was done to assess the functional and radiological outcomes following various surgical modalities and to compare them with other studies as available in literature.</p><p class="abstract"><strong>Methods:</strong> 30 patients with tibial plateau fractures treated by various surgical modalities at Saveetha Medical College and Hospital were studied from January 2013 to February 2015 and were followed up for a minimum period of 6 months. Functional and radiological outcomes were assessed by the Rasmussens scoring system.<strong></strong></p><p class="abstract"><strong>Results:</strong> All 30 patients fulfilling the inclusion criteria were thoroughly evaluated and were taken up for surgery with various modalities of fixation which included cannulated cancellous screws, T and L buttress plates and locking compression plates. Articular surface elevation with bone grafting was done in depressed fractures. Early knee mobilization was started and strict non-weight bearing walking was advocated. We had a 90% acceptable functional result which was comparable with other studies.</p><p><strong>Conclusions:</strong> In our study, we conclude that accurate reduction of the articular surface with stable internal fixation and early mobilization with bone grafting in depressed fractures with protracted weight bearing till fracture union gives good functional results. Also radiological values often do not often correlate well with functional outcomes. </p>

Juvenile fracture of tillaux. A distal tibial epiphyseal fracture

1989 ◽  
Vol 79 (6) ◽  
pp. 295-299 ◽  
Author(s):  
WH Simon ◽  
R Floros ◽  
H Schoenhaus ◽  
RM Jay
Keyword(s):  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Skeletal Maturity ◽  
Functional Results ◽  
Anatomical Reduction ◽  
Fracture Fragment ◽  
Reduction Techniques ◽  
Tibial Epiphysis ◽  
Tillaux Fracture

The juvenile fracture of Tillaux is a Salter-Harris type III fracture of the distal tibial epiphysis. The mechanism of injury is an external rotational force of the foot. The fracture fragment is avulsed from the anterolateral aspect of the distal tibial epiphysis by the anteroinferior tibiofibular ligament. Treatment is based on the amount of displacement after closed reduction techniques are attempted. If complete anatomical reduction cannot be obtained, the authors recommend open reduction with internal fixation. The method of internal fixation should be based on the skeletal maturity of the distal tibial epiphysis. The prognosis usually is good if anatomical reduction is performed. The most serious complication reported is pain and stiffness secondary to articular incongruity following inadequate closed reduction techniques. The case of a 14-year-old girl with a juvenile Tillaux fracture treated by open reduction with excellent functional results at 11 months follow-up was presented.

Distal Tibial Articular Fractures in Racing Greyhounds: A Review of Six Cases

1993 ◽  
Vol 06 (03) ◽  
pp. 146-152 ◽  
Author(s):  
J. F. Dee ◽  
R. Weiss ◽  
P. M. Montavon
Keyword(s):  
Conservative Treatment ◽  
Internal Fixation ◽  
Functional Results ◽  
Tibial Fractures ◽  
Anatomical Reduction ◽  
Distal Tibial Fractures ◽  
Rigid Internal Fixation ◽  
Articular Fractures ◽  
Fracture Patterns ◽  
Methods Of Treatment

SummarySix spontaneously occurring distal tibial fractures extending into the posterior articular margin of young racing greyhounds were reviewed. Concomitant fractures of both malleoli occurred in three cases. Fracture patterns, methods of treatment and functional results were determined. Open anatomical reduction and rigid internal fixation promoted healing with minimal osseous reaction and showed better results than conservative treatment. Complications adversely affecting the outcome were periarticular deformity and osteoarthritis, these were observed as early as five to seven weeks following the operations.Six spontaneously occurring distal tibial fractures extending into the posterior articular margin of young racing greyhounds were reviewed. Fracture patterns, methods of treatment and functional results were determined.

scholarly journals Plating as an operative management of intra articular fractures of the upper end of tibia: a prospective clinical study

2017 ◽  
Vol 3 (6) ◽  
pp. 1223
Author(s):  
Namdev Gorgile ◽  
Vinod Jagtap ◽  
Yash Shah ◽  
Vikas Rokade ◽  
Girish Bartakke
Keyword(s):  
Internal Fixation ◽  
Tibial Plateau ◽  
High Energy ◽  
Early Mobilisation ◽  
Anatomical Reduction ◽  
Plating Technique ◽  
Knee Stiffness ◽  
Articular Fractures ◽  
Buttress Plate ◽  
Stable Internal Fixation

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Tibial plateau fracture management is challenging because of the severe displacement of the bony fragments, the concomitant depression and impaction of the cancellous subchondral bone, and the inevitable associated cartilage injury.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A prospective cohort study of 25 patients who suffered high energy intra-articular fractures of proximal tibia was done and they were diagnosed and classified according to Schatzker’s classification. The study was done to study the outcomes of surgical management of high energy tibial plateau fractures with buttress plate, to achieve anatomical reduction and absolute stable internal fixation to prevent malunion, to achieve early mobilisation, to prevent post-operative knee stiffness and also to determine timing of operation after trauma and sequence of fixation of bicondylar fractures. All patients were treated with open reduction and internal fixation with a buttress plate either a lateral, medial or bicondylar plating</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Average radio-graphic bony union time was 12 weeks. Average full weight bearing time was 13 weeks. Knee stiffness improved with physiotherapy and full range was achieved on an average in 8 weeks, mean range of movement 0-124.5º was achieved. 4 patients (16%) developed infection. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Fractures of upper end of tibia can be treated with the plating technique, to achieve anatomical reduction and stable internal fixation with 82% good functional outcome. The plating technique facilitates early mobilisation of injured joint and attains good range of movements. Minimal mal reduction does not seem to vitiate the results. The infection rate of 16% is of concern with this procedure, but responds well to antibiotics and surgical debridement.</span></p>

scholarly journals COMPARATIVE STUDY OF RESULTS OF FRACTURE DISTAL THIRD FEMUR TREATED WITH VARIOUS OPERATIVE MODALITIES

2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Mithlesh Kumar Meena ◽  
Yogesh Kumar Gautam ◽  
Lokesh Jangir ◽  
Utsav C Shetty
Keyword(s):  
Internal Fixation ◽  
Distal Femur ◽  
Dynamic Compression ◽  
Femoral Fractures ◽  
Early Mobilization ◽  
Functional Results ◽  
Tertiary Hospital ◽  
Rigid Fixation ◽  
Surgical Methods ◽  
The Right

Distal femoral fractures are difficult to treat and ideal treatment of such fractures will include anatomical reduction, rigid fixation of articular surfaces and early mobilization of knee joint. The purpose of the study is to evaluate the end results of surgical management of fracture of distal end of femur using various surgical modalities and analyze the complications and the causes of fractures. Materials and methods: A Retrospective Study of 75 patients were evaluated from tertiary hospital for a period of july 2007 to July 2009. There were 75 fractures in 75 patients involving the distal femur, which were treated  surgically by internal fixation using various surgical modalities. Results: At the end of study, the cases were followed up for an average period of 15.6 months and functional results were evaluated using modified Schatzker and Lambert (1982) criteria. 36 cases were fixed with Supra Condylar nail ( SC nail), 20 cases were fixed with dynamic Condylar screw(DCS), 6 cases were fixed with Dynamic Compression Plate(DCP), 6 cases were fixed with Cancellous Screw, 4 cases were fixed with Enders Nail, 3 cases were fixed with Ext. Fixator Conclusion; Fractures of distal femur can be very effectively treated by surgical methods. The satisfactory osteosynthesis of fractures and stable osteosynthesis is achieved by the right approach and correct surgical technique. Keywords: distal femur fracture, internal fixation, dynamic condylar screws, supracondylar femur nail

scholarly journals Surgical treatment of displaced acetabular fractures

2011 ◽  
Vol 139 (7-8) ◽  
pp. 496-500 ◽  
Author(s):  
Sasa Milenkovic ◽  
Jordan Saveski ◽  
Mile Radenkovic ◽  
Goran Vidic ◽  
Neda Trajkovska
Keyword(s):  
Surgical Treatment ◽  
Internal Fixation ◽  
Open Reduction ◽  
Pelvic Ring ◽  
Articular Surface ◽  
High Energy ◽  
Acetabular Fractures ◽  
Anatomical Reduction ◽  
Severe Injuries ◽  
Stable Internal Fixation

Introduction. Acetabular fractures are severe injuries, generally caused by high-energy trauma, most frequently from traffic accidents or falls from heights. Fractures of the extremities, head injuries, chest, abdomen and pelvic ring injuries are most commonly associated injuries. Objective. The purpose of this study was to evaluate the results of open reduction and internal fixation of acetabular fractures. The open anatomical reduction of the articular surface combined with a rigid internal fixation and early mobilisation have become the standard treatment of these injuries. Methods. We conducted a retrospective analysis of 22 patients of average age 43.13 years. The patients were treated by open reduction and internal fixation at the Orthopaedic Clinic of Nis from 2005-2009. The follow-up was 12 to 60 months, with the average of 21.18 months after surgery. Results. All injured patients were operated on between 4 and 11 days (5.7 days on the average). According to the classification by Judet and Letournel, 15 (68.18%) patients had an elementary acetabular fracture, whereas 7 (31.82%) patients had associated fracture. A satisfactory postoperative reduction implying less than 2 mm of displacement was achieved in 19 (86.36%) patients. The radiological status of the hip joint, determined according to Matta score, was excellent in 15 (68.18%) patients, good in 4 (18.18%) patients and moderate in 3 (13.63%) patients. According to Merle d?Aubign? Scale, the final functional results of the treatment of all operated patients were excellent in 12 (54.54%) patients, good in 7 (31.81%) patients and moderate in 3 (13.63%) patients. Conclusion. Surgical treatment of dislocated acetabular fractures requires an open reduction and a stable internal fixation. Excellent and good results can be expected only if anatomical reduction and stable internal fixation are achieved.

Prosthetic Replacement of the Scaphoid Proximal Pole: Should It Be the Future?

Hand ◽  
2020 ◽  
pp. 155894472097412
Author(s):  
Matteo Ferrero ◽  
Enrico Carità ◽  
Francesco Giacalone ◽  
Julien Teodori ◽  
Alberto Donadelli ◽  
...  
Keyword(s):  
Avascular Necrosis ◽  
Early Mobilization ◽  
Functional Results ◽  
Good Alternative ◽  
Proximal Row Carpectomy ◽  
Proximal Pole ◽  
Subjective Outcomes ◽  
Clinical Worsening ◽  
Pyrocarbon Implant ◽  
Over Time

Background Scaphoid proximal pole fractures with avascular necrosis represent a complex surgical problem. Many reconstruction techniques are based on osteosynthesis with a vascularized or nonvascularized bone graft. These procedures do not allow early mobilization and therefore sometimes lead to unsatisfying functional results. In some cases, it is possible to perform a scaphoid hemiarthroplasty using a pyrocarbon implant (adaptive proximal scaphoid implant [APSI]) in place of the necrotic proximal pole, allowing an early mobilization and delaying palliative treatments such as 4-corner arthrodesis or proximal row carpectomy. Methods In this study, we reviewed all patients who had undergone a scaphoid hemiarthroplasty using APSI in our institutions from 1999 to 2017; the F.U. was performed through radiographic, clinical, and subjective (Disabilities of the Arm, Shoulder, and Hand) analysis. Results The performances of scaphoid proximal pole implants are encouraging; radiographic, clinical, and subjective outcomes were good, and the functional recovery proved to be fast and reliable over time. Conclusions This study reports our experience in the use of APSI implants, which proved to be a good alternative to traditional techniques for treating avascular necrosis of the proximal pole, still allowing further surgical steps in case of clinical worsening over time (wrist osteoarthritis). These patients are usually young and present high functional demands. Our experience is promising, but we believe that further evaluation over time will be needed.

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