ABSTRACT
OBJECTIVE@#To retrospectively analyze the clinical efficacy of olecranon osteotomy approach in the treatment of Dubberley type Ⅲ coronal fractures of the distal humerus and summarize the treatment experience.@*METHODS@#From January 2016 to June 2020, 17 patients (5 males and 12 females) with Dubberley type Ⅲ coronal fractures of the distal humerus were treated by olecranon osteotomy approach. The age ranged from 37 to78 years old with an average of (58.5±12.9) years old. According to Dubberley classification, there were 5 cases of type Ⅲ A and 12 cases of type Ⅲ B. The curative effect was evaluated using the Borberg-Morrey elbow function score. The flexion, extension and rotation range of motion of the elbow joint, complications and postoperative imaging evaluation were recorded.@*RESULTS@#All the 17 patients got bony union. The follow-up time ranged from 12 to 33 months with an average of (15.6±5.6) months. There was 1 case of ischemic necrosis of capitulum humeri, 2 cases of traumatic arthritis and 1 case of heterotopic ossification, 1 case of malunion of fracture. The range of motion was (114.80±19.50) °. The Broberg-Morrey score was 85.3±8.2, excellent in 5 cases, good in 9 cases, fair in 3 cases and poor in 0 case.@*CONCLUSION@#Through olecranon osteotomy approach, the articular surface of distal humerus could be fully exposed, and the operation is convenient. Anatomical reduction and rigid fixation of the articular surface of distal humerus are the key factors for the succesful outcome.
Subject(s)
Male , Female , Humans , Adult , Olecranon Process/surgery , Elbow Joint/surgery , Humeral Fractures/surgery , Retrospective Studies , Fracture Fixation, Internal/methods , Humerus/surgery , Treatment Outcome , Range of Motion, ArticularABSTRACT
@#Femoral condyle fracture in coronal plane, also known as Hoffa fracture, is a rare fracture. Non-union of Hoffa fracture is even rarer. We present a case of fibrous nonunion of a Hoffa fracture in which the fractured fragment, though not freely movable, led to painful walking. Since the fragment was un-displaced and non-movable we fixed the fractured fragment in situ. Patient regained full range of motion of the knee and was asymptomatic on follow-up.
ABSTRACT
Las fracturas de los cóndilos femorales en el plano coronal (Hoffa), son lesiones que afectan directamente la biomecánica de la rodilla. Están expuestas a un factor intrínseco de inestabilidad causado por el compromiso de los ligamentos y tendones insertados al fragmento condilar fracturado y a un factor extrínseco de inestabilidad dependiente del estrés mecánico en varo/valgo durante la fase de apoyo de la marcha y movimientos de flexo-extensión. El tratamiento quirúrgico con tornillos canulados sólo permite la compresión interfragmentaria y cierto grado de estabilidad rotacional, sin embargo, ese tipo de fijación podría no ser suficiente para soportar o neutralizar las cargas. Distintos autores han publicado otros métodos de osteosíntesis con el uso de placas en el plano lateral o posterior más la colocación de tornillos en sentido postero-anterior, pero siguen siendo opciones controversiales debido al tipo de morbilidad inherente a cada constructo. El objetivo de este artículo es realizar una revisión de la literatura para analizar la validez de los principios quirúrgicos y biomecánicos en el tratamiento de fracturas tipo hoffa.
Coronal plane fractures of the femoral condyles are commonly known as Hoffa fractures. These are intraarticular fractures that directly affect the biomechanics of the knee and have intrinsic and extrinsic instability patterns. The tendons and ligaments that remain attached to the condylar fragment produce the intrinsic instability. The extrinsic instability is due to the varus/valgus stress applied during the stance phase in the gait cycle as well as the flexion-extension movements. Surgical treatment with cannulated screws only achieves interfragmentary compression and certain amount of rotational stability that is not enough to support or neutralize the loads. Some authors have published different methods of osteosynthesis with lateral or posterior plates in conjunction with screws implanted in the posterior-anterior direction, still these techniques remain controversial due to the morbidity inherent to each construct. The purpose of this article is to review the current concepts of Hoffa fractures including biomechanics and surgical principles with the intention of analyzing their treatment efficacy.
Subject(s)
Humans , Femoral Fractures/surgery , Fracture Fixation, Internal/methods , Biomechanical Phenomena , Bone Screws , Femoral Fractures/classification , Femoral Fractures/physiopathologyABSTRACT
PURPOSE: The purpose of this study is to evaluate the surgical outcomes according to the Ring's classification system in patients with the distal humeral coronal plane articular fracture after treatment with open reduction and internal fixation (OR/IF). MATERIALS AND METHODS: Patients with the distal humeral coronal plane articular fracture treated with OR/IF in the three hospitals were reviewed retrospectively. The patients were evaluated clinically and radiographically according to the Ring's classification system. RESULTS: Eleven patients, including three males and eight female patients, with a mean age of 55 years (15–88 years) were enrolled in this study. Average Mayo elbow performance score was 85 (60–100), four patients had excellent, four had good, and three had fair results. Fracture union was achieved in ten of 11 patients who underwent open reduction and internal fixation. In the analysis of the results according to Ring's classification, patients presenting fracture of the posterior aspect of the lateral column showed worse clinical results than those who did not. It was the same for the patient presenting fracture of the posterior aspect of the trochlea. CONCLUSION: The open reduction and internal fixation provides good clinical and radiologic outcomes for the distal humeral coronal plane articular fracture. Our results suggest that the type of fracture involvement with posterior aspect of trochlear or capitellum can result in poor clinical outcomes.
Subject(s)
Female , Humans , Male , Classification , Elbow , Humerus , Retrospective StudiesABSTRACT
Coronal fractures of the anterior teeth are a common form of dental trauma that mainly affects children and adolescents. If the original tooth fragment is retained following fracture, reattachment of the fractured fragment to the remaining tooth can provide better and long-lasting aesthetics along with improved function. This report describes a case of fragment reattachment in an 18-year-old male patient following trauma to the maxillary central incisor, with 1 and 6-month follow-up.
ABSTRACT
O presente estudo teve como objetivo realizar um levantamento epidemiológico sobre os casos de fratura coronária em pacientes que foram atendidos no Projeto Trauma Dental da Escola de Odontologia da Unigranrio, no período de 2005 a 2011. O estudo foi baseado nos dados coletados dos prontuários e as informações obtidas estão relacionadas ao gênero, idade, etiologia da fratura, local do pronto atendimento, tempo decorrido até o pronto atendimento, dentes acometidos, situação clínica e a necessidade de tratamento endodôntico. Foi observada uma maior incidência em pacientes do gênero masculino, com a idade mais afetada entre 6 e 10 anos. Os resultados mostram a distribuição etiológica, clínica e demográfica das fraturas coronárias em um projeto de trauma dentário na cidade de Duque de Caxias.
The aim of the present study was to conduct an epidemiological survey on coronal fracture cases in patients treated at the Dental Trauma Project at Unigranrio School of Dentistry, from 2005 to 2011. This study was based on data collected from records and information related to gender, age, fracture cause, prompt service, elapsed time from the accident, affected teeth, clinical condition of the teeth and the need of endodontic treatment. It was observed a higher incidence in male patients, with the most affected age between 6 to 10 years. The results show the etiological, clinical and demographic distribution of coronal fractures in a project of dental trauma in Duque de Caxias city.
Subject(s)
Epidemiology , Tooth Injuries , EndodonticsABSTRACT
OBJECTIVE: To present and discuss a case of child who sustained a complicated crown fracture,with the lost portion of tooth embedded in his lower lip. RESULTS: Tooth fragment was surgicallyremoved and successfully reattached to the tooth using acid etch and dentin bonding resin technique.
OBJETIVO: Apresentar e discutir um caso de criança que sofreu fratura complicada de coroadentária, com parte do dente perdida e alojada no lábio inferior. RESULTADOS: O fragmentodentário foi cirurgicamente removido do lábio e colado, com sucesso, ao dente, utilizando-seataque ácido e cimentação com compósito.
Subject(s)
Humans , Female , Child , Dental Bonding/methods , Tooth Injuries/therapy , Composite Resins/therapeutic use , Lip/surgery , Surgery, Oral , Treatment OutcomeABSTRACT
PURPOSE: To evaluate the results of surgical and conservative treatment for coronal fracture of the distal femoral condyle. MATERIALS AND METHODS: The authors reviewed 19 cases from January 1993 to June 1999. Medial condyle (11 cases) was more common than lateral condyle (8 cases) and the causes of injuries included 10 cases of motor vehicle accident, 4 cases of motorcycle accident, 3 cases of falling down and 2 cases of slipping down. We divided the cases into an operation group (15 cases) and a non-operation group (4 cases) and evaluated results as good, fair and poor according to Letenneur's functional assessment. RESULTS: Anatomical reduction was obtained in all cases. The mean period of bone-union was 13.3 weeks in 12 cases of the operation group and 16.0 weeks in 2 cases of the non-operation group. The results at the last follow-up in the operation group were better than in the non-operation group. Letenneur's type III fracture had better results in both groups. CONCLUSION: In the case of coronal fractures of the femoral condyle, open reduction and internal fixation could allow earlier knee ROM exercise and procedure better results when it was indicated.