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Background: Multiple approaches exist for operative fixation of metacarpal fractures; with common treatments including lag screw fixation or open-reduction internal fixation (ORIF) with plates and screws. Recently, the adaptation of intramedullary screw (IMS) placement has allowed for an essentially closed approach with stable fixation and theoretically improved outcomes. Thus, we sought to compare such approaches to ultimately determine the superior method for achieving the goal of return to normal function.
View Article and Find Full Text PDFDelayed Surgery Increases the Rate of Infection in Closed Diaphyseal Tibial and Femoral Fractures.
J Bone Joint Surg Am
January 2025
Institute for Global Orthopaedics and Traumatology, University of California, San Francisco, San Francisco, California.
Background: Although delays in musculoskeletal care in low- and middle-income countries (LMICs) are well documented in the open fracture literature, the impact of surgical delays on closed fractures is not well understood. This study aimed to assess the impact of surgical delay on the risk of infection in closed long-bone fractures treated with intramedullary nailing in LMICs.
Methods: Using the SIGN (Surgical Implant Generation Network) Surgical Database, patients ≥16 years of age who were treated with intramedullary nailing for closed diaphyseal femoral and tibial fractures from January 2018 to December 2021 were identified.
The aim of this study was to investigate the effect of the presence of the "cortex sign" (corticalization) in femoral diaphysis fractures determined by the dynamization of nails because of delayed union. The study included 12 patients with a closed transverse femoral fracture (AO 32a3) treated with dynamization (all the screws distal of the nail were removed) because of delayed healing and followed up for at least 2 years. These patients were evaluated for the presence of bone union, cortex-like sclerosis (corticalization) distal to the nail, and the distance of the corticalization from the joint during follow- up after dynamization.
View Article and Find Full Text PDFOperating room times differ for surgical fixation of metacarpal fractures: An analysis of two principally different techniques.
Surg Pract Sci
March 2025
Arizona Center of Hand to Shoulder Surgery, Phoenix, AZ, United States.
Introduction: Time spent in the operating room (OR) has ramifications that impact patient outcomes and the economics of patients, physicians, surgery centers, and insurance industry. For that reason, there is an incentive to seek approaches that allow shorter times to be spent in the OR. To what extent varying routine techniques impact on operating times has not been extensively studied in metacarpal fixation literature, specifically investigating retrograde threaded intramedullary nail fixations (RTNF) and comparing it to open plating fixations (OPF).
View Article and Find Full Text PDFSyndromic fibrous dysplasia of the proximal femur.
BMJ Case Rep
January 2025
General Surgery, MS Ramaiah Medical College, Bangalore, Karnataka, India.
A woman in her 50s presented with a 1-year history of left hip pain that increased over the past 2 weeks. The pain began following a low-energy fall. During the 1-year period, she had multiple lesions in the thigh and gluteal region, which were surgically excised.
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