Acta Orthop Belg
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In this biomechanical study, the strength of five different fixation techniques -anterior tension band wiring with K-wires, separate vertical wiring, headless compression screws with anterior tension band wiring, cannulated screws with tension band wiring and memory shape patellar fixator- for distal patellar fractures were compared. Forty calf knees were used for the biomechanical testing. Each specimen was pre-loaded with 10 N at 1 N/s. ⋯ The ultimate load (N) and displacement (mm) values were recorded. The headless compression screw with anterior tension band wiring (656.9±167.9 N) and the cannulated screws with anterior tension band wiring (642.6±166.0 N) obtained significantly higher ultimate loading values compared to the other fixation methods (p<0.05). Fixation via cannulated screws with anterior tension band wiring techniques are more stabile than the patellar shape memory fixator and anterior K wire fixation.
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Comparative Study
Open Reduction And Internal Fixation Versus Primary Partial Arthrodesis For Lisfranc Injuries Accompanied By Comminution Of The Second Metatarsal Base.
The objective of this retrospective study was to compare open reduction and internal fixation (ORIF) with primary partial arthrodesis for the treatment of Lisfranc injuries accompanied by comminution of the second metatarsal base. Thirty-four patients were treated with ORIF or primary partial arthrodesis from 2007 to 2013. The patients were followed for an average of 28.5 months. ⋯ At two years postoperatively, the mean AOFAS Midfoot score was 84.33 points in the ORIF group and 85.05 points in the primary partial arthrodesis group (P> 0.05). Also, no significant differences were seen in the VAS for pain (1.20 vs 1.05 points), SF-36 physical component (79.60 vs 79.89 points) or SF-36 mental component (77.07 vs 79.21 points). With longer and conservative postoperative management, ORIF as well as primary partial arthrodesis for Lisfranc injuries accompanied by comminution of the second metatarsal base led to similar medium-term outcome.
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Randomized Controlled Trial Comparative Study
IA comparison of two minimally invasive procedures for intra-articular displaced calcaneal fractures in older children.
The purpose of this study was to compare the clinical outcomes of displaced intra-articular calcaneal fractures in older children treated with poking reduction and cannulated screws fixation or with plate fixation using a sinus tarsi approach. From June 2008 to May 2012, fifty patients were randomised to operative stabilisation either by poking reduction and cannulated screws fixation (Group A, 28) or by plates fixation using a sinus tarsi approach (Group B, 22). The two groups were comparable with respect to age, gender, BMI, the affected side, cause of injury, fracture type, time from injury to surgery and follow-up time. ⋯ Postoperative incision pain was more frequent in Group B than in Group A (P<0.05). Our results indicated that both cannulated screws and plates were efficient methods for intra-articular calcaneal fractures in older children. However, poking reduction and cannulated screws fixation had the advantages of a shorter operative time, fewer hospital costs and less incision pain.
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The purpose of this study is to report our experience of fractures in children riding Hoverboards. ⋯ Twelve children, 5 males and 7 females with ages ranging from 5.5 to 15.3 years were included in this study. All patients sustained upper limb fractures and the distal radius was the commonest fracture site (30%). Surgery was required in 6 (50%) out of the 12 patients because the respective fractures were displaced. No patient had any ongoing complaints or disability at the last clinic review. Conclusion : Children riding Hoverboards are predisposed to upper limb fractures and parents who purchase Hoverboards should be warned about this.
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Comparative Study
A comparison of ketamine sedation and general anaesthesia for manipulation of paediatric forearm fractures.
The purpose of the study was to compare the use of ketamine sedation and general anaesthesia for manipulation of paediatric wrist and forearm fractures. A retrospective analysis was performed of patients under 16 years treated at our centre between October 2014 and October 2015. Exclusion criteria were open fractures and fractures with complete displacement. ⋯ No statistically significant difference was found in the rate of re-intervention (p=0.48), quality of reduction (p=0.39), quality of cast (p=0.14 and p=0.21), or redisplacement (p=0.87). Those undergoing general anaesthesia used on average 50 minutes of theatre time and one third required an overnight admission. We conclude that ketamine sedation achieves comparable treatment outcomes to general anaesthesia whilst using fewer resources.