Introduction: Recently, intramedullary nailing for displaced middle third fractures of clavicle has received wide attention. Though open nailing has been widely described, closed nailing finds less mention. This paper...Introduction: Recently, intramedullary nailing for displaced middle third fractures of clavicle has received wide attention. Though open nailing has been widely described, closed nailing finds less mention. This paper therefore aims to study the outcome of closed titanium elastic nailing for displaced mid-clavicular fractures. Material and Methods: This was a prospective study of 34 patients with displaced middle third clavicle fracture who underwent closed intramedullary nailing with titanium elastic nail at a tertiary care centre. The operative time, length of incision, time for radiological union, pain and functional outcome after union were noted. Results: The mean operative time was 34.33 mins. The mean time of discharge was 2.25 days. The average time of radiological union was 10.23 weeks. All the patients achieved full, painless range of motion of the ipsilateral shoulder. The average Constant-Murley score at 12 months was 94.28 indicating excellent result. Conclusion: Closed titanium elastic nailing offers a safe and minimally invasive method of fixation for fractures of middle-third clavicle with excellent functional outcome.展开更多
Purpose： The aim of this study is to discuss the results of different intramedullary devices used in the management of paediatric radial neck fractures and to suggest methods to avoid the pitfalls of the technique. M...Purpose： The aim of this study is to discuss the results of different intramedullary devices used in the management of paediatric radial neck fractures and to suggest methods to avoid the pitfalls of the technique. Methods： Thirty patients with isolated Judet III and IV fractures were included in this prospective study. Judet I and II fractures and radial neck fractures associated with other injuries were excluded. The final results were graded using the Metaizeau functional scoring system and Oxford Elbow Score. Results： The functional result was good to excellent in 24 of 30 cases （80%）. The mean Oxford Elbow Score was 44.32. The mean follow-up was 40.11 months. The complications seen were radiocapitellar joint penetration - 6 cases at mean 4.87 weeks, redisplacement - 6, radial epiphyseal sclerosis - 5, and heterotopic ossification 1 case. Conclusion： lntramedullary K wires may result in radiocapitellar joint penetration. Titanium Elastic Nail System should not be used as purely fixation devices as they may not prevent redisplacement. Regular follow-up until at least 6 weeks is essential. Patients who have a Judet IV fracture and need open reduction should be given a guarded prognosis. The paper highlights the pitfalls of the technique and makes recommendations regarding the type of implant, follow-up and patient counselling in Judet IV fractures.展开更多
文摘Introduction: Recently, intramedullary nailing for displaced middle third fractures of clavicle has received wide attention. Though open nailing has been widely described, closed nailing finds less mention. This paper therefore aims to study the outcome of closed titanium elastic nailing for displaced mid-clavicular fractures. Material and Methods: This was a prospective study of 34 patients with displaced middle third clavicle fracture who underwent closed intramedullary nailing with titanium elastic nail at a tertiary care centre. The operative time, length of incision, time for radiological union, pain and functional outcome after union were noted. Results: The mean operative time was 34.33 mins. The mean time of discharge was 2.25 days. The average time of radiological union was 10.23 weeks. All the patients achieved full, painless range of motion of the ipsilateral shoulder. The average Constant-Murley score at 12 months was 94.28 indicating excellent result. Conclusion: Closed titanium elastic nailing offers a safe and minimally invasive method of fixation for fractures of middle-third clavicle with excellent functional outcome.
文摘Purpose： The aim of this study is to discuss the results of different intramedullary devices used in the management of paediatric radial neck fractures and to suggest methods to avoid the pitfalls of the technique. Methods： Thirty patients with isolated Judet III and IV fractures were included in this prospective study. Judet I and II fractures and radial neck fractures associated with other injuries were excluded. The final results were graded using the Metaizeau functional scoring system and Oxford Elbow Score. Results： The functional result was good to excellent in 24 of 30 cases （80%）. The mean Oxford Elbow Score was 44.32. The mean follow-up was 40.11 months. The complications seen were radiocapitellar joint penetration - 6 cases at mean 4.87 weeks, redisplacement - 6, radial epiphyseal sclerosis - 5, and heterotopic ossification 1 case. Conclusion： lntramedullary K wires may result in radiocapitellar joint penetration. Titanium Elastic Nail System should not be used as purely fixation devices as they may not prevent redisplacement. Regular follow-up until at least 6 weeks is essential. Patients who have a Judet IV fracture and need open reduction should be given a guarded prognosis. The paper highlights the pitfalls of the technique and makes recommendations regarding the type of implant, follow-up and patient counselling in Judet IV fractures.
