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Management of Open Injuries: What has changed?

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page: 7-11 | Devendra Agraharam, Arun Kamal C, Raja Bhaskara Rajasekaran, Vel Murugesan P, Ramesh Perumal, Dheenadhayalan J. Author: Devendra Agraharam [1], Arun Kamal C [1], Raja Bhaskara Rajasekaran [1], Vel Murugesan P [1], Ramesh Perumal [1], Dheenadhayalan J [1]. [1] Department of Orhtopaedics & […]

Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) using Locking Compression Plate (LCP) in Distal Tibial Fractures: A Prospective Study of 50 Cases.

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page: 34-37 | Rakesh Sharma, Rajesh Kapila, Sarika Kapila, Dharam Singh, Jagsir Mann doi-10.13107/ti.2018.v04i01.064 Author: Rakesh Sharma [1], Rajesh Kapila[1], Sarika Kapila [2], Dharam Singh [1], Jagsir Mann [1] . [1] Department of Orthopaedics, Govt. Medical College, Amritsar – 143001 (Punjab). India [2] Dept. Of […]

Management of Open Injuries: What has changed?

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) using Locking Compression Plate (LCP) in Distal Tibial Fractures: A Prospective Study of 50 Cases.

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

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Management of Open Injuries: What has changed?

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page: 7-11 | Devendra Agraharam, Arun Kamal C, Raja Bhaskara Rajasekaran, Vel Murugesan P, Ramesh Perumal, Dheenadhayalan J.

Author: Devendra Agraharam [1], Arun Kamal C [1], Raja Bhaskara Rajasekaran [1], Vel Murugesan P [1], Ramesh Perumal [1], Dheenadhayalan J [1].

[1] Department of Orhtopaedics & Trauma Ganga Medical Centre & Hospitals Pvt. Ltd, 313, Mettupalayam road, Coimbatore, India

Address of Correspondence
Dr. Raja Bhaskara Rajasekaran,
Ganga Hospital, Mettupalayam road,Coimbatore, India
Email: rajalibra299@gmail.com

Abstract

Introduction: Open injuries pose a major problem to the treating surgeon as they are prone to higher rates of infection and non-union and are usually associated with life threatening polytrauma. Nowadays, specialized trauma centres and a multimodal team approach have shown to give superior results in the outcome following open injuries. Early wound debridement, early fracture stabilization and early wound closure are important components as nowadays we focus on the ‘Era of functional restoration’. Serum Lactate is a widely used biochemical marker to assess the adequacy of tissue resuscitation and the Ganga Hospital Open Injury score (GHOIS) has a higher specificity towards limb salvage and also gives guidelines regarding timing and type of soft tissue reconstruction. A combined ‘Orthoplastic’ approach in the management of open injuries and adherence to the ‘Revised reconstruction ladder’ with regarding to wound coverage has shown to a favourable outcome.
Keywords: Open fractures, Debridement, Serum lactate, Ganga Hospital Open Injury score

References

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How to Cite this article: Agraharam D, Arun Kamal C, Rajasekaran RB, VelMurugesan P, Perumal R, Dheenadhayalan J. Management of Open Injuries: What has changed. Trauma International May -Aug 2018;4(1):7-11.

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Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) using Locking Compression Plate (LCP) in Distal Tibial Fractures: A Prospective Study of 50 Cases.

May 10, 2018/in May - Aug | volume 4 | issue 1| 2018

Vol 4 | Issue 1 | May – Aug 2018 | page: 34-37 | Rakesh Sharma, Rajesh Kapila, Sarika Kapila, Dharam Singh, Jagsir Mann

doi-10.13107/ti.2018.v04i01.064

Author: Rakesh Sharma [1], Rajesh Kapila[1], Sarika Kapila [2], Dharam Singh [1], Jagsir Mann [1] .

[1] Department of Orthopaedics, Govt. Medical College, Amritsar – 143001 (Punjab). India

[2] Dept. Of Oral and Maxillofacial Surgery, SGRD institute of dental sciences. Amritsar

Address of Correspondence
Dr. Rajesh Kapila

2-B , circular road, Amritsar-143001
Email: kapila.rajesh@ yahoo.com

Abstract

Background: The limited soft tissue, subcutaneous location of large portion of tibia and precarious blood supply renders the treatment of distal tibial fracture very challenging. The main treatment of this type of fracture is reinstatement of the normal alignment and articular congruity. Conventional osteosynthesis is not suitable because distal tibia is subcutaneous bone with poor vascularity. Closed Reduction and MIPPO with locking compression plate (LCP) has emerged as an alternative treatment option because it respects biology of distal tibia, maintains fracture haematoma and provides biomechanically stable construct, early mobilization, less complications and relatively higher rates of union. The aim of this study was to evaluate the functional and clinical outcomes of distal tibia fracture of patients, treated by internal fixation by minimally invasive plating osteosynthesis (MIPPO) technique with locking compression plate (LCP).
Methods: 50 patients with distal tibia fracture with or without intra articular extension were treated in our department, with MIPO with LCP and were prospectively followed for average duration of 6 months. The outcome was evaluated using American Orthopedic Foot and Ankle Society (AOFAS) score ( Ankle – Hindfoot Scale )
Results: There were 50 patients (36 males and 14 female) with mean age of 38.4 years. The mean follow up period of our patients was 6 months. All fractures united at an average of 19.13 weeks (range- 16-24 to weeks) except two cases of non- union. There were 8 superficial wound infections which were treated with oral antibiotics and progressed to union and there were no failures of implants. According to AOFAS score at 6 months, 6 cases had score of 31 to 70 and 44 cases had score of 71 to 100.
Conclusions: Minimally invasive plating osteosynthesis (MIPPO) is an effective method of treatment for distal tibial fractures. The use of indirect reduction techniques and small incision is technically demanding and it is effective, minimally invasive, optimises the operation time, promotes early healing and reduces the incidence of infections and complications associated with conventional method of open reduction and internal fixation.
Keywords: Distal tibia, LCP, MIPPO, Osteosynthesis, Plating.

References

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How to Cite this article: Sharma R, Kapila R, Kapila S, Singh D, Mann J.Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) using Locking Compression Plate (LCP) in Distal Tibial Fractures. A Prospective Study of 50 Cases. Trauma International May-Aug 2018;4(1):34-37.

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Management of Open Injuries: What has changed?

Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) using Locking Compression Plate (LCP) in Distal Tibial Fractures: A Prospective Study of 50 Cases.

Management of Open Injuries: What has changed?

Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) using Locking Compression Plate (LCP) in Distal Tibial Fractures: A Prospective Study of 50 Cases.

Full Sized Blog Element (Big Preview Pic)

Management of Open Injuries: What has changed?

Author: Devendra Agraharam [1], Arun Kamal C [1], Raja Bhaskara Rajasekaran [1], Vel Murugesan P [1], Ramesh Perumal [1], Dheenadhayalan J [1].

Abstract

References

(Abstract Text HTML) (Download PDF)

Minimally Invasive Percutaneous Plate Osteosynthesis (MIPPO) using Locking Compression Plate (LCP) in Distal Tibial Fractures: A Prospective Study of 50 Cases.

Author: Rakesh Sharma [1], Rajesh Kapila[1], Sarika Kapila [2], Dharam Singh [1], Jagsir Mann [1] .

Abstract

References

(Abstract Text HTML) (Download PDF)

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