Top PDF Original Article Supraclavicular nerves protection during open reduction and internal fixation

Original Article Supraclavicular nerves protection during open reduction and internal fixation

Original Article Supraclavicular nerves protection during open reduction and internal fixation

Between January 2012 and May 2014, 37 patients with unilateral midclavicular fractures, who required ORIF, were enrolled in this study. These patients all met the following inclusive criteria: (1) aged over 15 years old; (2) displaced midclavicular clavicular fracture with no corti- cal bone contact or shortening of over 15 mm, or the fracture fragments were tenting or com- promising the skin with an axial malalignment of over 30°. In addition, the patients were ex- cluded when (1) they suffered fractures over 4 weeks; (2) fractures were open or pathological; (3) they had history of trauma in the ipsilateral arms; (4) they simultaneously had other inju- ries in ipsilateral arms; (5) there was skin hypo- esthesia on location of fractures or ipsilateral arms before surgery. This study was approved by institutional review board (IRB) of Shanghai Jiao Tong University and written informed con- sent was obtained from each participant. Study design
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Open Reduction and Internal Fixation in Old Unreduced Perilunate Injury

Open Reduction and Internal Fixation in Old Unreduced Perilunate Injury

Objectives: The purpose of this study was to determine the mid-term results of open reduction and internal fixation (ORIF) treat- ment for old unreduced perilunate injury that had been unreduced and untreated for a minimum of 6 weeks after injury. Methods: Between 2011 and 2016, 12 patients with old PLFD and PLD, untreated for a minimum of 6 weeks after injury, were treated by ORIF. A retrospective review was performed with a minimum 12 months of follow-up. During the final follow up visit, the patients were evaluated for pain, range of motion, and grip strength. The MAYO wrist score was used for functional assessment. The patients were assessed using a validated Persian questionnaire Quick DASH score. Radiological outcomes were classified using the Herzberg classification.
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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 Efficacy and outcome of open reduction and internal fixation with mini-plate in ulnar coronoid process fractures

Original Article Efficacy and outcome of open reduction and internal fixation with mini-plate in ulnar coronoid process fractures

Coronoid process of the ulna, act as an anterior bony buttress preventing posterior dislocation, has been recognized as a key stabilizer of the elbow joint. However, it is controversial that the recovery of the stability of elbow joint whether demands the internal fixation of coronoid pro- cess in patients with coronoid process frac- tures [5, 6], and the optimal treatment of co- ronoid process fractures is still remained unknown [7]. Closkey et al. demonstrated that the stability of elbow were maintained in patients with type I or type II coronoid process fractures, but for type III, the elbow were gener- ally unstable, thereby the patients with type III coronoid process need open reduction and internal fixation [8]. Kim et al. insisted thatthe internal fixation for fractures of the tip of coro- noid processcombined with injuries of lateral collateral ligament was unnecessary due to the repaired lateral collateral ligament would pro- vide the sufficient confirmation for the stability of the elbow [9]. However, Ring et al. retrospec- tively analyzed a series of cases of terrible triad of the elbow with all the coronoid process frac- tures were type II according to the Regan and Morrey classification [10]. After closed reduc- tion in 10 of above patients and none of the them were treated surgically, redislocation oc- curred in seven of them, reoccurrence of insta- bility in one and finally need total elbow arthro- plasty, and ulnohumeral arthritis in seven. Finally, there were 7 poor results in total 11
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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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Outcome study of open reduction and internal fixation with lcp implant in lower limb: a prospective study at tertiary care centre

Outcome study of open reduction and internal fixation with lcp implant in lower limb: a prospective study at tertiary care centre

In present study it was seen that the implant with locking head screw when used in difficult fractures like distal femur provides a good fixation. Even in osteoporotic bone the locking head implant provides a good anchorage also comparing the results in non osteoporotic patients even with conventional plates locking plate has better results in all subtype, more notably so in 3 and 4 part. We studied 24 patients of distal tibia fractures, majority of them 12 (50%) were of 43A1 type. Majority 19 cases (75%) of distal tibia fractures were of close type and 5 cases (25%) were open type. Majority of the cases 15 (62.5%) started full weight bearing in 16-20 weeks. Majority of the cases 15 were in excellent group, 09 cases being in good group (according to Olerud Molander score). All patients achieved union clinically and radiologically at the end of the study Francois et al. (2004) conducted a retrospective study on percutaneous plate fixation of fractures of the distal tibia, they observed no significant soft tissue problems occurred. All fractures healed within one year without malunion. Wang Cheng et al. (2011) conducted study to compare the results between two surgical options for distal tibia fracture, i.e. minimally invasive plate osteosynthesis (MIPO) vs. open reduction and internal fixation (ORIF). Thirty cases of distal tibia fracture (15 pairs of ORIF and MIPO) were submitted, no malunion occurred and one case of osteomyelitis developed in the ORIF group. In the ORIF group, ten cases were evaluated as excellent, three as good, one as fair and one as poor. In the MIPO group, ten cases were excellent and five good. Majority of fracture tibia were Schatzker Labart type- VI (37.5%). All patients (24) get their range of motion more than 90 degree. There were 7 cases with superficial infections, two case developed shortening of 10mm and three case which had developed varus deformity.
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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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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

Background: Lateral condyle fractures of the distal humerus are the second most common fractures at the elbow in the paediatric population usually between the ages of 6-10 years old making up 5-20% of fractures in children. The aim of the present study was to assess the early results of patients with a displaced lateral humeral condyle fracture treated with open reduction and internal fixation. Methods: Our clinical trial was conducted involving 12 patients treated with open reduction and internal fixation (ORIF). Preoperative stage included clinical evaluation, routine investigations and radiological evaluation. Fractures were classified using the Milch. Patients were followed up weekly until radiological union of the fracture was evident. Results: 83.3% of our patients were males, while 16.7% were females. According to mechanism of injury, falling down continues to play a major role in causing disability. At (3-5) weeks all cases were with soft callus remove K wire; at 8 weeks, all cases were with union fracture; but at 12 weeks, one case (8.3%) was with mild stiffness and the rest was with full range of motion. As regards the carrying angle in our study, only 16.7% were with abnormal carrying angle. 33.3% were complicated; one case with mild limitation of motion and valgus; one case with varus and two cases with superficial infection. Conclusions: The open reduction and internal fixation of lateral humeral condyle fracture is the ideal treatment and it has a rate of complications.
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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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Original Article Assessment of the curative effects of open reduction and internal fixation with bone grafting on calcaneal displaced intra-articular fractures

Original Article Assessment of the curative effects of open reduction and internal fixation with bone grafting on calcaneal displaced intra-articular fractures

Abstract: Objective: The aim of this study was to compare the curative effects between open reduction and internal fixation with bone grafting and non-surgical treatment of calcaneal displaced intra-articular fractures. Methods: Data concerning 113 patients with closed calcaneal fractures, treated in Dongying People’s Hospital from February 2011 to January 2013, were retrospectively analyzed. Specifically, there was complete follow up data for 79 of the patients, in accord with inclusion criteria. Patients were divided into two groups based on different modes of treat- ment, including 37 cases in the surgical treatment group and 42 cases in the non-surgical treatment group. After treatment, patients were followed up in the clinic and Imaging Department for at least five years, until January 12, 2018. Patient foot function recovery was assessed with ankle hindfoot scores of American Orthopaedic Foot & Ankle Society (AOFAS). Bohler and Gissane angles were measured by reexamining lateral X-ray films of calcaneus. Post-treatment near-term complications (incision infections or necrosis of surrounding skin and plantar fascial com- partment syndrome) and long-term complications (subtalar arthritis) were recorded in detail. Results: Differences between the baseline data (sex ratio, age, Sanders typing, Bohler angle, Gissane angle, injury cause, etc.) of the two groups of patients were not statistically significant (all P>0.05). One year after treatment and at the time of last follow up, the surgical group’s Bohler and Gissane angles were superior to those of the non-surgical group, with statistically significant differences (all P<0.05). One year after treatment and at the time of last follow up, AOFAS ankle hindfoot scores of both groups increased compared with those upon admission, with statistically significant differences (all P<0.05). Moreover, AOFAS scores of the surgical group were higher than the non-surgical group, with statistically
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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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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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RETRACTED ARTICLE: Open reduction and closed reduction internal fixation in treatment of femoral neck fractures: a meta analysis

RETRACTED ARTICLE: Open reduction and closed reduction internal fixation in treatment of femoral neck fractures: a meta analysis

Emergency internal fixation is one of the main options for the treatment of displaced femoral neck fractures [5]. It contains open reduction internal fixation (ORIF) and closed reduction internal fixation (CRIF). Both of the two methods have their advantages and disadvantages [6]. Although ORIF has advantages of direct look and restoration of normal function, its application still lim- ited by the potential negative effects of nerve damage, swelling, incomplete healing of the bone, increased pres- sure and blood clot [7]. CRIF has advantages of avoiding injury to the medial circumflex femoral artery [8]. How- ever, intracapsular pressure formed by CRIF compro- mised femoral head circulation, and prolonged extension and internal rotation position on the fracture table re- duced the blood supply to the femoral head, what’s more, the repeated forceful manipulation increased the risk of AVN [6]. Thus, the optimal treatment of femoral
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A randomized controlled trial of nonoperative treatment versus open reduction and internal fixation for stable, displaced, partial articular fractures of the radial head: the RAMBO trial

A randomized controlled trial of nonoperative treatment versus open reduction and internal fixation for stable, displaced, partial articular fractures of the radial head: the RAMBO trial

A recent meta-analysis by Kaas et al. compared the re- sults of operative and nonoperative treatment of isolated, displaced, stable, partial articular fractures of the radial head [13]. Nine retrospective case series describing 224 patients met their inclusion criteria. Successful treatment was defined as an excellent or good result according to various performance scores. Nonoperative treatment was successful in 114 of 142 patients (80%) pooled from the studies. Subsequent operative treatment after failed non- operative treatment was reported in three patients (2%). Open reduction and internal fixation was successful in 76 of 82 patients (93%), with subsequent surgery in four patients (5%). These differences were statistically signifi- cant; however, the authors noted that the level of evidence of the included studies was too low to support any firm conclusions.
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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

With the development of biomechanics, the clinical efficacy of open reduction and internal fixation has gradually been accepted [18]. The principle of it is that first of all, the site of frac- ture is incised, then complete reduction is car- ried out at the site of fracture according to the anatomical site; next, the site of fracture is fixed with steel plates, which greatly reduces the possibility of displacement [19]. Patients can do wrist exercise after they are treated by open reduction and internal fixation, which is beneficial to the recovery of wrist function [20]. Open reduction and internal fixation can not Table 2. Comparison of fracture symptom scores
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Original Article Comparison of open reduction and internal fixation in treatment of delayed and early acetabular fractures

Original Article Comparison of open reduction and internal fixation in treatment of delayed and early acetabular fractures

Abstract: To retrospectively compare the clinical efficacy of open reduction and internal fixation (ORIF) in treating delayed and early acetabular fractures. Ninety cases with delayed (n = 35) and early acetabular fractures (n = 55) undergoing ORIF between September 2009 and March 2013 were retrospectively analyzed. Patients in the delayed acetabular fracture group underwent ORIF at 22-65 d (mean 36 d) after injury and those in the early acetabular fracture group received ORIF at 3-20 d (mean: 8.1 d) after trauma. Ilioinguinal, Kocher-Langenbenk or combined approaches were adopted according to the types of fracture. Fracture reduction was evaluated using the Matta standard. Clinical efficacy was assessed by Matta modified D’Aubigne and Postel grading system. Postoperative follow-up endured for 18-36 months, 25 months on average. In the delayed fracture group, 15 (43%) cases had ana- tomical reduction, 17 (49%) were satisfied with the reduction whereas 3 (9%) were unsatisfied. In the early fracture group, 35 (64%) cases had anatomical reduction, 19 (35%) cases were satisfied with the reduction and only 1 (3%) patient was unsatisfied with no statistical significance between two groups. In the delayed fracture group, 16 cases obtained excellent outcomes, 15 good, 2 average and 2 had poor results, and 35 excellent, 18 good, 1 average and 1 poor in the early fracture group. Excellent rate did not significantly differ between two groups. Satisfactory and excellent rates of ORIF did not significantly differ between two groups. ORIF is an effective and feasible treatment of delayed acetabular fracture.
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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

Calcaneal is a very important bearing bone of the human body, so it is very easy to affect the daily life and work of patients in case of improp- er treatment for calcanea fractures. At present, surgical treatment is mainly used clinically, including open reduction with internal fixation (ORIF) and percutaneous poking reduction fixa- tion, etc. Open reduction with internal fixation (ORIF) is a traditional surgical treatment for cal- caneal fractures, with advantages of restoring the anatomic calcaneal morphology and talo- calcaneal joints matching, which could achieve good clinical effect and reduce the incidence of traumatic arthritis. However, incision complica- tions with varying degrees of severity are often found after ORIF, even chronic calcaneal osteo- myelitis may be present [8, 9]. The results of this study showed that the incidence of compli- cations in patients undergoing ORIF in the inci- sion group was up to 10%. The complications such as incision infections and pain would seri- ously affect the prognosis and long-term clini- cal efficacy for patients.
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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

Due to atrophic pseudarthrosis, one revision surgery was performed. In this case (1° open fracture), initial tempor- ary external fixation was performed followed by anterior plating after wound closure. Union was achieved after re- vision with autologous iliac cancellous bone grafting. All 25 fractures (100%) healed after posterior plating. No sig- nificant difference was found in the union rate between the groups (p = 0.4). In 50 cases, healing was defined as secondary healing with callus formation. In seven cases, healing was defined as primary fracture healing. The mean operative duration for anterior plating was 96 min (range, 58–180). The mean operative duration for dorsal plating was 114 min (range, 56–238). No significant difference was found in the operative duration between the two groups (p = 0.19). Twelve of the 58 fractures (20.7%) were associated with primary radial nerve palsy prior to the index procedure. In all twelve cases, the palsy was defined as incomplete palsy with preserved but pathological ENG potentials. In the cases of nerve palsy, both the anterior (n = 5) and dorsal (n = 7) approaches had been used. Complete disruption of the radial nerve on surgical ex- ploration (neurotmesis) was not found in any of these twelve cases. In ten of the twelve cases (83.3%), the palsy recovered completely after the index surgery. Recovery was achieved in four of five cases (80%) after an anterior approach had been used and six of seven cases (85.7%)
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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

McQueen [8] in his randomized, prospective study compared the effective- ness of non-bridging and bridging external fixator in restoring the normal anatomy, carpal alignment, and hand function for the treatment of intra articu- lar distal radial fractures. He had conducted the evaluations immediately after the surgery and showed that non-bridging external fixation achieved signifi- cantly better radial length compared to bridging fixation. It was reported that the pain outcome measures between the bridging and non-bridging fixator were similar during the initial analysis and after 1 year of follow-up. There were no significant differences between both groups for the carpal pain at the final fol- low-up.
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Open Reduction and Internal Fixation in Pediatric Mandibular Fracture

Open Reduction and Internal Fixation in Pediatric Mandibular Fracture

Mandibular fractures in pediatric population are relatively uncommon. These patients present with their own unique treatment requirements. Closed reduction with MMF in young children though in theory seems a better option can pose several concerns including patient co-operation, compliance and adequate nutrition .Treatment of fractures using ORIF on the other hand circumvents the above concerns like the need for MMF and allows immediate jaw mobilization , early recovery and return to early function.

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