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Fractures: Bone Repair01:27

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Treatment for a fracture is based on the type of break, the bone affected, and the patient's age.
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the...
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Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
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Minimally Invasive Treatment for Thoracolumbar Burst Fracture Using Sagittal Alignment Screws and A Trauma Reduction Device
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THORACOLOMBAR BURST FRACTURES: SHORT FIXATION, WITHOUT ARTHRODESIS AND WITHOUT REMOVAL OF THE IMPLANT.

Carlos Humberto Targa Moreira1,2, Walter Krause3, Robert Meves1

  • 1Universidade da Santa Casa de São Paulo, Department of Orthopedics and Traumatology, São Paulo, SP, Brazil.

Acta Ortopedica Brasileira
|April 21, 2023
PubMed
Summary

Short posterior fixation for thoracolumbar burst fractures (A3, A4) without arthrodesis shows good functional outcomes. Most patients experienced minimal pain and reduced kyphosis after one year, with no implant failures.

Keywords:
AccidentsArthrodesisLumbar VertebraeThoracic Vertebrae

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Area of Science:

  • Orthopedic Surgery
  • Spinal Surgery
  • Traumatology

Background:

  • Thoracolumbar burst fractures (A3, A4) require effective treatment to restore function and prevent deformity.
  • Short posterior fixation without arthrodesis is a less invasive surgical option.
  • Evaluating functional outcomes and radiographic changes is crucial for this patient group.

Purpose of the Study:

  • To present the functional outcomes of patients with thoracolumbar burst fractures (A3, A4) treated with short posterior fixation.
  • To assess radiographic changes, specifically kyphosis, and implant-related complications.
  • To provide the first case series in the country on this specific surgical approach.

Main Methods:

  • Retrospective evaluation of 55 patients treated between 2010 and 2019.
  • Radiographic analysis using the Cobb method to measure kyphosis.
  • Functional assessment via SF-36 and Denis pain and work questionnaires at 12 months.

Main Results:

  • Significant kyphosis reduction from 14.9±7.8 degrees preoperatively to 9.1±5.2 degrees at 12 months (p≤0.01).
  • 82% of patients reported minimal, occasional, or no pain.
  • One patient (1.8%) required implant removal due to symptomatic prominence.

Conclusions:

  • Short posterior fixation without arthrodesis yields satisfactory functional results for thoracolumbar burst fractures (A3, A4).
  • The technique demonstrates effectiveness in reducing kyphosis and maintaining implant integrity.
  • This approach offers a viable treatment option with low complication rates.