ABSTRACT
Radial neck fracture in children is rare. This study attempted to evaluate the outcome of surgically treated patients and any associated complications. Methods: This study evaluated 23 children under 15 years of age with radial neck fracture who were treated with open reduction between 2006 and 2016 to determine their range of motion, postoperative complications, and radiographic outcomes. The results were assessed clinically using the Mayo clinic elbow performance score. Results: The mean follow-up duration for patients was 34.6 months. The average postoperative angulation was 3.6°. Hypoesthesia was reported in only 9% of patients, and none of the patients complained of postoperative pain. The postoperative X-ray results were excellent in 60% and good in 40%. No radiographic complications were identified. The elbow score was excellent in 87% and good in 13% (mean score, 96.74). There was a statistical relationship between range of motion limitations and age, degree of fracture, initial displacement, and surgical pin removal time. Conclusions: Although most patients accept the closed reduction method as a primary treatment, the present study suggests that an open-reduction approach has been associated with optimal therapeutic outcomes for patients in whom closed reduction was not satisfactory or indicated.
ABSTRACT
Background: Congenital vertical talus [CVT] is a common foot deformity that occurs at birth and has two forms of syndromic and idiopathic. Treatments of this disorder include serial casting or surgical correction. Several studies have shown that Dobbs method [reverse Ponseti] is effective in improving deformity and function of the foot. The aim of this study was to evaluate 2-year treatment of syndromic vertical talus with this method
Methods: In this retroespective study, 21 patients with congenital vertical talus with neuromuscular disease and/or genetic syndrome from 2007 to 2014 referred to Shohada Hospital of Tabriz were studied. 35 feet [14 patients with bilateral and 7 patients with unilateral involements] with syndromic type of disorder, using manipulation and serial casting with Dobbs method [reverse Ponseti] treated by an orthopedic surgeon and serial radiographs in 2 years follow-up were performed to control
Results: The mean age of the patients was 16.9 +/- 20.9 years and the average number of cast was 7.5 +/- 1.6. Talocalcaneal angle and talus-base of first metatars angle significantly decreased after treatment [P<0.0001]. There was no significant age-related changes in the studied angles [P>0.05]. There was no significant correlation between talocalcaneal angle changes and the number of cast [P=0.108], but there was a significant association between talus-base of first metatars angle [P=0.015]
Conclusion: This study showed that treatment with Dobbs method has successfully improved the foot deformity in the patients with syndromic CVT
ABSTRACT
Background and Objectives: The optimal treatment for Pilon fractures remains controversial. This study was conducted to evaluate the clinical outcome of the treatment of type C2 and C3 Pilon fractures [AO/OTA Classification] using limited open reduction and fixation with mini-plate and supplementary transarticular Kirschner wire
Materials and Methods: 31 type C2 and C3 Pilon fractures, including 5 open fractures, were included in this study. For 10 patients, including 5 open fractures, temporary external fixation spanning ankle joint was conducted as early as possible. Other 21 patients were temporarily immobilized in splint. At the final stage, tibial and fibular fractures were reduced and fixed using limited open reduction and transarticular Kirschner wires and mini-plates. Clinical and radiographic evaluations were performed. The American Orthopedic foot and Ankle Society Score [AOFAS] were obtained for the evaluation of function
Results: Anatomic reduction in articular surface was obtained in 29 [94%] patients. No nonunion or skin necrosis was observed during the follow up period. Minor infection occurred in 2 patients and deep infection occurred in 1 patient. Malunion occurred in 3 [9%] patients. The final functional results, based on the AOFAS score, were excellent and good in 74.41%, average in 19.35% and poor in 3.22% of the patients
Conclusion: Limited open reduction and fixation with mini-plate and transarticular Kirschner wires is a reliable treatment for closed and open AO/OTA type C2 and C3 Pilon fracture of the distal tibia
ABSTRACT
Carpal fracture-dislocation is regarded as an unusual orthopedic injury and, thus, orthopedic surgeons are less experienced in dealing with and treating these fractures and dislocations. We report a 20-year-old worker man suffering from an unusual carpal fracture-dislocation. There was trans-scaphoid fracture and lunate dislocation with other carpal proximal bones toward volar of the wrist. Two volar and dorsal approaches were used to treat and stabilize the fracture. It was completely stabilized after open reduction and fixation using several pins. After two days, neural symptoms were completely recovered and the patient was discharged. Postoperative radiographies revealed complete restitution of lesser and greater arcs and normalization of Gilula's line. Scapholunate and lunatocapitate angles reached to less than 60degree and 10 degree, respectively. The combined approach had favorable results for treatment of this unusual type of carpus fracture dislocation. However longer follow up is need to evaluate the arthritis and degenerative changes in wrist
ABSTRACT
To use Schanz screws as a simple and effective method for closed reduction of femoral shaft fractures. In the present cohort study, which was carried out in Shohada Orthopedic Center, Tabriz, Iran between January 2004 and February 2005, 30 adult patients, with a mean age of 29 [18-65 years] with femoral shaft fractures underwent closed reduction with Schanz pins. The patients were followed up for 12 months. Reduction was satisfactory in 93.3% of patients. The average time for reduction was significantly shorter if treated in the first 48 hours, and if the amount of pre-operative traction approached 15% of the body weight. Reduction time was also shorter in Winquist-Hansen type III and IV fractures than in type I and II fractures [5.9 +/- 0.2 minutes versus 15.7 +/- 0.4 minutes]. There was 13% valgus deformity [5-10 degrees], 33% external mal-rotation [5-15 degrees] and 37% shortening [up to 1-3 cm]. We encountered no need for blood transfusion or bone grafting. Schanz screws provide a very effective method for closed reduction of femoral shaft fractures, and complications are similar to or less than other methods, especially if carried out in the first 48 hours after the trauma and if the weight for pre-operative traction approaches 15% of body weight