scholarly journals An Effective and Feasible Method, “Hammering Technique,” for Percutaneous Fixation of Anterior Column Acetabular Fracture

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Lihai Zhang ◽  
Peng Yin ◽  
Wei Zhang ◽  
Tongtong Li ◽  
Jiantao Li ◽  
...  
Keyword(s):  
Acetabular Fracture ◽  
Guide Wire ◽  
Operation Time ◽  
Anterior Column ◽  
Percutaneous Fixation ◽  
Fluoroscopic Time ◽  
The Mean ◽  
Cortical Perforation ◽  
Mean Time ◽  
Time From Injury

Objective. The objective of this study was to evaluate the effectiveness and advantages of percutaneous fixation of anterior column acetabular fracture with “hammering technique.”Materials and Methods. We retrospectively reviewed 16 patients with percutaneous fixation of anterior column acetabular fracture with “hammering technique.” There were 11 males and 5 females with an average age of 38.88 years (range: 24–54 years) in our study. Our study included 7 nondisplaced fractures, 6 mild displaced fractures (<2 mm), and 5 displaced fractures (>2 mm). The mean time from injury to surgery was 4.5 days (range: 2–7 days).Results. The average of operation time was 27.56 minutes (range: 15–45 minutes), and the mean blood loss was 55.28 mL (range: 15–100 mL). The mean fluoroscopic time was 54.78 seconds (range: 40–77 seconds). The first pass of the guide wire was acceptable without cortical perforation or intra-articular perforation in 88.89% (16/18) of the procedures, and the second attempt was in 11.11% (2/18).Conclusion. Our study suggested that percutaneous fixation of anterior column acetabular fracture with “hammering technique” acquired satisfying surgical and clinical outcomes. It may be an alternative satisfying treatment for percutaneous fixation of anterior column acetabular fracture by 2D fluoroscopy using a C-arm with less fluoroscopic time.

scholarly journals Management of Vertical Sternal Fracture Nonunion in Elite-Level Athletes

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110108
Author(s):  
Andrea Bardos ◽  
Sanjeeve Sabhrawal ◽  
Graham Tytherleigh-Strong
Keyword(s):  
Ct Scan ◽  
Constant Score ◽  
Case Series ◽  
Sternal Fracture ◽  
Elite Level ◽  
The Mean ◽  
Mean Time ◽  
Time From Injury ◽  
Sternal Fractures

Background: Sternal fractures are rare, and they can be treated nonoperatively. Vertical sternal fractures have rarely been reported. Purpose: To describe the management and surgical treatment of a series of elite-level athletes who presented with symptomatic nonunions of a vertical sternal fracture. Study Design: Case series; Level of evidence, 4. Methods: Patients with an established symptomatic nonunion of a vertical sternal fracture, as diagnosed by computed tomography (CT) or magnetic resonance imaging (MRI), underwent open reduction and internal fixation using autologous bone graft and cannulated lag screws. The patients were assessed preoperatively and at the final follow-up using the Rockwood sternoclavicular joint (SCJ) score; Constant score; and shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) scores. Bony union was confirmed on postoperative CT scan. Results: Five patients (4 men and 1 woman) were included; all were national- or international-level athletes (rugby, judo, show-jumping, and MotoGP). The mean age at surgery was 23.4 years (range, 19-27 years), the mean time from injury to referral was 13.6 months (range, 10-17 months), and the mean time from injury to surgery was 15.8 months (range, 11-20 months). The mean follow-up was 99.4 months (range, 25-168 months). There was a significant improvement after surgery in the mean Rockwood SCJ score (from 12.6 to 14.8 [ P < .05]), Constant score (from 84 to 96.4 [ P < .05]; 80% met the minimal clinically important difference [MCID] of 10.4 points), and QuickDASH (from 6.8 to 0.98 [ P < .05]; 0% met the MCID of 15.9 points). Four of the patients were able to return to sport at their preinjury level, and 1 patient retired for nonmedical reasons. All of the fractures had united on the postoperative CT scan. There were no postoperative complications. Conclusion: Vertical fractures of the sternum are very rare and tend to behave clinically like an avulsion fracture injury to the capsuloligamentous structure of the inferior SCJ. The requirement of advanced imaging to diagnose this injury means that the actual incidence and natural history are not known. For high-demand athletes, early identification, surgical reduction, and fixation are likely to achieve the best outcome.

Modifield Desarda Repair and Hernioplastia Lichtenstein Repair for Inguinal Hernia

2021 ◽  
Vol 2 (3) ◽  
pp. 01-05
Author(s):  
Pedro Rolando Lòpez Rodrìguez ◽  
Eduardo Garcia Castillo ◽  
Olga Caridad Leòn Gonzàlez ◽  
Jorge Agustin Satorre Rocha ◽  
Luis Marrero Quiala ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Operative Time ◽  
Controlled Trial ◽  
Operation Time ◽  
Lichtenstein Repair ◽  
Prospective Randomized Controlled Trial ◽  
The Mean ◽  
Group 2 ◽  
Location Type ◽  
Mean Time

Introduction: The objective of this study is to compare the outcomes of Modified Desarda repair no mesh and Lichtenstein repair for inguinal hernia. Methods: This is a prospective randomized controlled trial study of 1342 patients having 1394 hernias operated from January 2008 to December 2020. 690 patients were operated using Lichtenstein repair and 652 using Desarda repair. The demographie data (Age,Sex) , hernia type and location , anesthetic , operative time , postoperative pain and complications were analysed. Results: There were no significant differences regarding age, sex, location, type of hernia, and pain in both the groups. The operation time was 52 minutes in Modified Desarda group and 42 minutes in the Lichtenstein group that is significant (p<0.05). The recurrence was 0.0 % in Modified Desarda group and 0.28 % in Lichtenstein group. But, there were 9 cases of infection to the polypropylene mesh in the Lichtenstein group, 2 of this required re-exploration. The morbidity was also significantly more in Lichtenstein group (7,6 %) as compared to Modified Desarda group (3.8 %). The mean time to return to work in the Modified Desarda group was 8.26 days while a mean of 12.58 days was in the Lichtenstein group. The mean hospital stay was 29 hrs. in Modified Desarda group while it was 49 hours in the Lichtenstein group in those patients who were hospitalized. Conclusions: The modified Desarda repair scores significantly on Lichtenstein repair in most of all aspects, including reexplorations and morbidity. Modified Desarda repair is a better option compared to Lichtenstein repair.

Morphology of Spring Ligament Fibrocartilage Complex Lesions

2019 ◽  
Vol 109 (5) ◽  
pp. 407-411 ◽  
Author(s):  
Marcin Domzalski ◽  
Adam Kwapisz ◽  
Sebastian Zabierek
Keyword(s):  
Surgical Treatment ◽  
Surgical Techniques ◽  
Anatomical Variations ◽  
Patient Age ◽  
Spring Ligament ◽  
The Mean ◽  
Mean Time ◽  
Time From Injury ◽  
Complex Lesions

Background: The spring ligament fibrocartilage complex (SLFC) is an important static foot stabilizer comprising the superomedial ligament (SML) and the inferior ligament, with anatomical variations (third ligament). The aim of this study was to describe the patterns of the lesions found during SLFC surgery, to allow direct comparison between the results with various surgical techniques. Methods: Fourteen consecutive patients with SLFC lesions were analyzed during surgical treatment. The mean patient age was 37.3 years, and the mean time from injury was 6.9 months. Intraoperative assessments and anatomical descriptions of the lesions were collected. Results: Three types of lesion were found. In 13 of 14 cases, only the superomedial ligament was involved: five superomedial ligament distentions and eight superomedial ligament ruptures. In one case, total SLFC (superomedial and inferior ligaments) rupture was observed. Conclusions: The first classification of SLFC lesions is presented, which is simple, consistent, and based on anatomical description.

scholarly journals Application of cystourethroscopy during tracheobronchial foreign body removal in children

2018 ◽  
Vol 46 (9) ◽  
pp. 3741-3747
Author(s):  
Bifan Deng ◽  
Weiguang Tang ◽  
Feiqun Su ◽  
Hua Li ◽  
Wanqiang Lai ◽  
...  
Keyword(s):  
Medical Records ◽  
Foreign Bodies ◽  
Operation Time ◽  
Foreign Body Removal ◽  
Operational Risks ◽  
Removal Time ◽  
Tracheobronchial Foreign Body ◽  
Successful Removal ◽  
The Mean ◽  
Mean Time

Objective This study aimed to describe preliminary experiences associated with removal of tracheobronchial foreign bodies (TFBs) by cystourethroscopy (CU). Methods We performed a retrospective analysis of 127 paediatric cases of TFB removal by CU at our centre from January 2009 to August 2016. Data that were extracted from the medical records included age, sex, location and nature of the TFBs, operation time, and complications. Results All TFBs were successfully removed by CU. The mean time of the procedure was 3.38 ± 2.86 minutes. A total of 102 (80.31%) patients had successful removal of TFBs by CU during the initial trial, 19 (14.96%) were successfully treated in the second trial, and six (4.72%) required a third trial. Otolaryngologists with 2, 5, and 7 years of professional CU training showed a mean TFB removal time of 3.38 ± 2.13, 3.40 ± 3.60, and 3.37 ± 2.86 minutes, respectively. In the operations, oxygen saturation fell below 90% at an average occurrence of 0.39 times, but no patients showed a decrease below 85%. Only one patient experienced laryngeal oedema after the procedure. Conclusion CU is a useful technique and minimizes complications and operational risks during removal of paediatric TFBs.

Study of Hazard Rate Functions on the Cumulative Damage Phenomenon

2011 ◽  
Vol 27 (1) ◽  
pp. 47-55 ◽  
Author(s):  
K. S. Wang
Keyword(s):  
Hazard Rate ◽  
Failure Mechanisms ◽  
Operation Time ◽  
Cumulative Damage ◽  
Hazard Rates ◽  
Type B ◽  
The Past ◽  
Rate Functions ◽  
The Mean ◽  
Mean Time

ABSTRACTIn this paper different failure mechanisms which yield cumulative damage are investigated through two types of hazard rate functions. They have been studied during the past two decades. Type A was developed early by assuming the hazard rate as a function of reliability. There are two kinds of trend, one follows the negative logistic decay model, the other the negative Gompertz decay. Some modifications are suggested according to the failure tendency and convenience of fittings. Type B is developed recently by assuming the hazard rate as a function of the expected operation time, T, which is defined as the integration of reliability over the time, normalized by the mean-time-between-failure. In both types the proposed hazard rates grow with the time monotonically. Typical examples are taken to examine these models, meanwhile the comparisons with the Weibull-typed distribution are also made. The results show that the most of proposed relations are successful in the expression of cumulative damage phenomenon, especially the Type B is a better choice even compared with the Weibull-typed description in some respects. The advantages of the models are discussed based on the physical meanings involved in the parameters.

scholarly journals Pregnancy outcome of laparoscopic tubal reanastomosis: retrospective results from a single clinical centre

2017 ◽  
Vol 45 (3) ◽  
pp. 1245-1252 ◽  
Author(s):  
Rana Karayalcin ◽  
Sarp Ozcan ◽  
Aytekin Tokmak ◽  
Beril Gürlek ◽  
Okan Yenicesu ◽  
...  
Keyword(s):  
Treatment Options ◽  
Operation Time ◽  
Careful Consideration ◽  
Tubal Ligation ◽  
Tubal Sterilization ◽  
Intrauterine Pregnancy ◽  
Clinical Centre ◽  
The Mean ◽  
Tubal Reanastomosis ◽  
Mean Time

Objective Tubal sterilization is a widespread method of contraception. Post-sterilization regret is encountered, despite careful consideration prior to the procedure. Two treatment options are available for women after having had tubal sterilization: microsurgical reversal and IVF treatment. Recent improvements in laparoscopy have allowed tubal reanastomosis to be performed. This study aimed to evaluate the reproductive outcome after laparoscopic tubal reanastomosis and surgical features of the patients. Methods From June 2007 to January 2010, 27 patients with bilateral tubal ligation who underwent laparoscopic tubal reanastomosis were evaluated retrospectively. Tubal sterilization was performed by Pomeroy’s technique during caesarean section in all of the patients. Before surgery, all of the patients were evaluated for possible other causes of infertility and the results of the evaluation were normal. Results The mean age of the patients was 31.8 years (range, 27–38 years). The mean interval between sterilization and reversal was 5.1 years (range, 1–14 years). Bilateral reversal was achieved in 24 patients. The operation time ranged from 85 to 140 minutes with a mean time of 105 minutes. All of the patients were discharged on the next day. There were no postoperative complications. Overall pregnancy, intrauterine pregnancy, and ectopic pregnancy rates were 55.5% (15/27), 51.8% (14/27), and 3.7% (1/27), respectively. Of the 14 intrauterine pregnancies, one ended with abortion at 6 weeks’ gestation (1/14). The mean interval from surgery to pregnancy was 270 days (range, 147–420 days). Conclusion Laparoscopic tubal reanastomosis has the advantages of fewer complications, less postoperative discomfort, a smaller incisional scar, a shorter recovery time, and earlier resumption of normal activities. This technique has a satisfactory pregnancy rate in selected patients who desire reversal of tubal sterilization.

Modified Laparoscopic Pyloroplasty During Laparoscopic Splenectomy and Azygoportal Disconnection for the Prevention of Postoperative Gastroparesis

2017 ◽  
Vol 24 (4) ◽  
pp. 328-335
Author(s):  
Guoqing Jiang ◽  
Dousheng Bai ◽  
Jianjun Qian ◽  
Ping Chen ◽  
Shengjie Jin
Keyword(s):  
Laparoscopic Splenectomy ◽  
Operation Time ◽  
Gastric Retention ◽  
Common Complication ◽  
Short Term ◽  
Gastric Emptying Scintigraphy ◽  
Cirrhotic Patients ◽  
The Mean ◽  
Time Required ◽  
Mean Time

Background. Gastroparesis is a common complication after splenectomy and azygoportal disconnection, remaining a chronic debilitating disorder with considerable treatment challenges. To minimize postoperative gastroparesis, we have developed a new modified laparoscopic pyloroplasty (LP) technique for use during laparoscopic splenectomy and azygoportal disconnection (LSD). Methods. We retrospectively evaluated the outcomes of 31 cirrhotic patients with portal hypertensive bleeding and secondary hypersplenism who underwent synchronous LSD with modified LP (n = 14) or LSD without modified LP (n = 17) between January 2015 and August 2015. Perioperative variables were compared. Results. LSD with and without modified LP were successful in all patients. Operation time was significantly longer for LSD with modified LP than LSD without modified LP ( P = .001). However, the LSD with modified LP group had significantly reduced incidences of bloating 1 month postoperatively ( P < .05), nausea ( P < .05), and bloating ( P < .05) 3 months postoperatively, gastric retention 3 months postoperatively ( P < .0001), and prokinetic use at 1 month ( P = .009) and 3 months postoperatively ( P < .05) compared with the LSD without modified LP group. Gastric emptying scintigraphy showed that the mean time required to empty 50% of the ingested meal was significantly shorter in the LSD with modified LP group than in the LSD without modified LP group at 3 months postoperatively (74.3 ± 19.1 vs 261.7 ± 61.0 minutes, P < .0001). Conclusions. Modified LP during LSD was feasible, effective, and safe, and significantly reduced short-term symptoms of postoperative gastroparesis.

scholarly journals Comparative study between saddle block and local anesthesia on excision of pilonidal sinus by using ligaSure

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Ayman Esmail Hussien ◽  
Amira Ibrahim Fahim
Keyword(s):  
Patient Satisfaction ◽  
Local Anesthesia ◽  
Pilonidal Sinus ◽  
Operation Time ◽  
Early Discharge ◽  
Procedure Time ◽  
General Anesthetic ◽  
The Mean ◽  
Mean Time ◽  
Room Time

Abstract Background The excision of the pilonidal sinus starts at 1833. Local, spinal, or general anesthetic procedures for the disease are widely used. The excision of the pilonidal sinus by using ligaSure reduces blood loss, reduces procedure time, and reduces patient length of stay. Therefore, the purpose of this study is to compare between local anesthesia and saddle block on the excision of the pilonidal sinus by using ligaSure, with respect to recovery time, postoperative complications, and patient satisfaction. Results Forty patients were analyzed; the mean time of anesthesia, operation time, and operating room time were showing highly significantly lower in group LA when compared to group SA (P value < 0.01). At the postoperative period, patients in group LA experienced less intense postoperative pain with prolonged time of the first request for analgesia than patients in other groups. Conclusion Local anesthesia has more efficacy in early start of anesthesia, early discharge from the hospital with prolonged analgesia, strong hemostasis, more patient satisfaction, and more than saddle block .Therefore, local anesthesia is considered as an alternative to the saddle block on the excision of the pilonidal sinus by using ligaSure.

scholarly journals A Novel Anatomical Locking Plate Combined With an Anterior Column Screw and Magic Screw for Acetabular Fractures Involving Both Columns: Reduction Effect and Functional Outcomes

2020 ◽  
Author(s):  
Gongzi Zhang ◽  
Shuwei Zhang ◽  
Yi Sui ◽  
Xiang Wang ◽  
Xiuyun Su ◽  
...  
Keyword(s):  
Acetabular Fracture ◽  
Locking Plate ◽  
Operation Time ◽  
Operative Approach ◽  
Acetabular Fractures ◽  
Fracture Classification ◽  
Reduction Effect ◽  
Transverse Fractures ◽  
Time From Injury

Abstract BackgroundA novel anatomical locking plate (NALP) was designed. The NALP is fixed via an anterior column screw and a Magic screw to apply pressure on the acetabular fracture ends. This study was performed to compare the reduction effect and clinical outcome of the NALP versus the anatomical locking plate (ALP) for acetabular fractures involving both columns.MethodsFrom January 2013 to January 2018, 22 patients with acetabular fractures involving both columns were treated using the NALP or ALP in a single institution. The general condition and type of fracture were recorded. The NALP and ALP groups were compared regarding the Letournel fracture classification, operative approach, time from injury to operation, intraoperative bleeding volume, and operation time. The radiographic reduction outcome and hip function at final follow-up were compared between the two groups based on the Matta scores and Harris hip scores, respectively.ResultsThe NALP was used in 10 patients, while the ALP was used in 12. Three patients had transverse fractures, 12 had transverse fractures involving posterior wall, and 7 had double-column fractures. The two groups had no significantly differ regarding sex, age, affected side, Letournel fracture classification, operative approach, or follow-up duration. The time from injury to the operation was 20.70±1.2 days in the NALP group and 13.17±7.5 days in the ALP group (p=0.089). The operation time was 332.20±128.9 minutes in the NALP group and 257.50±91.6 minutes in the ALP group (p=0.128). The intraoperative blood loss volume was 1550.00±869.5 ml in the NALP group and 666.67±370.1 ml in the ALP group (p=0.011). The Matta score at final follow-up was 1.10±0.8 in the NALP group and 2.46±1.9 in the ALP group (p=0.045). The Harris hip score at final follow-up was 87.50±10.5 in the NALP group and 81.00±10.1 in the ALP group (p=0.0782).ConclusionThe NALP achieves adequate compression of the acetabular fracture ends and obtains stronger fixation than the ALP.Trial registrationChiCTR,ChiCTR2000030825. Registered 15 March 2020 - Retrospectively registered, http://www.chictr.org.cn/ChiCTR2000030825

scholarly journals Z-Plasty of the Flexor Hallucis Longus Tendon at Tarsal Tunnel for Checkrein Deformity

2016 ◽  
Vol 24 (3) ◽  
pp. 354-357 ◽  
Author(s):  
Jae Hoon Lee ◽  
Young Jun Kim ◽  
Jong Hun Baek ◽  
Dong Hee Kim
Keyword(s):  
Flexor Hallucis Longus ◽  
Tarsal Tunnel ◽  
Foot And Ankle ◽  
Viable Option ◽  
Fibular Fracture ◽  
Tunnel Syndrome ◽  
The Mean ◽  
Mean Time ◽  
Time From Injury

Purposes To review the outcome of Z-plasty of the flexor hallucis longus (FHL) tendon at the tarsal tunnel for checkrein deformity in 8 patients. Methods Records of 6 males and 2 females aged 14 to 67 (mean, 39.5) years who underwent Z-plasty (lengthening) of the FHL tendon at the tarsal tunnel for checkrein deformity in the first and second toes by a single surgeon were reviewed. All patients had undergone 3 months of conservative treatment. The mean time from injury to surgical treatment was 8.4 (range, 5–12) months. All patients had associated injuries including distal tibiofibular fracture (n=6), distal fibular fracture (n=1), and crush injury around the ankle (n=1); they were treated with intramedullary nailing (n=6), long leg splinting (n=1), and short leg splinting (n=1). Results After a mean follow-up of 3.4 (range, 1–7) years, the FHL tendon was lengthened by a mean of 1.7 (range, 1.6–1.8) cm, and the mean American Orthopedic Foot and Ankle Society hallux score increased from 59 (range, 52–67) to 89 (range, 80–90). No patient had recurrence, nerve injury, or tarsal tunnel syndrome, although one patient had sensory disturbance of the posterior tibial nerve in the forefoot, which resolved spontaneously at week 2. Conclusion Z-plasty of the FHL tendon at the tarsal tunnel is a viable option for correction of checkrein deformity.

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