Purpose: Kirschner-wire fixation (KF) and external fixation (EF) for the treatment of displaced supracondylar femur fractures (SFFs) were demonstrated respectively in previous reports. However, there is no paucity of convincing information on better treatment options for children. The aim of this study was to show results of KF and EF in the treatment of paediatric SFFs according to clinical and radiological outcome.
Methods: A retrospective analysis including 22 displaced closed SFFs was performed. A total of 12 patients were treated with KF, other ten patients were treated with EF. All patients were followed up for at least 24 months. Demographic data, surgical outcomes and postoperative knee function using the Knee Society Score (KSS) scale were evaluated in this research.
Results: The patients in the KF group were significantly younger than in the EF group (p < 0.001). The KF group had superiority in operative time (p = 0.001), blood loss (p = 0.027) and length of hospital stay (p = 0.001). Clinical healing outcome did not differ between the two groups. The KF group achieved radiological union in a shorter period (p < 0.001), with a better range of movement (ROM) and KSS postoperative score.
Conclusion: Both KF and EF can achieve excellent outcomes for paediatric SFFs. KF has many advantages in younger children.
Level Of Evidence: IV.
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http://dx.doi.org/10.1302/1863-2548.14.200050 | DOI Listing |
Medicine (Baltimore)
January 2025
Hebei Province Tangshan Second Hospital Trauma Five, Hebei, China.
Ankle fractures are among the most common bone injuries, which are often accompanied by soft tissue injuries. Proper management of these fractures is crucial to promote healing and minimize complications. This study explores the effects of 2 treatment methods for ankle fractures: open reduction and internal fixation and manual reduction followed by plaster external fixation.
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Electrophysiology and Cardiac Pacing Unit, San Giuliano Hospital, Giugliano in Campania, Italy.
We present the case of a 64-year-old man who, during the implantation of an active-fixation leadless pacemaker (LP, Aveir VR, Abbott, USA), underwent several external defibrillation shocks up to 240 Joules, due to symptomatic sustained supraventricular tachycardia at 160 bpm. The shocks, delivered both before and after the screwing of the device in the low interventricular septum, did not cause any technical damage to the device, and no complications were observed. The device was then deployed successfully.
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December 2024
Department of Surgery, Florida Atlantic University Charles E. Schmidt College of Medicine, Boca Raton, USA.
Subtrochanteric fractures in older patients are typically due to low-energy falls. The standard of care is intramedullary nailing. The Smith & Nephew Trigen Intertan (Memphis, TN, US) is an intramedullary nail with a novel design that incorporates two integrated compression screws.
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December 2024
Neurological Surgery, Cleveland Clinic Foundation, Cleveland, USA.
Traumatic burst fractures of the atlas occur with axial loading of the cervical spine. Many of these injuries can be treated by nonsurgical management with external orthosis; however, cases with transverse ligament disruption or significant C1 lateral mass displacement require internal reduction and fixation. In patients with poor bone quality in the setting of osteoporosis or chronic illness, atlanto-axial fixation and reduction of the fracture can be a challenge, necessitating extension of fusion to the occiput, which significantly limits the range of motion.
View Article and Find Full Text PDFJBJS Case Connect
January 2025
Department of Orthopaedic Surgery, University of Tennessee Health Science Center College of Medicine Chattanooga, Chattanooga, Tennessee.
Case: A 41-year old man fell from height sustaining displaced radial shaft and ulnar styloid fractures underwent open reduction internal fixation of the radius with early recognition of a radiocapitellar dislocation and longitudinal forearm instability in the early postoperative period. Revision surgery was performed 13 days postoperatively involving annular ligament reconstruction, elbow spanning external fixation, and distal radioulnar joint stabilization. Favorable functional and radiographic outcomes are shown at 1-year follow-up.
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