8 research outputs found
Functional outcome of the treatment of AO-ASIF type C distal humerus fracture using Lambda plate
Introduction: Although the use of two plates for the treatment of type-C distal humerus fracture is popular, site of plate placement still is under debate. Use of Lambda plate for the fracture treatment can be easier and settle the dispute. This study aims to evaluate the functional outcome of the surgery using Lambda Plate. This can be a reference for surgeons and helps them make the decision about choice of implant for type C distal humerus fracture treatment among Nepalese people.
Methods: This interventional study used Lambda plate for the treatment of type C fracture of distal humerus. Patients were examined at 4, 12, and 24 weeks respectively for the measurement of the outcome. Visual analogous scale was used for assessment of pain, range of motion for functional recovery and Mayo Elbow Performance Score was used for the assessment of functional outcome. Paired-samples t-test and linear regression was used to for data analysis.
Results: Functional outcome at the last follow-up was excellent in 24(53.33%) patients, good in 18(40%) patients and fair in 3(6.67%) patients. Range of motion of elbow increased significantly with every follow-up (p-value <0.001). Average angle of flexion at last follow-up was 117.53°±11.74 while loss of extension was 7.53°±4.86. Average number of patients had their fracture union at 19.84±2.38 weeks. There was no association of age, sex and union weeks with functional outcome when measured with MEPS.
Conclusion: Fixation of distal humerus fracture by using Lambda plate gave excellent and satisfying outcome in terms of pain, range of motion and objective functional outcome
Mid-term results of complex distal humeral fractures.
The aim of this study was to assess outcomes
following open reduction and internal fixation in complex
fractures of the distal humerus. Between 2000 and 2006, 34
patients were operated for complex fractures of the distal
humerus. Bone fixation was obtained with a reverse
Y-shaped reconstruction plate in 13 cases and with double
plating in 21 cases. At final follow-up, all the patients were
assessed with the Mayo Elbow Performance Score. Satisfactory
results were observed in 71% of the cases despite a
high rate of complications. Age over 65 years is correlated
with increased risk for an inferior postoperative result.
Complex distal humeral fractures are difficult to treat and
are associated with a high incidence of complications. It is
therefore mandatory to obtain good anatomical reduction
and a stable fixation of lateral and medial columns of the
distal humerus. The results observed in older patients
suggest that an alternative treatment for these patients may
be joint replacement
Functional Outcome Analysis of Parallel-Plate technique for distal humerus fractures
INTRODUCTION: Fractures of the distal humerus accounts for 2-6% of all fractures and 1/3 of all humeral fractures. Intraarticular distal humerus fractures are very rare accounting for 0.5% of all fractures. In this modern society with a growing elderly population and a extremely active young population, the incidence of distal humeral fractures is increasing and having a bimodal distribution .In young adults, most distal humerus fractures occur from high-energy trauma like sideswipe injuries, motor vehicle accidents(MVA). In elderly persons with more osteoporotic bone, these injuries occur from simple falls. As a result of ongoing search for a more secure technique, later evolved the concept of parallel plating (180°), which involves placing one plate along the medial column of the distal humerus and the other plate along the lateral column, with the screws in the distal fragment interdigitating with each other restoring the ‘tie-beam arch’ of the distal humerus. Several biomechanical studies have proven the superiority of parallel over traditional plating methods, yet there are only fewer clinical studies to analyse the functional outcome of parallel plating in distal humerus fracture fixation.
AIM: To analyse the functional outcome of patients treated with parallel plate technique in distal humeral fractures in Institute of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, Madras Medical College, Chennai from May 2010 to November 2012.
MATERIALS AND METHODS: A prospective study was done to evaluate the functional outcome of parallel plating technique in treatment of distal humeral fractures and to analyse the results.
The study group consists of 24 Patients with distal humeral fractures, who underwent osteosynthesis with parallel plating technique between May 2010 and Oct 2012 at the institute of orthopaedics and traumatology, Madras medical college and Rajiv Gandhi Government General Hospital, Chennai. The study was done with clearance from Hospital ethical committee. Those who fulfilled the inclusion criteria given below were invited to participate in the study. Informed consent was obtained from all the patients willing to take part in the study. Inclusion Criteria: 1. Intra articular fractures of distal humerus, 2. Age >18 years, 3. AO Types A2,A3 and C (supracondylar and bicondylar), 4. Closed ,Grade I and grade II compound injuries, 5. Consenting to study. Exclusion Criteria: 1. With vascular injuries, 2. Grade III compound Open fractures, 3. severe unreconstructable intra-articular communited fractures in elderly, 4. uncooperative patients for the rehabilitation and follow up, 5. Patients who were not medically fit for surgery, 6. not willing to participate.
RESULTS: One patient who had a nonunion at the osteotomy site was done a revision osteosynthesis with tension band wiring. No patient died during treatment or follow up. Twenty four patients of distal humeral fractures were treated surgically with parallel plating and analyzed with average follow up of 13months (6 months – 2 ½ years). In our study, solid radiologic union was achieved primarily in all patients. The average time to union was about 14 weeks. Hardware failure or Nonunion did not occur in any patient. The mean flexion-extension arc was 107°. The mean MEPS score was 82 in our study. The results were excellent for 8 elbows, good for 11, fair for 3, and poor for 2 patients.
CONCLUSION: Incidence of complex distal humerus fractures among younger population is on
the rise due to increasing motor vehicle accidents. Absolute stability of the system allows early post-operative rehabilitation and thence a better functional outcome. Good to excellent functional outcome was achieved in about 80% of the study group in terms of arc of motion and stability Absence of implant failure and non-union may be attributed to the highly stable construct system achieved by parallel plating. Though it appears to be a variant of traditional plate placement, It is completely a different concept providing a greater stability in steoporotic and communited bones. Parallel plating can be a successful technique for internal fixation of these complicated fractures when its principles are strictly adhered to
A Prospective and Retrospective Study on Functional Outcome Analysis of Distal humerus fractures treated with Locking Compression Plates
INTRODUCTION:
Fractures of the distal humerus accounts for 2-6% of all fractures. Motor
vehicle accidents are the major cause of distal humerus fractures in young
population whereas simple accidental falls are the cause in elderly population.
Composite problems in distal humerus fracture management include frequent
articular involvement, metaphyseal communition, bone loss and osteopenia.
Attempt to achieve painless stable yet mobile elbow requires a systematic
approach. We hereby report the functional outcome of a series of distal humerus
fractures with articular extension surgically treated with locking compression
plates applied orthogonally.
MATERIALS AND METHODS:
15 Patients(9 males, 6 females) with type C distal humeral fractures
(C1-5 cases , C2 -8 cases and C3-2 cases ) were operated with locking
compression plates applied orthogonally and functional outcome was observed
for a mean duration of 8 months. All fractures were closed injuries. Causes were
motor vehicle accidents (10 cases) , accidental falls (4 cases) and assault (1
case). They were operated by chevron olecranon osteotomy (9 cases) ,
paratricipital (4 cases) , TRAP approach (1 case) and triceps splitting approach
(1 case).mean duration of fracture healing was 12 weeks. Functional outcomes
were assessed by Mayo elbow performance score system (MEPS).
RESULTS:
Excellent and good results were found in 6 cases each. 2 patients had fair
outcome and 1 patient had poor result. Complications encountered in our study
were paraesthesia along ulnar nerve distribution(2 cases), infection(superficial
treated with antibiotics 2 cases), stiffness, heterotopic ossification(2 cases each)
and hard ware prominence(1 case).
CONCLUSION:
Complications were minimal and outcomes were satisfactory in
patients with type C distal humerus fractures who underwent bicolumn
locking compression plates fixation applied orthogonally by posterior
approach
A study on functional outcome of adult Type C distal humeral fractures with bicolumnar fixation
Schizophrenia and apolipoprotein: a 10-year bibliometric analysis
Introduction: Schizophrenia is a chronic and complex mental disorder that significantly impacts one’s quality of life. The expansion of proteomic studies over the past decade offers a better understanding of the underlying pathophysiology of schizophrenia and the formulation of a protein targeted therapeutic approach. This study aimed to conduct a bibliometric analysis on the role of apolipoprotein as a biomarker in schizophrenia to provide a summary of its chronicle, present state and to identify potential future research directions. Materials and method: Publications on the association between schizophrenia and apolipoprotein were retrieved from the Scopus database using the search terms “schizophrenia” and “apolipoprotein”. Only original or review articles in English published between 2013 and 2023 were included. The bibliometric analysis was carried out using the R software packages Bibliometrix and Biblioshiny. Results: The filtered search identified 89 documents (80 original articles and 9 review articles) that generally showed an increasing trend with an annual growth rate of 10.31 percent. There were 580 authors that contributed to this field, with an average of eight to nine people co-authoring each paper. Altogether, 64 journals contributed to this field, with Neuropsychiatric Disease and Treatment, Frontiers in Psychiatry, and Translational Psychiatry being the three most productive. China leads in scientific production, followed by the Netherlands and the United States. In terms of country collaboration, the United Kingdom and Germany had the highest level of collaboration. The important keywords in the clusters were schizophrenia, biomarkers, proteomics, apolipoprotein E, antipsychotic drugs, bipolar disorder, and obesity. According to the thematic evolution analysis, apolipoprotein E has been frequently discussed and associated with schizophrenia and antipsychotic drugs. Conclusion: The association between schizophrenia and apolipoprotein has grown in significance over the past decade. Our findings highlight the potential role of apolipoprotein E in the establishment of schizophrenia and warrant further exploration
Adolescent Nasopharyngeal Carcinoma Mimicking Juvenile Nasopharyngeal Angiofibroma
We hereby present a 14-year-old teenage male who complained of painless neck swelling. Nasoendoscopy then discovered a huge lobulated angry-looking mass occluding the entire left posterior choana, hence a provisional diagnosis of juvenile nasal angiofibroma (JNA) was made and biopsy was not immediately undertaken. Subsequent computed tomography (CT) demonstrated a large heterogenous mass at the left nasopharyngeal region extending to the oropharynx and posterior choana. Though the left sphenopalatine foramen was not widened, the mass was seen minimally extending into it. Given the patient’s age, size and location of the mass, combined clinical and radiological diagnosis concluded JNA as the primary diagnosis and endoscopic excision of the mass was planned. However, he presented about 1 month later in casualty with right nasal epistaxis whereby repeated nasoendoscopy showed a larger mass extending to the right nasopharynx with contact bleeding. The tissue biopsy performed was complicated with significant bleeding, further validating the suspicion of JNA. Histopathological diagnosis otherwise revealed undifferentiated carcinoma. The patient otherwise showed good response to chemoradiation. JNA is a rare benign but locally aggressive vascular tumor of nasopharynx which occurs almost exclusively in pediatric or adolescent population. NPC on the other hand, although rare in children; has a predilection for adolescents. Since the treatment approach for NPC and JNA varies greatly, it is crucial to distinguish between the two conditions on radiological imaging. JNA arises from sphenopalatine foramen though both tend to exhibit some bony changes. An endoscopic endonasal approach with optional pre-operative embolization is the treatment option for JNA as opposed to chemoradiation for NPC. We would like to highlight that age is not a dependent risk factor in any malignancy, particularly NPC. When the clinical manifestations of NPC and JNA are similar, NPC diagnosis requires a high clinical suspicion followed by imaging; regardless of age
Epidemiology of Injury in English Women's Super league Football: A Cohort Study
INTRODUCTION: The epidemiology of injury in male professional football has been well documented (Ekstrand, Hägglund, & Waldén, 2011) and used as a basis to understand injury trends for a number of years. The prevalence and incidence of injuries occurring in womens super league football is unknown. The aim of this study is to estimate the prevalence and incidence of injury in an English Super League Women’s Football squad. METHODS: Following ethical approval from Leeds Beckett University, players (n = 25) signed to a Women’s Super League Football club provided written informed consent to complete a self-administered injury survey. Measures of exposure, injury and performance over a 12-month period was gathered. Participants were classified as injured if they reported a football injury that required medical attention or withdrawal from participation for one day or more. Injuries were categorised as either traumatic or overuse and whether the injury was a new injury and/or re-injury of the same anatomical site RESULTS: 43 injuries, including re-injury were reported by the 25 participants providing a clinical incidence of 1.72 injuries per player. Total incidence of injury was 10.8/1000 h (95% CI: 7.5 to 14.03). Participants were at higher risk of injury during a match compared with training (32.4 (95% CI: 15.6 to 48.4) vs 8.0 (95% CI: 5.0 to 10.85)/1000 hours, p 28 days) of which there were three non-contact anterior cruciate ligament (ACL) injuries. The epidemiological incidence proportion was 0.80 (95% CI: 0.64 to 0.95) and the average probability that any player on this team will sustain at least one injury was 80.0% (95% CI: 64.3% to 95.6%) CONCLUSION: This is the first report capturing exposure and injury incidence by anatomical site from a cohort of English players and is comparable to that found in Europe (6.3/1000 h (95% CI 5.4 to 7.36) Larruskain et al 2017). The number of ACL injuries highlights a potential injury burden for a squad of this size. Multi-site prospective investigations into the incidence and prevalence of injury in women’s football are require