Surgical Management of Clavicle Fracture: Functional Outcome of Open Reduction and Internal Fixation | Chapter 3 | New Visions in Medicine and Medical Science Vol. 2

 Background: Clavicle fracture is one of common bony injury; which is more common in young active individual. It accounts for approximately 5% to 10% of all fracture and up to 44% of injuries of shoulder girdle. It has been traditionally treated with non-operative method. This present study evaluates the role of the surgical management in the fresh middle third clavicle fracture.

 

Methods: 30 adult patients (21 male and 9 female) of the average age of 32 years presented with fresh middle third clavicle fracture treated surgically with open reduction and internal fixation with plate and screws and followed. This study was conducted between November 2011 to November 2012.

 

Results: In 27 patients, fracture were united at end of 12 weeks, in 2 patients, fracture were united at end of 24 weeks and 1 patient went for non-union. One patient had superficial infection. None of them had deep infection. One patient had plate loosening at 4week but fracture was united at the end of 24 weeks. 2 patients had persistent pain which is controlled with occasional analgesic but not effecting ordinary work. One patient had gross restriction of shoulder movement. Functional outcome assessed according to near shoulder scoring system. 24 patients had excellent result, 4 patients had satisfactory result, 1 patient had unsatisfactory result and 1 patient had failure. The advantage of rigid internal fixation and early mobilisation of fresh displaced clavicle fracture is that it gives immediate pain relief and prevents the development of shoulder stiffness and non-union.

 

Conclusions: The study showed rigid fixation with plate and screw for fresh middle third clavicle fracture especially displaced and comminuted give immediate pain relief and prevent the development of shoulder stiffness &non-union and give good functional outcome.

Author(s) Details:

Manju G. Pillai,
Department of Orthopaedics, Pushpagiri Institute of Medical Sciences and Research Center, Thiruvalla, Kerala, India.

Please see the link here: https://stm.bookpi.org/NVMMS-V2/article/view/13797

Surgical Management of Maxillofacial Trauma: Open Reduction and Internal Fixation with Intermaxillary Fixation Techniques and Outcomes | Chapter 6 | Key Flaps in Plastic Surgery

 This book chapter presents a case report and discussion on the use of open reduction and internal fixation (ORIF) with intermaxillary fixation (IMF) in the management of posttraumatic maxillofacial fractures. The chapter includes a detailed case presentation, operative procedure, and a comprehensive discussion of the surgical technique, advantages, limitations, and postoperative care associated with ORIF with IMF.

The case presentation describes a patient who sustained facial injuries in a road traffic accident, resulting in a Le Fort I maxillary fracture and a fracture of the right nasal bone. The diagnosis was confirmed through computed tomography with 3-D reconstruction. The surgical intervention involved ORIF with IMF, with an upper gingivobuccal sulcus incision used to access the fracture site. The maxillary alveolus was stabilized in class I occlusion using IMF, followed by the application of 3-D titanium miniplates for fixation. The postoperative period was uneventful, with satisfactory results observed during follow-up examinations.

The discussion section introduces ORIF with IMF as a commonly employed surgical procedure in the management of maxillofacial fractures. The surgical technique involves precise repositioning of fractured bone segments, internal fixation using various methods, and the use of intermaxillary fixation to stabilize the jaw. The advantages of ORIF with IMF, including precise fracture reduction, stable fixation, restoration of occlusion, and improved long-term outcomes, are discussed. The limitations, such as the requirement for surgical skill and experience, the need for an individualized approach, and potential complications, are also addressed.

In conclusion, this book chapter provides valuable insights into the use of ORIF with IMF for the management of posttraumatic maxillofacial fractures. Through a case report, operative details, and a comprehensive discussion, the chapter highlights the efficacy, considerations, and postoperative care associated with this surgical technique. This information can guide surgeons in making informed decisions and achieving successful outcomes in the treatment of maxillofacial fractures using ORIF with IMF.

Author(s) Details:

Mohd. Altaf Mir,
Department of Burns and Plastic Surgery, All India Institute of Medical Sciences (AIIMS),Bathinda-151001, India.

Jaya Jain,
All India Institute of Medical Sciences (AIIMS), Bathinda-151001, India.

Please see the link here: https://stm.bookpi.org/KFPS/article/view/11501