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A Comparative Study showing Elbow Kinematics in Radial Head Replacement Versus Radial Head Excision Versus Radial Head Fixation

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2

Vol 8 | Issue 2 | July-December 2022 | page: 01-05 | Amit Yadav, Sagar Bansal, Mrinal Kambli, Shaswat Mishra, Devenshu Gupta DOI: https://doi.org/10.13107/ti.2022.v08i02.026 Authors: Amit Yadav [1], Sagar Bansal [1], Mrinal Kambli [1], Shaswat Mishra [1], Devenshu Gupta [1] [1] Department of Orthopaedics, Grant Medical College and Sir J. J. Group of Hospitals, Byculla, […]

Efficacy and Safety of Tranexamic Acid Administration in Patients with Acute Traumatic Brain Injury: A Review of Current Literature

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2

Vol 8 | Issue 2 | July-December 2022 | page: 06-12 | Kenzie Kao, Mohammed Alsabri DOI: https://doi.org/10.13107/ti.2022.v08i02.027 Authors: Kenzie Kao [1], Mohammed Alsabri [2] [1] Saba University School of Medicine, Saba, Dutch Caribbean, Netherlands. [2] Department of Emergency Medicine, Al-Thawra Modern General Teaching Hospital, Sana’a City, Yemen. Address of Correspondence Dr. Mohammed Alsabri, Department […]

A Comparative Study showing Elbow Kinematics in Radial Head Replacement Versus Radial Head Excision Versus Radial Head Fixation

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2

Efficacy and Safety of Tranexamic Acid Administration in Patients with Acute Traumatic Brain Injury: A Review of Current Literature

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2

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A Comparative Study showing Elbow Kinematics in Radial Head Replacement Versus Radial Head Excision Versus Radial Head Fixation

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2

Vol 8 | Issue 2 | July-December 2022 | page: 01-05 | Amit Yadav, Sagar Bansal, Mrinal Kambli, Shaswat Mishra, Devenshu Gupta

DOI: https://doi.org/10.13107/ti.2022.v08i02.026

Authors: Amit Yadav [1], Sagar Bansal [1], Mrinal Kambli [1], Shaswat Mishra [1], Devenshu Gupta [1]

[1] Department of Orthopaedics, Grant Medical College and Sir J. J. Group of Hospitals, Byculla, Mumbai, Maharashtra, India.

Address of Correspondence
Dr Sagar Bansal,
Senior Resident, Department of Orthopaedics, Grant Medical College and Sir J. J. Group of Hospitals, Byculla, Mumbai, Maharashtra, India.

E-mail: sagarbansal59@gmail.com

Abstract

Background: Radial head fractures are quite common with incidence 1.5-4% of all adult fractures. The management of these fractures depends upon age and type of injury

Aim: To compare the outcome in comminuted radial head fractures(Mason type III) based on mayo elbow scoring and handgrip strength test when managed with radial head excision, radial head fixation or radial head replacement

Material and Methods: We did a prospective comparative study comprising 60 patients between age 20-60 years with Mason type III radial head fractures. The patients were randomised using the admission day of the week placing 20 patients each in arthroplasty , excision and in the fixation group. The patients were followed up for 18-24 months postoperatively. Results were evaluated by the Mayo’s elbow performance and Handgrip strength score at 6 months and 18 months and were statistically evaluated by one-way ANOVA test.

Results: As per Mayo’s score at 6 months follow up, mean and standard deviation (SD) of the scores in arthroplasty was 83.25 and 11.50, for excision it was 76.25 and 11.38 & for fixation, it was 68.75 and 17.83 respectively. At 18 months follow up, mean and standard deviation was 90 and 12.56 for arthroplasty, 83 and 9.92 for excision & 76.25 and 21.69 for fixation respectively. As per handgrip strength score at 6 months follow up, mean and standard deviation of the scores in arthroplasty was 31.1 and 4.37, for excision it was 28.75 and 4.27 & for fixation, it was 27.15 and 5.94 respectively. At 18 months follow up, mean and standard deviation was 32.95 and 4.006 for arthroplasty, 30.7 and 4.06 for excision & 28 and 6.75 for fixation respectively. The difference between the results according to both Mayo’s score as well as Handgrip strength test was statistically significant (p < 0.05).

Conclusion: Our study shows that long and short-term results of radial head replacement are better than radial head excision and radial head fixation in comminuted radial head fractures based on mayo elbow scoring and hand grip strength score.

Keywords: Radial head fracture, Radial head replacement, Mason classification

References

1. Duckworth AD, Clement ND, Jenkins PJ, Aitken SA, Court-Brown CM, McQueen MM (2012) The epidemiology of radial head and neck fractures. J Hand Surg Am 37(5):112–119.

2. Broberg MA, Morrey BF. Results of treatment of fracture-dislocations of the elbow. Clin Orthop. 1987;216:109-19.

3. Mason ML. Some observations on fractures of the head of the radius with a review of one hundred cases. Br J Surg. 1954;42:123-32.

4. Johnston GW. A follow-up of one hundred cases of fracture of the head of the radius with a review of the literature. Ulster Med J. 1962; 31:51-6.

5. Putz R, Milz S, Maier M, Boszczyk A. Functional morphology of the elbow joint. Orthopade. 2003; 32:684-90. 6. Kapandji IA. The Physiology of the Joints. Vol. 1. Edinburgh, London: E&S Livingstone, 1970:84.

7. Ring, David MD; Psychoyios, Vasilis N. MD; Chin, Kingsley R. MD; Jupiter, Jesse B. MD Nonunion of Nonoperatively Treated Fractures of the Radial Head, Clinical Orthopaedics and Related Research: May 2002 – Volume 398 – Issue – p 235-238.

8. Yamaguchi K, Sweet FA, Bindra R, Morrey BF, Gelberman RH: The extraosseous and intraosseous arterial anatomy of the adult elbow. J Bone Joint Surg 79A:1653–1662, 1997.

9. Singh AK, Jidge A, Ramteke U, Venkateswaran N, Rokade H, Mulje SM, Mukherjee S, Kotian A. Functional Outcome of Elbow Kinematics in Radial Head Excision Versus Radial Head Replacement: A Comparative Study. Open Access Maced J Med Sci. 2019 May 15;7(9):1505-1508.

10. Beingessner DM, Dunning CE, Gordon KD, Johnson JA, King GJ. The effect of radial head excision and arthroplasty on elbow kinematics and stability. J Bone Joint Surg Am. 2004 Aug;86(8):1730-9.

11. Ikeda M, Sugiyama K, Kang C, Takagaki T, Oka Y. Comminuted fractures of the radial head: comparison of resection and internal fixation. Surgical technique. J Bone Joint Surg Am. 2006 Mar;88 Suppl 1 Pt 1:11-23.

12. Swensen SJ, Tyagi V, Uquillas C, Shakked RJ, Yoon RS, Liporace FA. Maximizing outcomes in the treatment of radial head fractures. J Orthop Traumatol. 2019 Mar 23;20(1):15.

13. Sun H, Duan J, Li F. Comparison between radial head arthroplasty and open reduction and internal fixation in patients with radial head fractures (modified Mason type III and IV): a meta-analysis. Eur J Orthop Surg Traumatol. 2016 Apr;26(3):283-91.

14. Sinha S, Sarkar S, Singh A, Saraf SK, Rastogi A, Singh T. Radial Head Arthroplasty, Excision and Osteosynthesis in Complex Elbow Fracture-Dislocations in Young Adults: What is Preferred? Indian J Orthop. 2020 May 18;54(Suppl 2):260-269.

15. Heim U.[Combined fractures of the radius and the ulna at the elbow level in the adult. Analysis of 120 cases after more than 1 year]. Rev Chir Orthop Reparatrice Appar Mot. 1998 Apr;84(2):142-53.

16. Ring D, Quintero J, Jupiter JB. Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am. 2002 Oct;84(10):1811-5.

17. Herbertsson P, Josefsson PO, Hasserius R, Besjakov J, Nyqvist F, Karlsson MK. Fractures of the radial head and neck treated with radial head excision. J Bone Joint Surg Am. 2004 Sep;86(9):1925-30.

18. Shetty SK, Shetty A, Balan B, Ballal A, Rai HR, Hegde A. Excision Versus Fixation of the Radial Head: A Comparative Study of the Functional Outcomes of the Two Techniques. J Clin Diagn Res. 2017 Feb;11(2):RC01-RC03.

19. Bain GI, Ashwood N, Baird R, Unni R. Management of Mason type-III radial head fractures with a titanium prosthesis, ligament repair, and early mobilization. Surgical technique. J Bone Joint Surg Am. 2005 Mar;87 Suppl 1(Pt 1):136-47.

How to Cite this article: Yadav A, Bansal S, Kambli M, Mishra S, Gupta D | A Comparative Study showing Elbow Kinematics in Radial Head Replacement Versus Radial Head Excision Versus Radial Head Fixation | July-December 2022; 8(2): 01-05. https://doi.org/10.13107/ti.2022.v08i02.026

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Efficacy and Safety of Tranexamic Acid Administration in Patients with Acute Traumatic Brain Injury: A Review of Current Literature

December 10, 2022/in July-December 2022 | Volume 8 | Issue 2

Vol 8 | Issue 2 | July-December 2022 | page: 06-12 | Kenzie Kao, Mohammed Alsabri

DOI: https://doi.org/10.13107/ti.2022.v08i02.027

Authors: Kenzie Kao [1], Mohammed Alsabri [2]

[1] Saba University School of Medicine, Saba, Dutch Caribbean, Netherlands. [2] Department of Emergency Medicine, Al-Thawra Modern General Teaching Hospital, Sana’a City, Yemen.

Address of Correspondence

Dr. Mohammed Alsabri,

Department of Emergency Medicine, Al-Thawra Modern General Teaching Hospital, Sana’a City, Yemen.

E-mail: alsabri5000@gmail.com

Abstract

Hypothesis: Early administration of tranexamic acid (TXA) reduces mortality in patients suffering from acute traumatic brain injury (TBI).

Methods: A structured search of PubMed and CENTRAL from inception until July 1st, 2022 was carried out seeking RCTs comparing the effects of TXA administration to placebo in patients suffering from TBI. The primary outcome tested was 28-day all-cause mortality. Secondary outcomes included intracranial hemorrhage growth and thromboembolic events.

Results: Eight RCTs involving a total of 14,714 patients met the inclusion criteria; 7573 patients received TXA while 7141 patients received a placebo. There were 1415 patient deaths (18.7%) in the TXA group and 1410 patient deaths (19.7%) in the placebo group. None of the included studies reported a significant reduction in 28-day all-cause mortality, however, they all shared positive trends toward superior outcomes in the intervention arms. Two of the included studies reported significant reductions in intracranial hemorrhage expansion in those patients treated with TXA, with four more studies reporting trends toward superior outcomes in the TXA groups. There was no evidence of increased incidence of thromboembolic events in the TXA groups in four of the five studies that reported relevant data, with one study representing 1.2% of total patients reporting an increased incidence of pulmonary emboli in the intervention group.

Conclusions: In patients suffering from acute TBI, early administration of TXA reduces intracranial hemorrhage growth and may have positive effects on mortality with no corresponding increase in thromboembolic events. Given these results, early administration of TXA in patients experiencing TBI is recommended in initial care.

Keywords: Tranexamic acid, Traumatic brain injury, Intracranial hemorrhage, Mortality, Disability

References

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How to Cite this article: Kao K, Alsabri M | Efficacy and Safety of Tranexamic Acid Administration in Patients with Acute Traumatic Brain Injury: A Review of Current Literature | July-December 2022; 8(2): 06-12. https://doi.org/10.13107/ti.2022.v08i02.027

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

A Comparative Study showing Elbow Kinematics in Radial Head Replacement Versus Radial Head Excision Versus Radial Head Fixation

Efficacy and Safety of Tranexamic Acid Administration in Patients with Acute Traumatic Brain Injury: A Review of Current Literature

A Comparative Study showing Elbow Kinematics in Radial Head Replacement Versus Radial Head Excision Versus Radial Head Fixation

Efficacy and Safety of Tranexamic Acid Administration in Patients with Acute Traumatic Brain Injury: A Review of Current Literature

Full Sized Blog Element (Big Preview Pic)

A Comparative Study showing Elbow Kinematics in Radial Head Replacement Versus Radial Head Excision Versus Radial Head Fixation

Authors: Amit Yadav [1], Sagar Bansal [1], Mrinal Kambli [1], Shaswat Mishra [1], Devenshu Gupta [1]

Abstract

References

(Abstract Text HTML) (Download PDF)

Efficacy and Safety of Tranexamic Acid Administration in Patients with Acute Traumatic Brain Injury: A Review of Current Literature

Authors: Kenzie Kao [1], Mohammed Alsabri [2]

Abstract

References

(Abstract Text HTML) (Download PDF)

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