Background: Scapular fractures are a rare upper extremity injury brought on mostly by high-energy trauma. The bulk of these fractures are extra-articular. Un-displaced fractures can be successfully treated with conservative measures. However, displaced fractures do not produce excellent outcomes and require surgical intervention. Objective: The aim of the current study was to perform a review of literatures and meta-analysis on the function results of treating extra-articular scapular fractures.
Background: Physeal fractures of long bones are common injuries treated by orthopedists. Distal tibial physeal fractures account for 11% of all physeal injuries. Objectives: The aim of the work is evaluation of the clinical and radiological outcome of lower tibial epiphyseal injury managed by percutaneous pinning. Patients and Methods: This was a prospective randomized study carried out on 12 cases with distal tibial epiphyseal injuries admitted to Zagazig University with follow up period up to six months. The youngest patient was 8 years old, while the oldest was 16 years old, with an average of 12 years; the high incidence was in the age group 10-15 years. Results: Overall results obtained from 12 cases were satisfactory in 11 cases (91.66%) and unsatisfactory in 1 cases (8.37%). More satisfactory results in this work were in the age group 10-15 years. However, age did not affect the results significantly. Cases with closed injury showed more satisfactory results (100%) than those with open injury, the difference was statistically highly significant. All cases in this study were presented within the first 48 hours from onset of trauma. 8 cases were immobilized for 8 weeks and 4 cases for 6 weeks. The difference was statistically insignificant. 2 cases were managed by open reduction and internal fixation and the difference was statistically insignificant.
Conclusion:The percutaneous pinning for lower tibial epiphyseal injury showed good reduction of fracture, satisfactory functional outcome and less complications. The technique provided speed recovery, secure fixation and avoiding prolonged cast immobilization and conservative treatment.
Background: Metaphyseal tibial fractures contain distal and proximal metaphyseal fractures which account for (3-11%) and (5-11%) of total tibial fractures, respectively. Numerous treatment options exist for treating metaphyseal tibial fractures. Objectives: The aim of the current work was to assess the clinical and radiological functional outcomes of expert tibial intramedullary nail in treatment of metaphyseal tibial fractures in adult. Patients and Methods: This prospective study included a total of 12 patients who had metaphyseal tibial fractures, attending at Zagazig University Hospital and Damietta Specialized Hospital. Patients were operated by closed reduction and internal fixation with expert interlocking tibial nail and followed up for average 6 months from November 2019 to December 2020. Results: All patients underwent full history taking, Clinical examination and Radiographic views were taken for other skeletal injuries if suspected. 2 patients (16.7%) has proximal tibial fracture, 1 (8.3%) of them had excellent final result and 1 (8.3%) had good final result. 2 patients (16.7%) had segmental tibial fracture,1(8.3%) of them had excellent final result and 1 (8.3%) had fair final result. 8 (66.7%) patients had distal tibial fractures, 6 (50%) had excellent final result, 1 (8.3%) had good final result,1 (8.3%) had poor final result.
Conclusion:It could be concluded that intramedullary fixation with expert interlocking tibial nail is a safe and effective method for the treatment of metaphyseal tibial fractures. Multiple reduction aids as percutaneous clamps, blocking screws/wires help in obtaining and maintaining reduction. The nail design allows the distal or proximal segment to be controlled through placement of multiple locking screws within a small distance from the articular surface. The alignment can be well maintained despite the short metaphyseal segment. Expert nail showed excellent and good results in more than 83% in this study.
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