Online ISSN: 2515-8260

Keywords : Open reduction and internal fixation

A prospective study of bipolar clavicle fractures treated with Dual anatomical plates

Dr. Neelanagowda VP Patil, Dr. Deepak MK, Dr. Paramesh KC, Dr. Dhanush AN, Dr. Vishwas L .

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 2, Pages 1340-1345

Background: Clavicular fractures account for 4% of all adult fractures. However, simultaneous medial and lateral fractures occurring in the same clavicle (the so-called ‘bipolar clavicle fracture’) are rare. Treatment for this type of fracture is not well established. Herein, we report our experience of the operative management of bipolar clavicle fractures using two anatomical locking plates.
Methods: Patients who presented with bipolar clavicle fracture between Feb 2021 and December 2022 were prospectively enrolled in this study. All patients were operatively treated with open reduction and internal fixation (ORIF) using pre-contoured clavicle plate/recon plate for medial fractures and hook plate for lateral end fracture. Functional and radiological outcome evaluated
Aim: To evaluate the functional and Radiological outcome in patients with bipolar clavicle fractures treated with dual anatomical locking plates
Results: In all the patients, bony union achieved at an average duration of 17.9±1.4weeks. The mean shoulder forward flexion was 166°±11.4°, and the mean DASH score was 3.3±2.3 with four cases assessed as excellent and one case assessed as good. The mean abduction was 168֯±9.8֯. No complications occurred, and each patient was able to resume their preinjury daily activity and was highly satisfied with their treatment.
Conclusion: Dual plating is an effective surgical procedure for treating bipolar clavicle fractures with very good functional results and early mobilization

Study On Surgical Management Of Shaft Of Humerus Fractures With Locking Compression Plate

AVRMohan, Kotikalapudi Venkatamurali Mohan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11102-11115

Background:The recent development of LCP has revolutionized the surgical treatment
of fractures by overcoming the few drawbacks of older internal fixators. The fractures
of the shaft of humerus are one of the commonest fractures found and the accepted
management for fractures shaft of humerus is open reduction and internal fixation
using compression plating. Our present study is aimed at the assessment of results of
plate osteosynthesis of diaphyseal fractures of humerus using locking compression plate
and to assess the functional recovery with this procedure.
Materials and Methods: It is a prospective study which was carried out from December
2019 to June 2021 atDistrict Hospital, Eluru. In this study period 20 cases of fracture
shaft of the humerus were treated by open reduction and internal fixation using
Locking Compression Plate.
Results: In our series, majority of the patients were males, middle aged, with road
traffic accidents being the commonest mode of injury, involving middle third. 90% of
the fractures united with excellent, 5% good and 5% poor results.
Conclusion: The LCP for humeral shaft fractures produce excellent results, the
advantage being better stability, early mobilization, early union but the complication,
duration of surgery and surgical techniques remains unchanged.

Comparative study of functional outcome of distal humerus intra-articular fracture treated with parallel plates and with orthogonal plates (A study of 30 cases)

Dr.Daljinder Singh, Dr Akashdeep Singh, Dr Sanjeev Sareen, Dr Annie Sandhu

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 39-52

Intra-articular distal humerus fractures remain one of the most difficult injuries to
manage. These fractures comprises 2-6% of all fractures and have bimodal age
distribution. The majority of these fractures occur either as low energy falls or high
energy trauma. Most fractures in elderly patients are intra- articular with bi-columnar
involvement. They are commonly multifragmental and occur in osteopenic bone. High
energy injuries occur in adults, which are accompanied with other associated injuries.
The elbow is anatomically a trocho-ginglymoid joint in which distal humerus bifurcates
into two divergent cortical columns, termed as medial and lateral columns. The articular
segment functions architecturally as a tie arch. The elbow is one of the most constrained
joints of the body and tolerates immobilization poorly and any alteration within the
architecture of the joint has the potential to limit motion and compromise
function.Treatment outcomes are often related to elbow stiffness, weakness and pain.
Meticulous planning is required in obtaining an anatomic intra-articular reduction, and
creating a fixation construct that is rigid enough to tolerate early mobilization. Usually,
70% of patients that sustain an elbow fracture, fall directly on to the elbow because they
are unable to break their fall with an out stretched arm. This randomized, prospective
study was undertaken to compare the functional outcomes of distal humerus intraarticular
fractures in adults treated with parallel plates and orthogonal plates. From a
clinical perspective, a parallel plating method appears to provide better rigid fixation that
is adequate for obtaining bone union. However, no statistical significant differences were
observed between the orthogonal and parallel double plating methods in terms of clinical
outcomes and complication rates. If meticulously applied, with suitable plates, both
parallel and orthogonal positioning can provide adequate stability and anatomic
reconstruction of the distal humerus fractures.

Infective Organisms With Their Changing Antibiotics Sensitivity Trends In Orthopedics Implant Surgery Infections

Mangal Mohammad Naeem; Khalid M. Qasem; Orya Mujeeburrahman

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 3, Pages 5349-5352

Objective: To know about the various pathogens causing infection in orthopaedic implant surgeries and their antibiotic sensitivities.
Methods: This prospective study was conducted jointly in Departments of Orthpaedics and Trauma of Kausar Hospital, Afghan Hospital and Emergency Hospital, Kabul, from April 2019 to April 2020. All patients having close fractures of long bones including humerus, radius/ulna, femur and tibia requiring open reduction and internal fixation (ORIF) were included. Patients data was noted on a preformed proforma. Patients were followed up to 6 months.
Results: 30 patients out of 650 developed Surgical site infection were selected. 23 were male and 7 were female patients. Age range was from 5-75 years. Staphyloccus Aureus including Methicillin resistant Staphylococcus Aureus MRSA was most common cultured organism, followed by E Coli and pseudomonas. 23 cases yielded single organism, 5 cases yielded 2 organisms, 1 case yielded 3 organisms. There was no organism growth in one case.
Conclusion: Staphylococcus Aureus including MRSA is the main cause of surgical site infection in orthopedics implant surgery. Other bacteria like E.Coli may cause surgical site infection. Antibiotics should be prescribed according to culture and sensitivity reports.