An Assessment of 3.5mm Reconstruction Plate Fixation in Olecranon Fractures

Background: Olecranon process is a large, curved eminence comprising of the proximal and posterior part of the ulna. It lies subcutaneously which makes it more vulnerable to injury. Due to intra-articular extension of fractures, anatomical reduction and early mobilization should be achieved in every case and usually managed surgically. Aims and Objectives: To access the results of reconstruction plate in fracture olecranon.Materials &Methods: This was a prospective study consisted of 25 cases of olecranon fractures which were managed by open reduction and internal fixation using 3.5mm reconstruction plate. Patients were followed up every month till 6 months. At each follow up visit clinical and radiological parameters were assessed: Final assessment was done at 6 months using the Mayo Elbow Performance Score.Result: According to the AO classification, Type A-1 – 7 cases, A-3 – 1case, B-1 – 13 cases, B-3 – 1 case, C-1 – 1 case, C-2 – 1 case, C-3 – 1 case. An adequate reduction was maintained in all fractured olecranon until union. Average radiological union time was 12 weeks in 72% cases, 15 weeks in 16% cases, 18 weeks in 8% cases and > 18 weeks in 4% cases. The results were graded as per the criteria laid by Rogers et al as excellent in 84% cases, good in 12% and unsatisfactory in 4% cases. 2 cases developed superficial infection and 1 deep infection and 1 delayed union.Conclusion: Open reduction and internal fixation of fracture of olecranon with 3.5mm reconstruction plate is based on sound biomechanical principle with a good functional outcome and a low incidence of complications.

COMPLICATIONS OF RECONSTRUCTION PLATE INSTALLATION IN MANDIBULAR

Background: Mandibular resection will cause mandibular stability disturbance due to loss of some part of the bone. Instability of the mandible can cause aesthetic, physiological, and psychological malfunction. Installment of mandibular reconstruction plat on the remaining mandibular using screws were suggested to restore its stability. However, it is not uncommon that plat exposure occurs following mandibular reconstruction, caused by inaccurate adaptation of the plats to the mandibular bone. The aims of this report are to describe the various complications and managements after jaw resection and reconstruction with plates. Case Report: A 44 years old male patient complained the small defect in the chin, painless, and no fluid emited, accompanied by dermatitis. Intra oral examination showed no abnormalities. About 1 year ago the patient performed segmental resection of the mandible on the indication of ameloblastoma. The radiological x-ray showed all screw detached from the plat and radiolucent images appeared around the plat that attached to the mandible. The diagnosis was fistula at regio mentale, post resection and reconstruction surgery, suspected caused by titanium plate allergies. The provided therapies were fistulectomy, screw removal, and plate reconstruction. Post therapy conditions showed improvement and no patients complaints of pain. Conclusion: Plate exposure is a complication that can occur after the installation of the reconstruction plate, but besides that it can also cause an allergic reaction from the material used. Keywords: Complication, Mandibular Resection, Plate Reconstruction, Titanium Plate Allergies

The Clinical Efficacy of Anterior Pelvic Wall Locking Plate Fixation Through the Lateral Rectus Approach for Treating Quadrilateral Surface Acetabular Fractures

Background:Cases of acetabular fractures involving the quadrilateral surface are increasing annually. Quadrilateral surface surgery is complex, involves combined approaches, and the quality of fracture reduction closely depends on the surgical procedure. This study aimed to explore the clinical effects of the anterior pelvic wall locking plate through the lateral rectus approach for treating acetabular fractures involving quadrilateral surface. Methods:A retrospective analysis of 35 patients with acetabular fractures involving the quadrilateral surface treated with anterior pelvic wall-locking plates at the First Affiliated Hospital of Soochow University from June 2016 to December 2020. Patients included 25 males and ten females; age 23-82 years, average 52.4 years. The fracture classification was based on the Letournel-Judet classification: 13 cases of double-column fractures, seven cases of T-shaped fractures, seven cases of anterior wall with posterior semi-transverse fractures, and eight cases of transverse fractures. All patients were exposed through the lateral rectus approach, and fractures were fixed with the anterior pelvic wall-locking plate combined with the reconstruction plate. The Matta imaging standard assessed the quality of fracture reduction, and hip joint function was assessed according to the modified Merled’Aubigné-Postel scoring standard. Results:Patients meeting the inclusion and exclusion criteria were followed up for 12-42 months, with an average of 26.1 months. At the last follow-up, Matta imaging evaluation showed that 24 cases were anatomically reduced (68.6%, 24/35), seven cases were satisfied (20%, 7/35), and four cases were dissatisfied (11.4%, 4/35). The satisfaction rate was 88.6% (31/35), according to the modified Merled'Aubigné-Postel scoring standard. The hip function was excellent in 23 cases, good in six cases, fair in four cases, and poor in two cases. The excellent and good rates were 82.9% (29/35). Conclusion: The acetabular fracture involving the quadrilateral surface is clearly revealed through the lateral rectus approach. The anterior pelvic wall-locking plate combined with the reconstruction plate can fix well, with satisfactory clinical effects.