EVALUATION OF THE RESULTS OF INTERNAL FIXATION TREATMENT OF THE ANKLE FRACTURE

2016 ◽  
pp. 16-22
Author(s):  
Van Cu Tran ◽  
Nghi Thanh Nhan Le
Keyword(s):  
Internal Fixation ◽  
Skin Infection ◽  
Ankle Fractures ◽  
Whole Body ◽  
Anatomical Structures ◽  
Radiological Criteria ◽  
Operative Complications ◽  
Fixation Treatment ◽  
The Stability

Background: Ankles play an important rolesince the whole body weight is transmitted through this region, and locomotion depends on the stability of the ankle. Ankle fractures are most commonly foundat the lower extremity. Open reduction and internal fixation have become the main treatment for most of ankle fractures because these operative methods help restore the anatomy, biomechanics and contact loading characteristics of ankles. The aim of this research is to evaluate the results of surgical treatment for ankle fractures and give suggestions for proper indications and better techniques to improve the quality of treatment. Materials & Methods: The study surveyed a number of 41 patients whose fractures were classified according to Danis - Weber classification. They were operated from January 2012 to June 2014 and then treated with internal fixations. Assessment of postoperative outcomes was done at the third month and the sixth month basing on Baird and Jackson’s scoring system with clinical and radiological criteria. Results: Forty one patients (male : female = 2,7; with a mean age of thirty six years) were involved in the study; 17 of the fractures were classified as Weber B (41,5%) and 24 as Weber C (58,5%). 19 patients (46,4%) had peroneous fractures and 22 patients (53,6%) had peroneous fractures combinedwith the other malleolar fractures.Evaluation of 39 patients at sixth month postoperation shows overall good to excellent results were obtained in 33 patients 38,4% and 48,7% of Weber B and C fracture), fair in 3 patients (7,7% of Weber C) and poor in 2 patients (2,6% and 2,6% of Weber B and C). No intra operative complications were found. Skin infection was identified as postoperative complications in 3 patients. Conclusions: Internal fixation for treatment of ankle fractures obtain good results. Anatomical structures and functions of ankles were well restored in the malleolar fractures.

scholarly journals Immediate Weight Bearing and Range of Motion After Internal Fixation of Unstable Ankle Fractures: A Retrospective Controlled Study

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0021
Author(s):  
Brianna R. Fram ◽  
Ryan G. Rogero ◽  
Daniel Corr ◽  
Gerard Chang ◽  
James Krieg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Internal Fixation ◽  
Range Of Motion ◽  
Ankle Fracture ◽  
Weight Bearing ◽  
Ankle Fractures ◽  
Controlled Study ◽  
Posterior Malleolus ◽  
Significant Difference ◽  
Operative Complications

Category: Ankle; Trauma Introduction/Purpose: Ankle fractures are the third most common adult fractures. Further, they are the second most common fracture type to require inpatient admission, behind only hip fractures, despite occurring in a population on average nearly 30 years younger. There is evidence that early or immediate weight bearing and range of motion may be safe following ankle fracture fixation, but existing studies are small and largely exclude patients with syndesmotic or posterior malleolar fixation. We therefore studied the safety of immediate weight bearing as tolerated (IWBAT) and immediate range of motion (IROM) following open reduction internal fixation (ORIF) of unstable ankle fractures in a diverse cohort and attempted to identify risk factors for complications. Methods: We performed a retrospective case-control study. Out of 268 patients who underwent primary ORIF of an unstable ankle fracture from 2013-18, we identified 133 (49.6%) who were IWBAT and IROM. The treating surgeon excluded patients from IWBAT if they had an ipsilateral leg injury requiring non-weight bearing, a large displaced posterior malleolus fragment, or Maisonneuve injury with fracture of the proximal fibula. We used propensity-score matching to identify 172 controls who were non-weight bearing (NWB) and no range of motion for 6 weeks post-op. We reviewed medical records and radiographs for demographic, injury and treatment characteristics. Our primary outcome was complications. We compared demographics, injury characteristics, treatment episode, and complications between the IWBAT and NWB groups and performed within group analysis to identify risk factors for complications. A p-value <0.05 was considered significant. Results: The groups did not differ significantly in age, BMI, Charleston Comorbidity Index (CCI), smoking status, diabetes status, malleoli involved, percentages undergoing medial malleolus (60.9% IWBAT vs. 51.7% NWB, p=0.11), posterior malleolus (24.1% IWBAT, 26.7% NWB, p=0.59), or syndesmosis fixation (41.4% IWBAT, 42.4% NWB, p=0.85). There was no significant difference in total complications (9.8% IWBAT vs. 12.8% NWB, p=0.41), nonoperative complications (6.8% IWBAT vs. 8.7% NWB, p=0.53), or operative complications (3.8% IWBAT vs. 4.1% NWB, p=0.89). We did not identify any factors associated with increased complication risk, including posterior malleolus or syndesmosis fixation, diabetes, age, CCI or pre-injury assisted ambulation. Conclusion: IWBAT and IROM may be safe following ankle fracture ORIF in a broader patient population than previously believed. We did not identify specific risk factors for post-operative complications. Further study on patient selection may allow for more extensive use of this protocol to reduce the morbidity associated with unstable ankle fractures. [Table: see text]

scholarly journals High Prevalence of Chronic Pain With Neuropathic Characteristics After Open Reduction and Internal Fixation of Ankle Fractures

2017 ◽  
Vol 38 (9) ◽  
pp. 987-996 ◽  
Author(s):  
Nadia Rbia ◽  
Cornelis H. van der Vlies ◽  
Berry I. Cleffken ◽  
Ruud W. Selles ◽  
Steven E. R. Hovius ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Neuropathic Pain ◽  
Internal Fixation ◽  
Open Reduction ◽  
Late Complications ◽  
Ankle Fractures ◽  
Posttraumatic Arthritis ◽  
Pain Symptoms

Background: Unstable ankle fractures require treatment with open reduction and internal fixation (ORIF). Long-term functional outcome is satisfying in most patients; however, a number of patients have persistent complaints. Superficial nerve complications following ankle surgery may be the cause of chronic pain and disability. Methods: In this observational retrospective survey, a cohort of 527 women and men, who underwent ORIF in the period from January 2007 to January 2014, were invited to an online questionnaire. Pain symptoms were assessed using the McGill Pain Questionnaire (MPQ) and the Douleur Neuropathic en 4 Questions (DN4) Questionnaire. Descriptive statistics were used to present patient characteristics; a logistic regression model was used to analyze prognostic factors of neuropathic pain. A total of 271 patients completed the questionnaire. Mean follow-up period was 5.8 years (±1.9). Results: Persistent neuropathic pain symptoms were present in 61 of all patients, and 51 of these patients reported an impaired quality of life caused by their symptoms. In univariate analysis, the following parameters were associated with neuropathic pain: age, hypertension, a thyroid disorder, lower back pain, fracture dislocations, and late complications such as nonunion, posttraumatic arthritis, or osteochondral injury. In multivariate analysis, an age between 40 and 60 years was found to be a significant predictor of neuropathic pain. Hypertension, dislocation, and late complications were significant predictors of persistent pain without neuropathic characteristics. Conclusion: The present study demonstrated a prevalence of persistent neuropathic pain symptoms after ORIF for ankle fractures in 23% of the respondents, which caused an impaired health-related quality of life. We identified 4 significant predictors of chronic and neuropathic pain after ORIF. This knowledge may aid the treating surgeon to identify patients who are at increased risk of persistent postoperative neuropathic pain and may affect the treatment of pain in these patients. Level of Evidence: Level IV, retrospective case series.

scholarly journals Vouchering of Forensically Important Fly Specimens by Nondestructive DNA Extraction

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Seong Yoon Kim ◽  
Seong Hwan Park ◽  
Huguo Piao ◽  
Ukhee Chung ◽  
Kwang Soo Ko ◽  
...  
Keyword(s):  
Dna Extraction ◽  
Pcr Amplification ◽  
Nondestructive Method ◽  
Anatomical Structure ◽  
Whole Body ◽  
Anatomical Structures ◽  
Taxonomic Importance ◽  
Voucher Specimens ◽  
Phaenicia Sericata

DNA extraction frequently requires destruction of whole samples. However, when the sample is very rare or has taxonomic importance, nondestructive DNA extraction is required for preservation of voucher specimens. In the case of arthropod specimens, minor anatomical structures such as a single leg or a single wing are often sacrificed instead of the whole body for DNA extraction. In an attempt to save the entire anatomical structure of specimens, several authors tried to brew the whole specimen in a lysis buffer and to extract DNA from the “soup.” We applied this nondestructive DNA extraction technique to a forensically important blowfly species, Phaenicia sericata. With nondestructive DNA extraction, a satisfactory quantity and quality of DNA for PCR amplification was obtained with only minimal anatomical disruptions that do not alter the morphologic identification. This nondestructive method may be applicable to DNA extraction of rare samples as well as vouchering of regular fly samples.

Criteria for evaluation of the coordinate measurements quality of parts geometric parameters at pilot-experimental production

2019 ◽  
pp. 3-8
Author(s):  
N.Yu. Bobrovskaya ◽  
M.F. Danilov
Keyword(s):  
Quality Indicators ◽  
Quality Management System ◽  
Technical Specification ◽  
Experimental Production ◽  
Technological Heredity ◽  
Coordinate Measurements ◽  
Reasonable Choice ◽  
The Stability ◽  
Geometric Elements

The criteria of the coordinate measurements quality at pilot-experimental production based on contemporary methods of quality management system and traditional methods of the measurements quality in Metrology are considered. As an additional criterion for quality of measurements, their duration is proposed. Analyzing the problem of assessing the quality of measurements, the authors pay particular attention to the role of technological heredity in the analysis of the sources of uncertainty of coordinate measurements, including not only the process of manufacturing the part, but all stages of the development of design and technological documentation. Along with such criteria as the degree of confidence in the results of measurements; the accuracy, convergence, reproducibility and speed of the results must take into account the correctness of technical specification, and such characteristics of the shape of the geometric elements to be controlled, such as flatness, roundness, cylindrical. It is noted that one of the main methods to reduce the uncertainty of coordinate measurements is to reduce the uncertainty in the initial data and measurement conditions, as well as to increase the stability of the tasks due to the reasonable choice of the basic geometric elements (measuring bases) of the part. A prerequisite for obtaining reliable quality indicators is a quantitative assessment of the conditions and organization of the measurement process. To plan and normalize the time of measurements, the authors propose to use analytical formulas, on the basis of which it is possible to perform quantitative analysis and optimization of quality indicators, including the speed of measurements.

Statistical Management of Food Production Processes

2020 ◽  
pp. 30-35
Author(s):  
N.A. Jurk ◽  
Keyword(s):  
Production Process ◽  
Control Chart ◽  
Food Production ◽  
Time Interval ◽  
Bakery Products ◽  
Shewhart Control ◽  
Manufactured Products ◽  
Mnemonic Technique ◽  
The Stability

The article presents scientific research in the field of statistical controllability of the food production process using the example of bakery products for a certain time interval using statistical methods of quality management. During quality control of finished products, defects in bakery products were identified, while the initial data were recorded in the developed form of a checklist for registering defects. It has been established that the most common defect is packaging leakage. For the subsequent statistical assessment of the stability of the production process and further analysis of the causes of the identified defect, a Shewhart control chart (p-card by an alternative feature) was used, which allows you to control the quality of manufactured products by the number of defects detected. Analyzing the control chart, it was concluded that studied process is conditionally stable, and the emerging defects are random. At the last stage of the research, the Ishikawa causal diagram was used, developed using the 6M mnemonic technique, in order to identify the most significant causes that affect the occurrence of the considered defect in bakery products. A more detailed study will allow the enterprise to produce food products that meet the established requirements.

scholarly journals Identifying Stabilising Effects on Survey Based Life Satisfaction Using Quasi-maximum Likelihood Estimation

2021 ◽  
Author(s):  
Johannes Klement
Keyword(s):  
Life Satisfaction ◽  
Maximum Likelihood ◽  
Maximum Likelihood Estimation ◽  
Negative Binomial ◽  
Measurement Instrument ◽  
Likelihood Estimation ◽  
Satisfaction Scale ◽  
Quasi Maximum Likelihood ◽  
The Stability

AbstractTo which extent do happiness correlates contribute to the stability of life satisfaction? Which method is appropriate to provide a conclusive answer to this question? Based on life satisfaction data of the German SOEP, we show that by Negative Binomial quasi-maximum likelihood estimation statements can be made as to how far correlates of happiness contribute to the stabilisation of life satisfaction. The results show that happiness correlates which are generally associated with a positive change in life satisfaction, also stabilise life satisfaction and destabilise dissatisfaction with life. In such as they lower the probability of leaving positive states of life satisfaction and increase the probability of leaving dissatisfied states. This in particular applies to regular exercise, volunteering and living in a marriage. We further conclude that both patterns in response behaviour and the quality of the measurement instrument, the life satisfaction scale, have a significant effect on the variation and stability of reported life satisfaction.

Stability as a constraint in sagittal plane human force exertion modeling

1998 ◽  
Vol 1 (1) ◽  
pp. 23-39
Author(s):  
Carter J. Kerk ◽  
Don B. Chaffin ◽  
W. Monroe Keyserling
Keyword(s):  
Muscle Strength ◽  
Ankle Joint ◽  
Coefficient Of Friction ◽  
Sagittal Plane ◽  
Biomechanical Model ◽  
Whole Body ◽  
The Stability ◽  
Joint Center ◽  
Static Conditions ◽  
Stability Limits

The stability constraints of a two-dimensional static human force exertion capability model (2DHFEC) were evaluated with subjects of varying anthropometry and strength capabilities performing manual exertions. The biomechanical model comprehensively estimated human force exertion capability under sagittally symmetric static conditions using constraints from three classes: stability, joint muscle strength, and coefficient of friction. Experimental results showed the concept of stability must be considered with joint muscle strength capability and coefficient of friction in predicting hand force exertion capability. Information was gained concerning foot modeling parameters as they affect whole-body stability. Findings indicated that stability limits should be placed approximately 37 % the ankle joint center to the posterior-most point of the foot and 130 % the distance from the ankle joint center to the maximal medial protuberance (the ball of the foot). 2DHFEC provided improvements over existing models, especially where horizontal push/pull forces create balance concerns.

scholarly journals A Comparison of the Effect of Two Types of Whole Body Vibration Platforms on Fibromyalgia. A Randomized Controlled Trial

2021 ◽  
Vol 18 (6) ◽  
pp. 3007
Author(s):  
José Antonio Mingorance ◽  
Pedro Montoya ◽  
José García Vivas Miranda ◽  
Inmaculada Riquelme
Keyword(s):  
Quality Of Life ◽  
Motor Function ◽  
Whole Body Vibration ◽  
Whole Body ◽  
Control Group ◽  
Body Vibration ◽  
Positive Effects ◽  
Therapy Program

Whole body vibration has been proven to improve the health status of patients with fibromyalgia, providing an activation of the neuromuscular spindles, which are responsible for muscle contraction. The present study aimed to compare the effectiveness of two types of whole body vibrating platforms (vertical and rotational) during a 12-week training program. Sixty fibromyalgia patients (90% were women) were randomly assigned to one of the following groups: group A (n = 20), who performed the vibration training with a vertical platform; group B (n = 20), who did rotational platform training; or a control group C (n = 20), who did not do any training. Sensitivity measures (pressure pain and vibration thresholds), quality of life (Quality of Life Index), motor function tasks (Berg Scale, six-minute walking test, isometric back muscle strength), and static and dynamic balance (Romberg test and gait analysis) were assessed before, immediately after, and three months after the therapy program. Although both types of vibration appeared to have beneficial effects with respect to the control group, the training was more effective with the rotational than with vertical platform in some parameters, such as vibration thresholds (p < 0.001), motor function tasks (p < 0.001), mediolateral sway (p < 0.001), and gait speed (p < 0.05). Nevertheless, improvements disappeared in the follow-up in both types of vibration. Our study points out greater benefits with the use of rotational rather than vertical whole body vibration. The use of the rotational modality is recommended in the standard therapy program for patients with fibromyalgia. Due to the fact that the positive effects of both types of vibration disappeared during the follow-up, continuous or intermittent use is recommended.

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