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- 저자 : Nabil Ebraheim (검색결과 2 건)
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Jingwei Zhang,,Nabil Ebraheim,Ming Li,Xianfeng He,Jiayong Liu,Limei Zhu,Yihui Yu 대한정형외과학회 2015 Clinics in Orthopedic Surgery Vol.7 No.1
Background: The locking plates are often used for internal fixation of closed tibial fractures. The use of a locking plate as an externalfixator is still controversial, particularly for closed fractures. The purpose of this study is to evaluate the results of externalfixation using the femoral less invasive stabilization system (LISS) plate in proximal metaphyseal fractures of the tibia. Methods: We prospectively evaluated 35 patients (26 males and 9 females) with a mean age of 42 years (range, 21 to 62 years)who presented with fresh tibial proximal metaphyseal fractures. According to the AO Foundation and Orthopaedic Trauma Association(AO/OTA) classification, the fractures were identified as type 41-A2 in 18 cases and type 41-A3 in 17 cases, including 25closed fractures and 10 open fractures. The femoral LISS plate was used to fix these fractures, which was placed on the anteromedialaspect of the tibia as an external fixator. The mean follow-up period was 18 months (range, 13 to 22 months). Results: All fractures healed in a mean time of 14 weeks (range, 10 to 20 weeks). There was no case of nonunion, deep infection,and loosening of screws and plates. One month after the appearance of cortical bridging on biplanar radiographs, the locking platewas removed within 3 minutes in the clinic without any difficulty. According to the Hospital for Special Surgery (HSS) knee scoringsystem and American Orthopaedic Foot & Ankle Society (AOFAS) ankle scoring system, the mean HSS score was 91 (range, 85 to100) and 98 (range, 93 to 100), and the mean AOFAS score was 94 (range, 90 to 100) and 98 (range, 95 to 100) at 4 weeks postoperativelyand final follow-up, respectively. Conclusions: For proximal metaphyseal fracture of the tibia, external fixation using the femoral LISS plate is a safe and reliabletechnique with minimal complications and excellent outcomes. Its advantages include ease of performing the surgery, use of a lessinvasive technique, and convenience of plate removal after fracture healing.
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Prediction of Mortality in Nonagenarians Following the Surgical Repair of Hip Fractures
Ashraf Fansa,Scott Huff, BA,Nabil Ebraheim 대한정형외과학회 2016 Clinics in Orthopedic Surgery Vol.8 No.2
Background: The purpose of this study is to report on the mortality of nonagenarians who underwent surgical treatment for a hip fracture, specifically in regards to preexisting comorbidities. Furthermore, we assessed the effectiveness of the Deyo score in predicting such mortality. Methods: Thirty-nine patients over the age of 90 who underwent surgical repair of a hip fracture were retrospectively analyzed. Twenty-six patients (66.7%) suffered femoral neck fractures, while the remaining 13 (33.3%) presented with trochanteric type fractures. Patient charts were examined to determine previously diagnosed patient comorbidities as well as living arrangements and mobility before and after surgery. Results: Deyo index scores did not demonstrate statistically significant correlations with postoperative mortality or functional outcomes. The hazard of in-hospital mortality was found to be 91% (p = 0.036) and 86% (p = 0.05) less in patients without a history of congestive heart failure (CHF) and chronic pulmonary disease (CPD), respectively. Additionally, the hazard of 90-day mortality was 88% (p = 0.01) and 81% (p = 0.024) less in patients without a history of dementia and CPD, respectively. The hazard of 1-year mortality was also found to be 75% (p = 0.01) and 80% (p = 0.01) less in patients without a history of dementia and CPD, respectively. Furthermore, dementia patients stayed in-hospital postoperatively an average of 5.3 days (p = 0.013) less than nondementia patients and only 38.5% returned to preoperative living conditions (p = 0.036). Conclusions: Nonagenarians with a history of CHF and CPD have a higher risk of in-hospital mortality following the operative repair of hip fractures. CPD and dementia patients over 90 years old have higher 90-day and 1-year mortality hazards postoperatively. Dementia patients are also discharged more quickly than nondementia patients.
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