scholarly journals Using a reconstruction locking compression plate as external fixator in infected open clavicle fracture

2013 ◽  
Vol 5 (2) ◽  
pp. 11 ◽  
Author(s):  
Norachart Sirisreetreerux ◽  
Paphon Sa-ngasoongsong ◽  
Pongsthorn Chanplakorn ◽  
Noratep Kulachote ◽  
Sukij Laohajaroensombat ◽  
...  

Open clavicle fracture is an uncommon injury mostly caused by severe direct trauma. It is often associated with multiple organ injuries. Generally, surgical intervention with debridement and fracture repair is always indicated in order to prevent infection, non-union, and malalignment. In situations of bony exposure and significant contamination concomitant with severe soft tissue damage, the external fixation is the treatment of choice because of the possibility it offers of providing stable fixation with minimal local tissue damage resulting in excellent union rates and better soft tissue outcome. Nevertheless, traditional external fixation encountered some potential problems as its bulkiness and sharp edges caused discomfort to the patient. In this study, we present an interesting case of a polytraumatized patient with a gunshot injury with complex open clavicle fracture that was successfully treated with external fixation using reconstruction with a locking compression plate as definitive treatment.

2020 ◽  
Vol 7 (4) ◽  
pp. 133-136
Author(s):  
Dr. Vijay Patil

Background: Clavicle being most common fracture in human. It is mainly managed conservatively. The results are further improved surgically. Most common surgical treatment is locking compression plating. The aim of the present study is to compare results of reconstruction plating for mid shaft clavicle fractures over locking compression plate. Material & method: The study was conducted on the patients of clavicle fractures coming to Patil hospital Ahmednagar. Total 69 patients were operated with 3.5 millimeter reconstruction plate in this study, during the period of 3 years 2016-2019. Total 63 were male and 6 were females. All fractures were fixed with reconstruction plating and the butterfly fragments were stabilized with k-wires. The functional outcome was measured by the constant and murely score [17] at the end of 3 months from the injury. The fracture union time and associated problems are also compared. Results: Out of 69 patients, 61 patients (88.41%) had excellent results. 5 patient (7.25%) had good result and 8 patients (11.60%) had poor functional out come. 5 patients (7.25%) had complications out of which 1 patient (1.45%) had plate breakage, 2 patients (2.9%) had migration of pin. There was superficial infection in 2 patients (2.9%). The study shows excellent results with simple effective economical reconstruction plates with k-wires. The complications were minimal, mainly in the form of pin migration which was only subcutaneous, removed at the time of implant removal. Conclusion: In these study results of reconstruction plating for mid shaft clavicle fracture was studied. It was found that results were improved, in patient’s oriented outcome, earlier return to the function, reduced non union and mal union and was more effective and economical. For management of mid shaft fracture clavicle. The locking compression plate was not found any superior to reconstruction plate.  


Author(s):  
Rajesh Govindasamy ◽  
Ramkumar Gnanasundaram ◽  
Saravanan Kasirajan ◽  
Fawas Thonikadavath ◽  
Jeff Walter Rajadurai

<p class="abstract"><strong>Background:</strong> Humeral shaft nonunions are frequently seen in Orthopaedic practice. Osteosynthesis with bone grafting is the treatment of choice. Locking compression plate (LCP) is the latest implant used in treating them. We retrospectively evaluated the outcome of use of LCP in humeral shaft non-union resulted by both conservative management and following failed internal fixations.</p><p class="abstract"><strong>Methods:</strong> Eighteen patients with nonunion of humeral shaft in which ten were treated by traditional bone setters and eight followed by failed internal fixation were included in these study. The mean duration of nonunion was 18.3 months (range 8-22).  The mean follow up period was 18 months (range 12-26). The mean age of patients was 44.4 years (range 22-60). All patients underwent osteosynthesis with LCP and autologoous cortico-cancellous iliac crest graft. The outcome measures include radiographic assessment of fracture union and preoperative and postoperative function using modified constant and murley scoring system.<strong></strong></p><p class="abstract"><strong>Results:</strong> All fractures united following osteosyntesis average time for union was15 weeks (range 10-24). We did not have any delayed union or non-union. The complications were superficial infection (n=1) and wound haematoma (n=1).Three patients with preoperative radial nerve palsy recovered at the end of four months. Functional evaluation using constant-murley score showed excellent result in 14, good in 3 and fair in 1. We did not have any poor results.</p><strong>Conclusions:</strong> LCP with cancellous bone grafting is a safe reliable option for all forms of humeral shaft nonunion. We recommend it.


Author(s):  
Ho-Youn Park ◽  
Seok-Jung Kim ◽  
Yoo-Joon Sur ◽  
Jae-Woong Jung ◽  
Chae-Gwan Kong

Background: A midshaft clavicle fracture is a common fracture that typically responds well to open reduction and internal fixation (ORIF). However, refracture can occur after implant removal (IR). This study aimed to analyze the rate of refracture and related factors after removal of the locking compression plate (LCP) for displaced midshaft clavicle fractures. Methods: We retrospectively reviewed the medical records of 201 patients who had undergone ORIF with LCP for midshaft clavicle fractures after IR after bony union from January 2011 to May 2018 at our institute. We evaluated basic demographic characteristics and radiographic parameters. All patients were treated with an LCP for primary fracture. The patients were divided into two groups: a refracture group that experienced a second fracture within 1 year after IR and a no-fracture group.Results: There were four cases (1.99%) of refracture; three were treated conservatively, while one was treated surgically. All patients achieved bony union. The average interval between refracture and IR was 64 days (range, 6–210 days). There was a significant difference in classification of fractures (AO Foundation/Orthopaedic Trauma Association [AO/OTA] classification) between the two groups. However, other patient demographics and radiographic measurements between refracture and IR, such as bone diameter, showed no significant difference between the two groups. Conclusions: This study showed that one in 50 patients suffered from refracture after removal of the LCP. Thus, if patients desire IR, the surgeon should explain that there is a relatively higher possibility of refracture for cases with simple or segmental fractures than for other types of fracture.


Author(s):  
Rajesh Kumar Sharma ◽  
Anuradha Upadhyay ◽  
Rahul Parmar

<p class="Default"><strong>Background: </strong>The optimal treatment of complex supracondylar femur fractures remains always challenging and controversial. the purpose of this prospective study was to evaluate the efficacy of distal femoral locking compression plate (DF-LCP) in terms of functional outcome and union rate for highly unstable complex supracondylar femur fractures and to determine the influencing factors of an unfavourable outcome.</p><p><strong>Methods:</strong> After obtaining approval from institutional ethics committee, 45 patients with complex supracondylar femur fractures were managed by open reduction and internal fixation with DF-LCP through lateral approach and as per standard protocol. The follow-up results were analysed clinically and radiologically, using the “Schatzker and Lambert criteria” at once in a month for first three months, once in three months up to one year and once in six months thereafter up to 2 years post-operatively.</p><p><strong>Results:</strong> In the present study, average duration of radiological union was 16 (range 12-22) weeks. The average range of motion of knee joint was 105 degrees. Out of 45 patients, clinical results were excellent in 48.9%, good in 17.8%, fair in 22.2% and poor in 11.1% patients according to Schatzker and Lambert criteria. Knee stiffness (7 cases), secondary arthritis (5 cases), and non-union (4 cases) were the main complications observed in this study, which were treated accordingly.</p><p><strong>Conclusions: </strong>DF-LCP holds the metaphyseal bone strongly and prevents metaphyseal collapse and mal-rotation in complex or highly unstable supracondylar femur fractures and simultaneously, it provides stable fixation to promote fracture union and allows early rehabilitation with acceptable complications.</p>


2005 ◽  
Vol 30 (2) ◽  
pp. 220-225 ◽  
Author(s):  
J. IMATANI ◽  
T. NODA ◽  
Y. MORITO ◽  
T. SATO ◽  
H. HASHIZUME ◽  
...  

Five comminuted and displaced fractures of the distal metaphysis of the radius were treated by a technique of minimally invasive plate osteosynthesis (MIPO) with the aim of minimizing soft tissue damage and devascularization of the fracture fragments. This technique used the small AO T-shaped locking compression plate (AO LCP T-plate) and left the pronator quadratus intact. Radial inclination, palmar tilt, and ulnar variance were restored without loss of reduction in all five cases and the fractures healed at an average of 10 weeks, with good to excellent clinical outcomes.


Author(s):  
Mohammed Ismail Hathiwale ◽  
Prakash A. Sasnur ◽  
Md. Johorul Islam Tapadar

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Clavicle fractures had been traditionally treated non-operatively which resulted in high rates of non-union. The present study has been undertaken to study the role of precontoured locking compression plate in the fixation of mid-third clavicle fractures.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">We reviewed the results of 25 cases of displaced middle third clavicle fractures (Robinson type 2B) which were treated with open reduction and internal fixation with pre-contoured locking compression plate at Al-Ameen Medical College and Hospital</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Out of 25 patients operated with precontoured LCP, 21 were male and 4 were female patients. One patient had hypertrophic scar, one patient had plate prominence, two patients had delayed union and one patient had implant failure, none of them developed non-union. Constant Murley score was excellent in 19, good in 4 and fair in 1 patient and poor in 1 patient. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Precontoured locking compression plate fixation has better functional outcome, immediate pain relief, early return to function and avoids complications of conservative methods.</span></p>


2019 ◽  
Vol 3 (1) ◽  
pp. 57-61
Author(s):  
Dr. Anirudh Bansal ◽  
Dr. Vikramjit Singh ◽  
Dr. Arvind Kumar ◽  
Dr. Sudhir Rawat ◽  
Dr. Cheraventhan Mani

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