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At least 451 records · Page 25Linked to original sources
PubMed2006

The use of calcaneal anatomic plate in arthroscopically-assisted open reduction and internal fixation of intra-articular calcaneal fractures.

To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months (range 12-30 months). The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation (P < 0. 01), the total excellent and fine rate was 91.86%. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.

Adult↗
PubMed2000

Open reduction and internal fixation in flexion-distraction injuries to the lower spine in children and adolescents involved in traffic accidents as car occupants. A report and literature review.

Flexion-distraction injuries of the spine are reported after traffic accidents in individuals wearing only lap seatbelts. We examine here this type of injury in one child and two adolescents who all were seated in the rear seat of cars involved in traffic accidents. All of the children were wearing regular three-point safety belts not adjusted to children. They were all treated surgically. Two of the patients had no neurological impairment, while one patient suffered persistent complete paraplegia. In two patients intra-abdominal lesions required surgery. Flexion-distraction injuries in individuals with an immature skeleton, wearing standard three-point safety belts, have not been reported in the literature. The pathomechanism of the lesion in the lower spine may well involve damage to the intestines, particularly at the junction between the mobile intra-abdominal and the fixed retroperitoneal part of the gut. Reduction and stable fixation preserve the anatomy of the lower spine, while unstable fixation methods do not secure reduction sufficiently to allow early mobilisation.

Accidents, Traffic↗
PubMed2005

Internal fixation of proximal humerus fractures using the locking proximal humerus plate.

OBJECTIVE: Stable fixation of unstable proximal humerus fractures until bony consolidation. Early mobilization of the shoulder and early active rehabilitation program to ensure a good functional outcome and a good restoration of the activities of daily living. INDICATIONS: Unstable two-, three- and four-part fractures of the proximal humerus (classified according to the AO classification as: 11-A2, A3, B1, B2, B3, C1, C2, C3). Nonunions of the proximal humerus, especially at the neck. Pathologic fractures of the proximal humerus. CONTRAINDICATIONS: Comminuted humeral head fractures in old patients, which cannot be reconstructed adequately. Proximal humerus fractures in the immature patient. Local infection after previous surgery. SURGICAL TECHNIQUE: Deltopectoral approach. Blunt mobilization of the deltoid muscle. Suture loops through the supraspinatus tendon, the infraspinatus tendon, and the subscapularis tendon close to their bony insertion. Careful indirect reduction of the fracture fragments without further damage to their blood supply. Correct positioning of the LPHP (Locking Proximal Humerus Plate) on the lateral side of the humerus, approximately 5 mm below the tip of the greater tuberosity. Indirect approximation of the subcapital fracture component to the plate, by tightening a standard 3.5-mm cortical bone screw inserted into the first hole distal to the metaphyseal fracture line. Temporary fixation of the plate with 1.8-mm Kirschner wires. Fixed-angle fixation of the plate to the bone, using locking screws. Additional stabilization of the tuberosities to the plate with suture loops. RESULTS: Between January 1, 1997 and April 30, 2002, 64 patients with acute fractures of the proximal humerus were treated with fixed-angle plating at the UKH Graz. 36 patients meeting the inclusion criteria (that is primary operative stabilization within 14 days after trauma in a standardized way and minimal follow-up period of 12 months) were assessed 31 months after surgery on average, using the Constant Score and the DASH Score. The mean age of the 22 women and 14 men was 57.5 years (21-78 years). According to the AO classification eight fractures were classified as 11-A3, one fracture as B1, five fractures as B2, three fractures as B3, one fracture as C1, 16 fractures as C2, and two fractures as C3. A mean Constant Score of 62.6 points and an age-related Constant Score of 80.7% on average, as well as a DASH Score of 18.0 points were obtained, constituting a satisfactory result in three quarters of all patients. Complications observed were two humeral head necroses, one partial necrosis after a head-splitting fracture with nevertheless good clinical result, and a deep infection in two cases. Breakage of the plate was seen in one patient with an A3.3 fracture without medial buttress; no further surgery was necessary; the fracture healed after a short period of immobilization.

Adult↗
PubMed1999

[Limb preservation after clostridial myonecrosis following internal fixation of a closed femoral fracture].

A 24-year-old healthy man developed Clostridium perfringens myonecrosis with severe sepsis after plating of a closed femoral fracture. The leg could be preserved by complete resection of the fascia from all muscle compartments of the leg, including the pelvitrochanteric and the iliopsoas muscles, radical removal of necrotic muscle tissue, dissection of the para-aortal infrarenal lymphatics, daily débridements over 2 weeks, and systemic antibiotic therapy. The plate was removed because of a second septic episode followed by temporary stabilization with external fixation. After soft-tissue healing, plate fixation was carried out. The patient developed significant deficit of knee flexion (0 degree/0/20 degrees) due to heterotopic ossification of the quadriceps femoris muscle that could be improved by partial resection of heterotopic bone formation. In the same operation the bony defect of the femur was filled with autologous bone graft. The fracture healed 10 months after the accident. The patient can work full time in his previous profession as a mechanic, but again needs operative mobilization of the knee joint, including open arthrolysis and quadriceps plasty.

Adult↗
PubMed2003

Early internal fixation and soft tissue cover of severe open tibial pilon fractures.

We studied 32 consecutive patients with open distal tibial pilon fractures. All patients had radical debridement with immediate skeletal stabilisation and early soft-tissue cover with a vascularized muscle flap. The minimum follow-up was 1 (range 1-8) year. There were four superficial infections, two deep infections and two amputations. There were no long-term problems with union and no patient required an ankle fusion. Patients were assessed using the SF-36 questionnaire. There were significant differences from the US norm in physical function score ( p<0.01), role physical score ( p<0.05) and physical component score ( p<0.01). Physical component score of 38.5 was significantly better ( p<0.01) when compared with amputees from severe lower-extremity trauma. Our protocol for management resulted in a good functional outcome with low infection and amputation rates.

Amputation, Surgical↗
PubMed2002

Scaphoid fracture in the young athlete--therapeutic outcome of internal fixation using the Herbert screw.

BACKGROUND: A fractured scaphoid is a common disabling injury occurring in contact sports. This study was designed to evaluate the therapeutic outcome of Herbert screw fixation for scaphoid fracture in young athletes. METHODS: Thirty athletes with 30 scaphoid fractures were treated. According to the Herbert classification, 10 were classified as acute fracture (group I), 6 as fibrous union (group II) and 14 as pseudoarthrosis (group III). Twenty scaphoid non-unions were due to missed diagnosis or unsuccessful immobilisation. RESULTS: Bony union was evident at an average of 9.2, 8.0 and 11.9 weeks postoperatively in groups I, II and III, respectively, and times for returning to sports were 10.7, 14.0 and 22.9 weeks. The clinical outcome assessed using the Mayo wrist score was excellent in groups I (97.5 points) and II (93.3) and good in group III (85.4). CONCLUSION: Early definitive diagnosis and treatment can allow early return to sports in young athletes. The Herbert screw technique produces an excellent clinical result for scaphoid fracture.

Adolescent↗
PubMed1999

Early complications of surgically managed ankle fractures related to the AO classification.A review of 118 ankle fractures treated with open reduction and internal fixation.

The charts of 118 consecutive ankle fractures were reviewed. The patients' age, sex, energy of trauma, hospital stay, need for traction therapy, syndesmosis fixation and soft-tissue problems were related to the various types of fractures according to the AO classification. An interobserver check study revealed an agreement of 0.61 (kappa), which is considered good. The age of the patients with A-fractures was 33 years (SD +/- 13), B-fractures 56 years (SD +/- 18), and C-fractures 48 years (SD +/- 16). The age differences within these groups were highly significant (P < 0.005). The highest average ages were found in the patients with B2 and B3 type fractures, 57 and 61 years, respectively. Women were significantly older than men (P < 0.0001), and 61% of the patients were women. Perioperative problems, such as wound margin necrosis and infections, were significantly related to fracture types B2 and B3. Preoperative traction therapy was necessary in the least stable fractures, of which all but one C1 fracture were B2/3 type fractures. The energy of trauma was not related to perioperative problems. The period of hospitalisation was significantly longer in the patients with B2/B3 type fractures (P < 0.001). Judging by the significantly higher incidence of perioperative complications, longer hospital stay, and predominance of instability and skin damage in the AO B2 and B3 type fractures, these fractures may benefit from more attentive and urgent care.

Adult↗
PubMed2003

Clostridium difficile-associated diarrhoea after internal fixation of intertrochanteric femoral fractures.

The aim of the study presented here was to record the incidence and outcome of Clostridium difficile-associated diarrhoea in patients undergoing surgery for intertrochanteric femoral fractures. Between January 2000 and June 2001, a total of 239 patients who underwent surgery after sustaining an intertrochanteric femoral fracture were included in the study. Seventeen patients developed Clostridium difficile-associated diarrhoea (incidence risk, 7.1%), and six patients died after developing the condition (case fatality rate, 35%). Thus, Clostridium difficile-associated diarrhoea was found to cause significant morbidity and mortality after surgery for intertrochanteric femoral fractures, and antibiotics should be used judiciously in this group of patients.

Age Distribution↗