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Journal articles on the topic 'Compound fractures'
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Imran, Muhammad, Atiq Ahmed Khan, Syed Ijlal Ahmed, Shiraz Ahmed Ghouri, Alizay Rashid Khan, and Muhammad Osama Farooqui. "COMPOUND DEPRESSED FRACTURES;." Professional Medical Journal 25, no. 05 (2018): 633–38. http://dx.doi.org/10.29309/tpmj/2018.25.05.297.
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Background: It is defined as fracture in which fractured fragment is elevatedabove the level of the intact skull. Objectives: To assess the outcome of patients with delayedrepair of compound depressed fractures. Study Design: Retrospective comparative crosssectional study. Setting: Civil Hospital, Karachi, Pakistan. Period: 01-01-2015 to 31-12-2016.Methodology: Sample size was calculated and sampling technique was non probability. Datawas recorded from patients files to computer and analyzed on SPSS version 21. Results: Themean age of study participants was 21 years ± 5. There were 14 (77.7%) male and 4 (22.2%)female patients in our study. The maximum time from injury to intervention was 84 hours. Mostpatients presented to the emergency department with compound depressed fractures due to fallor hit by blunt object (40%) followed by road traffic accidents (33.3%) and assault (26.7%). Mostcommon location of the compound depressed fracture was frontal bone involving right sideof the skull. All the patients were successfully managed with satisfactory outcome without anymajor complications. Conclusion: The authors conclude that repair of depressed compoundfractures in adults, if managed properly shows good outcome with less complications even withdelay of 6 hours to 84 hours from injury to intervention.
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Komuravalli, Varun Krishna, and Vamsi Reddy N. "A Study of Management of Long Bones Fractures with Locking Plates." International Journal of Pharmaceutical and Clinical Research 14, no. 3 (2022): 485–91. https://doi.org/10.5281/zenodo.13850551.
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<strong>Background:</strong> The annual incidence of open long bone fractures is 11.5 per 100,000 people. They are more common in men, and their age distribution is bimodal. The most common type of open fracture is the tibial diaphysis, while open femoral diaphyseal, distal femoral, and proximal tibial fractures are more common among the most badly damaged individuals. Open fractures of the lower limbs are more serious than those of the upper limbs. We in the current study tried to evaluate the management of long bone fractures with locking plates. <strong>Methods:</strong> This cross-sectional interventional study was conducted in the Department of Orthopedics, Prathima Institute of Medical Sciences, Naganoor, Karimnagar, Institutional Ethical approval was obtained for the study. The common principle used for the treatment of the fracture was compression in 48% of cases followed by combination in 20% of cases and 16% each were treated with neutralization and bridging respectively. <strong>Results:</strong> In the current study 52% were closed fractures and 48% were open fractures. Grade I compound fractures were in 16% of cases followed by Grade II compound in 8% and Grade IIIA in 20% of cases and Grade IIIB in 4% of cases. The mean time of healing in closed cases n=13 was 16.5 ± 4.5 weeks. The mean healing time of Grade I compound fracture n=4 cases was 18.5 ± 2.5 weeks. Similarly, the mean healing time of grade II compound fracture n=2 cases was19.5 ± 2.5 weeks. The mean healing time for Grade IIIA compound fracture in n=5 cases was 22.5 ± 2.5 weeks. In the Grade IIIB case, the duration of the healing period was 24.0 weeks. <strong>Conclusion:</strong> Locked plating is a significant advancement in fracture treatment. In osteopenic bone and for comminuted and periarticular fractures, the locking plate improves fixing stability. Because the locking plates with screw heads thread into the plate and operate as fixed-angle devices, they provide more stability per screw than traditional nonlocking fixation.
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Usman, Babagana, and Auwal Mohammed Abubakar. "A Rare Report Of A Coexisting Everted And A Depressed Skull Fracture In A Child." Jewel Journal of Medical Sciences 4, no. 1 (2023): 79–84. http://dx.doi.org/10.56167/jjms.2023.0401.10.
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A fracture is a breach in the continuity of a bone. Skull fractures are common among head-injured patients, especially calvaria involvement among children under two (2) years old. Skull fractures are classified based on their radiological pattern (linear, diastatic, comminuted, elevated, and depressed), their anatomic location (calvarium, basal), and their type (simple, compound). When the fractured segment is raised or depressed relative to the nearby normal skull bone, it is said to be an elevated or depressed skull fracture, respectively. A distinct, rare form of an elevated skull fracture described as an everted type may result from a high-impact tangential force. Elevated skull fractures are rare among children compared to the depressed type. We report a rare coexistence of an everted (an elevated type of skull fracture) and a depressed skull fracture in a 4-year-old girl, probably never reported in the literature
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Imran, Muhammad, Atiq Ahmed Khan, Syed Ijlal Ahmed, Shiraz Ahmed Ghouri, Alizay Rashid Khan, and Muhammad Osama Farooqui. "COMPOUND DEPRESSED FRACTURES." Professional Medical Journal 25, no. 05 (2018): 633–38. http://dx.doi.org/10.29309/tpmj/18.4355.
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Anjit, Kumar, Sinha S.K., and K. Mallik S. "Management of Compound Fracture TibiaUsing an Unreamed Interlocking Nail." International Journal of Pharmaceutical and Clinical Research 16, no. 6 (2024): 869–74. https://doi.org/10.5281/zenodo.12738152.
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<strong>Background and Objectives:</strong> With increasing number of vehicles on the roads in India, complex trauma cases caused by traffic accidents have increased progressively. Fracture Tibia are among the commonest fractures sustained in road traffic accidents due to the subcutaneous nature of the tibia, they are frequently open and contaminated fractures. Due to the poor blood supply and poor soft tissue coverage these fractures are frequently complicated by delayed union, malunion, non-union and infection. This study was conducted at the Department of Orthopaedics Adichunchanagiri institute of medical sciences to evaluate the results of interlocking intramedullary nailing using an unreamed nail in the treatment of the compound fractures of tibia. It was done to compare the advantage of using an interlocking intramedullary nailing without reaming in the treatment of compound fractures of tibia with various studies in terms of time required for union, rate of malunion and malrotation, infection and range of motion of knee and ankle. <strong>Materials and Methods: </strong>This study was performed on 20 compound fractures of tibia with an unreamed interlocking intramedullary nail Department of Orthopaedics at NMCH Patna. All the cases selected were fresh fractures and mostly traumatic in nature. The procedure was done as early as possible and the secondary procedures of Dynamisation, skin grafting and musculocutaneous flap were done as and when needed. <strong>Conclusions: </strong>It was concluded that early interlocking intra medullary nailing using an unreamed nail with immediate soft tissue coverage resulted in good fracture union and low rates of complications compared to other modalities of treatment. It is cost effective with short hospital stay and facilitates earlier return to work. Over all morbidity is reduced and better patient satisfaction noted.
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Rosenwasser, Robert H., and William F. Young. "Compound Frontobasal Skull Fractures." Contemporary Neurosurgery 12, no. 16 (1990): 1. http://dx.doi.org/10.1097/00029679-199012160-00001.
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Seligson, David, and Stephen L. Henry. "Treatment of compound fractures." American Journal of Surgery 161, no. 6 (1991): 693–701. http://dx.doi.org/10.1016/0002-9610(91)91258-k.
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Steinbok, Paul, Olof Flodmark, Diana Martens, and Eva T. Germann. "Management of simple depressed skull fractures in children." Journal of Neurosurgery 66, no. 4 (1987): 506–10. http://dx.doi.org/10.3171/jns.1987.66.4.0506.
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✓ Surgical elevation is the treatment usually recommended for a simple depressed skull fracture if the depression is more than the full thickness of the adjacent skull, but there is no clinical evidence to support this management. On that basis, a progressively more conservative approach to the treatment of this condition was adopted, especially in young children. Experience with this mode of management over the period 1972 to 1984 is presented. Of 111 patients under 16 years of age with depressed skull fractures, 64 had simple and 47 compound fractures. Simple depressed skull fractures occurred in a younger age group after less significant trauma than compound fractures. In those patients who were treated surgically, there was an 11% incidence of dural laceration in patients with simple depressed fractures versus 67% for the patients with compound depressed fractures. There was no difference in outcome between surgically and nonsurgically treated patients with simple depressed fractures with respect to the occurrence of seizures, neurological dysfunction, or cosmetic appearance. Surgical treatment prolonged hospitalization, and the only case with a fatal outcome was found in the group of patients treated surgically. It is suggested that the standard treatment of simple depressed skull fractures in the pediatric age group should not include surgery. Surgery is indicated when there is definite evidence of dural penetration and in the older child with an unacceptable cosmetic appearance.
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FAHMY, N. R. M., and R. A. HARVEY. "The “S” Quattro in the Management of Fractures in the Hand." Journal of Hand Surgery 17, no. 3 (1992): 321–31. http://dx.doi.org/10.1016/0266-7681(92)90122-i.
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The “S” Quattro has shown its value in the management of displaced comminuted intra-articular phalangeal fracture dislocations. Since then the system has been used as a dynamic flexible external fixator in the treatment of five maluniting phalangeal fractures, five comminuted condylar and four severe compound fractures. These challenging fractures have been dealt with by easy operations, taking full advantage of the versatility of the “S” Quattro to achieve good results.
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Demir, Uğur, Mahmut Asirdizer, and Muhammet Bahattin Bingül. "An evaluation of the demographic features and causes of mandible fractures and the relationships with the side, type, and anatomic location." Medicine 104, no. 13 (2025): e41950. https://doi.org/10.1097/md.0000000000041950.
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Mandibular fractures are one of the most common maxillofacial bone fractures that can occur during many activities in daily life. The aim of this study was to provide data for practitioners and researchers about the variables and outcomes associated with mandibular fractures by examining the relationships between gender, age groups, trauma causes, side, type, and anatomic location of mandibular fractures and concomitant injuries. The demographic and clinical data of the patients were obtained from the hospital information management system of a university hospital. The hospital records for the 10-year period between 2014 and 2023 were examined retrospectively. The mandible fractures were classified according to type, side, and location and compared against gender, age group, and trauma cause. Evaluation was made of 142 patients with traumatic mandibular fracture, comprising 76.8% males and 23.2% females. Of these cases with mandible fracture, 82.4% were aged < 35 years, and 45.1% of the fractures occurred in road traffic accidents. The majority of mandibular fractures were caused by road traffic accidents in males and adults over the age of 18, whereas home, environmental, and leisure accidents were the major cause of mandibular fractures in females and persons under the age of 18. Compound fractures were determined in 59.2% of the cases, single fractures in 80.3%, and parasymphysis and symphysis fractures in 46.2%. The compound and parasymphysis/symphysis region fractures were more common in males, patients aged < 35 years, and those who had undergone any type of trauma. We consider the information obtained through this study could make significant contributions to the data bank for multicenter prospective in-depth epidemiological research in clinical and forensic sciences in the future.
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Chetan, Solanki, Khatri Praveen, Meher Brajesh, et al. "Antibiotic Impregnated Intramedullary Nailing in Compound Fractures of Long Bones." International Journal of Pharmaceutical and Clinical Research 14, no. 11 (2022): 161–68. https://doi.org/10.5281/zenodo.13257163.
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<strong>Objectives: </strong>To evaluate the prognostic value of compound femoral and tibial shaft fractures treated with antibiotic impregnated cement coated nailing, as well as the biological anmechanical upsides of primary antibiotic impregnated cement coated nailing in the management of compound femoral and tibial shaft fractures. <strong>Methods:</strong> At a tertiary facility in Bhopal, India, 23 individuals with Gustilo Type II and III compound tibial and femoral shaft fractures received antibiotic-impregnated IM nails between December 2019 and June 2021. <strong>Results:</strong> Infection was controlled (as indicated by a decrease in inflammatory markers like ESR and CRP, as well as clinical evaluations like any discharge from the lesion, signs of inflammation) and mechanical stability was achieved in 85 percent of cases, with really no restriction of movements across the adjacent joints, after an average follow-up of 6 weeks. After 6 weeks, 16 instances had their nails exchanged. <strong>Conclusion: </strong>An antibiotic-impregnated cement coated nail could be a reliable substitute for an external fixator in compound fractures of the tibia and femur, improving stability and limiting infection.
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van den Heever, C. Mauritz, and David J. van der Merwe. "Management of depressed skull fractures." Journal of Neurosurgery 71, no. 2 (1989): 186–90. http://dx.doi.org/10.3171/jns.1989.71.2.0186.
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✓ The management of 319 cases with nonmissile depressed skull fractures is discussed. The majority of these injuries (75%) resulted from assaults and more than 90% were compound fractures. Of these, 35 cases were excluded from the series; these were patients who died before investigation or treatment could be instituted, or whose major injury was an intracranial hematoma or extensive traumatic hemorrhagic necrosis rather than a depressed fracture with underlying localized contusion. In the remaining 284 cases a comparison is made between the outcome in 124 (44%) patients treated by a conventional surgical method and 160 (56%) selected patients whose wound was only inspected, cleaned, and sutured in the emergency room. The nonsurgical group included 21 (9%) patients with simple depressed fractures and also patients without severe wound contamination, established infection, severe comminution of the fracture, or brain or cerebrospinal fluid in the wound. The results of management were assessed in relation to septic complications, the outcome of focal neurological abnormalities, and fatal complications. The group treated conservatively compared favorably with the surgical cases and also with previously reported series. The obvious bias in favor of the conservative group is admitted; however, it is clear that the majority of simple fractures and some compound depressed skull fractures can be managed safely without major surgical intervention. Socioeconomic implications are discussed.
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Lone, Aadil H., Aamir N. Bhat, Aabid A. Rather, Saheel Maajid, and Kafeel Khan. "A comparative study of Ilizarov ring fixators and limb reconstruction system fixators in the treatment of compound tibial shaft fractures." International Journal of Research in Orthopaedics 9, no. 6 (2023): 1201–6. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20233264.
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Background: Tibia is the most commonly fractured long bone, and the prevalence of compound fractures has risen due to an increase in high-energy traumatic incidents. In addressing challenging tibial fractures with significant soft tissue damage, infected tibial nonunion, and compound tibial fractures, medical professionals have turned to specialized treatments, such as Ilizarov ring fixators and limb reconstruction system fixators. These fractures typically cannot be managed effectively with traditional internal fixation methods. To facilitate early weight-bearing, limb lengthening, and efficient wound care, two minimally invasive fixation systems have been developed: the Limb Reconstruction System and the ring fixator. Methods: The study was conducted on 40 patients with compound tibial shaft fractures treated by Ilizarov ring fixators and limb reconstruction system fixators with the aim to evaluate the functional outcome, union rate and amount of limb lengthening using Ring and ILRS fixators in compound tibial fixators. Results: In our study, a significant portion of the participants fell within the age range of 28 to 37 years, comprising 45% of the total sample. Furthermore, the majority of the study subjects were male, constituting 65% of the participant pool. The primary mode of injury reported in our study was road traffic accidents, accounting for 77.5%. Conclusions: The study concluded that LRS fixators show good and promising results like easy to apply, carry, compress, distract and clean while Ilizaro ring fixator is technically demanding, difficult to carry and cumbersome to the patient.
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S., Hari Kumar, and Panditrao Kale Vikas. "Antibiotic Coated Intramedullary Interlocking Nailing for Compound Lower Extremity Fractures – Assessment of ClinicoRadiological and Functional Outcomes." International Journal of Pharmaceutical and Clinical Research 14, no. 11 (2022): 187–93. https://doi.org/10.5281/zenodo.13259025.
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<strong>Introduction: </strong>Compound lower limb fractures are prone to infections that cause significant morbidity, increased health care cost, duration of hospital stays, and occupational loss. Antibiotic coated intramedullary nailing is one of the effective methods in preventing implant related infection. This study was designed to assess the clinico-radiological and functional outcome of compound lower limb fractures treated with antibiotic intramedullary interlocking nailing. <strong>Material and Methods:</strong> Thirty-two cases with compound lower limb fractures between age group 21 to 60 years belong to Gustilo grade I, grade II, grade IIIA and grade IIIB types were recruited. The antibiotic coated intramedullary nail was prepared by incorporating antibiotic bone cement, 4g vancomycin and 80mg gentamycin. Postoperative follow up was done till six months and parameter like status of infection, status of wound, and radiological assessment of fracture union were assessed. <strong>Results:</strong> Road traffic accidents (68.75%) were common cause of fractures. Postoperatively, 9.37% reported superficial and 3.15% showed deep infection. In regard to clinical outcome, 50% fair, 31.5% good and 15.62% excellent outcome recorded. The radiological outcome was good in 62.5%, and excellent in 25%. The functional outcome was good in 43.75%, excellent in 31.25% and fair in 18.75%. <strong>Conclusion:</strong> Antibiotic coated intramedullary nail was safe, effective management option for compound tibial fractures with minimal deep infection rate.
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Ramashish, Yadav, and Kumar Nand. "A Prospective Research to Evaluate the Functional Outcomes of Complex Extra Articular Tibial Pilon Fractures Treated with A Hybrid External Fixator System." International Journal of Pharmaceutical and Clinical Research 13, no. 6 (2021): 477–83. https://doi.org/10.5281/zenodo.14219716.
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<strong>Aim:</strong> Functional results of compound extra articular tibial pilon fractures managed with hybrid external fixator. <strong>Methods: </strong>This prospective study conducted in the Department of Orthopaedics, Darbhanga Medical College and Hospital, Laheriasarai, Darbhanga, Bihar, India, for 15 months. 50 patients were included in this study. The age of patients above 20 years, compound type 2 or 3 (a or b) and isolated extra articular displaced fractures of tibial pilon (AO 43-A1, A2, A3). <strong>Results: </strong>There were 20 (40%) patients with right distal tibia fractures and 30 (60%) patients with left distal tibial fractures. In our study, 40 (80%) of patients sustained injury following road traffic accident, 5 (10%) patient sustained injury following fall and 5 (10%) had history of trauma due to falling of heavy object on leg. All the open fractures were classified based on Gustillo Anderson classification of open fractures, 20 (40%) were type 2 compound while 30 patients were type 3 compound, out of which 20 (40%) were type 3a and 10 (20%) were type 3b. The fracture pattern was classified based on AO/OTA classification for fractures of distal tibia of the 50 cases studied, 10 (20%) cases were A1, 18 (36%) were A2, 22 (44%) were A3. Average time taken for union in our study was of 14.5 weeks. At the end of 6 months, out of 50 patients treated, 20 (40%) patients had excellent outcome, 22 (44%) had good results, 5 (10%) had fair outcome and 3 (6%) patients had a poor result as per objective examination. On subjective evaluation<strong>, </strong>out of 50 patients treated, 22(44%) patients had excellent outcome, 22(44%) had good results, 4 (8%) had fair outcome and 2(4%) patients had a poor outcome. <strong>Conclusion: </strong>The study shows that it is possible to achieve a satisfactory outcome in compound extra articular tibial pilon fractures with the hybrid fixator technique. It provided adequate stability and allowed early motion and ambulation. The fractures were treated immediately after the injury, regardless of soft-tissue damage.
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Rajesh, Kumar1 G.D. singh2 and Archana kumara1. "Management of compound fracture in long bone with economical ESF in goats." Science World a monthly e magazine 2, no. 8 (2022): 1395–97. https://doi.org/10.5281/zenodo.6997431.
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Fracture of long bones is one of the most common problems among orthopaedic condition encountered in goats and other small ruminants. It may treat either conservative management or surgical interference (Aithal <em>et al.,</em> 1998). In compound fracture conservative treatment is not applicable, so required surgical intervention. Most common constraints in management of fractures of these animals are the cost of the implants and postoperative management. Therefore, economical External Skeletal Fixation is one of most attractive choice as it is less invasive, requiring minimal equipment (kumar <em>et al.,</em> 2021) and relatively easy to perform. Economical external skeletal fixation device can be used in small ruminants as a successfully alternative to internal fixation. It is an external coaptation technique used to stabilize bone fragments or joints with percutaneous wires or pins held together by an external frame. Epoxy compound and acrylic material used rather than clamps and metallic connecting rods. Economical ESF device comes in less than 20% of the original price of the external skeletal fixator. So, economical skeletal fixations have emerged as boon to both farmer & ruminant veterinary surgery. Present study conducted to evaluate of epoxy ESF for the management of compound fractures of long bones in goats. Under university project on management of long bone fracture in goats with Economical External Fixators<strong> was</strong> performed in six clinical cases with objective to evaluate epoxy & acrylic ESF for the management of compound fractures in small ruminant.
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Lerner, Alexander, Ruta Jakusonoka, Andris Jumtins, and David Rothem. "Treatment of Bifocal Periprosthetic Fractures above and below a Knee after Tumor using Spanning Ilizarov Device: A Case Report." Journal of Orthopaedic Case Reports 13, no. 9 (2023): 33–37. http://dx.doi.org/10.13107/jocr.2023.v13.i09.3866.
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Introduction: Multiple treatment options and internal and external devices have been recommended for periprosthetic fractures management around total knee arthroplasty. Case Report: We present the case of the high-energy bifocal periprosthetic fractures of the femur and the tibia after total knee prosthesis following excision of a tumor. One of the fractures was an open tibial fracture Gustilo Type IIIB and the other – comminuted subtrochanteric fracture of the femur with extrusion of periprosthetic cement pieces out from the bone defect. The Ilizarov circular external fixator was used for the skeletal stabilization and early functional treatment in this compound case. Conclusion: The use of Ilizarov external fixator for patients with complex periprosthetic fractures, who present severe technical difficulties in bone stabilization, especially by concomitant severe soft-tissue damage after high-energy injuries, is a good surgical alternative. Keywords: Periprosthetic fracture, total knee replacement, tumor prosthesis, open fracture, Ilizarov external fixator.
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Muhammad, Ghulam, Farrukh Javeed, Lal Rehman, Asad Abbas, and Ali Afzal. "Pattern of Skull Fractures and Its Outcome in Pediatric Head Injury Patients." Pakistan Journal Of Neurological Surgery 24, no. 4 (2021): 350–56. http://dx.doi.org/10.36552/pjns.v24i4.485.
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Objective: Skull fractures are common in pediatric age group. The surgical management of paediatric patients with a skull fracture differs among institutions and surgeons. Our object of this study was to assess the pattern of skull fractures and outcome in paediatric population.
 Material and Methods: This study was conducted in the department of neurosurgery of a tertiary care hospital from June 2018 to April 2020. We included 152 children between ages 5 to 11 years who were brought with the head trauma and diagnosed to have skull fracture on computerized tomography (CT) Scan brain.
 Results: The mean age of patients was 6.91 + 1.84 years. There were 59.8% males and 40.1% females. The most common type of fracture at presentation was depressed fracture in 42% patients, followed by linear (35%) and compound fractures (23%). Parietal fractures were the commonest (63.1%) in our study. Associated intracranial hematomas were seen in 37.5% patients, epidural hematoma being the most common. Surgically treated patients were 36%. Good recovery was seen in 73% patients while mortality was 10.5%.
 Conclusion: Isolated skull fractures are overall benign conditions. Linear parietal skull fractures have good outcome amongst all fracture types.
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Soomro, Saifullah, and Zamir Ahmed Soomro. "Impacts of Circular Frame Fixator (Ilizarov) on Management of Compound fractures of proximal tibia." Pakistan Journal of Medical and Health Sciences 16, no. 11 (2022): 117–20. http://dx.doi.org/10.53350/pjmhs20221611117.
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Aim: To determine the outcome of patients diagnosed with complex fractures of tibial plateau with associated soft tissue compromise treated by using Ilizarov fixator. Study design: Prospective observational study. Place and period of study: Orthopaedic unit, Chandka Medical College SMBBMU Larkana from January 2021 to December 2021 Methods: Patients diagnosed with complex tibial plateau fracture with associated soft tissue compromise fulfilling inclusion criteria were enrolled in study. All participants were managed with Ilizarov fixator and it was removed when fracture was united clinically and radiologically. Outcome of patients was evaluated on the basis aggregate score of knee society score and knee functional score at 6month follow up. Results: Twenty seven consecutive patients met the inclusion criteria, of which 19(70.37%) were male and 8(29.7%) were female. Average age of patients was 32.37 years. All fractures healed by the end of the 4th month. Ring fixator was removed routinely at 16th weeks after initial surgery in all patients. Transient peroneal nerve injury was found in 2 patients; no patients developed deep vein thrombosis, whereas pin site infection was most common complication and occurred in 5 patients (18.5%). According to knee society score results were excellent in 15(55.55%) patients, good in 08(29.62%) patients, fair in 03(11.11%) in patients and poor in 01(3.70%) patient. Practical implication most of proximal tibial plateau fractures with soft tissue compromise are kept under observation till the soft tissue status become favorable for open reduction and internal fixation, while fixing these type of fracture with Ilizarov fixator one can provide early relief to patients and results of this study will be help for operating surgeons while managing complex proximal tibia fractures. Conclusion: complex tibial plateau fracture can be effectively treated with Ilizarov fixation method without any complication, when exposed reduction and interior fixation with plate is contraindicated due to compromised soft tissue. Keywords: Tibial plateau, fractures, Ilizarov, fixation method, outcome, soft tissue compromise,
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Ravi, Praveen, Muthumanickam Ramanujam, Jambu Nageswaran, and Sundar Suriyakumar. "Evaluation of compound tibial fractures managed with an Ilizarov ring fixator." International Journal of Research in Orthopaedics 6, no. 4 (2020): 710. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20202038.
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<p class="abstract"><strong>Background:</strong> The tibia is the most commonly fractured long bone and because of its location and the tenuous soft tissue coverage, its more prone for open fractures tibia than any other long bone. The ideal management of such fractures still remains controversial. We have evaluated the healing of fractures and functional outcomes in patients with open tibial fractures treated with an Ilizarov ring fixator.</p><p class="abstract"><strong>Methods:</strong> 32 patients who had open fractures of the tibia (II, IIIA or IIIB) who were treated with an Ilizarov fixator were included in the study. The patients were followed up for a minimum period of 1 year after removal of the fixator. Functional and radiological results were analysed using association for the study of applications of methods of Ilizarov scoring.<strong></strong></p><p class="abstract"><strong>Results:</strong> There were 20 cases of type IIIB, 7 cases of type IIIA, 5 cases of type II fractures. Union was achieved in all patients. Mean time for union was 25.2 weeks, with faster union times in type II, type IIIA fractures. Six cases of type IIIB needed flap cover. Limb discrepancy was seen in 3 cases. 17 cases of pin tract infections were seen, most of which were grade 3 and were managed with antibiotics. Two cases had delayed union, of which one was treated with bone marrow aspirate injection and the other one with bone grafting. At one year, 21 (65.6%) had excellent results, six (18.7%) had good results, four (12.5%) had fair outcomes and one (3.2%) had a poor result.</p><p class="abstract"><strong>Conclusions:</strong> Despite the associated complications, Ilizarov fixator is the ideal treatment for compound tibial fractures.</p>
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Mengistu, Zuriyash, Ahmed Ali, and Teferi Abegaz. "The pattern of orthopedic fractures and visceral injury in road traffic crash victims, Addis Ababa, Ethiopia." PLOS ONE 16, no. 9 (2021): e0253690. http://dx.doi.org/10.1371/journal.pone.0253690.
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Background Road Traffic crash injury is one of the main public health problems resulting in premature death and disability particularly in low-income countries. However, there is limited evidence on the crash fractures in Ethiopia. Objective The study was conducted to assess the magnitude of road traffic crash fractures and visceral injuries. Methods A hospital-based cross-sectional study was conducted on 420 fracture patients. Participants were randomly selected from Addis Ababa City hospitals. The study was carried out between November 2019 and February 2020. Data were collected using a questionnaire and record of medical findings. Multilevel logistic regression analysis was carried out. Ethical clearance was obtained from the Addis Ababa University, College of Health Sciences Institutional Review Board. Confidentiality of participants’ information was maintained. Results The study found out that the majority 265 (63. 1%) of fracture cases were younger in the age group of 18 to 34 years. Males were more affected—311(74.0%). The mortality rate was 59(14.1%), of those 50(85.0%) participants were males. The major road traffic victims were pedestrians—220(52.4%), mainly affected by simple fracture type -105(53.3%) and compound fracture type—92(46. 7%). Drivers mainly suffered from compound fracture type -23 (59.0%). One hundred eighty-two (43.3%) of fracture patients had a visceral injury. Homeless persons who sit or sleep on the roadside had a higher risk of thoracic visceral injury compared to traveler pedestrians (AOR = 4.600(95%CI: 1.215–17.417)); P = 0.025. Conclusion Visceral injury, simple and compound fractures were the common orthopedic injury types reported among crash victims. Males, pedestrians, and young age groups were largely affected by orthopedic fracture cases. Homeless persons who sited or slept on the roadside were significant factors for visceral injury. Therefore, preventing a harmful crash and growing fracture care should be considered to reduce the burden of crash fracture.
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Rajesh, Kumar archana kumari &. S.K. Bharti. "Management of long bone fracture in calves by Economical External Fixators." Science World a monthly e magazine 2, no. 8 (2022): 1383–86. https://doi.org/10.5281/zenodo.6993744.
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Fracture of long bones in calves occupies a substantial proportion among musculoskeletal disorders. This is an acute traumatic injury warranting immediate management of surgical intervention for its correction. Metacarpal & metatarsal fractures are most common fractures in cattle of all age (Greenough et al., 1972). These fractures are frequently comminuted & open due to limited soft tissue supporting structures covering the bone (Turner, 1984 & Ferguson, 1982). Statistical data of long bone fractures in cattle reveals that metacarpal & metatarsal fracture occurs up to 50%, tibial fracture 12%, radius & ulna fracture 7%, femur fracture uncommon & humerus fracture 5%, so more than 68% fracture reported are anatomically below the elbow joint in the forelimbs & below the stifle joint in the hind limbs. A severely comminuted fracture closed by application of an ESF is preferable to open reduction & internal fixation (Langley Hobbs et al., 1997). Economical ESF device comes in less than 20% of the original price of the external skeletal fixator. So, economical skeletal fixations have emerged as boon to both farmer & ruminant veterinary surgery. Present study conducted to evaluate of epoxy ESF for the management of compound fractures of long bones in calves.
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Sakas, Damianos E., David J. Beale, Ameen A. Ameen, et al. "Compound anterior cranial base fractures: classification using computerized tomography scanning as a basis for selection of patients for dural repair." Journal of Neurosurgery 88, no. 3 (1998): 471–77. http://dx.doi.org/10.3171/jns.1998.88.3.0471.
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Object. A classification is proposed to organize anterior cranial base fractures systematically according to their location and size. The goal of this study was to determine whether these two variables, irrespective of cerebrospinal fluid (CSF) rhinorrhea, are related to the long-term risk of posttraumatic meningitis and, hence, to standardize decision making concerning surgical repair of associated CSF fistulas. Methods. With the aid of high-resolution thin-section coronal computerized tomography (CT) scanning, anterior cranial base fractures were classified into the following four major types: I, cribriform; II, frontoethmoidal; III, lateral frontal; and IV, complex (any combination of the other three types). Fractures with a maximum bone displacement that extended farther than 1 cm in any plane were classified as “large” and those less than 1 cm as “small.” The authors used this classification in a study of 48 patients who were treated by conservative (20 patients) or surgical (28 patients) means. The results showed a gradation of risk: the fracture most likely to develop infection was a large cribriform (Type I) and the least likely was a small lateral frontal (Type III). Statistical analysis showed that the trend for an increased infection rate was related to the cumulative effect of three variables in the following order: 1) prolonged duration of rhinorrhea (analysis of variance [ANOVA], p = 0.017); 2) large size of fracture displacement (ANOVA, p = 0.079); and 3) fracture's proximity to the midline (ANOVA, p = 0.015). Conclusions. In this series, microsurgical repair was accompanied by a minimum complication rate. Hence, the authors recommend that patients with fractures that combine the aforementioned variables should be considered to have a high long-term risk of infection and their injury should be surgically repaired as soon as the posttraumatic edema has subsided. This applies to the following fractures: large cribriform (Type I) with transient rhinorrhea lasting 5 to 8 days and large frontoethmoidal (Type II) with prolonged rhinorrhea lasting longer than 8 days. Furthermore, the authors conclude that this classification can improve the management of posttraumatic CSF fistulas of the anterior cranial base and may provide insights into the mechanisms underlying their spontaneous repair and susceptibility to meningitis.
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Hitendra Wamborikar, Priyank Bhatt, Swapnil Date, Naresh Dhaniwala, and Khizar Khan. "The multi-modality approach in a case of fracture of the humerus with an ipsilateral floating knee: A case report." International Journal of Research in Pharmaceutical Sciences 11, SPL4 (2020): 1088–92. http://dx.doi.org/10.26452/ijrps.v11ispl4.4248.
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Ipsilateral fractures of humerus, femur and tibia is a rare entity. The number of fractures resulting due to road traffic accidents is on the rise. These Type of injuries usually occur due to high-velocity road traffic accidents. High-velocity road traffic accidents are associated with multiple bony injuries as well as injuries to various internal organs. These injuries are often difficult to manage due to their complex nature. Mostly multiple fractures are produced in ipsilateral limbs. This condition makes the management even more difficult. Hence a multi-modality approach is often required. A 55-year-old male sustained floating knee with ipsilateral shaft humerus fracture. After a three-staged surgical approach with three modalities for treating the compound injury, the patient had an excellent result with the full range of motion in the knee and complete coverage of wound. Compound floating injuries should be treated with simultaneous fixation of femur and tibia fractures to achieve early full range of knee motion with Vacuum-assisted closure followed by skin grafting for complete wound coverage.
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Davydkin, V. I., I. Yu Ippolitov, A. I. Kistkin, and S. A. Charyshkin. "CLINICAL RESULTS OF TREATING PATIENTS WITH COMPOUND LOWER LEG FRACTURES." Ulyanovsk Medico-biological Journal, no. 1 (March 30, 2021): 92–97. http://dx.doi.org/10.34014/2227-1848-2021-1-92-97.
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Management of patients with open diaphyseal fractures of the lower leg remains an urgent problem in traumatology and orthopedics. The aim of the study is to improve the results of surgical treatment of patients with open lower leg injuries by means of disease management. Materials and methods. The study under consideration was both retrospective and prospective. It included 67 patients with open lower leg injuries. The patients were divided into 3 groups depending on the fracture type and treatment modality. Results. The two-stage modality of surgical treatment of open lower leg fractures (types 1 and 2) made it possible to significantly shorten the time frame compared to the period of treatment in patients with open lower leg fractures with installation of the external fixator. Active surgical modelling of the open diaphyseal fractures of the lower leg reduced the purulent complications from 60 % to 11 %. Conclusion. In the case of an open lower leg fracture (type 1) blocking internal fixation is desirable, whereas in the case of open lower leg fractures (types 2, 3A and 3B) external fixation is preferable. In patients with open injuries (types 2 and 3A) two-stage fixation of bone fragments using external fixation with subsequent transition to internal one can be suggested. Keywords: intramedullary rod, non-union, Ilizarov apparatus. Ведение больных с открытыми диафизарными переломами костей голени остается актуальной проблемой травматологии и ортопедии. Цель работы – улучшение результатов хирургического лечения пациентов с открытыми повреждениями голени путем оптимизации лечебной тактики. Материалы и методы. Исследование ретроспективное и проспективное. В работу включены 67 больных с открытыми повреждениями костей голени. Пациенты были разделены на 3 группы в зависимости от типа перелома и способа лечения. Результаты. Двухэтапная тактика оперативного лечения открытых переломов костей голени I и II типов позволила значительно сократить сроки лечения по сравнению со сроками лечения больных, у которых сращение открытого перелома костей голени протекало в стержневом аппарате наружной фиксации. Активная хирургическая тактика в отношении открытых переломов диафиза костей голени позволила сократить процент гнойных осложнений с 60 до 11. Выводы. При открытом повреждении голени I типа оптимальным является применение блокирующего интрамедуллярного остеосинтеза, а при открытых переломах II, III А и III B типов – стержневого аппарата наружной фиксации. У пациентов с открытыми повреждениями II и III А типов показана двухэтапная фиксация костных отломков с применением стержневых аппаратов наружной фиксации с последующим переходом на интрамедуллярный штифт. Ключевые слова: интрамедуллярный штифт, несращение, аппарат Илизарова.
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Nargund, Sachin, Abdul Qadeer Patwegar, and Uday Chandran. "Comparative study of compound both bone leg fractures managed with versatile antibiotic intramedullary inter locking nailing with external fixator." International Journal of Research in Orthopaedics 10, no. 5 (2024): 966–69. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20242388.
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Background: Background Compound fractures of the tibia are more likely to result in non-union and the development of infection because of inadequate blood supply and the absence of soft tissues in the antero-medial side of the tibia. Whether to undertake a primary fixation or a staged fixation is still a difficult decision to make in situations like these. Hence, we performed this study to compare the clinical, functional and radiological outcome of compound both bone leg fractures managed with Versatile Antibiotic Intramedullary Interlocking Nailing system and external fixator. Methods: This is a Prospective comparative study performed on all patients admitted with compound fractures (Grade 1,2,3A,3B) of both bone leg fractures in the Department of Orthopaedics at a tertiary care center. Thorough wound debridement was done layer by layer after adequate extension of the wound. Fracture ends were debrided, thorough wound wash given with Reamer Irrigation Aspiration system (RIA). Results: In our study, there is a significant association between the time delay of surgery and post operative infection (p value 0.008). In our study, average time from admission to surgery was 20.9 hours in group A vs group B (21.81 hours). Conclusions: The final outcome in our study mainly depended on wound debridement and thorough pulsatile lavage and early intervention (VAIL Nailing), earlier the surgery better the outcome.
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Zhang, Jun, Yu-Wei Li, Wei Li, et al. "Study on Propagation Behaviors of Hydraulic Fracture Network in Tight Sandstone Formation with Closed Cemented Natural Fractures." Geofluids 2020 (September 11, 2020): 1–22. http://dx.doi.org/10.1155/2020/8833324.
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Natural fractures in tight sandstone formation play a significant role in fracture network generation during hydraulic fracturing. This work presents an experimental model of tight sandstone with closed cemented preexisting fractures. The influence of closed cemented fractures’ (CCF) directions on the propagation behavior of hydraulic fracture (HF) is studied based on the hydraulic fracturing experiment. A field-scaled numerical model used to simulate the propagation of HF is established based on the flow-stress-damage (FSD) coupled method. This model contains the discrete fracture network (DFN) generated by the Monte-Carlo method and is used to investigate the effects of CCFs’ distribution, CCFs’ strength, and in-situ stress anisotropy, injection rate, and fluid viscosity on the propagation behavior of fracture network. The results show that the distribution direction of CCFs is critical for the formation of complex HFs. When the angle between the horizontal maximum principal stress direction and the CCFs is in the range of 30° to 60°, the HF network is the most complex. There are many kinds of compound fracture propagation patterns, such as crossing, branching, and deflection. The increase of CCFs’ strength is not conducive to the generation of branched and deflected fractures. When the in-situ stress difference ranges from 3 MPa to 6 MPa, the HF network’s complexity and propagation range can be guaranteed simultaneously. The increase in the injection rate will promote the formation of the complex HF network. The proper increase of fracturing fluid viscosity can promote HF’s propagation. However, when the viscosity is too high, the complex HFs only appear around the wellbore. The research results can provide new insights for the hydraulic fracturing optimization design of naturally fractured tight sandstone formation.
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Yadav, Vamanagiri Rahul, and Vamshi Krishna Reddy C. "Mucormycosis in compound grade IIIa tibial plafond with medial malleolus fracture: A case report." Indian Journal of Orthopaedics Surgery 9, no. 1 (2023): 41–44. http://dx.doi.org/10.18231/j.ijos.2023.011.
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Tibial plafond fracture is defined by intra articular involvement of the distal tibia with metaphyseal extension. The plafond fracture accounts for less than 1% of lower limb injuries and 3–10% of tibial fractures. The rate of deep infection in open ankle fractures is approximately 5%. Pilon fractures are frequently associated with severe soft- tissue injuries that alter the management plan. Here we describe the case of 35year old man brought to ER after sustaining machinery injury to right ankle. On local examination a Laceration of 7x2x2 cms present over left ankle anteriorly extending from Medial Malleolus to Lateral Malleolus and cut ends of tendons of extensor digitorum longus, extensor hallucis longus and Tibialis anterior were identified. X-ray left ankle Ap and Lateral views were taken. X-ray showed Left Distal Tibia fracture. Thorough Wound wash given. Under spinal anesthesia debridement of wound was done and K-wire fixation done for distal tibia fracture. Tendon repair for extensor digitorum longus, extensor hallucis longus and tibialis anterior done using Ethibond suture material using Modified Kessler Technique. On 2 Post operative day a swab from the wound site sent for culture and sensitivity which revealed fungal growth of zygomycetes species. In view of angioinvasive properties of Zygomycetes, after checking Renal parameters patient was started on Inj Amphotericin B 1mg/kg for 4 days and later converted to Tablet Posaconazole 600mg BD. Patient was kept on posaconazole tablet for 6weeks. Regular dressings were done. On regular follow ups and regular dressings wound healed well.
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Sharma, D. K., Laxman Banodha, Pranav Mahajan, Anshul Meena, and Roshan Goyal. "Functional evaluation of various modalities of management in floating knee injuries at a tertiary care centre in central India." International Journal of Research in Orthopaedics 10, no. 1 (2023): 112–17. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20234048.
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Background: The injuries involving femur and tibia fractures due to high velocity are known as floating knee injuries. These fractures may involve the shaft, metaphysis or the articular surface. There are many complications associated with these injuries. This study evaluates the functional, clinical and radiological outcomes of floating knee injuries. Methods: A Prospective and interventional study was performed at MGMMC and MYH Hospital, Indore. We included 30 patients in our study. Femur fractures are managed by intramedullary nailing or distal femur plating. Tibia fractures are managed by Intramedullary nailing or tibia plating. Patient were called for regular follow up for a minimum of 6 months. Functional and clinical evaluation done by Karlstorm and olerud scoring system and radiological outcome by union on x rays were done. Results: Out of 30 patients 28 (93.33%) male and 2 (6.66%) female. According to Fraser classification, 17 (56.66%) type 1, 4 (13.33%) type 2A, 4 (13.33%) type2B, 5 (16.66%) type 2C injuries. A majority of the injuries occurred due to road traffic accidents involving right limb 21 (70%) more then left 9 (30%). Knee stiffness occurred in 8, infection in femur 3, infection in tibia 2, malunion of femur 2, limb length discrepancy in 2 patients. Outcome was excellent in 5 (16.66%), Good in 10 (33.33%), Acceptable in 9 (30%) and poor in 6 (20%). Conclusions: Fraser type 1 fracture has excellent results and Fraser type 2C has poor results. Closed fracture has better outcome compared to compound Fractures. A better functional outcome can be determined on the basis of implant choice based on Fraser Classification, level of injury, open or closed injury, simple or compound type of fracture.
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Somaiya, Kamya, Subrat Samal, and Manali Boob. "Case Report: Effectiveness of physiotherapy rehabilitation in a patient with compound grade IIIC proximal third tibia fracture along with vascular injury." F1000Research 12 (October 26, 2023): 1410. http://dx.doi.org/10.12688/f1000research.140306.1.
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The proximal metaphyseal region of the bone is thought to be the location of fractures of the proximal tibia. The surgical management of proximal tibial shaft fractures and high-energy bicondylar tibial plateau fractures is still challenging . Supra-cutaneous plating, also known as a locking compression plate, has been promoted as a crucial technique in the management of challenging reconstructive scenarios since it has shown to be adjustable, concealed, and well-accepted by patients. Physical therapy rehabilitation is critically necessary for a full recovery from a range of orthopaedic issues. Physical therapy rehabilitation is a vital step in the healing process for patients with lower limb fractures. In our study , we rehabilitated a patient with Compound grade IIIC proximal third tibia fracture right side managed with Closed reduction external fixator application and vascular repair along with proximal fibula fracture. Through this study, we developed a physiotherapy rehabilitation protocol that was very helpful for these patients, produced positive results, and served to enhance the patient's quality of life.
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Bhushan, Salunkhe, Sawarbandhe Sarang, and Agrawal Pravin. "Radiological and Functional Outcome Titanium Elastic Nailing System for Femur Shaft Fracture among Children." International Journal of Pharmaceutical and Clinical Research 16, no. 1 (2024): 618–25. https://doi.org/10.5281/zenodo.11099368.
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<strong>Introduction:</strong> Fractures of the femur shaft a`re common in all age groups and are frequently caused by high-energy events. For stable adults, intramedullary nailing is the recommended course of action, emphasizing prompt healing and functional recovery. 1.6% of juvenile bone injuries in children are femur fractures, and flexible intramedullary nailing has become a valuable surgical technique that provides stability, early mobilization, and less sequelae. <strong>Aim and Objectives: </strong>This study examines the functional and radiological results of the Titanium Elastic Nail System in kids who have fractured their femur shafts. <strong>Method: </strong>A one-year prospective institutional study was conducted with 28 patients aged 5-16 with femur shaft fractures using Titanium Elastic Nails (TENS) at a hospital. Initial assessment included airway, breathing, and circulation evaluation. Radiographs, limb immobilization with a Thomas splint, and comprehensive surveys were conducted. Inclusion criteria: ages 5-16, femur shaft fractures on X-rays, completion of investigations. Exclusion criteria: <5 or >16 years, prior fractures, pathological fractures, non-ambulatory/neuromuscular children, bilateral/compound femoral fractures. <strong>Result:</strong> The demographics, etiology, and fracture characteristics of pediatric femoral shaft fractures are examined in this study. Most reductions are closed because they are faster than open reductions. The majority of fractures heal in 8–9 weeks with little malunion. The surgical results show that Flynn’s method has a high success rate. Clinical decisions for the therapy of juvenile femur shaft fractures are informed by an understanding of these criteria, which emphasize effective interventions and postoperative care for the best possible results. <strong>Conclusion:</strong> Based on the research, Titanium Elastic Nails are very successful at promoting quick union, stability, and fewer problems in pediatric femur shaft fractures.
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Li, Duanru, Gang Liu, and Shengming Liao. "Study on Flow and Heat Transfer in Single Rock Fractures for Geothermal Heat Extraction." Processes 12, no. 2 (2024): 363. http://dx.doi.org/10.3390/pr12020363.
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A full understanding of the fluid flow and heat transfer behaviors within a single fracture is important for geothermal heat extraction. In this study, models of single fractures with varying aperture and inner surface roughness (characterized by fractal dimension) are constructed, and a compound fracture aperture (CFA) is proposed to describe the coupled effect of fracture aperture and inner surface roughness. The effect of the fluid flow Reynolds number on heat transfer was investigated as it ranged from 4.84 to 145.63. The results show that the overall heat transfer coefficient (OHTC) in a single fracture significantly increases with the rise in fluid velocity and the compound fracture aperture. Particularly, the OHTC in a single fracture with an inner surface fractal dimension of 2.09 can be up to 1.215 times that of a parallel flat fracture when the flow velocity reaches 0.18 m/s. Moreover, for a fracture with a smaller CFA, enhancing the fracture aperture plays a decisive role in increasing the OHTC. Aperture emerges as a more sensitive optimization parameter for efficient heat extraction compared to the flow velocity. Meanwhile, based on simulation results, a convective heat transfer correlation equation is derived to provide more accurate estimates of the OHTC in rock fractures with different geometries and morphological features.
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Ali, B. "Antibiotics in compound depressed skull fractures." Emergency Medicine Journal 19, no. 6 (2002): 552–53. http://dx.doi.org/10.1136/emj.19.6.552.
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SEEKAMP, A., M. VAN GRIENSVEN, M. ZIEGLER, and M. G??NDEROTH. "Transcutaneous Po2 measurement in compound fractures." European Journal of Emergency Medicine 2, no. 2 (1995): 69–74. http://dx.doi.org/10.1097/00063110-199506000-00003.
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Qureshi, M. Shoaib, Mangesh Panat, and Pratik Israni. "Two Staged Management Of Proximal Tibial Fractures With Impending Compartment Syndrome By Temporary External Stabilisation And Fasciotomy And Delayed Definative Fixation." Trauma International 3, no. 2 (2017): 16–20. http://dx.doi.org/10.13107/ti.2017.v03i02.049.
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Introduction: High energy proximal tibia fractures with soft tissue involvement presenting with dicolored patches over the leg and severe swelling, compound wounds, blisters with tight compartments and absent or feeble dorsalis pedis or posterior tibial arteries warrant to go in for a staged procedure. In patients with multiple injuries, an external fixator can be applied quickly with minimal blood loss for unstable periarticular fractures around the knee. Two-stage procedures involve (1) early joint spanning external fixators with fasciotomy for the medial and posterior compartments, (2) and late definitive fixation with plates or nails and with skin grafting. Materials and Methods: In our study, we present a short series of 15 proximal tibial fractures with impending compartment syndrome. Patients selected for this study were (1) closed proximal tibia fracture intra- and peri-articular and metaphysis diaphysis junction communited and noncommunited fractures (2) impending compartment syndrome evaluated based on excessive swelling, tight compartments, blisters over skin, feeble or absent dorsalis pedis or posterior tibial pulsations, color Doppler suggestive of severe subcutaneous edema associated with monophasic or absent flow over distal arteries. Exclusion criteria: (1) Low energy proximal tibia fracture without soft tissue insult and compound wounds over the proximal tibia fractures, (2) associated popliteal artery injuries. Conclusion: With the initial application of a bridging external fixator followed by delayed internal fixation protocol for pilon fractures has been successful in reducing the historically high rates of wound complications associated with these high-energy injuries. As well this protocol allows the use of minimally invasive plate osteosynthesis technique which is based on a combination of the principles of stability, restoration of anatomy and early motion while eliminating the need for excessive soft tissue dissection. Keywords: Proximal Tibial fractures, External fixators, Fasciotomy, Definitive fixation.
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Naskar, Avik Kumar, Saurabh Satyanarayan Kunwar, Meet Ajay Mehta, Loknath Bhowmick, Himanshu Pradeep Ganwir, and Vikas Anandrao Atram. "Circular Fixation, Endless Possibilities: Rebuilding a Shattered Tibia using the Ilizarov Technique – A Case Report." Journal of Orthopaedic Case Reports 15, no. 7 (2025): 116–20. https://doi.org/10.13107/jocr.2025.v15.i07.5790.
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Introduction: Tibial fractures, particularly complex and open types, present significant challenges in orthopedic trauma care due to their risk of complications and prolonged recovery. The Ilizarov technique offers a reliable and minimally invasive solution for achieving stable fracture fixation, promoting osteogenesis, and enabling early mobilization. Case Report: A 27-year-old male sustained a Grade 1 compound comminuted fracture of the right tibia along with a proximal fibular fracture following a motorcycle accident. The patient was managed with an Ilizarov external fixator. The procedure provided stable fixation, facilitated bone regeneration, and supported early rehabilitation. The patient achieved full functional recovery and complete radiological union without complications. At 1-year follow-up, bone alignment and regeneration were excellent. Conclusion: The Ilizarov ring fixation technique is an effective and dependable method for managing high-energy tibial fractures. It enhances bone healing, and promotes early functional recovery, making it a valuable tool in complex fracture management. Keywords: Ilizarov technique, distraction osteogenesis, tibial fractures, ring fixator.
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Zunzunwala, Saurabh. "REHABILITATION OF PATIENT WITH TIBIA-FIBULA FRACTURE." Journal of Medical pharmaceutical and allied sciences 10, no. 4 (2021): 3427–39. http://dx.doi.org/10.22270/jmpas.v10i4.1278.
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An orthopedic surgeon may find compound fractures of tibia-fibula challenging to treat. The degree of joint motion and the adequacy of reduction are the two factors that determine whether or not these fractures can be treated successfully. In many patients, open surgical treatment of comminuted tibial pilon fractures is associated with significant complications. Indirect reduction and stabilization of fractures using a circular external fixator can be a useful way of achieving adequate joint restoration, and it uses closed reduction principles to realign disturbed bones and joint structures. In this report, we describe about the effects of early rehabilitation compound grade IIIB fracture tibia, fibula of right side. The patient co-operation and motivation to return to daily functional activities also prove to very crucial for the rehabilitation process. The defect in bone is usually a result of high velocity trauma or a sudden impact. In present case open reduction and external fixation for distal one-third of tibia and fibula on right side was carried out followed by the rehabilitation protocol. Outcome measure used to check for the pain was NPRS. The patient morale and goal-oriented rehabilitation protocol progressed him to return to his functional activities.
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Lesic, Aleksandar, Bojan Karovic, Branislav Krivokapic, and Marko Bumbasirevic. "History and portraits in fracture treatment." Acta chirurgica Iugoslavica 62, no. 1 (2015): 19–25. http://dx.doi.org/10.2298/aci1501019l.
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During the human history there were many attempts to treat fractures and injuries of extremities. Since Mathijsen and his plaster cast there was many attempts to make immobilization at the fracture site, to protect obtained reduction. Hugh Owen Thomas invent traction which greatly decrease mortality in the patients with femoral fractures during the war. External fixation was used from the time of Malgaigne, Lambote, Parkhill in 19th century, and Anderson, Hofmann, Ilizarov in 20th century. This kind of fracture fixation still has place and role in the treatment of open, compound fractures, and in the patients with multiple fractures. Along with invention of antisepsis, antibiotics, X-rays, ant metallurgy, the internal fixation become widely used, from the Lane,s plate at the beginning of 20th century to the biogredable materials and new designed internal devices. Special problem of hip fracture treatment was solved by fixation dated from Hey Groves, Smith Petersen, while intramedullary fixation of long bones was introduced by Kuntscher. Clinical and biomechanical investigation during the 1950 and 1960 was established by members of AO group.
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Ali, Haider, Mohammad Mushtaq, Naeem ul Haq, Muhammad Anwar Ullah, Saqib Ali, and Anwar Shah. "Surgical management and Outcomes of Depressed Skull Fractures." Pakistan Journal of Medical and Health Sciences 15, no. 7 (2021): 2327–29. http://dx.doi.org/10.53350/pjmhs211572327.
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Objective: To determine the outcomes of surgical management in patients presented with depressed skull fractures. Study Design:Prospective Study Place and Duration of Study: Conducted at Neurosurgery department of Mardan Medical Complex/ Bacha Khan Medical College, Mardan during the period from 16th January 2019 to 15thJanuary 2020. Methodology: 65patients of both genders with ages were 10 to 60 year were included in this study. Patients were aged between 12-70 years of age. After taking informed written consent from all patient’s/parent/guardians, detailed demographics age, gender,body mass index cause of fracture, type of fracture and site of fracture wererecorded. CT scan was performed on all patients.Depressed fracture of more than 5 mm, cosmetically disfiguring fractures and fracture over the sinuses were operated. Patients were held under examination for 12-weeks.Glasgow Coma Scale (GCS) was used for final outcome. Data was analyzed by SPSS 27.0. Results:Out of all the patients, male patients were 45(69.23%) and female patients were 20 (30.76%). 35(53.85%) with ages <30, 20(30.76%) with ages 30 to 50 and 10(15.38%) with ages >50 were reordered in study. Mean body mass index was 20.04±3.14 kg/m2.The most common cause of the injury was road traffic accident 45(69.23%) followed by fall from the height 20 (30.76%). 40(61.53%)were compound fracture and 25 (38.46%) were closed fracture. 55 (87.5%) cases were treated surgically and 10 (12.5%) patients were treated conservatively. 45(69.23%) patients were completely recovered, 10 (12.5%) were moderately disabled and 7(10.77%) were severely disabled and 3(4.61%) were died. Conclusion:If treated promptly most of the cases of compound depress skull fracture revealed good results but outcomes of the depress skull fracture revealed contingent severity of injury and absence or presence of intracranial lesion. Key words: Depressed skull fracture, Non-missile injuries, Compund skull fracture, conservative management
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Dodda, Prasad Reddy, Kolluri Ravikanth, and P. Nagaraju. "A Prospective Study on Surgical Management of Supracondylar Fractures of Femur by Various Modalities." International Journal of Toxicological and Pharmacological Research 12, no. 5 (2022): 133–42. https://doi.org/10.5281/zenodo.11824967.
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<strong>Background:</strong> There is an increase in the frequency of distal femoral fractures in recent times. It is because of increased urbanization and high use of transport resulting in RTA. Distal femoral fractures are difficult to treat because of the thin cortex of the distal femur and the involvement of the knee joint in fractures or osteopenic bone in the elderly. We in the current study tried to evaluate three different methods of treatment of distal femoral fractures. <strong>Methods: </strong>This cross-sectional interventional study was conducted in the Department of Orthopedics, Kakatiya Medical College, and MGM Hospital, Warangal, Telangana State. The selected cases underwent a thorough clinical examination to find out the nature of fracture-associated injuries and the general condition of the patients. The injured limb was examined for swelling, tenderness, crepitus, abnormal mobility, and deformity. Splinting of the affected limb was done. A systemic examination was also performed. They were managed by Knee spanning External Fixator (Ex. Fix), Supra-Condylar Nail (SCN), and Locking Compression Plate (LCP). <strong>Results:</strong> A total of n=30 fractures n=14(46.67%) cases were closed fractures. Out of these n=14 cases, n=2(14.28%) cases were treated with Ex. Fix N=7(50%) treated with SCN and n=5(35.71%) cases were treated with LCP. Similarly, for type 1 compound fractures the total number of cases was n=6, and n=2 each was treated by the three methods. In type II n=5 cases were present out of which n=2 each by Ex. Fix and LCP respectively and n=1 case by SCN. Type 3 compound fractures were n=5 cases out of which n=4 cases were treated by Ex Fix and n=1 cases by LCP. <strong>Conclusion:</strong> Supracondylar femur fractures. remain a significant challenge to the orthopedic surgeon The significant forces applied to this area, even during restricted patient activities, require a strong implant. The best device for distal femur fixation is still a subject of debate. For all fractures, one implant is suitable. Patient factors, type of fracture, personality, soft tissue quality, and anatomical reduction of the distal femoral articular surface all influence the kind of fixation device used.
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Anyanechi, Charles E., Otasowie D. Osunde, and Birch D. Saheeb. "Complications of the use of trans-osseous wire osteosynthesis in the management of compound, unfavorable and non-comminuted mandibular angle fractures." Ghana Medical Journal 50, no. 3 (2016): 172–79. http://dx.doi.org/10.4314/gmj.v50i3.9.
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Objective: To analyze cases of compound, unfavorable and non-comminuted mandibular angle fractures treated by trans-osseous wiring, presenting postoperative complications, in a low resource center.Materials and methods: This was a 13-year retrospective study of 1,324 fractures in 1,317 subjects. The predictor variables were age, gender, aetiology, time lag between injury and treatment, and concomitant mandibular and midfacial fractures. The outcome variable was the development of complication(s) after treatment. Descriptive and bivariate statistics were computed with EPI INFO 7 version software, and the P value was set at 0.05.Results: The sample size was composed of 63/1317 (4.8%) of patients with complications. There were 48 males and 15 females with male: female ratio of 3.2:1. The age of the patients ranged from 21 to 62 years (mean 37.4± 5.6 years). The test of significance showed statistically significant association between complications of mandibular angle fractures and increasing age (P<0.002), male gender (P<0.001), road traffic accident (P<0.001), longer time lag between injury and treatment of fractures (P<0.000), and concomitant mandibular fractures (P<0.000). Deranged occlusion (n=19, 28.8%) and limited mouth opening <35mm (n=16, 24.2%) were the common complications. The complications were successfully treated during follow-up.Conclusion: The use of trans-osseous wire osteosynthesis gave good results, and can still be useful in centres that are less well equipped and where access to rigid internal fixation with mini plates is either limited or unavailable. Funding: Self-fundedKeywords: Mandible, angle, fracture, trans-osseous wiring, complications
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Griffin, M., M. Malahias, S. Hindocha, and W. Khan. "Update on the Management of Compound Lower Limb Fractures." Open Orthopaedics Journal 6, no. 1 (2012): 518–24. http://dx.doi.org/10.2174/1874325001206010518.
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Compound lower limb fractures pose a significant challenging pathology for orthopaedic and plastic surgeons to manage due to the combined soft tissue damage, bone injury and potential vascular compromise. These fractures require extensive team-work and expertise between several surgical specialties and the advice of non-surgical specialties, to ensure good clinical outcomes. Extensive research has improved the outcomes of compound lower limb fractures and current recommendation on the optimal management is always being updated to enhance patient outcomes. This review serves to provide an overview of the management of compound tibial fractures using current evidence and recently updated UK guidelines. The optimal time for surgical debridement, surgical intervention, antibiotic regime and soft tissue coverage will be outlined as well as the indications for amputation.
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Ashutosh, Vikram, Amer Sadem, Reena, and Kar Soumen. "Management of Open Tibial Shaft Fractures Treated with Primary Intramedullary Interlocking Nailing: A Prospective Study of the Functional and Radiological Outcome." International Journal of Pharmaceutical and Clinical Research 15, no. 12 (2023): 1650–57. https://doi.org/10.5281/zenodo.11205807.
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<strong>Background: </strong>As industrialization and urbanization progress year by year, with a rapid increase in road traffic, the incidence of high-energy trauma is increasing exponentially at the same speed. Tibial fractures are the most common long bone fractures encountered by orthopedic surgeons, with the majority being compound fractures. The use of titanium nails has improved the rate of fracture union and considerably decreased the rate of infection. <strong>Aim:</strong> This led us to study the functional results of primary interlocked intramedullary nailing in open tibial fractures. <strong>Materials & Methods:</strong> This study was conducted at the Department of Orthopedic Surgery, in a tertiary care hospital, from April 2019 to Oct 2021.This is a prospective study. 34 open tibial shaft fracture cases were analyzed, of which 3 were lost to follow-up. Of the 31 cases, 3 were female and 28 were male. The average follow-up period was one year. <strong>Results:</strong> Of the 31 patients, road traffic accidents were the mode of injury in 30 cases, and 1 had an Industrial Accident. In our study, there was 1 case of segmental fracture, 12 fractures were comminuted, 9 cases had an oblique pattern, and 8 cases had transverse fractures. We classified open fractures of the tibia according to the Gustilo and Anderson classification. Among 31 patients: Grade II – 15; Grade III A -12, and Grade III B- 4. <strong>Conclusion:</strong> The primary treatment of choice for such challenging fractures would be debridement, interlocking nailing, and primary flap cover for our patients with open tibial fracture.
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Shamova, Tetiana, and Viacheslav Blyzniuk. "Gunshot Fracture of the Mandible." Journal of Diagnostics and Treatment of Oral and Maxillofacial Pathology 6, no. 4 (2022): 65–66. http://dx.doi.org/10.23999/j.dtomp.2022.4.3.
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A 51-year-old male was transferred to the hospital with a gunshot injury of the lower face. Three-dimensional scan of the multislice computed tomography (MSCT) revealed a severely comminuted fracture (Panel A: arrow) of the left mandibular body at the inferior margin area (what corresponds to the gunshot marginal mandible fracture diagnosis among 12 variants of gunshot mandibular fractures)1. Also, the implantation of multiple different shape radiopaque foreign bodies (arrowhead) was also visualized along with metal artifacts. A rotated coronal scan of the MSCT (Panel B) showed linear continuation (waved arrow) of the fracture to the ramus (visualized as incomplete fracture)2, partially splitting it into medial and lateral fragments. Although the incomplete fractures are more common for the pediatric jaw fractures, in this gunshot injury the MSCT data also indicates an incomplete fracture. In this particular case, it was a gunshot compound fracture (also known as open fracture) of the mandible. 3 Intermaxillary fixation (also known as maxilla-mandibular4 or maxillomandibular fixation5) was performed for 3 weeks without open intervention in the mandible margin area. Antibiotic therapy (Ceftriaxone 1.0 g 2 times daily applying intramuscular administration) was done during 7 days after trauma.
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Parajuli, B., R. Sharma, SR Kayastha, J. Thapa, R. Shrestha, and D. Shrestha. "Assessing Spectrum of Fractures in Elderly; Perspective on Tertiary Care Hospital of Nepal." Kathmandu University Medical Journal 21, no. 1 (2023): 64–68. https://doi.org/10.3126/kumj.v21i1.80576.
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Background There is an increasing life expectancy and a surging elderly population in the last few decades, leading to a higher incidence of fractures in the elderly. The health care of the elderly in Nepal is below par and there are no studies done to evaluate the spectrum of fractures in the elderly. Objective To evaluate the demographical and epidemiological aspects of fractures in the elderly (≥ 65 years) presenting to a tertiary care hospital in Nepal in a 15 years’ timeline. Method This study was a retrospective epidemiological study conducted in the Department of Orthopedics, Dhulikhel Hospital, Kathmandu University Hospital (DH, KUH), Nepal. The patients of age ≥ 65 years having traumatic injuries, admitted in the orthopedics ward from 2006 January to 2020 December were included. Patient demographics, site of injury, fracture incidence, mechanism of injury, hospital stay duration, and mode of treatment (surgical/ conservative) were evaluated. Result Of the 787 patients with an average age of 73.65 ± 7.5 years, 54% were females. Peritrochanteric fracture was the most common fracture (29.4%) followed by spine (18.3%). The most common mechanism of injury was fall on the labeled ground (38.6%). The incidence of fragility fractures (peri-trochanteric, proximal humerus, spine, and distal radius) was increasing with age. Conclusion Females, peritrochantric fractures, and trivial trauma are the most common occurrences for fractures in elderly. The incidence of fragility fractures is increasing with age but the overall incidence of fractures compared to other studies is low. Higher incidences of road traffic accidents (RTA) and compound fractures among the elderly are serious public health concerns that highlight the importance of primary preventive measures.
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Damodar, Vishnu, B. G. Kulkarni, Varun T V, and Shyny Thankachan. "AYURVEDIC MANAGEMENT OF BONE FRACTURE IN SMALLER BONES: A SINGLE CASE STUDY." International Ayurvedic Medical Journal 12, no. 04 (2024): 798–802. http://dx.doi.org/10.46607/iamj1712042024.
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Bone fractures or broken bones are most common in day-to-day practice and can affect anyone at any age. It can be seen as a complete or partial break in the bone. The causes of bone fractures include trauma, over-use and diseases or deficiencies that weaken the bone. Commonly, people will go to a modern hospital after a trauma or hurt, in an emergency, or to manage pain. An X-ray investigation can quickly rule out a bone fracture. Depending on the fracture severity or presentation, there are various types of bone fractures: compound, spiral, comminute, transverse, etc. In our holistic science, can easily manage simple fractures in our OPDs. I got one patient came in clinic on October 2023 with trauma from a Road Traffic Accident. It was a slight fall from the bike on his own, and he was not that much bleeding or injured, but the right-hand ring finger started swelling with pain. As his sister is an Ayurveda medical student and the patient is having belief in Ayurveda, he came to OPD for the management. He consulted a modern hospital, took an X-ray; diagnosed it as a fracture, and he came to us. I managed the case of a simple fracture with Ayurveda medicines.
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Huang, Yitao, Juhui Zhu, Yongming Li, Le He, Zeben Fang, and Xiyu Chen. "Experimental Study on Factors Influencing the Propagation of Hydraulic Fractures in Shale Reservoirs with Developed Natural Weak Planes." Energies 18, no. 5 (2025): 1100. https://doi.org/10.3390/en18051100.
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Hydraulic fracturing is a key technology to build productivity in shale reservoirs; however, the evolution mechanism of fractures is extremely complex, especially in reservoirs with natural weak-planes development. There is an urgent need to conduct systematic research on the influence of natural weak planes on the vertical propagation of hydraulic fractures. This article takes the deep shale gas block of Luzhou in Southern Sichuan as the research basis and conducts different conditions of true triaxial large-scale hydraulic fracturing physical simulation experiments as well as the characteristics of natural weak-plane reservoir development and reservoir geological characteristics. This study clarifies the interaction mechanism between hydraulic fractures and natural weak planes and identifies the influence of parameters such as vertical stress difference, natural fracture strength, and approach angle on the propagation path of hydraulic fractures in reservoirs with developed natural weak planes, which help us gain a deeper insight into the interaction mechanism between fracture and weak plane. This study indicates that the widely developed natural weak planes in shale reservoirs significantly affect the initiation, propagation, and final distribution of hydraulic fractures. Based on pressure response characteristics, the fracture initiation types can be categorized into two scenarios: initiation along the direction of the maximum principal stress and initiation along natural weak planes. The propagation modes of fractures can be divided into three types: propagation perpendicular to natural weak planes, propagation parallel to natural weak planes, and multi-fracture propagation. The post-pressure fracture distribution patterns can be classified into four types: through-going fractures, T-shaped fractures, compound fractures, and complex fracture networks. The absence of developed natural weak planes, high vertical stress differences, high natural weak-plane cementation strength, and large intersection angles are favorable conditions for the vertical propagation of hydraulic fractures. The research findings enrich the fundamental theory of vertical propagation of hydraulic fractures in shale reservoirs with developed natural weak planes and provide a scientific basis for the formulation and optimization of stimulation schemes for deep shale reservoirs, contributing to better stimulation effects in the Southern Sichuan shale gas block.
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Dwaraganath, K., R. Rohit, Ch Arun Kumar, and A. Subramanian. "Locking Compression Plates in Proximal Ulna Fractures: A Study on Functional Outcomes." Innovative Medicine of Kuban 10, no. 2 (2025): 33–39. https://doi.org/10.35401/2541-9897-2025-10-2-33-39.
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Background: Proximal ulna fractures, such as olecranon and Monteggia fractures, can be challenging to treat.Objective: To assess the effectiveness of locking compression plates (LCP) in stabilizing and promoting early mobilization in these fractures.Materials and methods: This is a prospective study conducted at Saveetha Medical College and Hospital from January 2022 to December 2023. Patients with compound fractures, pediatric fractures, proximal bilateral forearm fractures, and those considered medically incompetent for surgery were excluded from the study.Results: Of 20 patients with olecranon and Monteggia fractures, the majority had comminuted olecranon fractures. Most cases did not have associated injuries, while a few had radial head or coronoid injuries. Fracture union times varied, with some cases taking 12, 16, or 18 weeks to heal. Most patients achieved good elbow range of motion, exceeding 100° in 75% of cases. One patient experienced an exposed implant, one developed an infection, and 3 cases had restricted terminal pronation and supination. Functional outcomes assessed using the Mayo Elbow Performance score were excellent in 16 patients and good in 4 patients.Conclusions: That comminuted olecranon and proximal ulna fractures can be effectively treated with LCP, resulting in good union and excellent clinical outcomes.
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H., Ashwin, and George Thomas. "A prospective study on results of bacterial culture from wound in type III compound fractures." International Journal of Research in Orthopaedics 4, no. 6 (2018): 935. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20184389.
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<p class="abstract"><strong>Background:</strong> Open fractures still represent a major challenge for the treating surgeon. Sound knowledge of the bacteriological epidemiology and antimicrobial susceptibility helps to prevent complications. Our aim is to study about the common bacteria causing open fracture infection and their antibiotic sensitivity in patients who are admitted in the department of Orthopedics, Government medical college, Kottayam.</p><p class="abstract"><strong>Methods:</strong> A prospective study on 130 patients with type III open long bone fractures were studied for infection during study period of June 2016 to July 2017. After initial debridement and at third day during follow up wound inspection, swabs were taken from wound site. Swabs were send for microscopic examination, culture and antimicrobial susceptibility testing.<strong></strong></p><p class="abstract"><strong>Results:</strong> Out of 130 type III open long bone fractures, 7.7% were having day 0 infection and 25.4% were having day 3 infection. 19.2% of patients developed infection from day 3 onwards. <em>Staphylococcus aureus</em> (37.1%) was the most commonly isolated bacteria from wound. Other organisms isolated were <em>Acinetobacter, Pseudomonas, Klebsiella</em>, <em>E coli</em>, <em>Enterococcus</em>, <em>Streptococcus</em> and <em>Enterobacter</em>. 100% of diabetic patients developed infection on day 3. Gentamicin, amikacin doxycycline, ciprofloxacin, vancomycin, piperacillin + tazobactum and cefoperazone + sulbactum were found to be effective against isolated organisms.</p><p class="abstract"><strong>Conclusions:</strong> Gram positive <em>Staphylococcus aureus</em> was found to be the most common cause of wound infection in type III open fractures. An early adequate wound debridement, proper antibiotic therapy and aseptic post-operative wound care are essential for wound healing and fracture union in an open fracture.</p>
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Shao, Xuefei, Qifu Wang, Jun Shen, Jiaqiang Liu, Sansong Chen, and Xiaochun Jiang. "Treatment of Traumatic Depressed Compound Skull Fractures." Journal of Craniofacial Surgery 30, no. 7 (2019): 2239–44. http://dx.doi.org/10.1097/scs.0000000000005982.
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