• Title/Summary/Keyword: Fracture fixation

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Radiological assessment and follow-up of a nonsurgically treated odontoid process fracture after a motor vehicle accident in Egypt: a case report

  • Ahmad Mokhtar Abodahab
    • Journal of Trauma and Injury
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    • v.36 no.4
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    • pp.411-415
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    • 2023
  • An odontoid process fracture is a serious type of cervical spine injury. This injury is categorized into three types based on the location of the fracture. Severe or even fatal neurological deficits can occur due to associated cord injury, which can result in complete quadriplegia. Computed tomography is the primary diagnostic tool, while magnetic resonance imaging is used to evaluate any associated cord injuries. These injuries can occur either directly from the injury or during transportation to the hospital if mishandled. There are two main treatment approaches: surgical fixation or external nonsurgical fixation, with various types and models of fixation devices available. In this case study, computed tomography follow-up confirmed that external fixation can yield successful results in terms of complete healing, even in cases complicated by other factors that may impede healing, such as pregnancy.

Results of Closed Reduction and Percutaneous Fixation of the Supracondylar Fractures of the Humerus in Adults (성인의 상완골 과상부 골절의 도수 정복 후 경피적 고정 방식의 치료 결과)

  • Park, Jin-Soo
    • Clinics in Shoulder and Elbow
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    • v.5 no.2
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    • pp.102-109
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    • 2002
  • Purpose: To evaluate the results of the treatment of the supracondylar fractures of the humerus according to the fixation methods in adults Materials and Methods: Seven patients, aged 55 to 52 years (average,69 years), were reviewed after a mean follow-up of 37 months (range, 11-65 months). According to AO classification all fractures were classified as type A2 (simple transverse supracondylar fracture). Six patients underwent closed reduction and one patient, open reduction after failure of closed reduction. Percutaneous fixation with cannulated screws was performed to the 4 patients, per- cuta)leous fixation with Kirschner wires in 3 patients. All except one patients have associated medical problems. The results were assessed based on the Mayo Elbow Performance Score. Results: All the patients with cannulated screw fixation had stable bony union with excellent ranges of motion (mean: 5-125 degrees). All the three patients who received percuatnaous smooth K-wire fixation had nonunion with poor results, one of them had changed into cannulated screw. and then had good result. Conclusion: Although simple supracondylar fracture is similar to the pediatric fracture in nature, it should be firmly fixed with the method such as threaded cannualted screw rather than the simple fixation with K-wires.

The Effect of Fibular Fixation on Ankle Function in Intramedullary Nailing for Distal Tibiofibular Fractures (원위 경비골 골절에 대한 골수강내 금속정술에서 비골 고정이 족근 관절 기능에 미치는 영향)

  • Suh, Byung-Ho;Lee, Soo-Won;Kong, Gyu-Min;Kim, Dong-Jun;Oh, Hyun-Keun
    • Journal of Korean Foot and Ankle Society
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    • v.13 no.2
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    • pp.169-174
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    • 2009
  • Purpose: To evaluate the clinical results between interlocking intramedullary nail with fibular fixation and nail only for treating distal tibiofibular diaphyseal fractures. Materials and Methods: From March 2003 to September 2006, 19 distal tibiofibular fractures were antegrade nailed after anatomical reduction and fixation of fibular fractures, and another 37 fractures fixed with nails only. Average age of patients was 48.6 years. These two groups were compared by VAS (visual analogue scale) & ankle ROM according to degree of comminution and fracture configuration. The statistical analysis was evaluated by t-test. Results: There was no statistical difference between fibular fixation group and non-fixation group in VAS score according to fracture comminution and configuration (p>0.05). However, compared according to fracture configuration, mean ankle eversion of fibular fixation group in oblique fractures was 18.3 degrees, and that of non-fixation group was 12.5 degrees (p<0.05). In addition, mean ankle plantar flexion, dorsiflexion, inversion and total ankle ROM of fibular fixation group in spiral fractures was 40.0, 20.0, 30.0 and 108.3 degrees of each and that of non-fixation group was 38.3, 18.5, 27.0 and 101.7 degrees (p<0.05). Conclusions: In oblique and spiral fractures of distal tibiofibular diaphysis, interlocking intramedullary nail with fibular fixation had the advantage in postoperative ankle ROM. So, it can be a worthy method for the treatment of distal tibiofibular diaphyseal fractures.

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The Role of Minimally Invasive Plate Osteosynthesis in Rib Fixation: A Review

  • Bemelman, Michael;van Baal, Mark;Yuan, Jian Zhang;Leenen, Luke
    • Journal of Chest Surgery
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    • v.49 no.1
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    • pp.1-8
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    • 2016
  • More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950's, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft $f{\ddot{u}}r$ osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO) technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has becomeavailable suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation.

THE HEALING OF MANDIBULAR FRACTURE WITHOUT INTERMAXILLARY FIXATION IN A LONG-TERM DISABLED BED PATIENT: REPORT OF A CASE (장기간 침대요양 장애환자에서 악간고정술 없이 치유된 하악 골절: 증례보고)

  • Yoo, Jae-Ha;Choi, Byung-Ho;Lee, Chun-Ui;Kim, Jong-Bae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.7 no.1
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    • pp.38-43
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    • 2011
  • Treatment of the mandibular fracture consists of reduction and fixation. Primary wire & Arch bar are perhaps the ideal method for intermaxillary fixation. But, daily feeding, swallowing, speech, and in some instances, respiration is difficult to maintain during the period of intermaxillary fixation, owing to muscle weakness, emotional disorder and poor oral hygiene in a position of the long-term bed disabled patient with multiple injuries. Therefore, Intermaxillary fixation is not applied in the disabled bed patient, the alternative methods must be obtained. In the case of the mandibular fracture, because of the absence of weight bearing, osseous union may eventually occur even without immobilization if the patient is maintained without wound infection on a controlled soft diet. For the purpose of the prevention of the wound infection, the establishment of an drainage on the oral lacerated wound is necessary for the removal of the hematoma & seroma in the fracture site. This is the report of a case that was managed conservatively without the intermaxillary fixation in the long-term disabled bed patient with a mandibular compound fracture.

Arthroscopy Assisted Percutaneous Reduction and Screw Fixation of a Displaced Intra-articular Glenoid Fracture - A Case Report - (유경나사를 이용한 견갑골 관절와 골절의 관절경적 정복 및 내고정 - 증례 보고 -)

  • Ko, Sang-Hun;Jeon, Hyung-Min;Shin, Seung-Myeong
    • Clinics in Shoulder and Elbow
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    • v.13 no.1
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    • pp.127-131
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    • 2010
  • Purpose: The authors used arthroscopy-assisted percutaneous reduction and cannulated screw fixation rather? than conventional arthrotomy for displaced glenoid fracture. Materials and Methods: We used arthroscopy assisted reduction and screw fixation for a 66 year old man who had a clavicle fracture, a displaced glenoid fracture and a scapula fracture. Results: At 9 months postoperatively, the patient had recovered full range of motion and was not inconvenienced by the surgery. Removal of the implant was done 12 months post-operatively under general anesthesia. Conclusion: The advantages of arthroscopy-assisted percutaneous screw fixation are less pain and less bleeding, shorter hospital stay and earlier rehabilitation. Arthroscopic percutaneous screw fixation for a displaced glenoid fracture seems to be a good alternative treatment method.

Patellar fracture after transverse screw fixation in sports athletes - A case report - (운동선수에서 횡방향 나사 고정 후 발생한 슬개골의 골절 - 증례 보고 -)

  • Ra, Ho Jong;Kim, Sung Tae;Ha, Jeong Ku;Kim, Jin Goo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.10 no.2
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    • pp.109-112
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    • 2011
  • Anatomical reduction and strong fixation in displaced patella fracture are needed for restoration of knee function and strength and early range of motion exercise. According to the type of fracture and various operational methods, their many complications have been reported. We report 2 cases of transverse patella fracture which were caused by transverse screw fixation in longitudinal patella fracture and fracture of bipartite patella in athletes.

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Comparison between Screw Fixation and Modified Tension Band Wiring for Medial Malleolar Fracture (족관절 내과 골절에 대한 금속나사고정술과 변형 긴장대고정술의 임상적 비교)

  • Ko, Sang-Hun;Park, Young-Jun;Jeong, You-Young;Kim, Woo-Suk
    • Journal of Korean Foot and Ankle Society
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    • v.6 no.1
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    • pp.54-59
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    • 2002
  • Purpose: To compare the clinical results between the screw fixation and modified tension band wiring in the treatment of medial malleolar fracture. Materials and Methods: From September 1998 to April 2002, 52 patients were treated by screw fixation and 43 patients were treated by modified tension band wiring for medial malleolar fracture. Results: Accoding to Lauge- Hansen classification, there were 28 cases of supination-external rotation type (53.8%), 9 of supination-adduction type (17.3%), 8 of pronation -external rotation type (15.4 %), 7 of pronation -abduction type (13.5 %) in screw fixation group and 21 (48.9%),11 (25.6%), 7 (16.3%) 4 (9.3%) of each type in tension band wiring group. The average time to union was 15.7 weeks in screw fixation group and 12.8 weeks in tension band wiring group.(p<0.05) In the functional outcome (according to Meyer and Kumler), 29 patients treated (76.2 %) with screw fixation showed excellent results and 34 patients (86.6%) treated with tension band wiring had excellent results (p<0.05). Conclusion: We concluded that more satisfactory result could be obtained with modified tension band wiring compared with screw fixation in the treatment of the medial malleolar fracture.

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Transmasseteric Approach for Open Reduction and Internal Fixation of Mandible Subcondylar Fracture (깨물근을 통한 하악골 관절돌기하부골절의 관혈적 정복 및 내고정술)

  • Kim, Hak-Soo;Kim, Seong-Eun
    • Archives of Plastic Surgery
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    • v.37 no.2
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    • pp.161-168
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    • 2010
  • Purpose: Surgical approaches to the condylar neck and subcondyle area can cause some morbidity such as, facial nerve injury, time-consuming nature and external scar etc. So many surgeons hesitate using open reduction and internal fixation for the treatment of subcondylar fractures. We report open reduction and internal fixation of subcondylar fractures in 13 adult patients via transmasseteric approach. Methods: From 2007 to 2009, 13 adults with subcondylar fracture of mandible were treated with open reduction and internal fixation via transmasseteric approach. A preauricular incision was extended downwards in a curvilinear fashion in the cervicomastoid skin crease. Skin flap was elevated above the SMAS layer. Masseter muscle was splitted at the anteroinferior edge of the parotid gland. After the fracture was reduced, fixed with appropriate plates and screws. All operation were performed under general anesthesia. Results: Mean follow-up period was 13.3 months. There were no signs and symptoms of facial nerve injury, difficulty in mouth opening, or malocclusion. Dissection time was roughly within 30 minutes. Conclusion: Transmasseteric open reduction and internal fixation of mandible subcondylar fracture can be performed with excellent visualization, and inconspicuous scar. It also offers swift access to the subcondylar area while substatially reducing the risk to the facial nerve and eliminating the complications associated with transparotid approaches.

A Comparative Study of Intermaxillary Fixation and Manual Reduction at Open Reduction and Internal Fixation of Mandibular Fractures

  • Jin, Soo-Young;Kim, Su-Gwan;Oh, Ji-Su;Kim, Jeong-Sun;Jeong, Mi-Ae
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.35 no.1
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    • pp.51-54
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    • 2013
  • Purpose: The purpose of this study is to evaluate the difference between open reduction and internal fixation (ORIF) and intermaxillary fixation (IMF) of mandibular fractures. Methods: A total of one hundred twenty-seven patients who were treated for mandibular fractures at Chosun University Dental Hospital, from January 2008 to December 2010, and analyzed their prognoses based on the use of IMF at the time of fracture reduction. The patients were divided into two groups; the manual reduction group without IMF and IMF group. Results: After reduction of the mandibular fracture, good results were obtained with majority patients. Nonetheless, seven patients (13.0%) in manual reduction method without arch bars or IMF, developed complications after surgery. Three patients underwent IMF due to occlusal instability after surgery, while one patient underwent re-operation. Thus, a significant difference was not observed between the IMF and manual reduction groups. Conclusion: Manual reduction and IMF at mandibular simple fracture could produce good results. In case of mandibular simple fracture, it was recommended with only manual reduction without IMF or IMF during a short period.