Purpose Post-traumatic arthritis is one of the leading causes of joint disability. This study aims at outlining outcomes of total knee arthroplasty in post-traumatic arthritis and technical difficulty and reviewing literature regarding this issue Patients and methods We analyzed the outcome of total knee arthroplasty following post-traumatic arthritis in 15 patients with unilateral involvement. Ten had stable arthritic knees treated with posterior stabilized (PS) prosthesis, while five with unstable arthritic knees treated as follows: three with ligamentous instability managed by constrained condylar prosthesis and two with osseous deficiency, metal augmentation used together with stemmed constrained condylar prosthesis (CCK). Average follow-up 6 years, mean age 49.8 years at time of arthroplasty. Patient outcomes were evaluated on the basis of Knee Society score. Results Mean clinical knee society scores (CKSS) at latest follow-up improved from 43.6 ± 11.66 points to 77.3± points postoperatively while mean functional knee society score (FKSS) improved from 40. ± 6.3 to 76.6 ± 84 postoperatively. Patients with stable knees had a higher mean values, both clinical and functional KSS, while unstable knees were poorer. Complications occurred in three cases, one with wound dehiscence with prolonged drainage treated by antibiotics and daily dressings until the wound closed completely, one was complicated by infection and improved by serial debridement, and the third case had aseptic loosening which required revision surgery. Conclusion Total knee arthroplasty for post-traumatic arthritis decreases pain and improves knee function. However; the procedure is not as simple as primary arthroplasty as it is technically demanding and requires adequate planning.
Aim: To introduce and characterize the modified biplanar opening high tibial osteotomy with rigid fixation to treat unicompartmental knee arthritis with varus deformity in active lifestyle patients. Patients and Method: 48 patients (19 females) with monocompartmental gonarthrosis of the knee combined with varus malalignment, 41 with bilateral affection and 7 cases with unilateral gonarthritis (total 89 knees). Mean age: 53 years (range from 42 to 61 years). They were treated and followed from June 2010 to May 2014 (35 months). Biplanar opening high tibial osteotomy technique was used and fixed by low profile locked T-plate (21 cases) and low profile anatomical proximal tibial plate (27cases). Pre-operative mean varus deformity was 16.5˚ (9˚-19˚). We utilized Lysholm score and Knee Society Score for evaluation of preoperative and follow-up data. Results: The average correction angle was 11.50 ± 2.50˚ (7˚-19˚). Preoperative posterior tibial slope was 8.04˚ ± 1.30˚ and at last follow-up 9.15˚ ± 1.60˚, respectively (p = 0.437). The joint space distance increased from 4.05 ± 1.30 mm to 4.83 ± 1.33 mm (p < 0.001). The average time to complete bone union was 14.69 ± 1.5 weeks. There were no cases of delayed union or non-union. No major complications like broken plate, nerve injury, or blood vessel injury occurred. No progression of degenerations developed in the three compartments of the knee at final follow-up. The mean score on the Lysholm-Gillquist knee functional scoring scale was 45.5 ± 21.7 preoperatively, and it improved to 77.0 ± 23.9 (p < 0.001). There was no obvious difference in the range of motion before and after operation. The average knee score improved from 51.19 ± 11.82 to 93.49 ± 5.
Aim of study: To demonstrate clinical and radiological effectiveness of intramedullary fixation of closed diaphyseal humeral fractures in adults using the elastic stable intramedullary nail (ESIN). Patients and methods:Between May 2011 and December 2013, twenty-eight patients (19 males) with closed diaphyseal humeral fractures treated with closed reduction and percutaneous fixation with 2 elastic stable nails. Age from 18 to 56 years (mean, 29 years). Patients with open or pathological fractures, those less than 18 years and medically unfit patients were excluded. Causative injury was pedestrian vehicular accident in 15, fall from height 9 and sport-related activity 4 patients. The time of surgical intervention varied from 24 to 72 hours post-injury. Results:Patients were followed up 12-31 months with an average of 20 months. X-ray films showed that twentysix fractures united completely at a range 14-20 week (mean, 13.1 weeks). Twenty-Six cases healed in good alignment at a median time of 13.1 weeks (range 14-20 weeks). One case developed delayed union where bone marrow injection and longer immobilization till full healing done. One case developed non-union which was treated by bone grafting and plating. There were no intraoperative complications. One patient with preoperative radial nerve injury recovered spontaneously by eight weeks. Patients followed and assessed using Disabilities of the Arm, Shoulder and Hand score (DASH). At last follow-up, the average DASH score was 90.5 (range 60-100). Final clinical evaluation showed 17 cases Excellent, 8 cases Good, 2 cases fair and one case Poor according to previous score. Conclusion:Elastic stable nail fixation is a good procedure for treating adult humeral shaft fractures in which stabilization is indicated as it provides stable fixation, with minimal soft tissue stripping at the fracture site and allows early mobilization of the extremity.
Aim: Pathologic fractures occur as a result of weakening of the mechanical properties of bone. There are many conditions, which lead to bone softening. There are neoplastic and non-neoplastic diseases that cause pathologic fractures. The aim is to evaluate and to highlight on value of prophylactic fixation of impending fractures in abnormal bone situation to prevent occurrence of pathological fracture and its complications. Patients and methods:Between 2003 and 2009, study on forty-nine patient (35 females and 14 males) between the age of 20 and 65 years with an average age of 49.9 years with expected possibility of fractures of lower extremities. The entire patient with fractures risks prophylactic fixation has done. Different types of fixation either surface plating (dynamic hip screws), medullary (Gamma nails or locking nail) or external fixation in cases unsuitable for surgery was used according to the type and the site of the deformity in combination of management of primary condition.Results: Most patients had significant relief of pain. 35 (71.5%) of patients with impending fracture were ambulatory after therapy and able to walk outdoor while 10 (20.5%) of patients could walk inside door. Three patients (6%) using wheel chair, and they were on renal dialysis. Only one patient (2%) was not able to walk, and he was not cooperative for unknown reason. The mean duration of hospitalization was 21 days (range from 7 to 35 days). That time included preoperative period of investigation and preparation and post-operative surgery and rehabilitation.Discussion: Pathological fractures create a serious morbidity in patients with bone disease. Orthopedic surgeons who look after patients with skeletal lesions should focus on proactive treatments designed to prevent pathologic fractures before they occur. Prophylactic fixations have decreased morbidity compared with patient's sustained fractures before fixation. Conclusion:Surgical fixation of fractures in weight-bearing long bones with impending fractures provides pain relief, and a functionally stable and durable construct. It helps early an ambulation and prevents fracture's complication. It allows independent function and avoids irretrievable catastrophes.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.