Top PDF Open Reduction and Internal Fixation in Old Unreduced Perilunate Injury

Open Reduction and Internal Fixation in Old Unreduced Perilunate Injury

Open Reduction and Internal Fixation in Old Unreduced Perilunate Injury

Perilunate fracture dislocation (PLFD) and perilunate dislocation (PLD) are among rare wrist injuries, which oc- cur after high-energy trauma (1). Even though the diag- nosis of these injuries could be easily possible by appro- priate radiographs and attention to radiological criteria, about 25% of these patients are diagnosed late (1). It is as- sumed that this rate is higher in less developed countries and eventually the patients refer for treatment with pain, limitation of motion and reduction in power of the wrist and symptoms of pressure on the median nerve (2). The treatment of the wrist in acute cases of these injuries is open reduction and ligament repair, which could result good clinical and functional outcomes (3-6). There are a few studies about methods and results for the treatment of old cases (2, 7). However, delay in treatment causes af- fection on the prognosis and the results of the treatment
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Original Article Comparative study of the efficacy of open reduction and internal fixation versus closed reduction and external fixation in treating distal radius fracture

Original Article Comparative study of the efficacy of open reduction and internal fixation versus closed reduction and external fixation in treating distal radius fracture

A total of 77 patients with distal radius fracture, who were diagnosed in the orthopedics depart- ment of the Affiliated Zhongshan Hospital of Dalian University from January 2017 to Dece- mber 2018, were enrolled in this analysis. The- re were 33 males and 44 females, aged from 40 years old to 75 years old, with an average age of 64.0±8.9 years old. Among them, 40 patients were treated with open reduction and internal fixation with steel plates (observation group). In the observation group, there were 18 males and 22 females, with an average age of 62.9±8.5 years. The other 37 patients were treated by closed reduction and external fixa- tion (control group), including 15 males and 22 females, with an average age of 63.4±8.7 ye- ars. This study was approved by the Ethics Com- mittee of Affiliated Zhongshan Hospital of Da- lian University. All the patients signed an infor- med consent form.
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Effects of different surgical techniques on mid distal humeral shaft vascularity: open reduction and internal fixation versus minimally invasive plate osteosynthesis

Effects of different surgical techniques on mid distal humeral shaft vascularity: open reduction and internal fixation versus minimally invasive plate osteosynthesis

Adequate blood supply is essential for the bone union process after fractures [14]. Mid-distal humeral shaft fractures are generally associated with damage to the main nutrient artery of the humeral shaft [15, 16]. Therefore, the blood supply to the fracture site mainly relies on an extraosseous blood supply derived from sur- rounding soft tissues [17, 18]. However, in the conven- tional method of open reduction and internal fixation of fractures of the mid-distal humeral shaft, the stripping of the soft tissues and periosteum around the fracture site is unavoidable. This may compromise the poor blood Table 1 The number of damaged accessory nutrient arteries
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The study of the functional outcome of open reduction and internal fixation of three and four part proximal humerus fracture (according to neer’s classification) with philos (proximal humerus internal locking system)

The study of the functional outcome of open reduction and internal fixation of three and four part proximal humerus fracture (according to neer’s classification) with philos (proximal humerus internal locking system)

treated with sling immobilization and physical therapy 7 [Ianotti et al 2003]. Approximately 20% of proximal humeral fractures are displaced & maybenefit from operative treatment 6 [shene et al]. Many surgical fixation techniques have been described inthe literature, but no single surgical fixation technique is considered to be the gold standard of care 8 [Robert j et al 2009]. There are various treatment options available like conservative treatment with immobilisation and gradualphysiotherapy, operative treatment including transosseous suture fixation, percutaneous k wire fixation, open reduction and internal fixation with conventional or locked-plate fixation, and hemiarthroplasty 6,9 [Shene et al and Koval et al].There is a uniform agreement that when the tuberosities and medial calcar are anatomically reduced the successful outcome is most likely and the range of motion occurs early in the rehabilitation process 10 [Gallo et al 2005]. Open reduction internal fixation offers best chance at accurate reduction and union of all fracture fragments, including the greater tuberosity and therefore, good and excellent functional results can be achieved 10 . However, this method has been limited by difficulty in obtaining adequate exposure especially if greater tuberosity is diplaced and rigid fixation without compromising soft tissue structures. There are several fixation options which have different methods & principles of maintaining reduction, however they also have specific implant related problems as well. [Gallo et al]
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A comparative analysis between methods of open reduction and closed reduction in internal fixation of proximal tibia fractures

A comparative analysis between methods of open reduction and closed reduction in internal fixation of proximal tibia fractures

This is to certify that this dissertation titled “A COMPARATIVE ANALYSIS BETWEEN METHODS OF OPEN REDUCTION AND CLOSED REDUCTION IN INTERNAL FIXATION OF PROXIMAL TIBIA FRACTURES” is a bonafide record of work done by DR. VINOTH.S , during the period of his Post graduate study from May 2013 to April 2016 under guidance and supervision in the INSTITUTE OF ORTHOPAEDICS AND TRAUMATOLOGY, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai-600003, in partial fulfillment of the requirement for M.S.ORTHOPAEDIC SURGERY degree Examination of The Tamilnadu Dr. M.G.R. Medical University to be held in April 2016.
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Arthroscopically assisted reduction and internal fixation (ARIF) versus open reduction and internal fixation (ORIF) for lateral tibial plateau fractures: a comparative retrospective study

Arthroscopically assisted reduction and internal fixation (ARIF) versus open reduction and internal fixation (ORIF) for lateral tibial plateau fractures: a comparative retrospective study

Tibial plateau fractures are articular lesions that typically involve either active young patients after high-energy trauma or older osteoporotic patients [1–3]. Due to the complexity of injury mechanism, mostly a combination of rotational and axial compression forces, these fractures are often associated with intra-articular lesions such as chon- dral damage, meniscal tear, and ligament rupture [4–6]. The severity of the fracture pattern is typically characterized according to the Schatzker classification system [7]. Schatz- ker type I–III fractures involve the lateral tibial plateau and traditionally were treated with open reduction and internal fixation (ORIF) through an anterolateral approach [8]. However, it requires extensive soft tissue dissection and in- creased risk of post-operative complications has been re- ported (e.g., infections, hematomas, surgical wound dehiscence, and wound necrosis) [9, 10] even when minim- ally invasive techniques were proposed for low-grade lateral tibial plateau fractures [11].
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Functional Outcome analysis of Open reduction and internal fixation of complex acetabular fractures.

Functional Outcome analysis of Open reduction and internal fixation of complex acetabular fractures.

This is to certify that this dissertation titled “Functional Outcome Analysis of Open reduction and internal fixation of complex Acetabular fractures” is a bonafide record of work done by DR.D.KAMALASEKARAN , during the period of his Post graduate study from June 2010 to May 2013 under guidance and supervision in the INSTITUTE OF ORTHOPAEDICS AND TRAUMATOLOGY, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai-600003, in partial fulfilment of the requirement for M.S.ORTHOPAEDIC SURGERY degree Examination of The Tamilnadu Dr. M.G.R. Medical University to be held in April 2013.
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Original Article A comparative study of open reduction with internal fixation and percutaneous poking reduction fixation for the treatment of Sanders type II calcaneal fractures

Original Article A comparative study of open reduction with internal fixation and percutaneous poking reduction fixation for the treatment of Sanders type II calcaneal fractures

Abstract: Objective: To compare and analyze the clinical efficacy of open reduction with internal fixation and per- cutaneous poking reduction fixation for Sanders type II calcaneal fractures. Methods: A total of 57 patients with calcaneal fractures were randomly divided into the poking group (27 cases, underwent percutaneous poking reduc- tion) and the incision group (30 cases, underwent open reduction with internal fixation). The operation time, drain- age volume, intraoperative blood loss, and hospitalization days were recorded. During the postoperative follow-up, fracture healing and incidence of complications were observed and recorded for both groups. At the last follow-up, Visual Analog Scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) score, and the MOS item short form health survey (SF-36) were used to evaluate the clinical efficacy. Results: The operation time, drainage volume, intraoperative blood loss and hospitalization days in poking group were significantly less than those in the incision group, with statistically significant differences (P<0.05). In the postoperative follow-up, it was found that there was no significant difference in fracture healing time between the two groups. The incidence of complications was 3.70% in poking group, significantly lower than 10.00% in incision group (P<0.05). The Böhler and Gissane angles were significantly improved after surgery in both groups (P<0.05), but there was no significant difference between the two groups after surgery (P>0.05). At the last follow-up, VAS and SF-36 scores in the poking group were signifi- cantly higher than those in the incision group (P<0.05). There was no significant difference in excellent and good rate between the poking group and the incision group (P>0.05). Conclusion: Percutaneous poking reduction fixation can effectively reduce the incidence of postoperative complications and significantly improve the clinical efficacy and outcomes in treatment of Sanders II calcaneal fractures, so it is an efficient treatment method for calcaneal fractures.
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OUTCOME OF OPEN REDUCTION AND INTERNAL FIXATION IN LATERAL CONDYLE HUMERAL FRACTURES IN PEDIATRICS

OUTCOME OF OPEN REDUCTION AND INTERNAL FIXATION IN LATERAL CONDYLE HUMERAL FRACTURES IN PEDIATRICS

With open reduction and internal fixation (ORIF) in a clinical study, Ages of our patients range between 2-8 years with a mean age of 4.83 years. It is demonstrated in our study that 83.3% of our patients were males, while 16.7% were females. Leonidou et al. [8] reviewed the results of patients with a displaced lateral humeral condyle fracture treated with open reduction and internal fixation (ORIF). They retrospectively reviewed children treated with ORIF of lateral humeral condyle fractures at a single institution over a period of 13 years. One hundred and five patients with a displaced paediatric lateral humeral condyle fracture were identified and included in the study, 76 males and 29 females. The age of the patients
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Evaluation of 3 Dimensional Plates in Open Reduction and Internal Fixation of Subcondylar Fractures

Evaluation of 3 Dimensional Plates in Open Reduction and Internal Fixation of Subcondylar Fractures

This is to certify that Dr.TRIVENI.P, Post Graduate student (2014-2017) in the Department of Oral and Maxillofacial Surgery, Tamil Nadu Government Dental College and Hospital, Chennai-600003, has done dissertation titled “EVALUATION OF 3 DIMENSIONAL PLATES IN OPEN REDUCTION AND INTERNAL FIXATION OF SUBCONDYLAR FRACTURES” under our direct guidance and supervision in partial fulfillment of the regulation laid down by The Tamilnadu Dr. M.G.R. Medical University, Guindy, Chennai-32 for Master of Dental Surgery, Oral and Maxillofacial Surgery (Branch III) Degree Examination.
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Minimally invasive reduction and percutaneous
fixation versus open reduction and internal
fixation for displaced intra articular calcaneal
fractures : a systematic review of the literature

Minimally invasive reduction and percutaneous fixation versus open reduction and internal fixation for displaced intra articular calcaneal fractures : a systematic review of the literature

include open reduction and internal fixation (ORIF), mini- mally invasive reduction with percutaneous fixation (MIRPF) or primary arthrodesis. Controversies and variable opinion exist among foot and ankle surgeons regarding the choice of operative or non-operative treatment. The results of a prospective randomized controlled trial (RCT) from Canada comparing operative and non-operative treatment of DIACFs suggested that without stratification of the groups, the functional results were equivalent in both groups. However, after unmasking the data by
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Original Article Supraclavicular nerves protection during open reduction and internal fixation

Original Article Supraclavicular nerves protection during open reduction and internal fixation

Abstract: Our study was to verify whether the approach of protecting supraclavicular nerve could effectively reduce the discomfort caused by iatrogenic injury to the supraclavicular nerve. A total of 37 patients with unilateral midcla- vicular fractures were enrolled and randomly assigned into the experimental group (patients received meticulous dissection by specially preservation of supraclavicular nerves with diameter > 0.5 mm during open reduction and internal fixation (ORIF)) and control group (patients received conventional ORIF). One year follow-up was performed after operation. Clinical outcomes including intraoperative and postoperative parameters were compared between groups. For the intraoperative parameters, no significant difference was found between groups in operative time (P = 0.074). However, the blood loss (P = 0.004) was significantly decreased and incision length (P = 0.008) was significantly longerin experimental group compared with control group. For postoperative parameters, the time of bone healing was similar between groups (P = 0.856). However, the degree and range of skin numbness were sig- nificantly decreased by specially preservation of supraclavicular nerves during ORIF compared with conventional ORIF at two weeks and one year after operation (P < 0.05). In addition, although no statistical significance (P = 0.090), the results also indicated a trend that experimental group had fewer patients with complications related to the supraclavicular nerve injury than control group, including hyperesthesia, Tinel’s sign, tenderness, afraid of cold or feel discomfort beneath the incision. The results of this study supported the application of preservation of supraclavicular nerves during ORIF in treatment of midclavicular fractures.
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Open reduction and internal fixation with bone grafts for comminuted mason type II radial head fractures

Open reduction and internal fixation with bone grafts for comminuted mason type II radial head fractures

Methods: From July 2010 to July 2014, 20 consecutive patients who underwent open reduction and internal fixation for a closed Mason type II radial head fracture were retrospectively reviewed. Patients with Mason type I, III, simple type II, and comminuted type II fractures treated without bone grafting were excluded. A clinical examination and radiographic evaluation were performed. The overall functional result was evaluated using the Mayo Elbow Performance Score (MEPS). The Broberg and Morrey classification was used to evaluate traumatic arthritis. Results: The average follow-up duration was 31 months (range, 24 – 50 months). Bone union of the radial head fracture was achieved in all patients at an average of 13.5 weeks (range, 12 – 17 weeks). Postoperative radiographs showed no cases of postsurgical ligamentous instability, necrosis of the radial head, or internal fixation failure. The mean range of motion of the affected elbow was 128° ± 8.4° in flexion, 14.5° ± 11.1° in extension, 68.7° ± 14.1° in pronation, and 65.2° ± 18.2° in supination. The mean MEPS was 92 ± 7.9 points (range, 80 – 100); the outcome was excellent (90 – 100 points) in 13 patients and good (75 – 89 points) in 7 patients. The MEPS tended to be higher in patients with an isolated fracture ( p = 0.016). Based on the Broberg and Morrey classification for radiographic assessment of post-traumatic arthritis, 15 elbows had no evidence of degenerative changes (grade 0), and 5 elbows had grade 1 changes.
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Ligamentotaxis versus Open Reduction and Internal Fixation for Distal Radius Intra Articular  Fractures

Ligamentotaxis versus Open Reduction and Internal Fixation for Distal Radius Intra Articular Fractures

In evidence based medicine (EBM), the amount of pain among patients treated with external fixation compared to that among patients treated by closed reduc- tion and casting did not show significant difference until the first year [9] . A consensus remains to be reached regarding the choice of bridging or non-bridging methods in the external fixator treatment for distal radial fractures. Atroshi et al. in 2006 reported that non-bridging external fixation had no clinically relevant advantage over wrist-bridging fixation, but was more effective in maintaining radial length [10].
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Open Reduction and Internal Fixation in Pediatric Mandibular Fracture

Open Reduction and Internal Fixation in Pediatric Mandibular Fracture

Rigid fixation is a technique used in the management of facial fractures that has developed for more than 20 years 9 . However, use in children is somewhat controversial. Many studies have been done on infant animals showing the plate fixation across midfacial and cranial sutures lines have resulted in growth retardation along these suture line. Since these studies were performed on infant animals with rapid facial growth patterns, it was difficult to draw firm conclusions with regard to human children. But these studies did highlight the fact that rigid fixation should be used cautiously in children. If proper reduction of facial fractures is not achievable by other means, rigid fixation should be performed because the alternative of improper correction is unacceptable.
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Open reduction and internal fixation of humeral midshaft fractures: anterior versus posterior plate fixation

Open reduction and internal fixation of humeral midshaft fractures: anterior versus posterior plate fixation

Humeral shaft fractures are commonly associated with lesions of the radial nerve. The anatomical proximity and association of the bone and nerves in the humeral shaft explain the incidence of between eight and 12 % [34, 35]. We documented primary radial nerve palsy in twelve of the 58 patients (20.7%). The best treatment for humeral shaft fractures complicated with radial nerve in- jury is highly controversial [36, 37]. While concomitant nerve injury has been used as an argument for the im- mediate surgical treatment of fractures in the past (using a posterior approach and visualizing the radial nerve) [38], recent investigations have shown no significant difference in radial nerve palsy recovery between initial operative and nonoperative management strategies [34, 39]. In accordance with these findings, we found no sig- nificant difference in the remission rate between the use of a posterior approach in conjunction with revealing the radial nerve and the use of an anterior approach without nerve exploration. Most radial nerve injuries in cases of humeral shaft fracture are caused by traction or compression of the nerve, which is known as neuro- praxia. Much fewer nerve injuries are identified as dis- continuity of the nerve (axonotmesis or neurotmesis) [40]. Neuropraxia is a reversible injury, resulting in spontaneous reversibility in a large portion of traumatic radial nerve palsy cases [34], which underlines our find- ings that even in cases of fracture with primary radial palsy, an anterior approach with plating is a feasible al- ternative to a posterior approach. However, certain stud- ies have described significant soft tissue damage related to the use of an anterior approach. Cutting through the brachialis muscle may lead to the loss of muscle strength and the loss of tension on elbow flexion [15, 41]. Add- itionally, the danger of iatrogenic damage to the radial nerve (innervating the lateral aspect of the muscle dur- ing distal dissection) and musculocutaneous nerve (en- tering the superior third of the brachialis muscle and innervating the medial aspect) has been described [42 – 44]. However, we did not detect any adverse effects on the musculocutaneous nerve resulting from anterior plating in this study. Although we detected a lower rate of secondary nerve palsy in the anterior plating group than in the posterior plating group (3.57% vs. 16.67%), this difference was not significant. We acknowledge that there have been contradictory descriptions of the inci- dence of postoperative radialis palsy with the use of an anterior approach in recent studies, reportedly ranging from 11 to 16% [15, 45]. Gouse et al. [45] reported a study including 37 closed humeral shaft fractures and 29
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Comparison of two surgical approaches for displaced intra articular calcaneal fractures: sinus tarsi versus extensile lateral approach

Comparison of two surgical approaches for displaced intra articular calcaneal fractures: sinus tarsi versus extensile lateral approach

Methods: This retrospective cohort study was performed from 2004 to 2011. Open reduction and internal fixation using the sinus tarsi and extensile lateral approach was studied in 100 cases (40 sinus tarsi and 60 extensile lateral) with displaced intra-articular calcaneal fractures. All patients were evaluated both clinically and radiologically. Results: Median Böhler and Gissane angle were improved to 26.5 degree (4.6 to 45), 115.5 degree (101.2 to 127.4) in the sinus tarsi group and 25.3 degree (3.7 to 44.6), 119.0 degree (73.5 to 145.6) in extensile lateral group at the final follow-up, respectively. Median calcaneal height, length, and width in the sinus tarsi and extensile lateral groups showed improvement to 45.1 mm (23.2 to 54.1), 75.9 mm (64.9 to 90.3), 37.6 mm (29.2 to 53.9) and 46.5 mm (32.7 to 59.5), 76.1 mm (67.3 to 97.9), 39.3 mm (29.2 to 47.8) at the final follow-up, respectively. Median AOFAS score was checked to 90 points (76 to 94) in the sinus tarsi group and 86 points (76 to 94) in the extensile lateral group at the final follow-up. No significant differences in clinical and radiologic outcomes were observed between the two groups. However, wound complication rate (13.3%) in the extensile lateral group was significantly higher compared to the sinus tarsi group ( p -value = 0.022).
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Fixed Time and Fixed Angle External Fixation in the Treatment of Gartland Type III Supracondylar Humerous Fractures in Children

Fixed Time and Fixed Angle External Fixation in the Treatment of Gartland Type III Supracondylar Humerous Fractures in Children

lengthen the soft tissue around the joint. When the stress is removed, the lengthened soft tissue can return to the original length, due to the elastic deformation of the soft tissue. Sometimes, when the stress is removed, the lengthened soft tissue can maintain a lengthened condition, known as the plastic deformation of the soft tissue. Whether the soft tissue presents elastic deformation or plastic deformation depends on the magnitude and duration of the stress. In order to ensure the stability of the fracture end, improper extending and bending of the elbow joint is prohibited after the operation. However, the single angle of immobilization increases the risk of elbow-joint dysfunction. To address this problem, our hospital applied open reduction internal fixation (ORIF)surgery combined with fixed-time and fixed-angle external fixation(FTFAEF) to treat Gartland type III supracondylar humerus fractures in children from March 2012 to December 2017 and obtained promising results.
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Low-grade myxofibrosarcoma following a metal implantation in femur: a case report

Low-grade myxofibrosarcoma following a metal implantation in femur: a case report

A 31-year-old male patient has a history of a multiple fracture involving the left femur shaft, the middle and distal segment of the left tibiofibula, as a result of a traf- fic accident in October 2008. Subsequently, the patient underwent an open reduction and internal fixation (ORIF), using titanium alloy plates and screws. Ten months after ORIF, an X-ray examination showed no displacement of the fracture site, and the bridging callus was visible on two standard views with partial obliteration of the fracture line. However, the patient did not undergo reoperation to re- move the metal implants due to financial difficulties.
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Prospective study on the outcome analysis of internal fixation of proximal humerus fractures

Prospective study on the outcome analysis of internal fixation of proximal humerus fractures

3 The blood supply of the head of the humerus is at risk however, not only from the injury, but also from dissection of the soft tissues at open reduction and fixation. (6) The incidence of malunion, nonunion, and avascular necrosis (AVN) after ORIF have been reported. Extensive exposure and the insertion of implants increase the risk of the development of AVN and limited exposure and dissection of the soft tissues at the fracture site with minimal internal fixation have been recommended. Stable reduction is essential for healing of the fracture and allows early movement of the shoulder
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