Treatment of Phalangeal Fractures by Tension Band Wiring

2001 ◽  
Vol 26 (1) ◽  
pp. 50-52 ◽  
Author(s):  
Y. SAFOURY
Keyword(s):  
Retrospective Study ◽  
Open Reduction ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Range Of Movement ◽  
Intraarticular Fractures ◽  
Phalangeal Fractures

This retrospective study assessed the outcomes of 30 patients with phalangeal fractures which were treated by open reduction and tension band wiring. Oblique, transverse and comminuted extraarticular fractures, as well as intraarticular fractures, were treated with this technique and they all united in about 8 weeks. There were no significant complications. At a mean follow-up period of 2.3 years, the active range of movement of the involved fingers was excellent in 17, and good in 13 instances. There were no fair or poor results.

scholarly journals Compression screws and buttress plate versus compression screws only for Hoffa fracture in Chinese patients: a comparative study

2018 ◽  
Vol 47 (1) ◽  
pp. 142-151 ◽  
Author(s):  
Bangbao Lu* ◽  
Shushan Zhao* ◽  
Zhongwei Luo ◽  
Zhangyuan Lin ◽  
Yong Zhu
Keyword(s):  
Retrospective Study ◽  
Comparative Study ◽  
Open Reduction ◽  
Knee Society Score ◽  
Chinese Patients ◽  
Plate Versus ◽  
Range Of Movement ◽  
Hoffa Fracture ◽  
Buttress Plate

Objective To compare compression screws and buttress plate (CS plus BP) with compression screws only (CS) in treating patients with Hoffa fracture. Methods This retrospective study included Chinese patients with Hoffa fracture treated by open reduction and internal fixation. Radiographs and clinical outcomes (range of movement [ROM], bone union and Knee Society Score [KSS]) were compared between patients treated using CS plus BP versus CS only. Results At 4 months following surgery, significantly better outcomes were shown in the CS plus BP group ( n = 24) versus CS only group ( n = 21) regarding ROM (120.4 ± 5.2° versus 110 ± 7.1°) and KSS (85.5 ± 4.1 versus 79.7 ± 3.3). At the 12-month follow-up, significantly better outcomes were maintained in the CS plus BP versus CS only group regarding ROM (126.2 ± 7.4° versus 120.5 ± 8.2°) and KSS (88.3 ± 4.6 versus 84.2 ± 4.0). At the final follow-up, all patients had normal fracture healing and no malunion, nonunion or reduction loss. Conclusions Fixation with CS plus BP for Hoffa fracture is effective and reliable, and may provide more adequate stability and better outcomes versus CS only.

scholarly journals Intramedullary screw fixation for simple displaced olecranon fractures

2019 ◽  
Vol 46 (1) ◽  
pp. 83-89 ◽  
Author(s):  
Willem-Maarten P. F. Bosman ◽  
Benjamin L. Emmink ◽  
Abhiram R. Bhashyam ◽  
R. Marijn Houwert ◽  
Jort Keizer
Keyword(s):  
Soft Tissue ◽  
Plate Fixation ◽  
Cannulated Screw ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Hardware Removal ◽  
Dash Score ◽  
Intramedullary Screw ◽  
Olecranon Fractures

Abstract Purpose Olecranon fractures are common and typically require surgical fixation due to displacement generated by the pull of the triceps muscle. The most common techniques for repairing olecranon fractures are tension-band wiring or plate fixation, but these methods are associated with high rates of implant-related soft-tissue irritation. Another treatment option is fixation with an intramedullary screw, but less is known about surgical results using this strategy. Thus, the purpose of this study was to report the clinical and functional outcomes of olecranon fractures treated with an intramedullary cannulated screw. Methods We identified 15 patients (average age at index procedure 44 years, range 16–83) with a Mayo type I or IIA olecranon fracture who were treated with an intramedullary cannulated screw at a single level 2 trauma center between 2012 and 2017. The medical record was reviewed to assess radiographic union, postoperative range of motion and complications (including hardware removal). Patient-reported outcome was evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score. Average follow-up was 22 months (range 8–36 months). Results By the 6th month post-operative visit, 14 patients had complete union of their fracture and 1 patient had an asymptomatic non-union that did not require further intervention. Average flexion was 145° (range 135–160) and the average extension lag was 11° (range 0–30). Implants were removed in 5 patients due to soft-tissue irritation. Average DASH score (± standard deviation) by final follow-up was 16 ± 10. Conclusions Fixation of simple olecranon fractures with an intramedullary screw is a safe and easy fixation method in young patients, leading to good functional and radiological results. Compared to available data, less hardware removal is necessary than with tension-band wiring or plate fixation.

Heterotopic ossification following total elbow arthroplasty

2018 ◽  
Vol 100-B (6) ◽  
pp. 767-771 ◽  
Author(s):  
P. M. Robinson ◽  
S. J. MacInnes ◽  
D. Stanley ◽  
A. A. Ali
Keyword(s):  
Retrospective Study ◽  
Heterotopic Ossification ◽  
Clinical Outcomes ◽  
Total Elbow Arthroplasty ◽  
Range Of Movement ◽  
Exact Test ◽  
Elbow Arthroplasty ◽  
Fisher’S Exact Test ◽  
Trauma Group

Aim The primary aim of this retrospective study was to identify the incidence of heterotopic ossification (HO) following elective and trauma elbow arthroplasty. The secondary aim was to determine clinical outcomes with respect to the formation of heterotopic ossification. Patients and Methods A total of 55 total elbow arthroplasties (TEAs) (52 patients) performed between June 2007 and December 2015 were eligible for inclusion in the study (29 TEAs for primary elective arthroplasty and 26 TEAs for trauma). At review, 15 patients (17 total elbow arthroplasties) had died from unrelated causes. There were 14 men and 38 women with a mean age of 70 years (42 to 90). The median clinical follow-up was 3.6 years (1.2 to 6) and the median radiological follow-up was 3.1 years (0.5 to 7.5). Results The overall incidence of HO was 84% (46/55). This was higher in the trauma group (96%, 25/26) compared with the elective arthroplasty group (72%, 21/29) (p = 0.027, Fisher’s exact test). Patients in the trauma group had HO of higher Brooker class. The presence of HO did not significantly affect elbow range of movement within the trauma or elective groups (elective arthroplasty, Mann–Whitney U test, p = 0.070; trauma arthroplasty, p = 0.370, Mann–Whitney U test). Conclusion HO after total elbow arthroplasty is seen more commonly than previously reported. We have reported a significantly higher rate of HO in TEAs performed for trauma than those performed electively. Cite this article: Bone Joint J 2018;100-B:767–71.

scholarly journals Comparison of total patellectomy and osteosynthesis with tension band wiring in patients with highly comminuted patella fractures: a 10–20-year follow-up study

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Xiangtian Deng ◽  
Lian Zhu ◽  
Hongzhi Hu ◽  
Jian Zhu ◽  
Weijian Liu ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Peak Torque ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Patient Demographics ◽  
Patella Fractures ◽  
Sf 36 ◽  
Kujala Score ◽  
Injured Knee

Abstract Background The purpose of this study was to evaluate and compare the long-term clinical outcomes between the total patellectomy and osteosynthesis with tension band wiring in patients with highly comminuted patella fractures. Methods Between January 1987 and December 2003, this retrospective study included a total of 35 patients (mean age, 51.4±16.8 years) with a minimum of 10 years follow-up period, comprising 29 males and 6 females, who were divided into the total patellectomy group (17 patients) or the open reduction and internal fixation (ORIF) group (18 patients) in the Third Affiliated Hospital of Hebei Medical University. We retrospectively collected patient demographics and data on the type of trauma, fracture type, and postoperative complications. Clinical outcomes including knee range of motion (ROM), 36-Item Short-Form Health Survey (SF-36) score [including physical component score (PCS) and mental component score (MCS)], Knee Injury and Osteoarthritis Outcome Score (KOOS), and Kujala score were evaluated and compared between the two groups. Biodex System dynamometer was used to quantitatively evaluate quadriceps femoris muscle power following measurement of peak torque. Results The mean follow-up periods of the total patellectomy group and the ORIF group were 17.2±5.6 and 16.8±4.9 years, respectively. There were no significant differences between the two groups of patient demographics in terms of the number of patients, age, sex, injury side, time to surgery, type of trauma, and fracture classification (p>0.05). Total patellectomy was comparable to osteosynthesis with tension band wiring in terms of ROM [injured knee: 120.4±3.1° vs 118.6±3.3°; uninjured knee: 126.5±2.8° vs 127.3±1.7°; both p>0.05], peak torque [Injured knee: 96.2±2.3 vs 97.3±2.6, N· m; Uninjured knee: 107.6±2.1 vs 106.3±1.8, N· m; both p>0.05], SF-36 score [PCS: 64.1±18.0 vs 61.5±17.9; MCS: 55.1±13.8 vs 54.3±12.4; both p>0.05], KOOS score [76.3±12.1 vs 73.4±11.7; p>0.05], and Kujala score [67.6±11.8 vs 70.8±11.9; p>0.05] at the final follow-up, while total patellectomy had significantly shorter operation time than ORIF group (47.5±12.1 vs 68.8±22.3, min, p<0.05). In the total patellectomy group, complications occurred in 6 of 17 cases (35.3%), and all occurred with calcification. In the ORIF group, complications occurred in 12 of 18 cases (66.7%), including 2 cases of infection (11.1%), 1 case of non-union (5.6%), 2 cases of implant failure (11.1%), 2 cases of soft tissue irritation (11.1%), and 5 cases of patellofemoral arthritis (27.8%). Conclusions Total patellectomy technique was a safe and reliable alternative treatment for treating patients with highly comminuted patella fractures when anatomically reduction and rigid fixation were difficult, although it caused relatively higher rates of calcification.

scholarly journals Short-term functional results of surgical management of fractures of olecranon process of ulna by locking hook plate

2021 ◽  
Author(s):  
Maruti B. Lingayat ◽  
Altamash Patel ◽  
Chandrakant R. Thorat
Keyword(s):  
Functional Results ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Olecranon Fracture ◽  
Hook Plate ◽  
Sensitivity Testing ◽  
Superficial Infection ◽  
Non Union ◽  
Olecranon Process

<p class="abstract"><strong>Background:</strong> The aim was to study functional results of fixation of fractures of olecranon process of ulna by locking hook plate.</p><p class="abstract"><strong>Methods:</strong> The study was conducted on 30 patients who underwent fixation of olecranon fracture by locking hook plate in department of orthopaedics, GMCH Aurangabad from September 2018 to September 2020. Patients were assessed functionally using Mayo elbow performance score and radiologically using serial follow up radiographs of elbow.<strong></strong></p><p class="abstract"><strong>Results:</strong> At 2 year follow up of 30 patients of all types of olecranon fracture treated by locking hook plate, no patient had evidence of non-union or loss of reduction or any other major complications. In our study 21 patients (70%) showed excellent results, 6 patients (20%) showed good results and 3 patients (10%) showed fair results. None of the patients in our study showed poor results. 3 patients (10%) had superficial infection which were treated by adequate antibiotics after doing culture and sensitivity testing and 4 patients (13.33%) had symptomatic metal prominence which underwent implant removal after union of fracture.</p><p><strong>Conclusions:</strong> Fixation of all types of fractures of olecranon by locking hook plate is good alternative to other methods of fixation like tension band wiring, intramedullary fixation using screw tension band wiring which are used only in selected cases. In our study we conclude that locking hook plate is excellent modality of treatment for all types of fractures of olecranon, it gives excellent functional and radiological outcome with minimal complication and stable fixation of all types of fractures including transverse as well as comminuted fractures.</p>

scholarly journals Functional Outcome of Revision Osteosynthesis after failed surgical treatment of patellar fractures

2019 ◽  
Vol 7 (6_suppl4) ◽  
pp. 2325967119S0023
Author(s):  
Elena Müller ◽  
Karl-Heinz Frosch
Keyword(s):  
Range Of Motion ◽  
Functional Outcome ◽  
Revision Surgery ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Fracture Dislocation ◽  
Secondary Fracture ◽  
Patellar Fractures ◽  
Tegner Score

Aims and Objectives: Patellar fractures account for approximately 1% of all skeletal fractures. They are rare, but due to the crucial function of the patella in the extensor mechanism of the knee they can lead to a serious impairment. New data are revealing functional impairment remains common even with improved surgical techniques. The aim of this study is to asses the functional outcome of patients after revision surgery in case of secondary fracture dislocation or remaining articular incongruity. Materials and Methods: The study was designed as a retrospective observatory study. We included all patients who underwent a revision surgery because of a remaining articular incongruity or a secondary fracture dislocation or re-fracture from January 2010 until december 2016. Results: Sixteen patients of mean age 51,8 years were included in the study with a mean follow-up period of 28,8 months. Fifteen patients had AO type C fractures, within ten a C3 fracture. Thirteen were initially treated with tension band wiring via k-wires or cannulated screws. The reason for a revision surgery were 5 times a remaining articular incongruity, 11 times a secondary fracture dislocation or re-fracture. We analysed pain, satisfaction, range of motion, Böstman-Score, Tegner-Score and KOOS and could extract follow-up data from 15 of the patients. All fractures healed, no articular incongruity remained. Mean pain measured with the visual analogue scale (0-10) was at rest 0,57 (range 0-3,5), on exertion 2,79 (range 0-8). The measurement of the range of motion compared with the opposite knee showed a complete extension. Mean Flexion was 120°, in the opposite knee 136° (p = 0,05). Mean postoperative Böstman-Score and Tegner-Score were 25,11 (good, max. 30) and 78,67 (moderate, max. 100). KOOS: symptoms 66,8 points, pain 77,55 points, ADL 75,67 points and qualitiy of life 56,25 points. Conclusion: Early revision surgery in case of secondary fracture dislocation, re-fracture or remaining articular incongruity leads to statisfactory functional outcomes. Furthermore in case of complexe fractures the tension band wiring technique shouldn’t be the first choice, alternatives like the plate osteosynthesis should be considered.

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