Introduction: Thoracolumbar fractures are the most common injuries being treated by spine surgeons. Conventionally these fracture were treated with 2 levels above and 2 levels below the fracture site. The goal of internal fixation is to minimize the number of vertebral levels involved in fusion of a spine fracture. This is achievable by utilizing short same segment posterior fixation (SSPF). SSPF is the use of pedicle screw instrumentation one level cephalad to and one level caudal to the fracture vertebra and pedicle screw inserted into the fractured vertebra. Materials & Methods: 15 patients who were operated between Jan 2012 to January 2015 were taken for the retrospective analysis. All patients were surgically treated with short same segment fixation using a posterior surgical approach with transpedicular instrumentation. Pedicle screws were placed at one level above and below the fracture site. Additionally, pedicle screws were also inserted at the level of the fracture. Connected with rods. Results and analysis: All the patients were followed up at 3 months, 6 months and 12 months postoperatively. The Mean pre-operative kyphosis was 14° (range 6° to 24°). Average post-operative kyphosis was 0° (range 6° to −18°). Average follow-up kyphosis of all cases was 10° (range 0.85° to 35.00°). Excluding failures, average follow-up kyphosis was 8° (range 0.85° to 25.00°). The height of the vertebral body was maintained upto 95% in 6 patients, 80% in 6 patients, and 70% in 3 patients. At initial one-month follow-up, average Oswestry disability score was severe at 52.63% (range 16% to 84%). At most recent follow-up, average Oswestry disability score was minimal at 5.5% (range 0% to 16%). One patient was lost to long-term follow-up. Mean difference from one-month follow-up to most recent follow-up (excluding failures) was 47.27% (P < 0.0001). Conclusion: In our study the short same-segment fixation decreases implantation failure rate and reoperation rate. However long term kyphosis correction was not maintained. Despite this loss of kyphosis correction, clinical pain and disability improved at long-term follow-up.
Background: Open fractures of tibial shaft are important for the reason that they are most commonly fractured long bone in the body & subcutaneous location of the anteromedial surface of the tibia makes their management controversial. The precarious blood supply and lack of soft tissue cover of the shaft of the tibia make these fractures vulnerable to delayed union, nonunion, malunion and infection. The treatment of tibial fractures has developed from a strictly non-operative to a variety of operative techniques. While reamed Intramedullary nailing offer improved stability of the fracture, their use carries a theoretical risk of infection and nonunion as a consequence of disturbing endosteal blood supply. Recent reports suggest that the reaming is safe for grade I, II and IIIA open fractures of tibia. Material & Method: A total of 25 patients presented to Father Muller Hospital, Mangalore from Jan'06 to July'07 with type I and II open tibial shaft fractures were included in the study and all cases underwent debridement within 6 hours of admission and treated with reamed intramedullary interlocking nailing. They were reviewed at every 2 weeks for 6 weeks and then monthly post operatively and x-rays were repeated at 6,12,24 weeks to check for fracture healing. The average duration of follow-up was 32 weeks. Functional results were graded according to criteria by klemm & borner. Result:The average time to union was 19.68 weeks. Type I united in 18.86 weeks as compared to 20.5 weeks for Type II fractures. The average range of motion in the knee joint was 135.6 degrees. Full ankle motion was observed in 19 patients. One patient showed a loss >25° of motion at ankle compared to normal side while 5 patients showed < 25 0 loss of joint motion. 92% patients achieved good or excellent results, fair results were obtained in one patient & in one patient functional results were poor. Conclusion: Anatomical & functional outcome of open tibial fractures type I and type II treated with reamed intramedullary interlocking nailing is excellent to good and it is safe and effective technique for the management of Gustilo type I and type II.
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.