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Management of a Polytrauma Case In a Resource-Constrained Hospital

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

Vol 8 | Issue 2 | July-December 2022 | page: 21-25 | Daniel Mossalbaye Adendjingue, S. Pascal Chigblo, Oswald Goukodadja, Adebola Padonou, Iréti Fiacre Tidjani, Aristote Hans-Moevi Akue DOI: https://doi.org/10.13107/ti.2022.v08i02.0230 Authors: Daniel Mossalbaye Adendjingue [1], S. Pascal Chigblo [2], Oswald Goukodadja [2], Adebola Padonou [2], Iréti Fiacre Tidjani [2], Aristote Hans-Moevi Akue [2] [1] Department […]

Tens Nailing in Fracture Clavicle – A Case Series

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

Vol 8 | Issue 2 | July-December 2022 | page: 17-20 | Mohd Danish, Hemant Gupta, Ashish Sao, Ravi Kant DOI: https://doi.org/10.13107/ti.2022.v08i02.029 Authors: Mohd Danish [1], Hemant Gupta [1], Ashish Sao [1], Ravi Kant [1] [1] Department of Orthopaedics, Max Superspeciality Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India. Address of Correspondence Dr. Mohd Danish, Department of […]

Management of a Polytrauma Case In a Resource-Constrained Hospital

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

Tens Nailing in Fracture Clavicle – A Case Series

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

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Management of a Polytrauma Case In a Resource-Constrained Hospital

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

Vol 8 | Issue 2 | July-December 2022 | page: 21-25 | Daniel Mossalbaye Adendjingue, S. Pascal Chigblo, Oswald Goukodadja, Adebola Padonou, Iréti Fiacre Tidjani, Aristote Hans-Moevi Akue

DOI: https://doi.org/10.13107/ti.2022.v08i02.0230

Authors: Daniel Mossalbaye Adendjingue [1], S. Pascal Chigblo [2], Oswald Goukodadja [2], Adebola Padonou [2], Iréti Fiacre Tidjani [2], Aristote Hans-Moevi Akue [2]

[1] Department of Orthopedic-Traumatology, National Teaching Hospital CHU-RN, N’Djamena-Chad. [2] Department of Orthopedic-Traumatology, National Teaching Hospital CNHU-HKM, Cotonou, Benin.

Address of Correspondence

Dr. Daniel Mossalbaye Adendjingue,

Department of Orthopedic-Traumatology, National Teaching Hospital CHU-RN, N’Djamena-Chad.

E-mail: dendjinguedaniel@gmail.com / adendjingue@yahoo.fr

Abstract

Introduction: The management of polytrauma patient should be beforehand and always in keeping in mind the damage control. the surgical treatment is secondary to the stabilization of the patient.

Clinical Case: we are reporting a 34 years old polytrauma patient from a motor vehicle accident. On physical examination, we noted : a severe brain injury, a closed articular fracture of right distal radius associated to a dislocation of distal radius and ulna distal joint, a closed bilateral fracture of both trochanters, an open communitive tibial fracture of proximal epiphysis methaphysis and diaphysis. The last one was classified as type IIIB of Gustilo and Anderson and associated to a closed fracture of the head and the neck of right fibula, a closed fracture of the right lateral malleolus. After patient stabilization, the head injury improves to normal Glasgow score on 8th day of admission. Necrosis of soft tissus and exposition of the tibia was noted. The surgical treatment was done on 2 stages due to financial issues. A bone synthesis of the trochanteric fracture was done only on the left and external frame as well as a muscle flap was done for the right tibial fracture on the 18th day. On the 42nd day a PAPINEAU technic associated to a proximal inter tibiofibular graft was done. The functional outcome of the orthopaedic treatment of the wrist was bad (malunion). That last complication was managed by a SAUVE KAPANDJI surgery (at 6 months) and the contracture (pronation and supination) at 12 months post trauma. The outcome was fair good despite patient financial issue and local complications that compromise an optimal surgical management and a delay. He resumes normal professional activities at about 2 years. At 5 years follow up, functional and anatomical results were satisfactory.

Conclusion: In a limited ressources’ setting, the management of lesions including a multiple fractures is a challenge for the practitioner and the injuried patient. A management taking into account social and economic ressources is mandatory to minimise sequelae. Keywords: Management, Polytrauma, Limited ressources.

References

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How to Cite this article: Adendjingue DM, Chigblo SP, Goukodadja O, Padonou A, Tidjani IF, Akue AHM | Management of a Polytrauma Case In a Resource-Constrained Hospital | July-December 2022; 8(2): 21-25 | https://doi.org/10.13107/ti.2022.v08i02.030

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Tens Nailing in Fracture Clavicle – A Case Series

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

Vol 8 | Issue 2 | July-December 2022 | page: 17-20 | Mohd Danish, Hemant Gupta, Ashish Sao, Ravi Kant

DOI: https://doi.org/10.13107/ti.2022.v08i02.029

Authors: Mohd Danish [1], Hemant Gupta [1], Ashish Sao [1], Ravi Kant [1]

[1] Department of Orthopaedics, Max Superspeciality Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India.

Address of Correspondence

Dr. Mohd Danish,

Department of Orthopaedics, Max Superspeciality Hospital, Vaishali, Ghaziabad, Uttar Pradesh, India.

E-mail: danish.shan@gmail.com

Abstract

INTRODUCTION: Clavicle is one of the most commonly fractured bones accounting for 2.6 – 4 % of all the fractures. 69 – 82% of these occur in middle third of clavicle, 73 % of which are displaced midshaft clavicular fractures). Surgery has been indicated for displaced fractures of clavicle, one with NV compromise and skin tenting. Intramedullary fixation for clavicular fractures was first described by Peroni in 1950. The use of a TENS nail carries advantages of less soft tissue compromise, less operative time, better cosmetic results, load sharing fixation with relative stability that encourages copious callus formation.

MATERIAL AND METHOD: A prospective review of 20 patients who presented to our institute between January 2021 and June 2022 with displaced midshaft clavicle fractures and treated with TENS nailing was carried out. All the patients had Constant Murley score and DASH score, which were done at 6 and 12 weeks.

RESULTS: All the patients achieved clinical and radiological union at a mean of 19.6 ± 6.67.80% of the patient had excellent Constant Murley score on follow up. Based on the assessment parameters (Disability of Arm Shoulder and Hand) Score, the mean DASH score was 25.03 ± 3.36 (range 20-30), 18.56 ± 3.46 (range 14-25) at the end of 6 weeks and 12 weeks respectively.

CONCLUSION: The intramedullary fixation using TENS of midshaft clavicle fractures is a safe minimally invasive technique in indicated cases and in our hands, it provides good functional outcome and cosmetic results.

KEYWORDS: Tens, Clavicle, Fracture, Intramedullary

References

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3. Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial. J Bone Joint Surg Am. 2007; 89(1):1–10.

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5. Assobhi JE. Reconstruction plate versus minimal invasive retrograde titanium elastic nail fixation for displaced midclavicular fractures. J Orthop Traumatol. 2011; 12(4):185–92. doi: 10.1007/s10195-011- 0158-7 PMID: 21948051

6. Zlowodzki M, Zelle BA, Cole PA, Jeray K, McKee MD. Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the Evidence-Based Orthopaedic Trauma Working Group. J Orthop Trauma. 2005; 19(7):504– 7.

7. Kontautas E, Pijadin A, Vilkauskas A, Domeika A. Biomechanical aspects of locking reconstruction plate positioning in osteosynthesis of transverse clavicle fracture. Medicina (Kaunas). 2012; 48(2):80– 3.

8. Zlowodzki M, Zelle BA, Cole PA, Jeray K, McKee MD, Evidence-Based Orthopaedic Trauma Working G. Treatment of acute midshaft clavicle fractures: systematic review of 2144 fractures: on behalf of the EvidenceBased Orthopaedic Trauma Working Group. J Orthop Trauma. 2005;19(7):504-507.

9. Grassi FA, Tajana MS, D’Angelo F. Management of midclavicular fractures: comparison between nonoperative treatment and open intramedullary fixation in 80 patients. J Trauma.2001;50(6):1096-100.

10. Leppilahti J, Jalovaara P. Migration of Kirschner wires following fixation of the clavicle–a report of 2 cases. Acta Orthop Scand. 1999;70(5):517-519.

11. Lyons FA, Rockwood CA, Jr. Migration of pins used in operations on the shoulder. J Bone Joint Surg Am. 1990;72(8):1262-1267.

12. Naidoo P. Migration of a Kirschner Wire from the clavicle into the abdominal aorta. Arch Emerg Med. 1991;8(4):292-295.

How to Cite this article: Danish M, Gupta H, Sao A, Kant R | Tens Nailing in Fracture Clavicle – A Case Series | July-December 2022; 8(2): 17-20 | https://doi.org/10.13107/ti.2022.v08i02.029

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Management of a Polytrauma Case In a Resource-Constrained Hospital

Tens Nailing in Fracture Clavicle – A Case Series

Management of a Polytrauma Case In a Resource-Constrained Hospital

Tens Nailing in Fracture Clavicle – A Case Series

Full Sized Blog Element (Big Preview Pic)

Management of a Polytrauma Case In a Resource-Constrained Hospital

Authors: Daniel Mossalbaye Adendjingue [1], S. Pascal Chigblo [2], Oswald Goukodadja [2], Adebola Padonou [2], Iréti Fiacre Tidjani [2], Aristote Hans-Moevi Akue [2]

Abstract

References

(Abstract Text HTML) (Download PDF)

Tens Nailing in Fracture Clavicle – A Case Series

Authors: Mohd Danish [1], Hemant Gupta [1], Ashish Sao [1], Ravi Kant [1]

Abstract

References

(Abstract Text HTML) (Download PDF)

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