scholarly journals Open Fracture of the Acromion: An Isolated Injury with Oblique-Type Fracture

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Mohammad O. Alawad ◽  
Saleh Alharthi ◽  
Jameel Mahmoud ◽  
Basam Alanazi ◽  
Saad Surur
Keyword(s):  
Clinical Outcome ◽  
Open Fracture ◽  
Screw Fixation ◽  
Fracture Classification ◽  
Good Recovery ◽  
Scapular Fracture ◽  
Type Fracture ◽  
Isolated Injury ◽  
Acromial Fracture ◽  
Excellent Clinical Outcome

Open acromial fractures are a rare set of fractures. We report a case of Gustilo IIIA open acromial fracture (14A2 as per OTA scapular fracture classification) that was isolated from any other injury. Our patient had a good recovery and showed excellent clinical outcome after irrigation and screw fixation of the acromial fracture. We also reviewed the literature for other cases of open acromial fracture.

An unusual ischaemic presentation of thrombosed intracranial mycotic aneurysm with subsequent subarachnoid haemorrhage

2020 ◽  
Vol 13 (10) ◽  
pp. e237044
Author(s):  
Patrick Brown ◽  
Daniel Fulks
Keyword(s):  
Clinical Outcome ◽  
Subarachnoid Haemorrhage ◽  
Mycotic Aneurysm ◽  
Unusual Case ◽  
Endovascular Management ◽  
Coil Embolisation ◽  
Vessel Occlusion ◽  
Aneurysmal Rupture ◽  
Excellent Clinical Outcome

We present an unusual case of acute ischaemic stroke secondary to thrombosed mycotic aneurysm with subsequent early aneurysmal rupture and subarachnoid haemorrhage, successfully treated with endovascular coil embolisation of the thrombosed segment. Imaging correlates are presented demonstrating successful endovascular management despite vessel occlusion precluding angiographic visualisation of the aneurysmal segment. Imaging and clinical follow-up is provided demonstrating durable occlusion and excellent clinical outcome with full functional recovery.

scholarly journals Guideline update for the performance of fusion procedures for degenerative disease of the lumbar spine. Part 12: Pedicle screw fixation as an adjunct to posterolateral fusion

2014 ◽  
Vol 21 (1) ◽  
pp. 75-78 ◽  
Author(s):  
Michael W. Groff ◽  
Andrew T. Dailey ◽  
Zoher Ghogawala ◽  
Daniel K. Resnick ◽  
William C. Watters ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Clinical Outcome ◽  
Pedicle Screw ◽  
Chronic Low Back Pain ◽  
Screw Fixation ◽  
Lumbar Fusion ◽  
Pedicle Screw Fixation ◽  
Controlled Study ◽  
Low Back

The utilization of pedicle screw fixation as an adjunct to posterolateral lumbar fusion (PLF) has become routine, but demonstration of a definitive benefit remains problematic. The medical evidence indicates that the addition of pedicle screw fixation to PLF increases fusion rates when assessed with dynamic radiographs. More recent evidence, since publication of the 2005 Lumbar Fusion Guidelines, suggests a stronger association between radiographic fusion and clinical outcome, although, even now, no clear correlation has been demonstrated. Although several reports suggest that clinical outcomes are improved with the addition of pedicle screw fixation, there are conflicting findings from similarly classified evidence. Furthermore, the largest contemporary, randomized, controlled study on this topic failed to demonstrate a significant clinical benefit with the use of pedicle screw fixation in patients undergoing PLF for chronic low-back pain. This absence of proof should not, however, be interpreted as proof of absence. Several limitations continue to compromise these investigations. For example, in the majority of studies the sample size is insufficient to detect small increments in clinical outcome that may be observed with pedicle screw fixation. Therefore, no definitive statement regarding the efficacy of pedicle screw fixation as a means to improve functional outcomes in patients undergoing PLF for chronic low-back pain can be made. There appears to be consistent evidence suggesting that pedicle screw fixation increases the costs and complication rate of PLF. High-risk patients, including (but not limited to) patients who smoke, patients who are undergoing revision surgery, or patients who suffer from medical conditions that may compromise fusion potential, may appreciate a greater benefit with supplemental pedicle screw fixation. It is recommended, therefore, that the use of pedicle screw fixation as a supplement to PLF be reserved for those patients in whom there is an increased risk of nonunion when treated with only PLF.

scholarly journals Use of intramedullary implants in adult diaphyseal fracture both bone forearm

2018 ◽  
Vol 4 (2) ◽  
pp. 243
Author(s):  
Rajesh Kumar Jain ◽  
Nitin Kiradiya
Keyword(s):  
Success Rate ◽  
Open Reduction ◽  
Open Fracture ◽  
Screw Fixation ◽  
Excellent Result ◽  
Forearm Fracture ◽  
Operating Time ◽  
Surgical Trauma ◽  
Acceptable Result ◽  
Operative Planning

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Fractures of the forearm bones are very common. The most common form of stabilization is plate and screw fixation. The role of Intramedullary nailing of fractures of the shafts of the adult radius and ulna is still to be defined. This study was perform to analyze anatomical and function outcome of the patients treated by Talwarkar square nail.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">We evaluated 46 patients (29 males and 17 females) had fracture both bone forearm treated by intramedullary nail. We analyzed patients in two broad group one with close fracture or grade I, II open fracture (34 patients) and other have open fracture grade IIIA or IIIB (12 patients). First group patients further analyzed weather close (22 patients) or open reduction (8 patients) required. Functional outcome was calculated by Grace and Eversman system</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Out of 32 patients of close fracture or open grade 1 or 2 fracture, 29 (90.62%) have excellent or acceptable result. All the patients (100%) in whom close reduction succeeds achieved excellent result. 22 (64.70%) patients close nailing possible.12 patients in whom open reduction required 9 (75%) goes into union. Close nailing have overall success rate is 90.62% where it fail and open nailing require success rate bring down to 75%.. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">IM nailing gives satisfactory results. Advantages of close nailing are- early union, low incidence of infection, small scars, less blood loss, short operating time with minimal surgical trauma, easier implant removal. Even though plate and screw fixation is the gold standard for stabilization of both bone forearm fracture but intramedullay implant can be used in selected cases with good result. To achieve acceptable result – early surgery, proper selection of the case, pre-operative planning, proper assessment of diameter, length and radial bowing of the nail, is required.</span></p>

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