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Strategies in Trauma and Limb Reconstruction

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https://www.readbyqxmd.com/read/29116576/bridging-hard-callus-at-48%C3%A2-days-in-an-open-femoral-shaft-fracture-with-segmental-defect-treated-with-a-first-stage-masquelet-technique-i-wasn-t-expecting-that
#1
Andrew James Hotchen, Lynne V Barr, Matija Krkovic
The Masquelet technique is a strategy for management of segmental bone defects. It is a two-stage procedure that involves inducing a synovial-like membrane that can be used for a bone graft. Segmental bone defects can occur following trauma and can accompany traumatic brain injury. There is a well-documented, albeit debated, association between traumatic brain injury and increased rate of new bone formation. Here, we present a case of unexpected callus formation in a segmental femoral fracture. The patient had a traumatic brain injury and was treated with the first stage of the Masquelet technique...
November 7, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/29103207/complex-tibial-fractures-are-associated-with-lower-social-classes-and-predict-early-exit-from-employment-and-worse-patient-reported-qol-a-prospective-observational-study-of-46-complex-tibial-fractures-treated-with-a-ring-fixator
#2
Rasmus Elsoe, Peter Larsen, Juozas Petruskevicius, Søren Kold
The long-term outcomes following complex fractures of the tibia are reported to carry a risk of knee pain, malalignment, articular injury and post-traumatic osteoarthritis. The main objective of this study was to account for the patient-reported quality of life (QOL) 12 months after ring fixator removal in patients with a complex tibial fracture. Secondary objectives included a review of the socio-economic characteristics of the patient group and the rate of return to work in the study period. A prospective follow-up study was conducted of 60 patients with complex fractures of the tibia treated with ring external fixation...
November 4, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/29052080/calcaneal-fractures-where-are-we-now
#3
REVIEW
Aisha Razik, Mark Harris, Alex Trompeter
This review article on the current management for calcaneal fractures discusses the advantages and disadvantages of different treatment options including the problems encountered. Controversies are described and the evidence reviewed. The management of some types of displaced intra-articular calcaneal fractures remains contentious; is there a preferred stabilisation method for each type of calcaneal fracture? How constant is the "constant fragment" in an intra-articular calcaneal fracture and what is the evidence for primary arthrodesis and what is its place in these fractures?...
October 20, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/29039127/dermotaxis-v-s-loop-suture-technique-for-closure-of-fasciotomy-wounds-a-study-of-50-cases
#4
Naveen Mittal, Robin Bohat, Jagandeep Singh Virk, Payal Mittal
Fasciotomy incisions lead to large, unsightly, chronic wounds after surgical intervention. Classic management was to use split-thickness skin grafts, but this leads to insensate skin with reports that as many as 23% of patients are dissatisfied by the appearance of the wound. Since no skin loss has occurred with the fasciotomy incision, utilizing the dermal properties of creep, stress relaxation and load cycling, closure can be achieved in a better way. We describe using dermotaxis for skin edge approximation that is done using inexpensive equipment available readily in any standard operating room...
October 16, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28889364/open-complete-anterior-dislocation-of-the-sacro-iliac-joint-in-a-4-year-old-boy-a-case-report-of-a-rare-injury-with-5-year-follow-up
#5
Walid A Elnahal, Mahmoud Fahmy, Mehool Acharya
Pelvic fractures are uncommon in children and account for between 0.3 and 7.5% of all pediatric injuries. Open pelvic fractures only account for up to 12.9% of all pediatric pelvic fractures. An unusual case of open complete anterior sacro-iliac joint dislocation in a 4-year-old boy is presented with a long-term follow-up. The multidisciplinary approach is reported with review of the current literature. A 4-year-old male presented to our institution in January 2012 after having been run over by a tractor. He presented with gross hemodynamical instability, MISS of 25, and an unstable lateral compression type III pelvic fracture with complete anterior dislocation of the left hemipelvis and a groin wound extending into the left thigh...
September 9, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/29039128/distal-femoral-flexion-deformity-from-growth-disturbance-treated-with-a-two-level-osteotomy-and-internal-lengthening-nail
#6
Austin T Fragomen, Fiona R Fragomen
Salter Harris fractures of the distal femur can lead to growth disturbance with resulting leg length inequality and knee deformity. We have looked at a case series (3) of patients who presented with a distal femur flexion malunion and shortening treated with a distal femoral osteotomy and plating and a proximal femoral osteotomy with a magnetic internal lengthening nail. Does a two-level osteotomy and internal fixation approach provide a reliable result both radiographically and functionally? The average knee extension loss was 12°, LLD 47 mm, PDFA 65°, MAD 2 mm...
November 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28986774/the-history-evolution-and-basic-science-of-osteotomy-techniques
#7
REVIEW
John Dabis, Oliver Templeton-Ward, Alice E Lacey, Badri Narayan, Alex Trompeter
Osteotomy techniques date back to Hippocrates circa 415 BC (Jones Hippocrates collected works I, Harvard University Press, Cambridge, 2006; Brorson in Clin Orthop Relat Res 467(7):1907-1914, 2009). There is debate about the best way to divide the bone surgically and which technique yields the best bone regenerate in lengthening; ensuring predictable new bone formation and healing of the osteotomy are the primary goals. We review the history and techniques of the osteotomy and consider the evidence for optimum bone formation...
November 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28825169/midshaft-clavicle-fractures-treatment-threaded-kirschner-wire-versus-conservative-approach
#8
Valentino Coppa, Luca Dei Giudici, Stefano Cecconi, Mario Marinelli, Antonio Gigante
Clavicle fractures are common, accounting for 2.6 to 10% of all fractures. Treatment of these fractures is usually non-surgical. Recent evidence, however, reveals that the final result of non-surgically midshaft clavicular fractures, particularly those with quite large displacements or shortening, is not like that which was previously thought. This study evaluated retrospectively all patients presented with a clavicle fracture at Emergency Department of our Institution, between January 2006 and December 2011...
November 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28786027/anterior-hip-dislocation-with-ipsilateral-displaced-fracture-neck-of-femur-treated-by-open-reduction-and-internal-fixation-case-report-and-review-of-the-literature
#9
Ayman Mohammad El Masry
Combined fracture neck femur with anterior dislocation of the head of femur is a very rare injury with little resources available in the literature. This case report describes a case that was treated by open reduction and internal fixation with 2-year follow-up showing good radiological and functional outcome. Functional evaluation was done according to Merle d'Aubigné score modified by Matta JM, which takes into account the presence of pain, ability to walk and joint range of motion. The measured functional score was 15 points out of a maximum of 18, signifying a good postoperative result...
November 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28712047/shaped-graft-for-aneurysmal-bone-cyst-of-upper-limb-bones
#10
Mohamed F Mostafa, Yasser Y Abed, Sallam I Fawzy
The optimal treatment of aneurysmal bone cyst remains challenging. The aim of this prospective study was to evaluate the results of using bone grafts shaped to the defects caused by aneurysmal bone cysts of upper limb bones. Fifteen patients (12 males and 3 females) with an average age of 12 years (range 6-16 years) were treated for aneurysmal bone cysts of upper limb bones by intralesional resection, argon beam coagulation and shaped bone graft. The grafts were harvested from 14 patients (11 fibulas and 3 iliac bones) and from the mother of one patient (proximal fibula)...
November 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28593359/guided-growth-for-valgus-deformity-correction-of-knees-in-a-girl-with-osteopetrosis-a-case-report
#11
Dmitry Popkov
Autosomal dominant osteopetrosis (Albers-Schönberg disease) classically displays the radiographic signs of osteosclerosis. The main ADO complications involve the skeleton: low-impact bone fractures, scoliosis and hip osteoarthritis. Management of osteopetrosis-related orthopedic problems is a surgical challenge due to increased bone density. The healing process is very slow in these patients because of bone remodeling defects related to osteoblast function failure. In case of bone deformities, a realignment method should be appropriated to osteopetrosis conditions...
November 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28593358/accuracy-in-identifying-the-elbow-rotation-axis-on-simulated-fluoroscopic-images-using-a-new-anatomical-landmark
#12
J K Wiggers, R M Snijders, J G G Dobbe, G J Streekstra, D den Hartog, N W L Schep
External fixation of the elbow requires identification of the elbow rotation axis, but the accuracy of traditional landmarks (capitellum and trochlea) on fluoroscopy is limited. The relative distance (RD) of the humerus may be helpful as additional landmark. The first aim of this study was to determine the optimal RD that corresponds to an on-axis lateral image of the elbow. The second aim was to assess whether the use of the optimal RD improves the surgical accuracy to identify the elbow rotation axis on fluoroscopy...
November 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28512698/repair-of-the-pronator-quadratus-after-volar-plate-fixation-in-distal-radius-fractures-a-systematic-review
#13
REVIEW
Marjolein A M Mulders, Monique M J Walenkamp, Fernande J M E Bos, Niels W L Schep, J Carel Goslings
To position the volar plate on the distal radius fracture site, the pronator quadratus muscle needs to be detached from its distal and radial side and lifted for optimal exposure to the fracture site. Although the conventional approach involves repair of the pronator quadratus, controversy surrounds the merits of this repair. The purpose of this study was to compare the functional outcomes of patients with distal radius fractures treated with pronator quadratus repair after volar plate fixation versus no pronator quadratus repair...
November 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28447315/neglected-hip-dislocation-an-unusual-presentation-its-management-and-review-of-the-literature
#14
Sandeep Kumar, Anshul Dahuja, M S Narula, Sangam Garg, Rashmeet Kaur
Neglected traumatic posterior hip dislocation is not an uncommon condition seen in developing countries. Its treatment is fraught with great difficulties and controversies. Here we present a 31-year-old female patient presented to our hospital 2 years after sustaining an accident. She had gone through multiple treatments for her dislocated hip without any success. After arrival to our hospital, patient managed by constrained total hip replacement (THR). Her Harris hip score improved from 48 (preoperative) to 81 (postoperative)...
November 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28364344/giant-cell-tumour-of-proximal-radius-in-a-50-year-old-female-with-wrist-drop-a-rare-case-report
#15
Anshul Dahuja, Rashmeet Kaur, Shiraz Bhatty, Simmi Garg, Kapil Bansal, Mandeep Singh
Giant-cell tumour is a locally aggressive tumour of long bones of epiphyseal region commonly occurring in adults aged 20-40 years. Most common location is distal femur, proximal tibia, and distal radius. Different treatment options being used are curettage with bone graft or bone cement, resection with arthrodesis, reconstruction, radiation, and chemotherapy. We are reporting a case of giant-cell tumour of right proximal radius in a 50-year-old female with posterior interosseous nerve palsy. It is very rare, and only four cases have been reported in the literature...
November 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28500371/the-silhouette-technique-improving-post-operative-radiographs-for-planning-of-correction-with-a-hexapod-external-fixator
#16
Jonathan Wright, Shiraz A Sabah, Shelain Patel, Gavin Spence
Correction of deformity of a bone through use of a hexapod external fixator requires clear definition of the relationship between the bone and the frame. Achieving adequate orthogonal calibrated radiographs for this aim, with minimum X-ray exposure, can prove a challenge in the radiography suite. We describe a simple technique for obtaining adequate imaging, without the use of additional equipment. Introduction of the technique to our department has demonstrated an improvement in the adequacy of planning radiographs and a reduction in the requirement for repeat imaging...
August 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28444580/three-dimensional-virtual-planning-of-corrective-osteotomies-of-distal-radius-malunions-a-systematic-review-and-meta-analysis
#17
REVIEW
R J O de Muinck Keizer, K M Lechner, M A M Mulders, N W L Schep, D Eygendaal, J C Goslings
The purpose of this study was to summarize and evaluate results of three-dimensional (3D-) planned corrective osteotomies of malunited distal radius fractures. 3D-planning techniques provide the possibility to address 3D-deformity that conventional planning methods might not address. We systematically searched PubMed, EMBASE and the Cochrane library for studies that performed a 3D-planned corrective osteotomy on patients with a malunited distal radius fracture. Fifteen studies with a total of 68 patients were included in the analysis...
August 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28439819/lengthening-of-the-humerus-with-intramedullary-lengthening-nails-preliminary-report
#18
Julian Fürmetz, Søren Kold, Nikola Schuster, Florian Wolf, Peter H Thaller
Distraction osteogenesis of the humerus with fully implantable lengthening is now possible since the diameter of the available nails was reduced to 10 mm and below. We report on the first intramedullary lengthening cases of the humerus with two different lengthening devices (FITBONE and PRECICE). Two different approaches and implantation techniques were used. We retrospectively reviewed clinical and radiographic data and pointed out results, pitfalls and complications of the procedure. Four adult patients with relevant length discrepancy of the humerus were treated with fully implantable systems in two centers between 2012 and 2015...
August 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28439818/can-experienced-surgeons-predict-the-additional-value-of-a-ct-scan-in-patients-with-displaced-intra-articular-distal-radius-fractures
#19
Y V Kleinlugtenbelt, K Madden, S R Groen, S J Ham, P Kloen, R Haverlag, M P Simons, M Bhandari, J C Goslings, V A B Scholtes, R W Poolman
There are no clear guidelines when an additional CT scan should be obtained for the treatment of displaced intra-articular distal radius fractures (DRF). This study aimed to investigate whether surgeons can predict the usefulness of CT scans to facilitate choice of treatment plan and/or pre-operative planning for DRF. Four surgeons evaluated 51 patients with displaced DRF. The choice of treatment (operative or nonoperative) was based on conventional radiographs. Subsequently, the surgeons were asked whether they would have requested an additional CT scan to determine this treatment choice, and also whether they required a CT scan for pre-operative planning...
August 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28386803/bioactivity-and-osteointegration-of-hydroxyapatite-coated-stainless-steel-and-titanium-wires-used-for-intramedullary-osteosynthesis
#20
Arnold V Popkov, Elena N Gorbach, Natalia A Kononovich, Dmitry A Popkov, Sergey I Tverdokhlebov, Evgeniy V Shesterikov
A lot of research was conducted on the use of various biomaterials in orthopedic surgery. Our study investigated the effects of nanostructured calcium-phosphate coating on metallic implants introduced into the bone marrow canal. Stainless steel or titanium 2-mm wires (groups 1 and 2, respectively), and hydroxyapatite-coated stainless steel or titanium wires of the same diameter (groups 3 and 4, respectively) were introduced into the tibial bone marrow canal of 20 dogs (each group = 5 dogs). Hydroxyapatite coating was deposited on the wires with the method of microarc oxidation...
August 2017: Strategies in Trauma and Limb Reconstruction
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