Fixation Of Fractures In Adults Research Articles

Preliminary clinical outcomes of the double-row anchor suture-bridge technique for the fixation of tibial intercondylar eminence fractures in adults: a 12-months minimal follow-up

BackgroundTibial intercondylar eminence avulsion fractures occur primarily in adolescents and young adults. However, the incidence of such fractures is increasing in adults, concurrent with an increase in sports injuries and traffic accidents. This study describes the fixation-based double-row anchor suture-bridge technique, a novel technique for treating tibial intercondylar eminence fractures in adults; and evaluates its preliminary clinical outcomes.MethodsA retrospective evaluation of adult patients with tibial intercondylar eminence fractures treated at our institution from June 2016 to June 2018 was conducted. Seven such patients, treated with the anchor suture-bridge technique, were included. All patients were assessed for knee joint range of motion (ROM), Lysholm knee score, International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form score, Tegner activity score pre-surgery, and the healing of the fracture at 3, 6 and 12 months minimal post-surgery follow-up.ResultsPatients were followed for a mean of 12.43 months (range 9-15 months). By the final follow-up, all fractures had fully healed. The mean Lysholm score improved from 27.86 (range, 2 to 54) pre-surgery to 88.14 (range, 81 to 100) 3 months post-surgery (p < 0.05). Similarly, the mean IKDC score improved from 48.86 (range, 43 to 55) to 84.29 (range, 75 to 90) (P < 0.05); and the mean Tegner activity score improved from 1.71 (range, 0 to 4) to 3.29 (range, 2 to 4) (p < 0.05). Furthermore, knee joint ROM, Lysholm scores, IKDC scores, and Tegner activity scores displayed excellent outcomes at the 6 and 12 months minimal follow-up.ConclusionThe arthroscopic anchor suture-bridge technique is a valid and secure method for achieving effective fixation of tibial intercondylar eminence fractures in adults.

Fixation of Unstable Neck Femur Fractures in Adults : Review Article

Background ː Femoral neck fracture is a common problem especially in young adults. There are different methods of fixation of unstable neck femur fractures in adults, some of which are accompanied by complications. Aim of study: A systematic review on the different methods of fixation of unstable femoral neck fractures in adults with clarifying the incidence of nonunion, avascular necrosis, displacement and other complications in each type of fixation. Methods ː A systematic review of literatures was conducted on five studies (306 patients ) published in literature in the last 10 years using different methods of fixation with inclusion criteria including ː English literature, human studies on adults aged 18-60 years with unstable neck femur fractures Pauwel grade 3. Exclusion criteria including ːin vitro studies, pathological and non united fractures in people aged below 18 or above 60 years with stable neck femur fractures Pauwel grade 1,2 Results: showed that Achieved union in management by osteosynthesis and primary valgus intertrochntric osteotomy using broad DCP showed better results than by other methods of fixation (cannulated screws , DCS, cephalomedullary nail) and by achieving union percentage of 92,7% as in (MP Singh 2008), the same percentage achieved by fixation by DHS as in (Frank Liporace 2008), followed by 92% rate of union achieved by fixed angle device (DCS or cephalomedullary nail) in (Frank Liporace 2008) Comparing complications in different fixation methods showed that complications are inevitable yet manageable, but higher complications rate associated with fixation of neck femur fractures using DHS by achieving 26,4% rate of nonunion and 26,4% rate of AVN in (carlos Roberto schwartsmann 2017) while rate of non union was 7,3% in valgus intertrochntric osteotomy by broad DCP and rate of AVN was 11% as in (MP Singh 2008). Summary and conclusion Management of unstable neck femur fractures in adults is done by means of direct fixation with cannulated screws, DHS, fixed angle device (DCS or cephalomedullary nail) or osteosynthesis and valgus intertrochntric osteotomy to avoid some adverse effects of the direct fixation methods, so,recent studies showed that valgus intertrochntric osteotomy achieve better results than traditional methods with less complications.

Definitive treatment of mandibular fractures in young children

Mandibular fractures in young children are difficult to treat by means of the standard procedures used in reduction and fixation of fractures in adults. Achieving stable intermaxillary fixation with arch bars or interdental wiring (for example, Ivy loops) is difficult because of the shape of the clinical crowns of the deciduous teeth. Open reductions are complicated by the presence of the permanent tooth buds. These procedures may be avoided by employing splinting techniques that make use of orthodontic bands and labial and lingual arch bars, or acrylic splints with circummandibular wires. Often, these splinting techniques provide adequate stability without intermaxillary fixation.