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Multi-Fragment Patellar Non-Union in a Young Patient Due to Failed Fixation and its Management – A Rare Case Report

January 10, 2021/in January-June 2021 | Volume 7 | Issue 1

Vol 7 | Issue 1 | January-June 2021 | page: 12-14 | Neetin P Mahajan, Prasanna Kumar GS, Pranay Kondewar, Kishor Jadhav Author: Neetin P Mahajan [1], Prasanna Kumar GS [1], Pranay Kondewar [1], Kishor Jadhav [1] [1] Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India. Address of Correspondence Dr. Prasanna Kumar GS, […]

Prospective Evaluation of The Results of External Fixation of Unstable Fractures of Distal Radius- A Comparison Between Open and Close Fractures and an Analysis of Similar Studies

January 10, 2021/in January-June 2021 | Volume 7 | Issue 1

Vol 7 | Issue 1 | January-June 2021 | page: 05-11 | Brijesh Sharma, Vipul Agrawal, Rajendra Kumar Shakunt, Chandra Prakash Pal, Mayur Gupta, Rohit Yadav Author: Brijesh Sharma [1], Vipul Agrawal [1], Rajendra Kumar Shakunt [1], Chandra Prakash Pal [1], Mayur Gupta [1], Rohit Yadav [1] [1] Department of Orthopaedics, Sarojini Naidu Medical College, […]

Multi-Fragment Patellar Non-Union in a Young Patient Due to Failed Fixation and its Management – A Rare Case Report

January 10, 2021/in January-June 2021 | Volume 7 | Issue 1

Prospective Evaluation of The Results of External Fixation of Unstable Fractures of Distal Radius- A Comparison Between Open and Close Fractures and an Analysis of Similar Studies

January 10, 2021/in January-June 2021 | Volume 7 | Issue 1

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Multi-Fragment Patellar Non-Union in a Young Patient Due to Failed Fixation and its Management – A Rare Case Report

January 10, 2021/in January-June 2021 | Volume 7 | Issue 1

Vol 7 | Issue 1 | January-June 2021 | page: 12-14 | Neetin P Mahajan, Prasanna Kumar GS, Pranay Kondewar, Kishor Jadhav

Author: Neetin P Mahajan [1], Prasanna Kumar GS [1], Pranay Kondewar [1], Kishor Jadhav [1]

[1] Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India.
Address of Correspondence
Dr. Prasanna Kumar GS,
Department of Orthopaedics, Grant Government Medical College, Mumbai, Maharashtra, India.
E-mail: prasannakumargs5@gmail.com

Abstract

Introduction: Multi-fragmentary patellar non-union is rare and it causes functional disability in patients. The purpose of studying this case is to present an unusual patella multi-fragmentary non-union and discuss its management.
Case presentation: We present a case of a 25-year-old male patient presented with pain and instability and decreased movements of the right knee since last 1 year. The patient had a history of trauma for which he was operated at the local hospital. X-ray and CT scan of the right knee was suggestive of the non-union of the right patella with three main fragments. We managed with open reduction and internal fixation using CC screw, cerclage and tension band wiring. At one-year follow up, the patient is having a clinical and radiological union of non-union with good functional outcome.
Conclusion: Combination of cannulated cancellous screw, cerclage and tension band wiring provides stable fixation in the multi-fragmentary patellar non-union, helps in early mobilisation which in turn helps in getting good functional outcome and prevents implant-related complications.
Keywords: Non-union; Multi-fragmentary patella; Internal fixation; Fixation failure.

References

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How to Cite this article: Mahajan NP, Prasanna Kumar GS, Kondewar P, Jadhav K | Multi-Fragment Patellar Non-Union in a Young Patient Due to Failed Fixation and its Management- A Rare Case Report | Trauma International | January-June 2021; 7(1): 12-14.

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Prospective Evaluation of The Results of External Fixation of Unstable Fractures of Distal Radius- A Comparison Between Open and Close Fractures and an Analysis of Similar Studies

January 10, 2021/in January-June 2021 | Volume 7 | Issue 1

Vol 7 | Issue 1 | January-June 2021 | page: 05-11 | Brijesh Sharma, Vipul Agrawal, Rajendra Kumar Shakunt, Chandra Prakash Pal, Mayur Gupta, Rohit Yadav

Author: Brijesh Sharma [1], Vipul Agrawal [1], Rajendra Kumar Shakunt [1], Chandra Prakash Pal [1], Mayur Gupta [1], Rohit Yadav [1]

[1] Department of Orthopaedics, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
Address of Correspondence
Dr. Mayur Gupta,
Department of Orthopaedics, Sarojini Naidu Medical College, Agra, Uttar Pradesh, India.
E-mail: mayur29.mg@gmail.com

Abstract

Background: Unstable or severely comminuted and intra-articular fractures of distal radius represent traumatic high energy injuries. Prospective study to evaluate the results of external fixation of such fractures was conducted from January 2017 to January 2020 in the Department of Orthopaedics. The aim of this study is to identify the results of external fixation of unstable fractures of distal radius and find out the best treatment options for such fractures under different clinical conditions by comparing the results for open and close fractures and analysis of similar studies.

Materials and Methods: 50 cases of unstable distal radius fractures, including 25 patients with open fractures and 25 patients with close fractures, were treated by external fixation. The patients had mean age of 33 years with 3:2 male female ratio. The fracture was anatomically reduced and fixed with external fixator. The mean follow up was of 24 months.

Results: Final assessment was done at 6 months postoperative follow up using the Sarmiento’s modification of Lindstrom criteria for radiological outcome, showing excellent to good results in 60% cases among open fracture group and 80% cases among close fracture group , Mayo Wrist Score for functional outcome showing excellent to good results in 52% cases among open fracture group and 76% cases among close fracture group. Long term assessment done using Jakim’s scoring system (for clinicoradiological correlation) at 24 months follow-up for all 50 patients, showed excellent to good results in 88% patients. Analysis of similar studies shows external fixation to be the most rewarding treatment option for varied clinical presentations of unstable fractures of distal radius.
Conclusions: Outcome at 6 months is significantly better in close fracture group as compared to open fracture group showing that good soft tissue cover is necessary for functional fracture healing. The long-term outcome in majority of the patients (44 cases) was excellent to good showing reliability of biological ligamentotaxis under various clinical presentations as suggested by analysis of similar studies. This treatment of choice leads to clinically rewarding functional, anatomical and radiological outcomes in unstable distal radius fractures.
Keywords: External fixation, ligamentotaxis, Distal radius.

References

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[4] Gouk, C., Ng, S.-K., Knight, M., Bindra, R., & Thomas, M. (2019). Long term outcomes of open reduction internal fixation versus external fixation of distal radius fractures: A meta-analysis. Orthopedic Reviews, 11(3). https://doi.org/10.4081/or.2019.7809
[5] Williksen JH, Husby T, Hellund JC, Kvernmo HD, Rosales C, Frihagen F. External Fixation and Adjuvant Pins Versus Volar Locking Plate Fixation in Unstable Distal Radius Fractures: A Randomized, Controlled Study With a 5-Year Follow-Up. J Hand Surg Am. 2015;40(7):1333-40. doi:10.1016/j.jhsa.2015.03.008
[6] Zhang Li-hai , Wang Ya-nan, Mao Zhi , Zhang Li-cheng, Li Hong-da, Yan Huan , Liu Xiao-xie , Tang Pei-fu . Volar locking plate versus external fixation for the treatment of unstable distal radial fractures: a meta-analysis of randomized controlled trials. J Surg Res. 2015;193(1):324-33. doi:10.1016/j.jss.2014.06.018
[7] Kasapinova K, Kamiloski V. Open reduction and internal fixation versus external fixation and/or kirschner wires for distal radius fractures. A systematic review. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2014;35(1):225-36. Review. PubMed PMID: 24802315.
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[10] Xuetao Xie, Xiaoxing Xie, Hui Qin, Longxiang Shen & Changqing Zhang (2013) Comparison of internal and external fixation of distal radius fractures, Acta Orthopaedica, 84:3,286-91, DOI: 10.3109/17453674.2013.792029
[11] Esposito J, Schemitsch EH, Saccone M, Sternheim A, Kuzyk PR. External fixation versus open reduction with plate fixation for distal radius fractures: a meta-analysis of randomised controlled trials. Injury. 2013;44(4):409-16. doi:10.1016/j.injury.2012.12.003
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How to Cite this article: Sharma B, Agrawal V, Shakunt RK, Pal CP, Gupta M, Yadav R | Prospective Evaluation of The Results of External Fixation of Unstable Fractures of Distal Radius- A Comparison Between Open and Close Fractures and an Analysis of Similar Studies | Trauma International | January-June 2021; 7(1): 05-11.

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Multi-Fragment Patellar Non-Union in a Young Patient Due to Failed Fixation and its Management – A Rare Case Report

Prospective Evaluation of The Results of External Fixation of Unstable Fractures of Distal Radius- A Comparison Between Open and Close Fractures and an Analysis of Similar Studies

Multi-Fragment Patellar Non-Union in a Young Patient Due to Failed Fixation and its Management – A Rare Case Report

Prospective Evaluation of The Results of External Fixation of Unstable Fractures of Distal Radius- A Comparison Between Open and Close Fractures and an Analysis of Similar Studies

Full Sized Blog Element (Big Preview Pic)

Multi-Fragment Patellar Non-Union in a Young Patient Due to Failed Fixation and its Management – A Rare Case Report

Author: Neetin P Mahajan [1], Prasanna Kumar GS [1], Pranay Kondewar [1], Kishor Jadhav [1]

Abstract

References

(Article Text HTML) (Download PDF)

Prospective Evaluation of The Results of External Fixation of Unstable Fractures of Distal Radius- A Comparison Between Open and Close Fractures and an Analysis of Similar Studies

Author: Brijesh Sharma [1], Vipul Agrawal [1], Rajendra Kumar Shakunt [1], Chandra Prakash Pal [1], Mayur Gupta [1], Rohit Yadav [1]

Abstract

References

(Article Text HTML) (Download PDF)

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