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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 […]

Pure Obturator Dislocation of the Hip, a Rare Variety of Regular Dislocations, and Long-Term Clinical Outcomes

June 10, 2022/in January-June 2022 | Volume 8 | Issue 1

Vol 8 | Issue 1 | January-June 2022 | page: 19-21 | Walid Bouziane, Machmachi Amine, Soufiane Aharram, Omar Agoumi, Abdelkrim Daoudi DOI: 10.13107/ti.2022.v08i01.025 Authors: Walid Bouziane [1], Machmachi Amine [2], Soufiane Aharram [1], Omar Agoumi [1], Abdelkrim Daoudi [1] [1] Department of Orthopaedic Surgery and Traumatology, University Hospital Oujda, Morocco. [2] Department of Medicine […]

Tens Nailing in Fracture Clavicle – A Case Series

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

Pure Obturator Dislocation of the Hip, a Rare Variety of Regular Dislocations, and Long-Term Clinical Outcomes

June 10, 2022/in January-June 2022 | Volume 8 | Issue 1

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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

1. Postacchini F, Gumina S, De Santis P, Albo F. Epidemiology of clavicle fractures. J Shoulder Elbow Surg. 2002; 11(5):452–6.

2. Nordqvist A, Petersson C. The incidence of fractures of the clavicle. Clin Orthop Relat Res. 1994; (300: ):127–32.

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.

4. Houwert RM, Wijdicks FJ, Steins Bisschop C, Verleisdonk EJ, Kruyt M. Plate fixation versus intramedullary fixation for displaced mid-shaft clavicle fractures: a systematic review. Int Orthop. 2012; 36 (3):579–85.

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

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Pure Obturator Dislocation of the Hip, a Rare Variety of Regular Dislocations, and Long-Term Clinical Outcomes

June 10, 2022/in January-June 2022 | Volume 8 | Issue 1

Vol 8 | Issue 1 | January-June 2022 | page: 19-21 | Walid Bouziane, Machmachi Amine, Soufiane Aharram, Omar Agoumi, Abdelkrim Daoudi

DOI: 10.13107/ti.2022.v08i01.025

Authors: Walid Bouziane [1], Machmachi Amine [2], Soufiane Aharram [1], Omar Agoumi [1], Abdelkrim Daoudi [1]

[1] Department of Orthopaedic Surgery and Traumatology, University Hospital Oujda, Morocco.
[2] Department of Medicine and Pharmacy, Mohammed First Oujda University, Oujda, Morocco.

Address of Correspondence

Dr Walid Bouziane,
Department of Orthopaedic Surgery and Traumatology, University Hospital Oujda, Morocco.
E-mail: walidbouziane93@gmail.com

Abstract

Introduction: Traumatic knee dislocation is considered an orthopedic emergency. Knee dislocations are relatively infrequent injuries. This injury frequently occurs from high-energy impact trauma. Neurovascular injuries can result in debilitating consequences if the diagnosis and treatment are delayed. Associated complications include degenerative arthritis, permanent neurovascular injury, and amputation. The poorest prognosis is seen in patients with knee dislocation longer than 6-8 hours before reduction.

History: The 25-year-old male patient presented with a history of a road traffic accident to the emergency department. The patient presented with swelling, pain, and deformity of the left knee and leg. Examination: On examination, the patient had tense swelling and tenderness of the left knee joint and leg. Visible deformity of the left knee joint is seen. The posterior tibial artery and dorsalispedis artery were not palpable. Active ankle and toe movements were absent.

Investigations: Plain radiograph was taken at the emergency department of the left knee and leg. X-rays showed anterior dislocation of the knee joint.

Treatment: After valid written informed consent, the dislocated left knee joint was reduced under sedation in the operation theatre and immobilized in the above knee plaster slab. Reduction of the knee joint was done within 4 hours of injury. Then the distal pulses were re-assessed. The posterior tibial and dorsalispedis artery was absent. Hence, MR Angiography of the left lower limb was done. It showed popliteal artery transection. So, the artery was explored and end-to-end vascular anastomosis was done. A knee-spanning external fixator was applied to the left lower limb. Fasciotomy was done for the tense leg compartments. After a week, the fasciotomy wounds were infected for which extensive debridement of the wounds was done and antibiotic beads were placed. Knee was mobilized with a gradual range of motion exercises and non-weight bearing mobilization with a foot drop splint. Gradually full weight-bearing ambulation was allowed.

Conclusion: Knee dislocation is rare, albeit a serious and potentially limb-threatening condition. The prognosis of knee dislocations is variable and is heavily dependent on the time interval between trauma and initiation of management. Immediate, timely, and proper management can salvage the limb, and amputation is not the only solution.

Keywords: Dislocation, Posterior tibial artery, Fasciotomy

References

[1] Phillips AM, Konchwalla A. The pathologic features and mechanism of traumatic dislocation of the hip. Clin Orthop 2000;377:7.

[2] Elouakili I, Ouchrif Y, Ouakrim R, Lamrani O, Kharmaz M, Ismael F, Lahlou A, El BardouniA,Mahfoud M, Berrada MS, El Yaacoubi M. Luxation obturatrice de la hanche: un traumatisme rare en pratique sportive. Pan AfricanMedical Journal. 201418 : 138.

[3] Epstein HC, Wiss DA. Traumatic anterior dislocation of the hip. Orthopedics 1985;8:130–2.

[4] Bouya A, et al. Luxation obturatrice de la hanche : survenue rare en milieu sportif. J Traumatol Sport (2017).

[5] Phillips AM, Konchwalla A. The pathologic features and mechanism of traumatic dislocation of the hip. Clin Orthop. 2000;377:7–1.

[6] Catonné Y, Meyer A, Sariali E, Biette G. Pathologie du complexe pelvi-fémoral du sportif. Pathologie du complexe pelvi-fémoral du sportif. 2009:88–99.

[7] Dellanh YY, et al. Luxation obturatrice de la hanche : à propos d’un cas. Pan African Med J 2015;22:195.

[8] Toms AD, Williams S, White SH. Obturator dislocation of the hip. J Bone Joint Surg (Br). 2001; 83(1): 113- 115.

[9] Brav EA. Traumatic anterior dislocation of the hip. J Bone Joint Surgery (Am). 1962; 44(A): 1115-1121.

[10] Polesky RE, Polesky FA. Intrapelvic dislocation of the femoral head following anterior dislocation of the hip: a case report. J Bone Joint Surg (Am). 1972;54(5):1097-8.

[11] Richards BS, Howe DJ. Anterior perineal dislocation of the hip with fracture of the femoral head: a case report. Clin Orthop. 1988;228: 194-201.

[12] Catonné Y, Meyer A, Sariali E, Biette G. Luxation de hanche sans fracture au cours d’activités sportives. In: Pathologie du complexe pelvi-fémoral du sportif; 2009. p. 88–99.

[13] Yang RS, Tsuang YH, Hang YS. Traumatic dislocation of the hip. Clin Orthop 1991;265:218.

[14] Hougaard K. Traumatic posterior dislocation of the hip: prognostic factors influencing the incidence of avascular necrosis of femoral head. Arch Orthop Trauma Surg. 1986;106(1):32–5.

How to Cite this article: Bouziane W, Amine M, Aharram S, Agoumi O, Daoudi A | Pure Obturator Dislocation of the Hip, a Rare Variety of Regular Dislocations, and Long-Term Clinical Outcomes | January-June 2022; 8(1): 19-21.

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Tens Nailing in Fracture Clavicle – A Case Series

Pure Obturator Dislocation of the Hip, a Rare Variety of Regular Dislocations, and Long-Term Clinical Outcomes

Tens Nailing in Fracture Clavicle – A Case Series

Pure Obturator Dislocation of the Hip, a Rare Variety of Regular Dislocations, and Long-Term Clinical Outcomes

Full Sized Blog Element (Big Preview Pic)

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)

Pure Obturator Dislocation of the Hip, a Rare Variety of Regular Dislocations, and Long-Term Clinical Outcomes

Authors: Walid Bouziane [1], Machmachi Amine [2], Soufiane Aharram [1], Omar Agoumi [1], Abdelkrim Daoudi [1]

Abstract

References

(Abstract Text HTML) (Download PDF)

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