جستجوی مقالات مرتبط با کلیدواژه « orif » در نشریات گروه « پزشکی »

Bicondylar tibial plateau fractures are technically demanding fractures that have a high complication rate. We sought to review the recent literature with the aim to summarize the development of new classification systems that may enhance the surgeon's understanding of the fracture pattern and injury. We highlight the best methods for infection control and touch on new innovative solutions using 3D printer models and augmented mixed reality to provide potentially personalized solutions for each specific fracture configuration. Level of evidence: N/A (Narrative review/commentary)

 Medial malleolar stress fractures are rare injuries resulting from excessive and repetitive stress loads on bone. The incidence rate of these stress fractures varies from 0.6% to 4.1% of all stress fractures and has been almost exclusively reported in athletes. Typical clinical presentation is a gradual onset of pain and tenderness at the medial malleolus site with a history of long-term physical activity. 

Presentation: 

A 60-year-old postmenopausal woman with a gradual onset of pain and point tenderness over the medial malleolus and a history of daily walking for several months.

Diagnosis:

 The initial anterior-posterior and lateral plain radiographs were normal. After the initial conservative medication therapy failed, magnetic resonance imaging (MRI) was obtained. It demonstrated a vertical linear zone of decreased signal intensity originating between the tibial plafond and the medial malleolar junction, which suggested medial malleolar stress fracture. 

Intervention: 

We started treatment with a short leg cast and non-weight bearing for six weeks that failed; open reduction and internal fixation were performed under general anesthesia. 

Outcomes:

 Six months postoperatively, the pain entirely resolved, and the patient returned to her regular daily physical activity and conducted plain radiographs demonstrating complete union, and no complications occurred.

 Medial malleolar stress fractures are rare injuries and might be misdiagnosed due to normal initial radiographs. They must be considered in those with gradual onset of pain and point tenderness of medial malleolus, especially with a history of long-term physical activity. Early diagnosis and surgical intervention lead to faster healing and a return to physical activity

Proximal humeral fracture is a common injury particularly in elderly. A proper management of these fractures is very challenging, based on the various characteristics of patient, fracture anatomy, equipment and the surgeon experience. Bilateral PHF is a rare condition, which almost always caused by seizure, electric shock and trauma, respectively. An appropriate treatment of these patients needs especial attention to obtain a good clinical outcome. We report a 29-year-old patient who suffered from bilateral proximal humeral fracture with posterior dislocation and splitted humeral head due to the combined mechanism of injury including severe trauma after high voltage electric shock. We did not find similar case(s) reported before in the literature. The patient treated with bilateral open reduction and internal fixation (ORIF). He was able to do his daily activities after 6 months

Radial head fractures commonly occur during elbow traumas. Among those, treatment of Mason type III fractures is still under controversy. Common treatment methods for these fractures include open reduction and internal fixation (ORIF) as well as radial head excision. In this study, we compared long-term outcomes of both methods in treatment of patients with Mason type III fractures of radial head. Fifteen men and five women with Mason type III radial head fractures were evaluated retrospectively. Ten patients had undergone excision whereas the other ten patients had been treated with ORIF. Outcomes were assessed based on stability and range of motion of the elbow joint, grip strength, and pain. Data were gathered using Mayo elbow performance index (MEPI), Oxford elbow score, and disability of arm-shoulder-hand (DASH), along with the short form (SF)-36 questionnaire. The mean age of the subjects was 36.25±9.22 years and the mean follow-up time was 25.05±11.43 months. The ranges of extension and supination, and frequency of pain reporting was significantly different between the groups. The average grip strength in the operated side was significantly higher in the ORIF group, compared with the excision (P= 0.03). Ten (100%) patients of ORIF group and 5 (50%) patients of excision group had elbow joint stability (P=0.01). Mean MEPI and DASH scores were significantly higher in ORIF group (Prespectively). The results are in favor of ORIF method. Therefore, this method is recommended and preferred over excision in treating radial heads with Mason type III frac ture.

Little is known about trends and predictors of hardware related infection following open reduction and internal fixation (ORIF) of extremity fractures, one of the major causes of failure following ORIF. The present study was designed and conducted to determine trends and predictors of infection-related hardware removal following ORIF of extremities using a nationally representative database. We used Nationwide Inpatient Sample data from 2002 to 2011 to identify cases of ORIF following upper and lower extremity fractures, as well as cases that underwent infection-related hardware removal following ORIF. Multivariate analysis was performed to identify independent predictors of infection-related hardware removal, controlling for patient demographics and comorbidities, hospital characteristics, site of fracture, and year. For all ORIF procedures, the highest rate of hardware removal related to infection was observed in tarsal fractures (5.56%), followed by tibial (3.65%) and carpal (3.37%) fractures. Hardware removal rates due to infection increased in all fractures except radial/ulnar fractures. Tarsal fractures(odds ratio (OR)=1.06, 95% confidence interval (CI): 1.04-1.09, P<0.001), tibial fractures (OR=1.04, 95% CI: 1.03-1.06, P <0.001) and those patients with diabetes mellitus (OR=2.64, 95% CI: 2.46-2.84, P<0.001), liver disease (OR=2.04, 95% CI: 1.84- 2.26, P <0.001), and rheumatoid arthritis (OR=2.06, 95% CI:1.88-2.25 P <0.001) were the main predictors of infection-related removals; females were less likely to undergo removal due to infection (OR= 0.61, 95% CI: 0.59-0.63 P <0.001). Hardware removal rates due to infection increased in all fractures except radial/ulnar fractures. Diabetes, liver disease, and rheumatoid arthritis were important predictors of infection-related hardware removal. The study identified some risk factors for hardwarerelated infection following ORIF, such as diabetes, liver disease, and rheumatoid arthritis,that should be studied further in an attempt to implement strategies to reduce rate of infection following ORIF.