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العنوان
Dorso lumbar fractures type A1 treated by
segmental fixation versus conservative
treatment /
المؤلف
Mazeed, Magdy Gamil.
هيئة الاعداد
باحث / مجدي جميل مزيد
مشرف / أحمد محمد البدراوي
مشرف / فادي ميشيل فهمي
مشرف / عبدالراضي محمــود عبد الراضي
تاريخ النشر
2023.
عدد الصفحات
127 P. :
اللغة
الإنجليزية
الدرجة
الدكتوراه
التخصص
جراحة العظام والطب الرياضي
تاريخ الإجازة
1/1/2023
مكان الإجازة
جامعة عين شمس - كلية الطب - قسم جراحة العظام
الفهرس
Only 14 pages are availabe for public view

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from 127

Abstract

T
horacolumbar fractures types A1 of AO classification are very common spine injuries. However, its management is usually without operative intervention especially if its patients are neurologically intact (39).
The aim of the current study was to assess the results, advantages & disadvantages of operative and non operative fixation of such fracture.
60 patients were enrolled in the current study, 29 were males and 31 were females with a mean age of 31.300 years old in non operative patients and 33.867 years old in operative patients at time of surgery.
In non operative group the treatment program was wearing a hyperextension brace for about 6 weeks with bed rest and returning to work with restriction to hold any heavy objects for about 6 month.
Short segment fixation was done for all cases, the inclusion criteria were neurologically intact patients with type A1 thoracolumbar fractures (wedge fracture less than 50%). Exclusion criteria were the presence of any neurological deficit, pathological or osteoporotic fractures, wedge fracture more than 50%.
Intraoperative blood loss was less than 100 ml in all cases. The mean operative time was 86.4 minutes. The mean postoperative hospital stay was 48 hours.
Regarding radiological parameters, this study included measurements of local kyphosis angle, and vertebral body wedging. The results showed statistically significant differences between preoperative values in comparison to both postoperative and follow up values.
Regarding the functional assessment scores, the mean VAS was 1.125 in non operative patients and the mean VAS was 1.040 in operative patients.
the mean ODI was 10.633 % in non operative patients and about 8.700% in operative patients at the last follow up visit.
There is no great difference between operative and non operative patients in VAS and ODI but there is more satisfaction in operative patients.
The degree of kyphosis is more in non operative patients which made few of them in mild pain in the last follow up.
The complications encountered were very few, not including any major or neurological complications.
At the end of our study, the only purpose to do fixation on those patients of type A1 fracture is to permit early ambulation and to protect them from kyphosis. but VAS and ODI have no big difference between the two groups but more in non operative in cases suffering from post traumatic kyphosis.