B. 21
TREATMENT OF RADIAL HEAD FRACTURES WITH BIODEGRADABLE IMPLANTS
P. Givissis
Lecture at Inion OTPS User’s meeting,
Tampere, Finland, 14-16 December 2006
It was presented the late results of 21 cases of radial head fractures fixed with bio-absorbable pins. The material used was poly-L-DL-lactide polymer. Its slower degradation process necessitates the study of the long term outcomes including possible delayed adverse effects. Our patients were followed up for an average period of six and a half years (range 2.5 – 11 years). There were 9 Mason II, 10 Mason III and 2 Mason IV factures which were evaluated clinically and radiologically. According to the Mayo Elbow Performance Score, there were 17 excellent, three good and one poor result. All fractures healed well with no radiological signs of osteolysis. No material-related adverse effects were observed. Concerns considering soft tissue or bone reactions from the use of these materials in radial head fractures, having overcome the maximum degradation period, are not justified according to our results.
Β. 22
AVULSION OF THE DISTAL INSERTION OF THE BICEPS BRACHIL TENDON TREATED SURGICALLY WITH ANTERIOR ONLY PROCEDURE
P. Givissis, K. Ditsios, V.Kefalas, D. Karataglis, J. Pournaras
Ανακοινώθηκε στο Federation of European Societies for Surgery of the Hand
Athens , 27-30 June 27-30, 2007
Β. 23
LATE RESULTS OF CONSERVATIVE TREATMENT OF FRACTURE OF THE NECK OF THE FIFTH METACARPAL
P. Givissis, E. Balabanidou, K. Ditsios, A.Cristodoulou,
J. Pournaras
Ανακοινώθηκε στο Federation of European Societies for Surgery of the Hand
Athens , 27-30 June 27-30, 2007
Β. 24
UPPER LIMB FRACTURES TREATED WITH BIOABSORBABLE MATERIALS
P. Givissis, D.Kapoutsis, K. Ditsios, A.Cristodoulou,
J. Pournaras
Ανακοινώθηκε στο Federation of European Societies for Surgery of the Hand
Athens , 27-30 June 27-30, 2007
Β. 25
BONE DEFECT RECONSTRUCTION OF THE RADIUS USING FREE VASCULARIZED FIBULA GRAFT
K. Ditsios, P. Givissis, V.Kefalas, A.Cristodoulou,
J. Pournaras
Έκθεμα στο Federation of European Societies for Surgery of the Hand
Athens , 27-30 June 27-30, 2007
Β. 26
METAKARPAL FRACTURES FIXATION WITH ABSORBABLE IMPLANTS
P. Givissis, K.Ditsios, S.Stavridis, D.Kapoutsis, A.Cristodoulou, J. Pournaras
Ανακοινώθηκε στο 6th Greek – Turkish Intrauniversity Meeting
Thessaloniki, 30 August – 2 September 2007
Purpose of the study: Mid-term evaluation of the use of bioabsorbable plates and screws for internal fixation of metacarpal fractures.
Material-Methods: From 15/12/2004 until 16/03/2007 a total of 12 fractures in 10 patients (7 male, 3 female; mean age 36.5 y, range 18-75 y) were treated with the Inion® OTPSTM Biodegradable Mini Plating System. 9 patients (10 fractures) were available for follow-up (mean 17.4 months, range 6 to 32).
Patients were examined radiologically to evaluate fracture healing, and clinically by completing the DASH-score and a visual analog scale for pain assessment. Grip strength, finger strength and range of motion of metacarpo-phalangeal and interphalangeal joints were also measured.
Results: Fracture healing occurred uneventfully in all patients. The mean DASH-score result was 15.6 points (range 0 to 48) and the visual pain scale displayed a mean value of 13 (range 0 to 60). Grip strength loss of more than 20% of the affected limb compared to the healthy one was recorded in 2 older patients, while finger strength displayed no difference. Significant reduction of metacarpo-phalangeal range of motion was recorded in one elderly patient.
However, a foreign body reaction occurred in 4 of our patients exceeding 12 months of F.U. All of them required reoperation and the intraoperative findings were formation of a yellowish abscess and a different level implant resorption. Histological examination confirmed the diagnosis of aseptic inflammation, while obtained cultures were negative.
Conclusion: Although internal fixation of metacarpal fractures by using absorbable plates and screws is a satisfactory alternative fixation method, regarding the union rate, the problem of late foreign body reaction is a significant drawback that invalidates the major theoretical advantage of bioabsorbable plates -namely the avoidance of a second operation for implant removal.
Β. 27
CLINICAL AND RADIOLOGICAL RESULTS OF BILATERAL EXTRAPEDICULAR BALLOON KYPHOPLASTY WITH A MEAN FOLLOW-UP OF 13.4 MONTHS
Christodoulou A., Antonarakos P., Balabanidou E., Katranitsa L., Givissis P., Petsatodes G.
Ανακοινώθηκε στο 5th Spine Experts Group Annual Meeting, 6-8/12/07, Belgrade, Serbia
We evaluate the preoperative and postoperative changes on clinical outcomes and radiological indexes of patients treated with bilateral extrapedicular balloon kyphoplasty for vertebral compression fractures (VCFs). Between 2002 – 2006 50 patients with 69% osteoporotic, 20% traumatic and 11% osteolytic VCF in 58 levels totally were treated under local anaesthesia with extrapedicular ballon kyphoplasty. Intraoperatively a uniplanar, profile fluoroscopy of the spine was used which significantly reduced the mean operative time and the exposure of the patients to radiation. The mean age of the patients was 68.2 years (ranged 40 to 84), there were 40 females and 10 males and the follow up ranged from 10 to 40 months (mean 13.4 months). Clinical outcomes were based on pain intensity assessment (visual analogue scale) and improvements of a disease specific HQ (Oswestry disability index) while radiological indexes included the restoration of midline vertebral body height, the kyphosis correction and the incidence of cement extravasation. 80% of the pts presented with immediate pain relief, 12% showed no improvement and 8% presented with aggravation of pain. Restoration of vertebral height greater than or equal to 10% restoration occurred in 80% of the fractures while mean kyphosis correction was 4.2 degrees. Cement leakage occurred in 5% of the patients with no clinically important consequences. Mean operative time was 25΄. Bilateral extrapedicular balloon kyphoplasty with a single uniplanar projection of the spine intraoperatively is a safe and effective minimal invasive procedure for the treatment of vertebral compression fractures.
1. EXTRAPEDICULAR BALLOON KYPHOPLASTY: Clinical and radiological results with a mean follow-up of 15 months 5th SPINE EXPERT 2007
Β. 28
DISTAL RADIUS FRACTURES. ELECTION OF SURGICAL TECHNIQUE
P. Givissis
Διάλεξη που δόθηκε στο 2nd International Seminar WRIST PROBLEMS
Thessaloniki, 18-19 January 2008
B. 29
TENDON ENTRAPMENT SYNDROMES IN UPPER EXTREMITY
P. Givissis
Διάλεξη που δόθηκε στο 2nd International Musicians Medicine Congress in Greece
Thessaloniki, 2- 6 April 2008