Armin Akbarzadeh; Hamid Namazi; Ayub Gharebeigi Tavabeh; Seyyed Arash Haghpanah; Doroudchi Alireza
Volume 12, Issue 3 , July 2024, , Pages 117-123
Abstract
Objective: Intra-articular screw penetration is a probable complication of coronoid fracture fixation. Thepresent study aimed to determine the best radiography technique for visualizing the proximal radioulnar joint(PRUJ) space. Moreover, it aimed to determine the safe angle and length of the screw to ...
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Objective: Intra-articular screw penetration is a probable complication of coronoid fracture fixation. Thepresent study aimed to determine the best radiography technique for visualizing the proximal radioulnar joint(PRUJ) space. Moreover, it aimed to determine the safe angle and length of the screw to avoid PRUJ penetrationduring coronoid fracture fixation.Methods: The Mimics software was used to construct a three-dimensional model of a healthy man’s forearmfrom a computer tomography scan. It was analyzed using the Solidworks software to determine the X-ray anglethat clearly showed the PRUJ space to detect penetration of screws from the coronoid process into the PRUJand determine the maximum screw angle and length that could be used without intra-articular penetration. Toverify these findings, a cadaveric study combined with radiographs was conducted.Results: To visualize PRUJ space, the optimal X-ray angle was 13º lateral to the perpendicular line when theforearm was positioned at full supination. If the coronoid process was segmented into zones 1 (closest to theradioulnar joint) to 4 (farthest from the joint), the screw could only be inserted at a right angle in zone 1. In zones2, 3, and 4, inclination angles less than 15, 35, and 60 would prevent intra-articular penetration, respectively.Conclusions: The X-rays could visualize the PRUJ space with an anteroposterior radiograph at an angle of13º ulnar deviation from the perpendicular plane. During coronoid process fracture fixation, shorter screwswith less lateral inclination were safer when inserting screws in the zones of the coronoid process adjacent tothe PRUJ.
Jose Ramon Auso-Perez; Gloria Maria Rodríguez-Blanes
Volume 8, Issue 3 , July 2020, , Pages 142-147
Abstract
Objective: To describe the demographic characteristics and to assess possible risk factors related to the moment of presentation at Emergency Department (ED) for pediatric humeral supracondylar fractures. Methods: This was cross-sectional study being conducted during 5-year period from 2013 to 2017 at ...
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Objective: To describe the demographic characteristics and to assess possible risk factors related to the moment of presentation at Emergency Department (ED) for pediatric humeral supracondylar fractures. Methods: This was cross-sectional study being conducted during 5-year period from 2013 to 2017 at ED of a regional hospital in Spain. We have included all the pediatric patients ( Results: We have included 52 pediatric patients with supracondylar fractures in this series. The mean age was 7.48 ± 2.97 years with a minimum age of 2 years and a maximum of 14 years. Among the patients there were 32 (61.54%) male and 20 (38.46%) female. Age less than 7 years found to be a protective factor against unstable fractures [OR 0.33 (0.10 - 1.02)]. Fractures presented during daytime hours showed a greater instability [OR 3.49 (1.07-11.39)]. However, the risk of presentation at nighttime was higher during the summer months (June to September). Conclusion: The older is the child, the greater is the risk of suffering an unstable fracture, which increases the need for surgery. This risk is greater during the daytime. Otherwise, during the summer months, there is a higher risk of patient presentation at nighttime.
Uttam Chand Saini; Deepak Neradi; Deepak Kumar; Vikas Bacchal; Praveen Sodavarapu; Akshay Shetty
Volume 8, Issue 3 , July 2020, , Pages 207-208
Nadeem Ali; Naseer Ahamd Mir; Tahir Ahmad Dar; Mohmad Nawaz Rather; Wajahat Ahmad Mir; Senin Shah; Saheel Maajid
Volume 6, Issue 4 , October 2018, , Pages 306-312
Abstract
Objective: To determine the time to radiological union and final functional outcome of fixation of extra-articular distal humeral fractures with extra-artricular distal humerus locking plate.Methods: This prospective study was conducted from March 2014 to February 2018 and included extra-articular distal ...
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Objective: To determine the time to radiological union and final functional outcome of fixation of extra-articular distal humeral fractures with extra-artricular distal humerus locking plate.Methods: This prospective study was conducted from March 2014 to February 2018 and included extra-articular distal humeral fractures managed by operative fixation using extra-articular distal humerus locking plate. All the fractures were approached using lateral para-tricepetal approach of Gervin, and stabilized with extra-articular distal humerus locking plate with or without lag screws. Time to radiological union was assessed in the follow up and at the final follow up functional outcome was evaluated using Mayo Performance Elbow Score (MEPS). Complications and need for any additional procedures was also recorded.Results: A total of 20 patients with mean age of 36.5 years and an average follow up of 17 months were included. The mean time to radiological union was 17.4 weeks (12 to 36 weeks) which included one delayed union that required bone grafting. The mean flexion at elbow was 127o with only one patient having flexion extension arc movement of less than 100o at the final follow up. The average MEPS at final follow up was 94.7±8 with 19 patients having excellent and good results.Conclusion: Use of extra-articular distal humeral locking plate using lateral para-tricepetal approach in extra-articular distal humeral fractures allows stable fixation of the fracture to allow early return to function with minimal soft tissue dissection and excellent final functional results and minimum complications.