ABSTRACT
BACKGROUND: Hypertrophic nonunion after intramedullary (IM) nailing and plating is Uncommon and the treatment remained controversial. The aim of this study was to show the result of a simple augmentative lag screws technique for vital non-unions after internal fixation PATIENTS AND METHODS: We retrospectively reviewed the patients with nonunion after internal fixation between January 2016 to August 2022. Patients with unacceptable shortening or deformity were excluded as well as nonunion septic cases. All the patients were followed up for at least 6 months. RESULTS: Seven patients achieved bony union in a median time of 12 weeks (IRQ 12-16). There was a failure case with persistent non-union and brokerage of the screws. DISCUSSION: Various techniques have been described to treat non-union after intramedullary nailing or plating. The existing nail is frequently removed, and the non-union site is either re-reamed and re-nailed or fixed with a plate or external fixation devices or rechanged by a nail in the case of plates. In our study of non-union, augmentative lag screws were successfully applied to treat eight patients with aseptic nonunion, resulting in the healing of non-union in all cases except one. CONCLUSION: Augmentative lag screws represent a simple technique for the management of aseptic hypertrophic nonunion after internal fixation with a significantly shorter operating time.
Subject(s)
Femoral Fractures , Fracture Fixation, Intramedullary , Fractures, Ununited , Humans , Retrospective Studies , Femoral Fractures/surgery , Fractures, Ununited/diagnostic imaging , Fractures, Ununited/surgery , Fracture Fixation, Internal/methods , Fracture Fixation, Intramedullary/methods , Bone Nails , Bone Plates , Treatment Outcome , Fracture HealingABSTRACT
This study aimed to establish factors associated with delayed surgery in patients with proximal femoral fracture and to assess patients' health-related quality of life (HRQoL) after surgery including all-cause 6-months mortality. This was a single-center, observational, prospective cohort study that included patients with a proximal femur fracture. We described patients' HRQoL measured by EuroQoL (EQ-5D-5L and EQ-VAS) questionnaire and perioperative complications (including mortality) 6 months after surgery. We included 163 patients with a mean age of 80.5 years, the majority were women and 76.1% reported falling from their own height. The mean time between hospital admission and surgery was 8.3 days (SD 4.9 days) and the mean hospital stay was 13.5 days (SD 10.4 days). After adjustment, the principal factor associated with delayed surgery was adjournment in surgery authorization (3.7 days). EQ-5D-5L index values and the VAS score at 1 month after surgery were 0.489 and 61.1, at 3 months were 0.613 and 65.8, and at 6 months 0.662 and 66.7 respectively. Mortality at 6 months of follow-up was 11% (18 patients). In conclusion, administrative authorization was the strongest associated factor with delayed time from hospital admission to surgery. HRQoL of patients with a proximal femoral fracture improved 6 months after surgery.Trial registration: NCT04217642.
Subject(s)
Proximal Femoral Fractures , Humans , Female , Male , Aged, 80 and over , Prospective Studies , Quality of Life , Accidental Falls , HospitalizationABSTRACT
El propósito del estudio fue evaluar el resultado del tratamiento quirúrgico de la luxación acromioclavicular tipo III de Tossy, utilizando el implante placa gancho de Synthes, placa DCP 3,5 mm, la cual se fija mediante tornillos y su extremo lateral se ubica extra articular por debajo de la superficie del acromion mediante un gancho, manteniendo reducida la articulación. Es un estudio serie de casos, 31 pacientes con luxaciones acromioclaviculares tipo III fueron evaluados de manera prospectiva, desde noviembre 2002 hasta diciembre 2003, en hospitales de Popayán y Pereira. Se efectuaron controles clínicos y radiográficos la segunda, cuarta, sexta y octava semana y luego mensualmente hasta el sexto mes y al año. Las variables evaluadas fueron: condición funcional, síntomas, rehabilitación, reintegro laboral y satisfacción del paciente. Todos los pacientes mostraron satisfacción con el resultado, salvo un caso todos habían obtenido recuperación funcional total a las 8 semanas. Este implante presenta como ventajas el hecho de no invadir la articulación, permite fijación estable y rehabilitación precoz sin necesidad de inmovilización alguna.
