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N. Limpaphayom - One of the best experts on this subject based on the ideXlab platform.
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Surgical treatment of pediatric supracondylar humerus fracture could be safely performed by general Orthopedists
MUSCULOSKELETAL SURGERY, 2019Co-Authors: P. Osateerakun, I. Thara, N. LimpaphayomAbstract:Purpose Displaced pediatric supracondylar humerus fracture (SCHF) requires a reduction and instrumentation. The trend is to send the cases to a fellowship-trained pediatric Orthopedist. This study reviewed the outcomes and complications of SCHF surgically managed by orthopedic surgeons with different backgrounds of subspecialty training. Methods The medical records of 87 children (87 elbows) with an average age of 5.9 ± 3.1 (range 1.3–14.1) years with SCHF Gartland 2 and 3 who underwent operative fixation were reviewed. The demographics data and operative details were obtained. Radiographically, the Baumann and humerocapitella angles were measured. The lateral rotational percentage of Gordon was calculated. The Griffet index 1 and 2 were retrieved. The parameters were compared among groups of surgeons with a pediatric fellowship-trained background and surgeons with other subspecialty training. A univariate analysis was calculated for the risk of postoperative complications. Results The demographics data were comparable between the two groups. Children who were treated by non-pediatric fellowship-trained Orthopedists showed higher but not significant degrees of postoperative Baumann angles; however, the proportion of children with an acceptable range of Baumann angle were similar. The overall complications rate was 17.5% and comparable between the two groups. Only SCHF Gartland 3 was associated with complications ( P = 0.01). Conclusions Pediatric SCHF could be efficiently managed by a general orthopedic surgeon because the radiographic outcomes and complications were comparable to pediatric fellowship-trained Orthopedists. Extra precautions need to be exercised in SCHF Gartland type 3 because the chance of complications is higher among these types of injuries. Level of evidence Level III.
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Surgical treatment of pediatric supracondylar humerus fracture could be safely performed by general Orthopedists.
Musculoskeletal surgery, 2018Co-Authors: P. Osateerakun, I. Thara, N. LimpaphayomAbstract:Purpose Displaced pediatric supracondylar humerus fracture (SCHF) requires a reduction and instrumentation. The trend is to send the cases to a fellowship-trained pediatric Orthopedist. This study reviewed the outcomes and complications of SCHF surgically managed by orthopedic surgeons with different backgrounds of subspecialty training.
P. Osateerakun - One of the best experts on this subject based on the ideXlab platform.
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Surgical treatment of pediatric supracondylar humerus fracture could be safely performed by general Orthopedists
MUSCULOSKELETAL SURGERY, 2019Co-Authors: P. Osateerakun, I. Thara, N. LimpaphayomAbstract:Purpose Displaced pediatric supracondylar humerus fracture (SCHF) requires a reduction and instrumentation. The trend is to send the cases to a fellowship-trained pediatric Orthopedist. This study reviewed the outcomes and complications of SCHF surgically managed by orthopedic surgeons with different backgrounds of subspecialty training. Methods The medical records of 87 children (87 elbows) with an average age of 5.9 ± 3.1 (range 1.3–14.1) years with SCHF Gartland 2 and 3 who underwent operative fixation were reviewed. The demographics data and operative details were obtained. Radiographically, the Baumann and humerocapitella angles were measured. The lateral rotational percentage of Gordon was calculated. The Griffet index 1 and 2 were retrieved. The parameters were compared among groups of surgeons with a pediatric fellowship-trained background and surgeons with other subspecialty training. A univariate analysis was calculated for the risk of postoperative complications. Results The demographics data were comparable between the two groups. Children who were treated by non-pediatric fellowship-trained Orthopedists showed higher but not significant degrees of postoperative Baumann angles; however, the proportion of children with an acceptable range of Baumann angle were similar. The overall complications rate was 17.5% and comparable between the two groups. Only SCHF Gartland 3 was associated with complications ( P = 0.01). Conclusions Pediatric SCHF could be efficiently managed by a general orthopedic surgeon because the radiographic outcomes and complications were comparable to pediatric fellowship-trained Orthopedists. Extra precautions need to be exercised in SCHF Gartland type 3 because the chance of complications is higher among these types of injuries. Level of evidence Level III.
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Surgical treatment of pediatric supracondylar humerus fracture could be safely performed by general Orthopedists.
Musculoskeletal surgery, 2018Co-Authors: P. Osateerakun, I. Thara, N. LimpaphayomAbstract:Purpose Displaced pediatric supracondylar humerus fracture (SCHF) requires a reduction and instrumentation. The trend is to send the cases to a fellowship-trained pediatric Orthopedist. This study reviewed the outcomes and complications of SCHF surgically managed by orthopedic surgeons with different backgrounds of subspecialty training.
Liao-jun Sun - One of the best experts on this subject based on the ideXlab platform.
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Traitement des fractures diaphysaires de l’avant-bras chez l’enfant : la spécialité pédiatrique ou non du chirurgien joue-t-elle un rôle ?
Revue de Chirurgie Orthopédique et Traumatologique, 2017Co-Authors: Z. Lin, Jia-yu Zhang, Huiqian Chen, Liao-jun SunAbstract:Abstract Purpose of the study The objective of this study was to compare the clinical and radiological outcomes of pediatric forearm midshaft fractures treated operatively with titanium elastic nails (TENs) by pediatric Orthopedists and non-pediatric Orthopedists. Material and methods We conducted a prospective cohort study of 88 children of forearm midshaft fractures, who were randomized to operative stabilization either by pediatric Orthopedists (Group A, 44 cases) or by non-pediatric Orthopedists (Group B, 44 cases) from April 2013 to February 2014. At baseline, the groups were comparable with respect to age, sex, AO classification, injured side and interval from injury to surgery. We collected data on operative and radiation time, open reduction rate, length of hospitalization, bone union time, return to full physical activity time, complications, and measured clinical results using the Children's Hospital of Philadelphia (CHOP) Forearm Fracture Fixation Outcome Classification. Results The mean follow-up period was 15.8 ± 3.3 months for group A and 15.2 ± 4.2 months for group B ( P = 0.491). No significant difference existed in time to union ( P = 0.282), the overall complication rate ( P = 0.750), return to activity time ( P = 0.408), and clinical outcomes according to CHOP classification ( P = 0.908) between the two groups. However, the mean operating time and radiation time was significantly longer in Group B than in Group A ( P = 0.001 and P = 0.001, respectively). Also, there was a trend for patients of Group B to have a higher rate of open reduction ( P = 0.035). Discussions Our results indicated that children forearm midshaft fractures treated surgically by pediatric Orthopedists offered potential advantages including a shorter operating time and radiation time, a lower rate of open reduction. However, both pediatric and non-pediatric Orthopedists had achieved satisfactory clinical results in the treatment of these injuries. Level of evidence Level II prospective randomized study.
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The outcomes of pediatric femoral shaft fractures treated surgically by different types of Orthopedists.
Injury, 2016Co-Authors: Jie Yang, Hua Chen, Jing-dong Zhang, Liao-jun SunAbstract:Abstract Background The objective of this study was to compare the outcomes of pediatric femoral shaft fractures treated with titanium elastic nail (TEN) by pediatric Orthopedists and non-pediatric Orthopedists. Methods From May 2006 to June 2014, 88 children with femoral shaft fractures were randomized to operative stabilization either by pediatric Orthopedists (Group A, 44 cases) or by non-pediatric Orthopedists (Group B, 44 cases). Demographic data and clinical characteristics (age, sex, weight, fracture side and type, cause of injury, associated injuries and interval from injury to surgery) were comparable between the two groups before surgery. Peri-operative data, clinical and functional outcomes between the two groups were recorded. Results The mean follow-up period was 20.9 ± 4.5 months for Group A and 20.0 ± 3.6 months for Group B (P = 0.356). There was no significant difference in the time to union, length of hospitalization, full weight-bearing time and TEN scores between the two groups (P = 0.785, P = 0.835, P = 0.803, P = 0.940, respectively). However, the mean operating time and radiation time was longer in Group B than in Group A (P = 0.001 and P = 0.047, respectively). Also, there was a trend for patients of Group B to have a higher rate of open reduction (P = 0.047). When comparing the total complications, no significant difference existed between the groups (P = 0.978). Conclusions This study indicated that both pediatric and non-pediatric Orthopedists provided satisfactory clinical and functional results in treating these common injuries.
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Treatment of pediatric forearm midshaft fractures: Is there a difference between types of orthopedic surgeon?
Orthopaedics & traumatology surgery & research : OTSR, 2016Co-Authors: Z. Lin, Jia-yu Zhang, Huiqian Chen, Liao-jun SunAbstract:Abstract Purpose of the study The objective of this study was to compare the clinical and radiological outcomes of pediatric forearm midshaft fractures treated operatively with titanium elastic nails (TENs) by pediatric Orthopedists and non-pediatric Orthopedists. Material and methods We conducted a prospective cohort study of 88 children of forearm midshaft fractures, who were randomized to operative stabilization either by pediatric Orthopedists (Group A, 44 cases) or by non-pediatric Orthopedists (Group B, 44 cases) from April 2013 to February 2014. At baseline, the groups were comparable with respect to age, sex, AO classification, injured side and interval from injury to surgery. We collected data on operative and radiation time, open reduction rate, length of hospitalization, bone union time, return to full physical activity time, complications, and measured clinical results using the Children's Hospital of Philadelphia (CHOP) Forearm Fracture Fixation Outcome Classification. Results The mean follow-up period was 15.8 ± 3.3 months for Group A and 15.2 ± 4.2 months for Group B (P = 0.491). No significant difference existed in time to union (P = 0.282), the overall complication rate (P = 0.750), return to activity time (P = 0.408), and clinical outcomes according to CHOP classification (P = 0.908) between the two groups. However, the mean operating time and radiation time was significantly longer in Group B than in Group A (P = 0.001 and P = 0.001, respectively). In addition, there was a trend for patients of Group B to have a higher rate of open reduction (P = 0.035). Discussions Our results indicated that children forearm midshaft fractures treated surgically by pediatric Orthopedists offered potential advantages including a shorter operating time and radiation time, a lower rate of open reduction. However, both pediatric and non-pediatric Orthopedists had achieved satisfactory clinical results in treatment of these injuries. Level of evidence Level II prospective randomized study.
I. Thara - One of the best experts on this subject based on the ideXlab platform.
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Surgical treatment of pediatric supracondylar humerus fracture could be safely performed by general Orthopedists
MUSCULOSKELETAL SURGERY, 2019Co-Authors: P. Osateerakun, I. Thara, N. LimpaphayomAbstract:Purpose Displaced pediatric supracondylar humerus fracture (SCHF) requires a reduction and instrumentation. The trend is to send the cases to a fellowship-trained pediatric Orthopedist. This study reviewed the outcomes and complications of SCHF surgically managed by orthopedic surgeons with different backgrounds of subspecialty training. Methods The medical records of 87 children (87 elbows) with an average age of 5.9 ± 3.1 (range 1.3–14.1) years with SCHF Gartland 2 and 3 who underwent operative fixation were reviewed. The demographics data and operative details were obtained. Radiographically, the Baumann and humerocapitella angles were measured. The lateral rotational percentage of Gordon was calculated. The Griffet index 1 and 2 were retrieved. The parameters were compared among groups of surgeons with a pediatric fellowship-trained background and surgeons with other subspecialty training. A univariate analysis was calculated for the risk of postoperative complications. Results The demographics data were comparable between the two groups. Children who were treated by non-pediatric fellowship-trained Orthopedists showed higher but not significant degrees of postoperative Baumann angles; however, the proportion of children with an acceptable range of Baumann angle were similar. The overall complications rate was 17.5% and comparable between the two groups. Only SCHF Gartland 3 was associated with complications ( P = 0.01). Conclusions Pediatric SCHF could be efficiently managed by a general orthopedic surgeon because the radiographic outcomes and complications were comparable to pediatric fellowship-trained Orthopedists. Extra precautions need to be exercised in SCHF Gartland type 3 because the chance of complications is higher among these types of injuries. Level of evidence Level III.
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Surgical treatment of pediatric supracondylar humerus fracture could be safely performed by general Orthopedists.
Musculoskeletal surgery, 2018Co-Authors: P. Osateerakun, I. Thara, N. LimpaphayomAbstract:Purpose Displaced pediatric supracondylar humerus fracture (SCHF) requires a reduction and instrumentation. The trend is to send the cases to a fellowship-trained pediatric Orthopedist. This study reviewed the outcomes and complications of SCHF surgically managed by orthopedic surgeons with different backgrounds of subspecialty training.
Flávio Faloppa - One of the best experts on this subject based on the ideXlab platform.
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A visão do ortopedista brasileiro sobre a descarga parcial de peso em ortostase nas fraturas expostas da diáfise da tíbia após osteossíntese The view of Brazilian Orthopedists on partial weight bearing in open fractures of the tibial shaft following
2009Co-Authors: Valéria R. G. Sella, Paula Machado, Hélio Jorge Alvachian Fernandes, William R. Limonge, Fernando Baldy Dos Reis, Flávio FaloppaAbstract:Background: Tibial shaft fractures are the most frequent among long bone fractures. They are described in the literature according to the device and method of treatment, with recommendations that range from full weight bearing to non-weight bearing restrictions. There are studies comparing osteosynthesis devices and surgical aspects, but no references were found on how or when to allow weight bearing on the affected limb in the standing position. Objectives: The present study learned from Brazilian Orthopedists which methods of osteosynthesis they use to treat open tibial fractures, whether they refer patients to physical therapy, when and why they allow partial weight bearing for both physical activity and therapy. Methods: Two hundred and thirty-five Orthopedists answered a questionnaire during the 14 th Brazilian Conference of Orthopedic Trauma. Results: The results showed that, in Brazil, the most widely used osteosynthesis device is the external fixator, but earlier weight bearing while standing occurs when intramedullary nails are used. Most Orthopedists refer patients to physical therapy and allow partial weight bearing in the standing position according to the material used for synthesis. Conclusions: It was concluded that there is a preference for external fixation, that most Orthopedists refer patients to physical therapy and that the synthesis material influences restrictions on partial weight bearing.
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The view of Brazilian Orthopedists on partial weight bearing in open fractures of the tibial shaft following osteosynthesis A visão do ortopedista brasileiro sobre a descarga parcial de peso em ortostase nas fraturas expostas da diáfise da tíbia após
2009Co-Authors: Valéria R. G. Sella, Paula Machado, Hélio Jorge Alvachian Fernandes, William R. Limonge, Fernando Baldy Dos Reis, Flávio FaloppaAbstract:Abstract Background: Tibial shaft fractures are the most frequent among long bone fractures. They are described in the literature according to the device and method of treatment, with recommendations that range from full weight bearing to non-weight bearing restrictions. There are studies comparing osteosynthesis devices and surgical aspects, but no references were found on how or when to allow weight bearing on the affected limb in the standing position. Objectives: The present study learned from Brazilian Orthopedists which methods of osteosynthesis they use to treat open tibial fractures, whether they refer patients to physical therapy, when and why they allow partial weight bearing for both physical activity and therapy. Methods: Two hundred and thirty-five Orthopedists answered a questionnaire during the 14 th Brazilian Conference of Orthopedic Trauma. Results: The results showed that, in Brazil, the most widely used osteosynthesis device is the external fixator, but earlier weight bearing while standing occurs when intramedullary nails are used. Most Orthopedists refer patients to physical therapy and allow partial weight bearing in the standing position according to the material used for synthesis. Conclusions: It was concluded that there is a preference for external fixation, that most Orthopedists refer patients to physical therapy and that the synthesis material influences restrictions on partial weight bearing.Key words: osteosynthesis; tibia; physical therapy; Orthopedist.
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fractures of the distal radius colles fracture
Sao Paulo Medical Journal, 2007Co-Authors: João Carlos Belloti, Joao Baptista Gomes Dos Santos, Walter Manna Albertoni, Álvaro Nagib Atallah, Flávio FaloppaAbstract:CONTEXT AND OBJECTIVE: Although Colles' fracture is a common clinical situation for the Orthopedist, we did not find any information in the literature that would allow safe decision-making on the best treatment for each fracture type. The aim of the present study was to investigate Brazilian Orthopedists' opinions regarding the main aspects of treatments for Colles' fracture. DESIGN AND SETTING: Cross-sectional study conducted during the 34th Brazilian Congress of Orthopedics and Traumatology. METHODS: Five hundred questionnaires containing 12 items were randomly distributed to Orthopedists who were attending the congress; 439 were filled out correctly and were considered in this study. RESULTS: The main factors in making decisions on interventions in fracture cases were whether the fracture was intra-articular, the existence of shortening of the distal radius and the patient's age. The classification method most used was Frykmann. The closed reduction method most used was manual reduction. The principal surgical interventions were percutaneous pinning (39%), external fixation (27%) and volar plate (19%). Most of the interviewees only used bone grafts for osseous gaps in special cases. The most frequent complications were impairment of joint mobility and residual pain. CONCLUSIONS: Brazilian Orthopedists have concordant opinions regarding conservative treatment methods and the use of bone grafts. There were conflicting opinions regarding surgical treatment methods, classification types and complications.
