RESUMO
BACKGROUND: We have conducted this study to evaluate the effectiveness of Orange City tapping nail in humeral diaphyseal fractures in terms of radiological union, shoulder function and complications. It's a pilot study with the new implant "Orange City tapping nail" developed at our institute. MATERIALS AND METHODS: Thirty patients with humeral diaphyseal fractures were treated with Orange City tapping nail through antegrade nailing procedure. The cases were followed up prospectively for a period of minimum six months. Outcome of the procedure were assessed according to American Shoulder and Elbow Surgeons (ASES) score, radiological union, complications and secondary procedures required. RESULTS: Twenty eight (93.33%) fractures united with an average consolidation time of 15.75 weeks. Two patients had nonunion. Functional outcome was excellent to good in 24 (80%) patients. One (3.33%) case had infection with Orange City tapping nail. CONCLUSION: Results of Orange City tapping nail were excellent to good for humeral diaphyseal fractures in terms of union, shoulder function and complications. It is a safe, easy and reliable method for the treatment of humeral diaphyseal fractures. Postoperative shoulder stiffness and impingement depends on operative technique and postoperative rehabilitation. We need a larger comparative study with conventional antegrade nail to evaluate the effectiveness of the implant.
RESUMO
PURPOSE: To evaluate treatment outcomes of minimally invasive plate osteosynthesis (MIPO) for distal femoral fractures in 31 patients. METHODS: 22 male and 9 female consecutive patients aged 21 to 65 (mean, 42) years underwent minimally invasive plate osteosynthesis using a locking compression plate (LCP) for distal femoral fractures. The causes of injury were vehicular accidents (n=24), falls (n=6), and assault (n=1). According to the AO classification, the fractures were classified as types A1 (n=10), A2 (n=7), and A3 (n=14). Most fractures were closed; 3 were Gustilo type-II fractures. Clinical and functional outcomes were assessed using the Knee Society Scores. RESULTS: The mean operating time was 70 (range, 60-100) minutes. The mean length of hospital stay was 9 (6-14) days. The mean time to union was 3.7 (range, 2.8-4.6) months. The mean follow-up period was 18 (14-26) months. At the one-year follow-up, 29 of the patients had good or excellent outcomes. No patient had angular or rotational deformity of >10º. One osteoporotic woman with a type-A1 fracture had implant failure at 10 weeks and underwent revision surgery. Another patient with a type-A1 fracture had persistent pain on the lateral aspect of the distal thigh and underwent implant removal at 22 months. No patient developed deep infection, malunion or nonunion. CONCLUSION: MIPO using a LCP achieves favourable biological fixation for distal femoral fractures with few complications. Bone grafting is not needed even in cases of metaphyseal comminution. Proper patient selection and preoperative planning are essential to prevent complications.
