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Background- Fractures of distal femur are one of the most prevalent fractures encountered in high-velocity trauma which are associated with high morbidity and mortality if not managed well. The isolated fracture can itself lead to complications such as Acute Respiratory Distress and pulmonary embolism. This neccesitaties early stabilisation of the fractures. Open reduction and internal fixation (ORIF) with locking compression plate is the treatment of choice for closed fractures of the distal femur. Distal femur anatomic contoured locking compression plate (LCP) has shown to give one of the best results regarding recovery, fracture union, return to work and the functional outcome. We present our experience of management of distal femur fracture at our centre. Study Material and Methodsdone on 36 patients, (NEER'S Classification) age range of 18 to 70 years (irrespective of their sex), were subjected to fixation by locking compression plate after obtaining thorough written informed consent. The observational study was carried at our institute between June 2021 to June 2022 Patients of both gender who were skeletally mature are taken into the study. In 61.5% of patients up to 50 years old and in Results40% of patients older than 50 years, the functional evaluation of LCP using Neers criteria was excellent. There was no statistically significant (p>0.05) difference in patients' functional status according to their age group who had distal femur fractures, which were stabilise by LCP. For supracondylar femur fractures, locking compression plates is a safe technique that has a good functional outcome, early clinical and radiographic union, and few complications.
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Objective:To discuss the clinical effect about the external locking compression plate(LCP) combined with lower abdominal conjoined flap for fixing the open fracture and covering the soft tissue defects on tibia.Methods:From August 2017 to December 2020, 18 patients with serve tibial open fracture were admitted into the trauma center, including 15 males and 3 females with a median age of 38 (ranged, 25-58) years old. The etiology involving: 9 cases by traffic accident, 3 by downfall, 6 by crushing, which classified as type III B( n=6) and III C( n=12) by the Anderson-Gustilo criterion. All wounds were taken radical debridement, fixed by the femur LCP and covered by the VSD during the emergency operation. The lower abdominal conjoined flap was dissected to cover the soft tissue defect, of which the dimension and pedicle length were tailored to the defect. Primary closure was performed on the donor site. Followed-up was conducted by telephone and WeChat. Results:One flap was changed to gastrocnemius myocutaneous flap because of the venous crisis. Seventeen flaps survived completely without significant complications. All the donor and recipient sites had primary healing. A mean follow-up of 15 (ranged, 12 to 18) months. The fracture healed without bone infection and bone nonunion. The aesthetic outcomes were satisfied without overgrown hairy and hyperpigmentation for all flaps. The concealed linear scar was left without hernia or other morbidity on the donor site. At the final follow-up, 12 cases were excellent and 6 cases were good evaluated by the Johner-Wruhs criteria.Conclusion:The external LCP can immobilise the knee and ankle joint with the preservation of the soft tissue, and the free lower abdominal conjoined flap was useful for covering extreme defects with concealed donor site, with enough tissue volume. The combination of both could lower the postoperative infection, reduce the operation time and shorten the hospital stay.
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Objective:To evaluate the biomechanical stability of our slot-designed compression bolt (SCB) combined with bilateral locking compression plates (LCPs) in the treatment of intra-articular distal femur fracture.Methods:In 24 adult male knee specimens treated with formalin, the femoral bony part was preserved to establish standard models of intra-articular distal femur fracture (AO type 33-C1). According to the random number table, the fracture models were divided into 2 equal groups: an experimental group ( n=12) subjected to fixation with one SCB combined with bilateral LCPs with 10 locking screws and a control group ( n=12) subjected to fixation with bilateral LCPs with 12 locking screws. In each model, a vertical ballast test was conducted to record the maximum axial displacement of the system and a horizontal torsion test to calculate the torsional stiffness of the system. When the loading pressure was 0-1,000 N in the biomechanical machine, structural abnormalities were observed in the 2 groups of models and the system maximum axial displacement and system torsional stiffness were compared between the 2 groups. Results:When the vertical ballast pressure was 400 N, 600 N, 800 N and 1,000 N, the maximum axial displacement of the system was, respectively, (0.14±0.01) mm, (0.25±0.01) mm, (0.41±0.02) mm and (0.63 ± 0.02) mm in the experimental group, and (0.15 ± 0.01) mm, (0.26 ± 0.01) mm, (0.46 ± 0.03) mm, and (0.67 ± 0.04) mm in the control group. Compared with the control group, the average maximum axial displacement in the experimental group decreased significantly under the axial pressure of 600-1,000 N ( P<0.05). When the horizontal torsion reached 5°, the torsional stiffness was, respectively, (2.00±0.12) Nm/° and (2.02±0.07) Nm/° in the experimental group and the control group, showing no significant difference between the 2 groups ( P>0.05). Conclusions:In the treatment of intra-articular distal femur fracture, compared with simple bilateral LCPs, our SCB combined with bilateral LCPs demonstrate similar torsional stability but better axial biomechanical stability. As our SCB has advantages of bilateral compression and minimal invasion in operation, it may be a new option for the reduction and compression treatment of intra-articular fractures.
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Objective To compare biomechanical properties of the traditional and novel locking compression plate （LCP） for treating femoral shaft fracture, so as to provide theoretical basis for selecting more effective bone plate. Methods The bending strength and fatigue tests on the plate were performed, and the finite element analysis on deformation, stress and life of the plate were conducted by using ANSYS Workbench. Results The average bending yield load and bending strength of the novel LCP were 1.4 times of that of the traditional LCP, and the average cycle times of the novel and traditional LCP were 106 and 47 091, respectively. The difference of service life for two LCPs was 33.8%. ConclusionsThe failure probability of the novel LCP is smaller than that of the traditional LCP, and the novel LCP has more effective biomechanical stability.
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Supra-condylar and inter-condylar fractures of the distal femur historically have been difficult to treat. They account for 7% of all femoral fractures. If hip fractures are excluded, 31% of femoral fractures involve distal portion. Because of the proximity of these fractures to the knee joint, regaining full knee motion and function may be difficult. Many of these fractures are the result of high energy trauma which generates severe soft tissue damage and articular and metaphyseal comminution, the management of which still remains complex and challenging to the orthopedic surgeons. The incidences of mal-union, non-union and infection are relatively high. Methods: A total of 25 patients were enrolled for this prospective study and all were treated with locking compression plate. Physical examination and radiographs were performed at regular follow-ups. Functional outcomes were analyzed using Modified Hospital for Special Surgery scoring system. Results: Patients were followed up every 2 weeks in the first month, then monthly for 3 months and then once every 3 months. The average range of knee flexion achieved was about 101°. The average knee score was 88.88 rated using Modified Hospital for Special Surgery functional score.The difference in knee range of motion was statistically significant for closed and open fractures but knee score and age was not statistically significant. Intra-articular fractures tend to have poorer results with respect to pain and function, more so because of the nature of the injury rather than the implant used, which limits the movement and causes loss of strength more than instability. Conclusion: The outcome seems to correlate with fracture severity, anatomic reduction, etiology, bone quality, length of time elapsed from injury to surgery, concomitant injuries and the exact positioning and fixation of the implant. Furthermore, the initial severe concomitant cartilage damage may predispose to early osteoarthritis although there is no evidence of that. Closed fractures have a higher range of motion as well as a better knee score as compared to open fractures thereby showing that soft tissue compromise also affects range of motion and further rehabilitation of the limb.
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Introduction: Fractures shaft of the humerus is common in an orthopedic practice. Open reduction and plating of these fracturesallow anatomical reduction without affecting elbow and shoulder function but involve extensive soft tissue stripping. We treat22 cases of humeral shaft fractures using locking compression plate (LCP).Objective: The objective of this study was to measure the clinical outcome which includes fracture healing, radial nerve recovery,infection, and functional range of motion in the shoulder and elbow. Radiographic measurements included fracture alignment,time to healing, delayed union, and non-union.Materials and Methods: Twenty-two skeletally mature patients with acute humeral shaft fractures requiring surgical stabilizationas indicated by the fracture pattern, failure to maintain reduction by conservative method, and associated injuries were treatedby open reduction and internal fixation (ORIF) using LCP. Follow-up was possible only on 20 patients.Results: Nineteen Humeral shaft fractures united completely, one fails to unite necessitating subsequent procedure whichwas united afterwards within 1½ years. Two superficial wound infections in patients with an open fracture and one transientpost-operative radial nerve palsy were the only complications. A functional range of motion in the elbow and shoulder wasregained in all except in one patient who had severe bone and soft tissue injuries in the same extremity.Conclusion: ORIF with locking compression plating becomes the treatment of choice with increased popularity for humeralshaft fracture as it can give good results by providing both biologic and mechanical advantages.
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Purpose: The purpose of this study was to compare the short-term functional and radiological outcome between Joshi’s externalstabilization systems (JESSs) with volar locking compression plate (LCP) in treatment of unstable distal end radius fractures.Materials and Methods: A prospective study was conducted which included a total of 50 patients between the age group of20–60 years with fresh closed unstable distal end radius fractures and was randomized into two groups of 25 patients eachand their outcomes were compared.Results: The average period of follow-up was 2 years after which range of motion of the two groups was compared and clinicaland radiological evaluation was done. The functional result according to modified Gartland and Werley scoring was excellent in8%, good in 40%, fair in 48%, and poor in 4% in JESS group while it was excellent in 8%, good in 84%, fair in 4%, and poor in4% in volar LCP group. According to Stewart scoring system, the result was excellent in 8%, good in 40%, fair in 48% cases,and poor in 4% cases in JESS group while it was excellent-good in 88%, fair in 8%, and poor in 4% in the LCP group.Conclusions: The mean time to union was 5.71 months in volar LCP group and 3.75 months in JESS group. The functional andanatomical evaluation of both the groups showed that fixation by volar LCP group had better result in comparison to externalfixation by JESS with accurate maintenance of articular margin. Better functional results can be expected in the early postoperative period in association with open reduction and internal fixation, and this form of treatment should be considered forpatients requiring a faster return to function after the injury, but in the long run, this is comparable with JESS fixation.
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Background: Clavicle fracture is one of the most common fractures of young active individuals; most of the clavicle fracturesare managed by the conservative method previously, but after understanding the fracture, biomechanics of clavicle surgicalmanagement found to have a good functional outcome and early mobilization of the patient. Fracture pattern-like displacedcomminuted, shortening <2 cm all have an impact on union and functional outcome.Methods: This is a prospective study of 40 cases of the clavicle fracture treated by ORIF with locking compression plate andclosed reduction internal fixation/open reduction internal fixation (ORIF) with an elastic nail. The period of study follow-up extendsfrom 2017 to 2019 in the Department of Orthopedics, KAPV Medical College Hospital, Tiruchirapalli.Results: In our study, we evaluated 40 cases of clavicle fracture treated by ORIF with locking plate (20 cases) and titaniumelastic nailing (20 cases). All the 20 cases of plating, two cases had a superficial infection and treated by higher antibioticsand one case after fracture healing implant exit done. The infection was settled. All the 20 cases of nailing, 18 cases are goodoutcome, one case are non-union, and two cases were superficial infection after higher antibiotics infection was settled.Conclusion: Locking compression plate is recommended for displaced midshaft comminuted clavicle fracture. When comparedto elastic nailing, locking compression plate has an excellent functional outcome and minimal complication.
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Objective: To investigate the feasibility and effectiveness of unexposed ulnar nerve medial elbow incision, open reduction and internal fixation of anatomical locking compression plate (LCP) for distal humerus fractures. Methods: Fourteen patients with distal humerus fracture were treated between January 2014 and June 2017. There were 5 males and 9 females, aged 18-85 years (mean, 65.5 years). The causes of injury included falling from height in 12 cases and traffic accident in 2 cases, all were closed fractures. Fractures were classified according to the AO/Association for the Study of Internal Fixation (AO/ASIF): 3 cases of type A2, 2 cases of type A3, 4 cases of type B2, 2 cases of type C1, 2 cases of type C2, and 1 case of type C3; without ulnar nerve damage. The time from injury to operation was 4-15 days, with an average of 7 days. The type B2 fractures were treated with unexposed ulnar nerve elbow medial incision and anatomic LCP internal fixation, the rest patients were all treated with unexposed ulnar nerve medial plus conventional lateral approach and bilateral LCP internal fixation. Results: The operation time was 50-140 minutes (mean, 80 minutes), and the intraoperative blood loss was 20-200 mL (mean, 70 mL). There was no blood vessels or nerve damage during operation. All incisions healed by first intension, and no incision infection occurred. All the 14 cases were followed up 9-24 months (mean, 13 months). X-ray films showed that all fractures healed within 4 months without complications such as nonunion and osteomyelitis. No ulnar nerve injury, cubitus varus deformity, and ossifying myositis occurred during follow-up. At last follow-up, the elbow function was assessed by Mayo Elbow Performance score (MEPS), the results were excellent in 8 cases, good in 4 cases, fair in 1 case, and poor in 1 case (type C3 fracture), with the excellent and good rate of 85.7%. Conclusion: The unexposed ulnar nerve medial elbow incision can be used effectively to reduct the fracture, and it is not prone to ulnar nerve injury. Combined with the lateral approach to treat the distal humerus fracture, which has the advantages of short operation time, few trauma, little bleeding, and reliable effectiveness.
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@#plate osteosynthesis depends on the quality of the bone,design of the fixation devices and intra-operative soft tissuedissection. This study evaluates the functional outcome ofminimally invasive percutaneous plate osteosynthesis usinglocking compression plate in proximal humerus fracturetreatment. MaterialsandMethods:The study was conducted on 30patients with complex proximal humerus fractures treated byminimally invasive percutaneous plate osteosynthesis usinglocking compression plate (PHILOS). There were 21 malesand 9 females. The average age of our study group was 58.8years. All the patients were evaluated at six weeks, threemonths, four months, six months and 12 months followingsurgery. Results:All patients had fracture union at an average of 13.2weeks. The mean DASH score at the follow-up was 8.69 (2.5to 17.16), the average range of flexion was 143.83 degrees(100 to 170 degrees) and abduction was 121.49 degrees (90to 160 degrees). We had superficial infection in three patientswhich resolved with a short course of antibiotics. There wasexcellent outcome in 26 patients, good and fair in twopatients each. Conclusion:Proximal humerus fractures treated withminimally invasive percutaneous plate osteosynthesis usinglocking compression plate with minimal soft tissuedissection, provides good functional outcome and earlyreturn of shoulder function.
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Objective To investigate the clinical efficacy of Kirschner wire,reconstruction plate and locking compression plate internal fixation in the treatment of Robinson type 2A and 2B midshaft clavicle fracture.Methods One hundred and fifty patients with midshaft clavicle fracture in the hospital from August 2006 to August 2015 were selected and divided into the group A,B and C.The group A adopted Kirschner wire,group B adopted the reconstruction plate and group C adopted the locking compression plate internal fixation.Then the incision length,operative time,intraoperative blood loss,fracture healing time,postoperative Constant-Murley scores and DASH scores and postoperative complications incidence rate were compared among the three groups.Results The incision length,operative time and intraoperative blood loss in the group A and C were significantly better than those in the group B(P＜0.05).The fracture healing time,postoperative activity,muscle strength and daily life score,postoperative complications incidence rate,postoperative DASH score in the group C were significantly better than those in the group A and B(P＜0.05).Conclusion The locking compression plate in the treatment of Robinson type 2A and 2B midshaft clavicle fracture can effectively reduce the surgical trauma,shortens the fracture healing time and decreases the postoperative complications.
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Objective To investigate the effect of minimally invasive plate osteosynthesis combined with locking compression plate fixation on postoperative fracture healing and serum levels of and serum nerve growth factor (NGF),vascular cell adhesion molecule (s VCAM),alkaline phosphatase (ALP) in patients with limb comminuted fracture.Methods From January 2014 to May 2016,seventy-four patients with limb comminuted fracture in the Eighth People's Hospital of Shanghai were enrolled in this study and randomly divided into the control group (37 cases) and the study group (37 cases).The traditional incision and reduction fixation were used in the control group.The study group was treated with locking compression plate internal fixation combined with minimally invasive plate bone grafting technique.The patients were followed up for 1 ～ 4 months after operation.The clinical efficacy,perioperative indicators (operation time,intraoperative blood loss,fracture healing time),serum (nerve growth factor,vascular cell adhesion molecule,alkaline phosphatase) levels change at the time of admission and after first D and complications rate were statistically compared.Results The total effective rate of the study group was 97.30％ (36/37),higher than that in the control group (78.38％ (29/37)),and the difference was statistically significant (x2 =4.554,P＜0.05).The operation time of the study group was (84.76 ± 11.08) min,longer than that of the control group ((71.89 ± 10.54) min),the intraoperative blood loss of the study group ((108.52 ± 21.33) ml) was less than that of the control group ((245.30±24.61) ml),and the fracture healing time of the study group ((9.04 ± 1.81) weeks) was shorter than that of the control group ((12.79 ±2.02) weeks),and the difference was statistically significant (t =5.119,t =25.547,t =8.410,P＜ 0.05).The levels of serum NGF,s VCAM and ALP in the two groups after operation were higher than those before operation,and the levels of serum NGF ((1.33±0.19) ng / L) and ALP ((312.04±31.07) U/L) in the study group were higher than those in the control group ((0.85 ± 0.22) ng/L,(181.28±30.45) U/L),and the level of serum s VCAM ((502.18±40.07) μg/L) was lower than that in the control group ((579.28 ± 41.15) μg/L),and the difference was statistically significant (t =10.044,18.283,8.165,P＜0.05).The incidence of complications in the study group was 8.11％ (3/37),lower than that in the control group (27.03％ (10/37)),the difference was statistically significant (x2 =4.573,P ＜ 0.05).Conclusion Minimally invasive plate osteosynthesis combined with locking compression plate fixation in the treatment of limb comminuted fracture can shorten the healing time of the fracture,improve the treatment effect,improve the levels of serum NGF,s,VCAM and ALP,and it have lower complication rate with higher safety.
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Objective: To investigate the difference in the effectiveness between proximal femoral nail anti-rotation (PFNA) and proximal femoral locking compression plate (PFLCP) for intertrochanteric fracture in elderly patients combined with hemiplegia due to cerebral infarction. Methods: The clinical data of 67 cases of intertrochanteric femoral fractures combined with hemiplegia due to cerebral infarction between October 2013 and January 2017 were retrospectively analyzed. Among them, 32 cases were treated with PFNA internal fixation (PFNA group), and 35 cases were treated with PFLCP internal fixation (PFLCP group). There was no significant difference in gender, age, injury side, modified Evans classification of fracture, preoperative medical disease, and interval from injury to operation between 2 groups ( P>0.05). The operation time, intraoperative blood loss, postoperative bed time, incidence of perioperative complications, time of fracture healing, and hip Harris score at 6 months and 1 year after operation were recorded and compared. Results: Both groups were followed up 12-24 months with an average of 14 months. Compared with the PFLCP group, the PFNA group had shorter operation time, less intraoperative blood loss, and shorter bed time, and the differences were significant ( P0.05); However, the joint deformity and activity score of the PFNA group was significantly better than that of the PFLCP group ( t=4.112, P=0.000). Conclusion: For intertrochanteric fracture in elderly patients with cerebral infarction hemiplegia, the PFNA has shorter operative time, less intraoperative blood loss, shorter bed time after operation, and better short-term hip function when compared with the PFLCP.
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Objective To investigate the effect of locking compression plate(LCP)and anatomi-cal plate(AP)in the treatment of closed tibial Pilon fracture and its influence on lower limb functional re-habilitation.Methods A total of 82 patients with closed tibial Pilon fractures were randomly divided into LCP internal fixation group(LCP group,n=41)and AP internal fixation group(AP group,n=41).The perioperative indexes and the incidence of postoperative complications were compared between the two groups.The ankle function was evaluated by American Orthopaedic Foot & Ankle Society Ankle Hindfoot Scale(AOFAS-AHS),the lower limb function was evaluated by Lysholm scale,the serum levels of inter-leukin-1β(IL-1β)and interleukin-6(IL-6)were detected.Results The intraoperative blood loss,opera-tion time,hospitalization time,first ground time,fracture healing time were(103. 34 ± 11. 34)ml, (47.65 ± 7.89)min,(9.01 ± 2.23)d,(5.31 ± 1.27)d,(16.23 ± 2.12)weeks in LCP group respective-ly,the AP group were(132.25 ± 34.41)ml,(60.54 ± 11.23)ml,(11.43 ± 2.57)d,(6.23 ± 1.56)d, (23.12 ± 3.31)weeks,respectively.The LCP group were significantly lower than AP group(P<0.05);The excellent rate of ankle function of LCP group was 95.12%,significantly higher than 82.93% in the AP group(P<0.05);The incidence of postoperative complications was 4.88% in the LCP group,which was significantly lower than 29.27% in the AP group(P<0.05);At 3,6 and 12 months after operation, the AOFAS-AHS scores in the LCP group were(69.52 ± 4.18)points,(78.89 ± 6.73)points and (87.23 ± 6.34)points respectively,the AP group were(65.09 ± 4.45)points,(70.13 ± 5.34)points and (76.69 ± 5.91)points respectively,the LCP group were significantly higher than AP group(P<0.05);At 3,6 and 12 months after operation,the Lysholm scores were(77.12 ± 6.43)points,(82.12 ± 7.81)points and(86.19 ± 8.11)points in LCP group,AP group were(67.25 ± 5.56)points,(72.21 ± 7.23)and (77.12 ± 7.54)points,the LCP group was significantly higher than AP group(P<0.05).At 3 d and 4 weeks after operation,the serum levels of IL-1β in LCP group were(0.37 ± 0.09)pg/ml,(0.19 ± 0.06) pg/ml,while in AP group were(0.45 ± 0.13)pg/ml,(0.27 ± 0.09)pg/ml;the serum levels of IL-6 in LCP group were(201.23 ± 30.12)ng/L,(102.23 ± 25.21)ng/L,while in AP group were(246.71 ± 41.23)ng/L,(158.95 ± 25.21)ng/L.The AP group were significantly lower than those in AP group(P<0.05).Conclusion LCP and AP in treatment of closed tibial Pilon fractures have a significant effect,but LCP can reduce the surgical trauma,shorten the operation time and postoperative recovery time,to a cer-tain extent,improve the ankle and lower limb function,and reduce the postoperative fixation fracture heal-ing and other complications.
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Objective To evaluate the clinical effects of proximal femoral locking compression plate(PFLCP) combined with iliac structural bone grafting for the treatment of comminuted femoral calcar intertrochanteric fractures.Methods A total of 45 patients with comminuted femoral calcar intertrochanteric fractures were treated with PFLCP combined with iliac structural bone grafting.The hip function was evaluated by Harris hip score system.Results All patients were followed up from 8 to 34 months(average 16 months) in the outpatient department.All cases healed without complications of non-union,reduction lost,varus deformity of the hip,losening,breakage or cut-out of the internal fixation,femoral head necrosis and shortening of the limbs.According to Harris hip score,there were 29 excellent cases,11 good cases,4 fair cases and 1 poor case,with excellent and good rate of 88.9%.Conclusion Reconstruction of the comminuted or defected femoral calcar with the iliac structural bone grafting can enhance the internal fixation and promote the bone healing.Combined with PFLCP fixation it is an effective method for treatment of comminuted femoral calcar intertrochanteric fractures.
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PURPOSE: This study aimed to evaluate the surgical outcomes of biologic plating using locking compression plate-distal femur (LCP-DF) in patients with subtrochanteric fracture of the femur. MATERIALS AND METHODS: Between January 2010 and December 2013, 28 consecutive patients with subtrochanteric fractures of the femur, treated with biologic fixation using LCP-DF, were enrolled. Preoperative values, including patient age, sex, body mass index, fracture type, type of lung injury, and surgical timing from injury to surgery, were retrospectively evaluated. Radiologic assessments included time to union, coronal alignment, rotational alignment, and complications such as implant breakage and screw breakage. Adverse events, including postoperative fat embolism and adult respiratory distress syndrome, infection during the follow-up period, and walking ability at the last follow-up visit, were assessed. RESULTS: Union was achieved in 27 patients (96.4%) after a mean duration of 5.4 months (range, 3-14 months). No patients developed fat embolism or adult respiratory distress syndrome during the hospitalization period of this study. CONCLUSION: Biologic fixation using locking compression plates may represent a safe surgical option which can be utilized in patients with subtrochanteric fracture regardless of injury severity, surgical timing, fracture type, and presence of lung injury.
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Humans , Body Mass Index , Embolism, Fat , Femur , Follow-Up Studies , Hip Fractures , Hospitalization , Lung Injury , Respiratory Distress Syndrome , Retrospective Studies , WalkingABSTRACT
BACKGROUND: Increased frequency of comminuted clavicle mid-shaft fractures and importance of functional satisfaction through early joint exercise has resulted in higher emphasis on surgical treatments. This study aimed to evaluate the clinical radiological results of treatment of clavicle mid-shaft fractures by open reduction and internal fixation using a plate with a small incision. METHODS: The subjects of this study were 80 clavicle mid-shaft fracture cases treated with internal fixation using a plate from October 2010 to July 2014. Clavicle mid-shaft fractures were internally fixated using anatomical plates or locking compression plates. Achievement of bone union, union period, and clavicle length shortening were evaluated radiologically, and clinical assessment was done by using Constant and University of California at Los Angeles (UCLA) scores. RESULTS: All 80 cases were confirmed to have achieved bone union through radiographs with an average union period of 10.9 weeks (range: 7–18 weeks). The average clavicle length of shortening in the affected side was 1.8 mm (range: 0–17 mm). The average UCLA score and Constant score were 33.6 (range: 25–35) and 92.5 (range: 65–100), respectively. Regarding complications, four cases reported skin irritation by metal plates, and one case reported a screw insertion site fracture due to minor trauma history. CONCLUSIONS: We were able to induce successful bone union and obtain clinically satisfactory results in displaced mid-shaft fractures of the clavicle without major complications such as nonunion through treatment of internal fixation using a plate.
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California , Clavicle , Joints , SkinABSTRACT
BACKGROUND: Increased frequency of comminuted clavicle mid-shaft fractures and importance of functional satisfaction through early joint exercise has resulted in higher emphasis on surgical treatments. This study aimed to evaluate the clinical radiological results of treatment of clavicle mid-shaft fractures by open reduction and internal fixation using a plate with a small incision. METHODS: The subjects of this study were 80 clavicle mid-shaft fracture cases treated with internal fixation using a plate from October 2010 to July 2014. Clavicle mid-shaft fractures were internally fixated using anatomical plates or locking compression plates. Achievement of bone union, union period, and clavicle length shortening were evaluated radiologically, and clinical assessment was done by using Constant and University of California at Los Angeles (UCLA) scores. RESULTS: All 80 cases were confirmed to have achieved bone union through radiographs with an average union period of 10.9 weeks (range: 7–18 weeks). The average clavicle length of shortening in the affected side was 1.8 mm (range: 0–17 mm). The average UCLA score and Constant score were 33.6 (range: 25–35) and 92.5 (range: 65–100), respectively. Regarding complications, four cases reported skin irritation by metal plates, and one case reported a screw insertion site fracture due to minor trauma history. CONCLUSIONS: We were able to induce successful bone union and obtain clinically satisfactory results in displaced mid-shaft fractures of the clavicle without major complications such as nonunion through treatment of internal fixation using a plate.
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California , Clavicle , Joints , SkinABSTRACT
La picnodisostosis es una enfermedad poco común que pertenece a las displasias esqueléticas que presentan fragilidad ósea y fracturas frecuentes. Radiológicamente se caracteriza por incremento de la densidad y fragilidad óseas. OBJETIVO: Presentar el caso de un escolar con displasia esquelética con fracturas en hueso patológico y manejo quirúrgico. CASO CLÍNICO: Escolar de sexo femenino, con antecedente de picnodisostosis detectado en etapa preescolar. Consulta posterior a caída de bicicleta con fractura de ambos fémures que se manejan quirúrgicamente con placa de compresión bloqueada.
Pycnodysostosis is a rare condition within skeletal dysplasias presenting with brittle bones and frequent fractures. Radiologically, it is characterised by increased bone density and fragility. OBJECTIVE: To present the case of a primary schoolchild with skeletal dysplasia with pathological bone fractures and their surgical management. CASE REPORT: A female primary schoolchild with a history of pycnodysostosis detected during the pre-school period. She was seen after bicycle fall that resulted in the fracture of both femurs, that were surgically managed with a locking compression plate.
Subject(s)
Humans , Female , Child , Femoral Fractures/surgery , Femoral Fractures/etiology , Pycnodysostosis/complications , Fracture Fixation, Internal/methods , Radiography , Minimally Invasive Surgical Procedures , Femoral Fractures/diagnostic imaging , Pycnodysostosis/diagnostic imagingABSTRACT
Objective To explore the clinical efficacy of minimally invasive percutaneous plate osteosynthesis (MIPPO) combined locking compression plate treatment for humeral shaft fractures. Methods The clinical data of 15 patients suffering humeral shaft fractures and receiving MIPPO combined locking compression plate treatment hospitalized from Jan 2012 to Dec 2015 were retrospectively analyzed. The 15 patients included 9 males and 6 females, aged from 23 to 65 years with an average of 42; The fracture was proximal in 4, middle in 8, and distal in 3 patients; There were 5 type A, 7 type B and 3 type C fracture patients according to AO/ASIF classification. The radial nerve function, fracture healing time, and the shoulder and elbow joint function were observed in all the patients. Results The operation time of 15 patients was 65-110min with an average of 80min. Surgical incision of all patients healed well, and no iatrogenic radial nerve injury was found. All patients were followed-up for 5-22 months, with a mean of 13 months. The fracture healing time was 10-15 weeks, with a mean of 12.5 weeks. The clinical outcome was 14 excellent and 1 of good according to UCLA score, and 13 excellent and 2 good according to Mayo score at the last follow-up. Conclusion MIPPO combined locking compression plate is a safe and simple method for humeral shaft fractures.