1
|
Kim J, Kim TI, Seo KY, Tchah H, Koh K. A comparative study of two presbyopia-correcting intraocular lenses combining bifocal and extended depth-of-focus profiles. Int Ophthalmol 2024; 44:54. [PMID: 38341384 DOI: 10.1007/s10792-024-02979-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 10/29/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVE To compare the visual performance of two presbyopia-correcting intraocular lenses (IOLs) that combine both bifocal and extended depth-of-focus profiles, Artis® Symbiose® Plus (Symbiose Plus; Cristalens Industrie, Lannion, France) and Tecnis® Synergy® (Synergy; Johnson & Johnson Vision, Santa Ana, CA, USA). METHODS The medical records of patients with cataract bilaterally implanted with either Symbiose Plus or Synergy between January 2022 and January 2023 were assessed. The principal measures of postoperative findings included uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near (40 and 33 cm) visual acuity (UNVA), objective optical quality (OOQ) parameters, distance-corrected defocus curve analysis, and surveys of subjective satisfaction. RESULTS Total of 96 eyes from 48 patients were enrolled. Each group was equally composed of 24 patients, 48 eyes. There were no significant differences between the two groups on baseline characteristics. Both IOLs displayed excellent binocular UDVA, CDVA, and UNVA (40 and 33 cm) with no statistical difference (p = 0.467(UDVA), p = 0.584(CDVA), p = 0.096(40-cm UNVA), and p = 0.621(33-cm UNVA)). However, with regard to UIVA, the Synergy group showed significantly superior results (p < 0.001). In contrast, the Symbiose Plus group showed significantly better results on OOQ parameters and patient-reported quality of vision survey outcomes (both p < 0.001). CONCLUSIONS Both IOLs provided a decent continuous range of vision from near to far distance.
Collapse
Affiliation(s)
- Jeongmin Kim
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, 136 Youngshinro, Youngdeungpo-gu, Seoul, 07301, Republic of Korea
| | - Tae-Im Kim
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Kyoung Yul Seo
- Department of Ophthalmology, Severance Hospital, Institute of Vision Research, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Hungwon Tchah
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, 136 Youngshinro, Youngdeungpo-gu, Seoul, 07301, Republic of Korea
| | - Kyungmin Koh
- Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, 136 Youngshinro, Youngdeungpo-gu, Seoul, 07301, Republic of Korea.
| |
Collapse
|
2
|
Atzmon R, Iohanes E, Dubin J, Rosenthal A, Drexler M, Sherman SL. Bifocal avulsion fracture and fixation of the patellar tendon: a case report. J ISAKOS 2023; 8:497-501. [PMID: 37487912 DOI: 10.1016/j.jisako.2023.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/21/2023] [Accepted: 07/04/2023] [Indexed: 07/26/2023]
Abstract
Acute distal patella tendon avulsion from the tibial tubercle (TT) is a relatively rare injury that is usually described in the adolescents or elderly population in their 7th or 8th decades. Bifocal avulsion fractures of the patella tendon from the TT and the distal pole of the patella are exceptionally rare in adults. In this case report, we present a 52-year-old healthy old male who was treated for bifocal avulsion of the patellar tendon with open reduction and internal fixation augmented with two ULTRATAPE sutures. To our knowledge, this is the first case report to describe this injury in a healthy middle-aged patient.
Collapse
Affiliation(s)
- Ran Atzmon
- Stanford University, Department of Orthopaedic Surgery, Stanford, CA, 94305, USA.
| | - Eitan Iohanes
- Assuta Medical Center, Department of Orthopaedic Surgery, Affiliated with the Faculty of Health and Science and Ben Gurion University, HaBarzel St 20, Tel Aviv-Yafo, Israel.
| | - Jeremy Dubin
- Tel Aviv Medical Center, Department of Orthopaedic Surgery, Affiliated with the Sackler Faculty of Medicine and Tel Aviv University, Kaufmann St 6, Tel Aviv-Yafo, 6801298, Israel.
| | - Alex Rosenthal
- Assuta Medical Center, Department of Orthopaedic Surgery, Affiliated with the Faculty of Health and Science and Ben Gurion University, HaBarzel St 20, Tel Aviv-Yafo, Israel.
| | - Michael Drexler
- Assuta Medical Center, Department of Orthopaedic Surgery, Affiliated with the Faculty of Health and Science and Ben Gurion University, HaBarzel St 20, Tel Aviv-Yafo, Israel.
| | - Seth L Sherman
- Stanford University, Department of Orthopaedic Surgery, Stanford, CA, 94305, USA.
| |
Collapse
|
3
|
Calvo-Sanz JA, Sánchez-Tena MA. Characterization of optical performance with defocusing curve: Analysis of two refractive intraocular lens models with high and medium addition. J Optom 2020; 13:35-40. [PMID: 30391111 PMCID: PMC6951828 DOI: 10.1016/j.optom.2018.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 09/20/2018] [Accepted: 10/01/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE To characterize the optical performance of two models of refractive bifocal intraocular lenses, with medium and high addition, using defocus curves. METHODS 20 eyes from 20 subjects were included in this study. 10 eyes underwent caratact surgery with an implant of a medium addition refractive bifocal intraocular lens (IOL) (Lentis LS-313 MF20) and the other 10 eyes underwent cataract surgery with an implant of a high addition refractive bifocal IOL (Lentis LS-313 MF30). Six weeks after surgery, subjective refraction and defocus curve were made. RESULTS Mean final residual refraction in spherical equivalent was +0.10±0.07D in the LS-313MF30 group and +0.12±0.10D in the LS-313MF20 group. Defocus curve showed a different optical performance in intermediate/near distance depending on the IOL model. The medium addition IOL provided good visual acuity (VA) at far and intermediate distance up to 50cms, and the high addition IOL provided better VA in near distance up to 25cms. CONCLUSIONS The high addition intraocular lens provides better visual acuity in the spatial range from infinity to the point close to 25cm. The medium addition intraocular lens provides excellent visual acuity in far and intermediate vision. The defocus curve seems to be a valid and reproducible tool for evaluating the optical behavior of multifocal sector refractive lenses.
Collapse
|
4
|
Jin S, Friedman DS, Cao K, Yusufu M, Zhang J, Wang J, Hou S, Zhu G, Wang B, Xiong Y, Li J, Li X, He H, Wan X. Comparison of postoperative visual performance between bifocal and trifocal intraocular Lens based on randomized controlled trails: a meta-analysis. BMC Ophthalmol 2019; 19:78. [PMID: 30871503 PMCID: PMC6419463 DOI: 10.1186/s12886-019-1078-1] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 03/01/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To compare the clinical performance of bifocal and trifocal intraocular lenses (IOLs) in cataract surgery, a meta-analysis on randomized controlled trials was conducted. METHODS A comprehensive literature retrieval of PubMed, Science Direct and EMBASE was performed in this systematic review. Clinical outcomes included visual acuity (VA), contrast sensitivity (CS), spectacle independence, postoperative refraction and surgical satisfaction. RESULTS There were 8 RCTs included in this study. The difference of uncorrected near VA (UNVA) between the bifocal IOLs and trifocal IOLs had no significance [MD = 0.02, 95%CI: (- 0.03,0.06)]. There was no significant difference in the distant-corrected near VA (DCNVA) with MD of 0.04 [95%CI (- 0.02, 0.10)]. Compared with trifocal group, the uncorrected intermediate visual acuity (UIVA) [MD = 0.09,95%CI:(0.01,0.17)] was significantly worse in the bifocal group. No difference was found in distance-corrected intermediate VA (DCIVA) [MD = 0.09, 95%CI: (- 0.04, 0.23)] between two groups. Analysis on AT LISA subgroup indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839 M) [MD = 0.18, 95%CI: (0.12, 0.24) for UIVA and MD = 0.19, 95%CI: (0.13, 0.25) for DCIVA]. However, there was no statistically significant difference between the two groups in the uncorrected distance VA (UDVA) and corrected distance visual acuity (CDVA) [MD = 0.01, 95%CI: (- 0.01,0.04) for UDVA; MD = 0.00, 95%CI: (- 0.01,0.01) for CDVA]. The postoperative refraction of bifocal group was similar to that of trifocal group [MD = -0.08, 95% CI: (- 0.19, 0.03) for spherical equivalent; MD = -0.09, 95%CI: (- 0.21, 0.03) for cylinder; MD = -0.09, 95% CI: (- 0.27, 0.08) for sphere]. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs. [RR = 0.89, 95% CI: (0.71, 1.12) for spectacle independence; RR = 1.81, 95% CI: (0.50, 6.54) for PCO incidence; RR = 0.98, 5% CI: (0.86, 1.12) for patient satisfaction]. CONCLUSION Patients receiving trifocal IOLs, especially AT LISA tri 839 M, have a better intermediate VA than those receiving bifocal IOLs. Near and distance visual performance, spectacle independence, postoperative refraction and surgical satisfaction of bifocal IOLs were similar to those of trifocal IOLs.
Collapse
Affiliation(s)
- Shanshan Jin
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - David S Friedman
- Dana Center for Preventive Ophthalmology, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kai Cao
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Mayinuer Yusufu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Jingshang Zhang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Jinda Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Simeng Hou
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Guyu Zhu
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Bingsong Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Ying Xiong
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Jing Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Xiaoxia Li
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Hailong He
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China
| | - Xiuhua Wan
- Beijing Institute of Ophthalmology, Beijing Tongren Eye CenterBeijing Tongren Hospital of Capital Medical University, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Beijing, China.
| |
Collapse
|
5
|
Abstract
AIMS Many authors have reported a shorter treatment time when using trifocal bone transport (TFT) rather than bifocal bone transport (BFT) in the management of long segmental tibial bone defects. However, the difference in the incidence of additional procedures, the true complications, and the final results have not been investigated. PATIENTS AND METHODS A total of 86 consecutive patients with a long tibial bone defect (≥ 8 cm), who were treated between January 2008 and January 2015, were retrospectively reviewed. A total of 45 were treated by BFT and 41 by TFT. The median age of the 45 patients in the BFT group was 43 years (interquartile range (IQR) 23 to 54). RESULTS The size of the bone defect was significantly longer (p = 0.005), the number of previous operations was significantly higher (p < 0.001), the operating time was significantly longer (p < 0.001), and the bone transport distance was significantly increased (p = 0.017) in the TFT group. However, the external fixation time (p < 0.001), the healing index (p < 0.001), the number of additional procedures (p = 0.013), and the number of true complications (p < 0.001) were significantly reduced in this group. Both groups achieved highly satisfactory bone and functional results. CONCLUSION TFT can significantly reduce the treatment time, the number of additional surgical procedures, and true complications compared with BFT in the treatment of long segmental tibial bone defects.
Collapse
Affiliation(s)
- M A Catagni
- Medical School, University of Milan, Milan, Italy; Director of the Ilizarov Unit, Mangioni Hospital, Lecco, Italy
| | - W Azzam
- Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - F Guerreschi
- Department of Orthopaedic Surgery and Traumatology, Alessandro Manzoni Hospital, Lecco, Italy
| | - L Lovisetti
- Villa Aprica Clinical Institute, Como, Italy
| | - P Poli
- Department of Orthopaedic Surgery and Traumatology, Alessandro Manzoni Hospital, Lecco, Italy
| | - M S Khan
- Isra University Hospital, Hyderabad, Pakistan
| | - L M Di Giacomo
- Division of Orthopaedics and Trauma Surgery, University of Perugia, S. Maria della Misericordia Hospital, Perugia, Italy
| |
Collapse
|
6
|
Yoon CH, Shin IS, Kim MK. Trifocal versus Bifocal Diffractive Intraocular Lens Implantation after Cataract Surgery or Refractive Lens Exchange: a Meta-analysis. J Korean Med Sci 2018; 33:e275. [PMID: 30369857 PMCID: PMC6200906 DOI: 10.3346/jkms.2018.33.e275] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 07/20/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND We compared the efficacy between trifocal and bifocal diffractive intraocular lens (IOL) implantation. METHODS Through PubMed, MEDLINE, EMBASE, and CENTRAL, we searched potentially relevant articles published from 1990 to 2018. Defocus curves, visual acuities (VAs) were measured as primary outcomes. Spectacle dependence, postoperative refraction, contrast sensitivity (CS), glare, and higher-order aberrations (HOAs) were measured as secondary outcomes. Effects were pooled using random-effects method. RESULTS We included 11 clinical trials, with a total of 787 eyes (395 subjects). The trifocal IOL group showed better binocular distance VA corrected with defocus levels of -0.5, -1.0, -1.5, and -2.5 diopter than the bifocal IOL group (All P ≤ 0.004). The trifocal IOL group showed better monocular uncorrected distance and intermediate VAs (mean difference [MD], -0.04 logarithm of the minimum angle of resolution [logMAR]; 95% confidence interval [CI], -0.07, -0.01; P = 0.006 and MD, -0.07 logMAR; 95% CI, -0.13, -0.01; P = 0.03, respectively). Postoperative refraction, glare, CS, and HOAs were not significantly different from each other. CONCLUSION The overall findings indicate that trifocal diffractive IOL implantation is better than the bifocal diffractive IOL in intermediate VA, and provides similar or better in distance and near VAs without any major deterioration in the visual quality.
Collapse
Affiliation(s)
- Chang Ho Yoon
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
| | - In-Soo Shin
- Department of Education, Jeonju University College of Education, Jeonju, Korea
| | - Mee Kum Kim
- Department of Ophthalmology, Seoul National University College of Medicine, Seoul, Korea
- Laboratory of Ocular Regenerative Medicine and Immunology, Seoul Artificial Eye Center, Seoul National University Hospital Biomedical Research Institute, Seoul, Korea
| |
Collapse
|
7
|
Padha V, Awasthi B, Singh D, Kalia S. A very rare Presentation of Bifocal Non Union Radius with Ipsilateral Ulnar Shaft Non Union: Case Report. J Orthop Case Rep 2016; 6:82-84. [PMID: 28845394 PMCID: PMC5245950 DOI: 10.13107/jocr.2250-0685.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION A bifocal non-union of shaft of radius associated with ipsilateral non-union shaft of ulna in an adult has not been reported in the literature till date to the best of our knowledge, though few similar cases of fresh fractures have been reported. The case being reported by us is the first of its kind. CASE PRESENTATION We report a case of bifocal non-union of shaft radius with non-union ipsilateral shaft of ulna in a 48-year-old right handed male along with discussion of alternative treatment options. CONCLUSION We describe an extremely rare and complicated non-union in which our patient got excellent results along with satisfactory functional recovery as a result of appropriate surgical treatment.
Collapse
Affiliation(s)
- Vikas Padha
- Department of Orthopaedics, Dr RPGMC, Tanda, Kangra, Himachal Pradesh, India,Address of Correspondence Dr. Vikas Padha, Assistant Professor, Department of Orthopeadics, Dr RPGMC Kangra At Tanda, Himachal Pradesh. India. E-mail:
| | - Bhanu Awasthi
- Department of Orthopaedics, Dr RPGMC, Tanda, Kangra, Himachal Pradesh, India
| | - Dhananjay Singh
- Department of Orthopaedics, Dr RPGMC, Tanda, Kangra, Himachal Pradesh, India
| | - Sandeep Kalia
- Department of Orthopaedics, Dr RPGMC, Tanda, Kangra, Himachal Pradesh, India
| |
Collapse
|
8
|
Harshwal RK, Sankhala SS, Jalan D. Management of nonunion of lower-extremity long bones using mono-lateral external fixator--report of 37 cases. Injury 2014; 45:560-7. [PMID: 24342368 DOI: 10.1016/j.injury.2013.11.019] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 11/16/2013] [Accepted: 11/17/2013] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The management of nonunion has remained a constant challenge. The associated bone defect, shortening, deformity and infection complicate the management. A mono-lateral external fixator may minimise some of the problems frequently encountered in these patients. We report our results of prospectively evaluated 37 consecutive patients regarding nonunion of lower-extremity long bones managed using a mono-lateral external fixator. PATIENTS AND METHODS A total of 37 patients (7 femurs and 30 tibias), mean age 36 years, were stabilised using a mono-lateral fixator for nonunion of long bones. The mean time since injury was 8 months. Fifteen cases were infected and they received debridement and antibiotic treatment as per culture and sensitivity reports. In cases where the bone gap or shortening was >3 cm in the tibia and >5 cm in the femur, corticotomy and bone transport (bifocal procedure) was done and in the remaining cases, only compression-distraction (monofocal procedure) was done. The bone and functional results were assessed at the end of treatment according to the criteria described by Paley et al. RESULTS Union was achieved in 34 cases (91.9%). The average time for union was 5 months. Five cases were treated with the bifocal method and 32 cases were treated with the monofocal method. The average length gain in the bifocal method was 5.7 cm, mean duration of treatment was 8.2 months and bone healing index (BHI) was 1.44 months cm(-1). In six cases, the monofocal treatment was used for limb lengthening. The average length gain was 1.9 cm, mean duration of treatment was 4.83 months and BHI was 2.5 months cm(-1). Bone grafting was required in two cases at the docking site. The bone results were excellent in 24 cases, good in nine cases, fair in one case and poor in three cases. The functional results were excellent in 27 cases, good in six cases, fair in one case and poor in three cases. The most common complication in this series was pin-tract infection (11.5%). CONCLUSIONS A mono-lateral external fixator is an effective method for treating nonunion in the lower extremity with or without bone loss. The nonunion site can be carefully controlled with simultaneous correction of angulation and length.
Collapse
|
9
|
Abstract
INTRODUCTION Multifocal humeral fractures are extremely rare. These may affect the neck and the shaft, the shaft alone, or the diaphysis and the distal humerus. There is no classification of these fractures in the literature. MATERIALS AND METHODS From 2004 to 2010, 717 patients with humeral fracture were treated surgically at our department. Thirty-five patients presented with an associated fracture of the proximal and diaphyseal humerus: synthesis was performed with plate and screws in 34 patients, and the remaining patient had an open fracture that was treated with an external fixator. RESULTS Mean follow-up was 3 years and 3 months. A classification is proposed in which type A fractures are those affecting the proximal and the humeral shaft, type B the diaphysis alone, and type C the diaphysis in association with the distal humerus. Type A fractures are then divided into three subgroups: A-I, undisplaced fracture of the proximal humerus and displaced shaft fracture; A-II: displaced fracture of the proximal and humeral shaft; and A-III: multifragmentary fracture affecting the proximal humerus and extending to the diaphysis. DISCUSSION Multifocal humeral fractures are very rare and little described in the literature, both for classification and treatment. The AO classification describes bifocal fracture of the humeral diaphysis, type B and C. The classification suggested in this article mainly concerns fractures involving the proximal and humeral shaft. CONCLUSIONS A simple classification of multifocal fractures is suggested to help the surgeon choose the most suitable type of synthesis for surgical treatment.
Collapse
|