Plate Fixation
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Author(s):  
Jahidul Bari ◽  
Wang . ◽  
Wu .

<p class="abstract"><strong>Background:</strong> Injuries to the tibial plateau generally occur because of a force directed either medially or laterally an axial compressive force or both an axial force and force from the side. Tibial plateau fractures resulting frequently in functional impairment.</p><p class="abstract"><strong>Methods: </strong>The total of cases included in the study was 47 in number. More than 20 years old patients of both sexes with tibial plateau fractures attended in the study. Proper informed consent was taken from the patients under the study and purpose of the study was explained. Ethical approval was obtained from the Institutional Ethics Committee. All data were processed, analyzed, and disseminated by MS Office and Statistical package for social sciences (SPSS) version 26 as per need.</p><p class="abstract"><strong>Results: </strong>In this study, for majority (51%) patients &lt;12 weeks were in needed for union. Besides these, for 23.40% and 21.28% patients, time for union were 12-14 and &gt;14 weeks respectively. Unfortunately, in 4.26%% cases (n=2) incidence of non-union was occur. The mean period of radiological union was 12.75 weeks (12-16 weeks). Most of the patients were allowed complete weight bearing at 11 to 14 weeks. Average time gap for complete weight bearing was 13.5 weeks. In assessing the knee stability of the participants, we observed, the mean (±SD) angle of knee joints was 112.08 ±12.32 degree. The mean (±SD) Knee Society Score (KSS) was found 77.51 ± 8.16. As per the functional outcomes among all the participants, majority of them (57.45%) got ‘good’ results whereas 29.79% got ‘Excellent’ and 8.51% got ‘Poor’ results.</p><p class="abstract"><strong>Conclusions:</strong> Satisfactory knee joint stability for patients with tibial plateau fracture angular locking plate fixation technic may be considered as an effective treatment method for orthopedic surgeons.  </p>


Author(s):  
Arno A. Macken ◽  
Jonathan Lans ◽  
Sezai Özkan ◽  
Simon Kramer ◽  
Jesse B. Jupiter ◽  
...  

Abstract Aim A rare complication following volar plate fixation of a distal radius fracture is flexor pollicis longus (FPL) rupture. This study aims primarily to analyze the radiographic features and secondly to report the patient-reported outcomes of FPL reconstruction after volar plate fixation. Methods Ten patients were retrospectively identified and contacted for follow-up. Seven patients participated in the study and completed the numeric rating scale (NRS) for pain, patient-reported outcome measurement information system—upper extremity (PROMIS-UE), and quick disability of arm, shoulder, and hand (QuickDASH) questionnaires at a median of 3.4 years following FPL reconstruction. Soong grade was determined on preoperative radiographs. Results Six patients were classified as Soong grade 1 and two patients had a screw or wire protruding volarly. The median time to tendon rupture was 21.6 months. At final follow-up, the median NRS pain score was 0 (range: 0–7); the median PROMIS-UE score was 47.1 (range: 25.9–61); and the median QuickDASH-score was 12.5 (range: 4.5–75). Conclusions The outcome of FPL reconstruction after volar plate fixation is highly variable. All ruptures in our cohort occurred in patients with plate positioning classified as Soong grade 1 and occurred at up to 3 years following distal radius fixation.


2021 ◽  
pp. 1-8
Author(s):  
Rawaa Y Al-Rawee ◽  
Bashar Abdul-Ghani Tawfeeq

Aims and objectives: To compare the efficacy and outcome of arch bar versus plating fixation on the integrity of the osteomised segment. Materials And Methods: The study involved a total of 43 patients (86 jaws) undergoing upper (Wassmund) and lower (Kole) anterior segmental osteotomy from (2006-2013) in the Maxillofacial Department in Al-Salam Teaching Hospital/Mosul. The sample was divided into two groups, group A (43 jaws), the osteotomized segments fixed with the arch bar, while group B (43 jaws) fixed with mini-plates. The clinical evaluation includes the following criteria: pain, swelling, bleeding, wound healing, oral hygiene ,integrity of stabilization, relapse rate and duration of operation. Results: Clinical parameters as pain, swelling, and wound healing show no significant differences between groups; on the contrary, the bleeding scale and gingival health scale show very high significant differences in p-value. The integrity of stabilization immediately in operation reveals stable surgical correction in both groups. Still, one jaw from each group develops significant mobility (grade II) that necessitate the use of additional local types of fixation. Duration of operation: this manure could be operator skill dependent, in that most cases managed clinically in teaching hospitals necessitating some delayed time in operative work, but as a mean time overall patients in group A was 90 minutes, while in group B was 77 minutes. Conclusions: According to this study, we prefer to use an arch bar rather than manipulates for fixation of anterior segmental osteotomies. Key words: Arch Bar, Complication, Fixation, Miniplate, Osteotomy.


2021 ◽  
Author(s):  
Dae Jin Nam ◽  
Min Seok Kim ◽  
Tae Ho Kim ◽  
Min Woo Kim ◽  
Suc Hyun Kweon

Abstract Introduction: We evaluated the radiologic and clinical outcomes of a lateral incision single plate with and a single-incision double plating in elderly patients with osteoporotic distal femoral fractures.Materials and Methods: We performed a retrospective study of 82 cases of distal femoral fractures from May 2004 to June 2018. Group A consisted of 42 patients who underwent single-plate fixation. Group B consisted of 40 patients who underwent double-plate fixation. The mean patient age was 77 years (67–87 years) and 76 years (64–86 years) in groups A and B, respectively. All patients were evaluated for procedure duration, time to union, range of knee motion, Lysholm knee score, and presence of complications.Results: The average procedure time was 81 min (66–92 min) and 110 min (95–120 min) in groups A and B, respectively(p=0.33). One case in group B required bone grafting after 5 months. The average time to union was 14 weeks (9–19 weeks) and 12.2 weeks (8–19 weeks) (p=0.63), and the mean range of knee motion was 105° (90–125°) and 110.7° (90°–130°) (p=0.37) in groups A and B, respectively. There was no significant statistical difference between the two groups in the Lysholm knee score(p=0.44) and knee society score(p=0.53).Conclusion: The clinical and radiological outcomes were similar in the 2 groups. In elderly patients, double plate fixation for distal femoral fractures is an useful method for several advantages such as adequate exposure, easy manipulation, anatomical reduction and stable fixation.


2021 ◽  
Author(s):  
Bryan Tan ◽  
Jingwen Ng ◽  
Wei Xiang Ng ◽  
Wei Yuan ◽  
Ernest Beng Kee Kwek

Abstract Introduction. Olecranon fractures are a common fracture of the upper extremity. The primary aim was to investigate the evolution of olecranon fractures and fixation method over a period of 12 years. The secondary aim was to compare complication rates of Tension Band Wiring (TBW) and Plate Fixation (PF). Materials and Methods Retrospective Study for all patients with surgically treated olecranon fractures from 1 January 2005 to 31 December 2016 from a tertiary trauma center. Records review for demographic, injury characteristics, radiographic classification and configuration, implant choices and complications. Results grouped into three 4-year intervals, analyzed comparatively to establish significant trends over 12 years. Results 262 patients were identified. Demographically, increasing mean age (48.7 to 58.9 years old, p-value 0.004) and higher ASA scores (7.1% ASA 3 to 21.0% ASA 3 p-value 0.001). Later fractures were more oblique (fracture angle 86.1 to 100.0 degrees, p-value 0.001) and comminuted (Schatzker D type 10.4–30.0%, p-value 0.025, single fracture line 94.0–66.0%, p-value 0.001). Implant choice, sharp increase in PF compared to TBW (PF 16.0% to PF 80.2%, p-value 0.001). Complication-wise, TBW had higher rates of symptomatic implant, implant and bony failures and implant removal. Conclusion Demographic and fracture characteristic trends suggest that olecranon fractures are exhibiting fragility fracture characteristics (older age, higher ASA scores, more unstable, oblique and comminuted olecranon fractures). Having a high index of suspicion would alert surgeons to consider use of advanced imaging, utilize appropriate fixation techniques and manage the underlying osteoporosis for secondary fracture prevention. Despite this, trends suggest a potential overutilization of PF particularly for stable fracture patterns and the necessary precaution should be exercised.


2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Valérie Lemieux ◽  
Soheil Afsharpour ◽  
Diane Nam ◽  
Amr Elmaraghy

Abstract Background Operative management of clavicle fractures is increasingly common. In the context of explaining the risks and benefits of surgery, understanding the impact of incisional numbness as it relates to the patient experience is key to shared decision making. This study aims to determine the prevalence, extent, and recovery of sensory changes associated with supraclavicular nerve injury after open reduction and plate internal fixation of middle or lateral clavicle shaft fractures. Methods Eighty-six patients were identified retrospectively and completed a patient experience survey assessing sensory symptoms, perceived post-operative function, and satisfaction. Correlations between demographic factors and outcomes, as well as subgroup analyses were completed to identify factors impacting patient satisfaction. Results Ninety percent of patients experienced sensory changes post-operatively. Numbness was the most common symptom (64%) and complete resolution occurred in 32% of patients over an average of 19 months. Patients who experienced burning were less satisfied overall with the outcome of their surgery whereas those who were informed of the risk of sensory changes pre-operatively were more satisfied overall. Conclusions Post-operative sensory disturbance is common. While most patients improve, some symptoms persist in the majority of patients without significant negative effects on satisfaction. Patients should always be advised of the risk of persistent sensory alterations around the surgical site to increase the likelihood of their satisfaction post-operatively.


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