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https://www.readbyqxmd.com/read/28422876/low-complication-rate-of-elastic-stable-intramedullary-nailing-esin-of-pediatric-forearm-fractures-a-retrospective-study-of-202-cases
#1
Christiane Kruppa, Pamela Bunge, Thomas A Schildhauer, Marcel Dudda
Elastic stable intramedullary nailing (ESIN) has been established as state of the art treatment for forearm fractures in children, if operative stabilization is required. Their use has been expanded to single bone shaft fractures, and also more complex injuries such as Monteggia fractures or Monteggia-like lesions. A wide range of complications has been reported in the literature, up to 70% in certain investigations. The purpose of this study was to assess the complication rate after ESIN treatment of forearm fractures in children and adolescents in a representative cohort of patients from a level 1 trauma center in Germany...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28420623/externalised-locking-compression-plate-as-an-alternative-to-the-unilateral-external-fixator-a-biomechanical-comparative-study-of-axial-and-torsional-stiffness
#2
B F H Ang, J Y Chen, A K S Yew, S K Chua, S M Chou, S L Chia, J S B Koh, T S Howe
OBJECTIVES: External fixators are the traditional fixation method of choice for contaminated open fractures. However, patient acceptance is low due to the high profile and therefore physical burden of the constructs. An externalised locking compression plate is a low profile alternative. However, the biomechanical differences have not been assessed. The objective of this study was to evaluate the axial and torsional stiffness of the externalised titanium locking compression plate (ET-LCP), the externalised stainless steel locking compression plate (ESS-LCP) and the unilateral external fixator (UEF)...
April 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28410572/incidence-of-infection-following-internal-fixation-of-open-and-closed-tibia-fractures-in-india-infiniti-a-multi-centre-observational-cohort-study
#3
Prakash Doshi, Hitesh Gopalan, Sheila Sprague, Chetan Pradhan, Sunil Kulkarni, Mohit Bhandari
BACKGROUND: Trauma is a major public health problem, particularly in India due to the country's rapid urbanization. Tibia fractures are a common and often complicated injury that is at risk of infection following surgical fixation. The primary objectives of this cohort study were to determine the incidence of infection within one year of surgery and to describe the distribution of infections by location and time of diagnosis for tibia fractures in India. METHODS: We conducted a multi-center, prospective cohort study...
April 14, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28400667/epidemiology-of-lower-limb-musculoskeletal-trauma-with-associated-vascular-injuries-in-a-tertiary-care-institute-in-india
#4
Nirmal Raj Gopinathan, Siva Swaminathan Santhanam, Balaji Saibaba, Mandeep Singh Dhillon
BACKGROUND: Vascular trauma associated with bony injuries is an orthopaedic emergency. Lack of timely intervention can lead to loss of limb or even life. Inspite of the rising incidence of high speed road traffic accidents in India, there is paucity of literature regarding the demographic pattern, clinical morbidity, management strategies and outcome of arterial injuries associated with lower limb trauma. The aim of this study is to describe the epidemiology and outcome of lower extremity musculoskeletal trauma with associated vascular injuries in a tertiary care institute in India...
March 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28394750/impact-of-body-mass-index-and-bacterial-resistance-in-osteomyelitis-after-antibiotic-prophylaxis-of-open-lower-extremity-fractures
#5
Derek Bremmer, Brandon Bookstaver, Mark Cairns, Kenneth Lindley, Martin Durkin, David Koon, April Miller Quidley
BACKGROUND: We investigated the clinical effectiveness of antimicrobial prophylaxis in lower-extremity open fractures following the Eastern Association for the Surgery of Trauma Guidelines. METHODS: This observational, retrospective, single-center study included adults with lower-extremity open fractures of the ankle, tibia, fibula, or femur. The primary endpoint was the incidence of osteomyelitis within 12 months of the fracture. Secondary endpoint comparisons were the time of antibiotic initiation and drug selection...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28393309/free-non-vascularized-fibular-graft-for-treatment-of-large-bone-defect-around-the-elbow-in-pediatric-patients
#6
Kamolporn Kaewpornsawan, Perajit Eamsobhana
BACKGROUND: Large bone defect is a challenging problem in orthopedics practice. Several methods are available for bridging of these bone defects, including cancellous bone graft, free vascularized fibula graft, and bone transport with external ring fixator. The aim of this study was to describe our experience in nine pediatric cases of free non-vascularized autogenous fibular strut bone graft in which large bone defect and bone loss of >7 cm was caused by open fracture and infective nonunion around the elbow joint...
April 9, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28391431/sclerostin-antibody-increases-callus-size-and-strength-but-does-not-improve-fracture-union-in-a-challenged-open-rat-fracture-model
#7
Alyson Morse, Michelle M McDonald, Aaron Schindeler, Lauren Peacock, Kathy Mikulec, Tegan L Cheng, Min Liu, Hua Zhu Ke, David G Little
Open fractures remain a challenge in orthopedics. Current strategies to intervene are often inadequate, particularly in severe fractures or when treatment is delayed. Sclerostin is a negative regulator of bone growth and sclerostin-neutralizing antibodies (Scl-Ab) can increase bone mass and strength. The application of these antibodies to improve orthopedic repair has shown varied results, and may be dependent on the location and severity of the bony injury. We examined Scl-Ab treatment within an established rat osteotomy model with periosteal stripping analogous to open fracture repair...
April 8, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/28385655/incidence-and-risk-factors-for-surgical-site-infection-after-open-reduction-and-internal-fixation-of-tibial-plateau-fracture-a-systematic-review-and-meta-analysis
#8
REVIEW
Jiashen Shao, Hengrui Chang, Yanbin Zhu, Wei Chen, Zhanle Zheng, Huixin Zhang, Yingze Zhang
BACKGROUND: This study aimed to quantitatively summarize the risk factors associated with surgical site infection after open reduction and internal fixation of tibial plateau fracture. METHODS: Medline, Embase, CNKI, Wanfang database and Cochrane central database were searched for relevant original studies from database inception to October 2016. Eligible studies had to meet quality assessment criteria according to the Newcastle-Ottawa Scale, and had to evaluate the risk factors for surgical site infection after open reduction and internal fixation of tibial plateau fracture...
April 4, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28377261/an-inception-cohort-analysis-to-predict-nonunion-in-tibia-and-17-other-fracture-locations
#9
Robert Zura, J Tracy Watson, Thomas Einhorn, Samir Mehta, Gregory J Della Rocca, Ze Xiong, Zhe Wang, John Jones, R Grant Steen
INTRODUCTION: The epidemiology of fracture nonunion has been characterized so it is potentially possible to predict nonunion using patient-related risk factors. However, prediction models are currently too cumbersome to be useful. We test a hypothesis that nonunion can be predicted with ≤10 variables, retaining the predictive accuracy of a full model with 42 variables. METHODS: We sought to predict nonunion with prospectively-acquired inception cohort data for 18 different bones, using the smallest possible number of variables that did not substantially decrease prediction accuracy...
March 27, 2017: Injury
https://www.readbyqxmd.com/read/28365071/trochanteric-entry-femoral-nails-yield-better-femoral-version-and-lower-revision-rates-a-large-cohort-multivariate-regression-analysis
#10
Richard S Yoon, Mark J Gage, David K Galos, Derek J Donegan, Frank A Liporace
INTRODUCTION: Intramedullary nailing (IMN) has become the standard of care for the treatment of most femoral shaft fractures. Different IMN options include trochanteric and piriformis entry as well as retrograde nails, which may result in varying degrees of femoral rotation. The objective of this study was to analyze postoperative femoral version between three types of nails and to delineate any significant differences in femoral version (DFV) and revision rates. MATERIALS & METHODS: Over a 10-year period, 417 patients underwent IMN of a diaphyseal femur fracture (AO/OTA 32A-C)...
March 18, 2017: Injury
https://www.readbyqxmd.com/read/28362519/salvage-of-combat-hindfoot-fractures-in-2003-2014-uk-military
#11
Philippa M Bennett, Thomas Stevenson, Ian D Sargeant, Alistair Mountain, Jowan G Penn-Barwell
BACKGROUND: Hindfoot fractures pose a considerable challenge to military orthopaedic surgeons, as combat injuries are typically the result of energy transfers not seen in civilian practice. This study aimed to characterize the pattern of hindfoot injuries sustained by UK military casualties in recent conflicts, define the early amputation and infection rate, and identify factors associated with poor early outcomes. METHODS: The UK Joint Theatre Trauma Registry was searched for British military casualties sustaining a hindfoot fracture from Iraq and Afghanistan between 2003 and 2014...
March 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28351609/orthoplastic-surgical-collaboration-is-required-to-optimise-the-treatment-of-severe-limb-injuries-a-multi-centre-prospective-cohort-study
#12
Filippo Boriani, Ata Ul Haq, Tommaso Baldini, Roberto Urso, Donatella Granchi, Nicola Baldini, Domenico Tigani, Moazzam Tarar, Umraz Khan
Open fractures are severe, complex, limb-threatening and high-energy injuries, often involving lesions of both bone and soft tissues. Traditionally, treatment has been piecemeal by orthopaedic and plastic surgeons. This study aimed to prospectively investigate whether combining orthopaedic and plastic surgery in treating these injuries is more effective than the conventional orthopaedic care. A prospective multi-centre cohort study was conducted. Differences in the type of approach to severe limb trauma allowed a comparison between combined orthoplastic and traditional exclusively orthopaedic treatment...
February 28, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28351547/the-road-to-union-protocol-for-the-reconstruction-of-isolated-complex-high-energy-tibial-trauma
#13
Erik Hohmann, Franz Birkholtz, Vaida Glatt, Kevin Tetsworth
INTRODUCTION: The purpose of this study was to describe a standardized staged approach, "The Road to Union", for the reconstruction of isolated complex tibial trauma, both acute and chronic in nature. METHODS: This retrospective study included all patients treated for complex tibial trauma at a specialized limb reconstruction centre, including acute open fracture as well as infected and aseptic non-unions. This standardized approach includes eight specific steps, employed in sequence...
March 18, 2017: Injury
https://www.readbyqxmd.com/read/28344521/timing-of-debridement-and-infection-rates-in-open-fractures-of-the-hand-a-systematic-review
#14
REVIEW
Constantinos Ketonis, Joseph Dwyer, Asif M Ilyas
Background: Literature on open fracture infections has focused primarily on long bones, with limited guidelines available for open hand fractures. In this study, we systematically review the available hand surgery literature to determine infection rates and the effect of debridement timing and antibiotic administration. Methods: Searches of the MEDLINE, EMBASE, and Cochrane computerized literature databases and manual bibliography searches were performed. Descriptive/quantitative data were extracted, and a meta-analysis of different patient cohorts and treatment modalities was performed to compare infection rates...
March 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28341102/bicolumnar-90-90-plating-of-ao-13c-type-fractures
#15
Cemal Kural, Ersin Ercin, Mehmet Erkilinc, Evren Karaali, Mustafa Gokhan Bilgili, Suleyman Altun
OBJECTIVE: The aim of this study was to evaluate functional results and complication rate of patients who underwent medial-dorsolateral plating for intra-articular distal humeral fracture (Müller AO type 13C). METHODS: Twenty-four patients (14 men, 10 women; mean age: 47 years) with AO type 13C distal humerus fracture were included in the study. Mean follow-up time was 28 months. Nine patients were in 13C1 subgroup, according to AO classification system, 11 patients were categorized as 13C2, and 4 patients were 13C3...
March 21, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28336040/the-impact-of-negative-pressure-wound-therapy-on-orthopaedic-infection
#16
REVIEW
Lawrence X Webb
By hastening the resolution of edema and improving local microcirculation, topical negative pressure wound therapy (TNP) aids the establishment of early wound coverage. Its use in the setting of type III open fractures is reviewed. The author's initial use of TNP for closed surgical incisions and how it morphed its way into being applied to closed surgical wounds with heightened likelihood for infection is presented. Several case studies are presented to illustrate the role and the technique for management of acute or subacute infections involving bone and implant...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28336038/role-of-systemic-and-local-antibiotics-in-the-treatment-of-open-fractures
#17
REVIEW
David C Carver, Sean B Kuehn, John C Weinlein
The orthopedic community has learned much about the treatment of open fractures from the tremendous work of Ramon Gustilo, Michael Patzakis, and others; however, open fractures continue to be very difficult challenges. Type III open fractures continue to be associated with high infection rates. Some combination of systemic and local antibiotics may be most appropriate in these high-grade open fractures. Further research is still necessary in determining optimal systemic antibiotic regimens as well as the role of local antibiotics...
April 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28323803/patient-response-to-an-integrated-orthotic-and-rehabilitation-initiative-for-traumatic-injuries-the-prioriti-mtf-study
#18
Joseph R Hsu, Johnny G Owens, Jennifer DeSanto, John R Fergason, Kevin M Kuhn, Benjamin K Potter, Daniel J Stinner, Robert G Sheu, Sandra L Waggoner, Jason M Wilken, Yanjie Huang, Daniel O Scharfstein, Ellen J MacKenzie
Although limb salvage is now possible for many high-energy open fractures and crush injuries to the distal tibia, ankle, hindfoot, and midfoot, orthotic options are limited. The Intrepid Dynamic Exoskeletal Orthosis (IDEO) is a custom, energy-storing carbon fiber orthosis developed for trauma patients undergoing limb salvage. The IDEO differs from other orthoses in that it allows patients with ankle weakness to have more normal ankle biomechanics and increased ankle power. This article describes the design of a study to evaluate the effectiveness of the IDEO when delivered together with a high-intensity, sports medicine-based approach to rehabilitation...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28320508/staged-minimally-invasive-plate-osteosynthesis-of-proximal-tibial-fractures-with-acute-compartment-syndrome
#19
Joon-Woo Kim, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Kyeong-Hyeon Park, Hee-June Kim, Jae-Wook Jung, Young-Soo Jung
PURPOSE: High-energy proximal tibial fractures often accompany compartment syndrome and are usually treated by fasciotomy with external fixation followed by secondary plating. However, the initial soft tissue injury may affect bony union, the fasciotomy incision or external fixator pin sites may lead to postoperative wound infections, and the staged procedure itself may adversely affect lower limb function. We assess the results of staged minimally invasive plate osteosynthesis (MIPO) for proximal tibial fractures with acute compartment syndrome...
March 11, 2017: Injury
https://www.readbyqxmd.com/read/28303656/incidence-and-risks-for-surgical-site-infection-after-adult-tibial-plateau-fractures-treated-by-orif-a-prospective-multicentre-study
#20
Yanbin Zhu, Song Liu, Xiaolin Zhang, Wei Chen, Yingze Zhang
Tibial plateau fractures are difficult to treat and more likely complicated by subsequent surgical site infection (SSI). There is limited information about its characteristics and related risk factors for SSI. This study was designed as a prospective and multicentre one to address this issue. From July to 15 November in 2014, 235 patients with tibial plateau fractures were treated by open reduction and internal fixation (ORIF) and followed up with complete data. Twelve patients (5·1%, 12/235) developed SSI, with 2·1% for deep SSI and 3·0% for superficial SSI...
March 16, 2017: International Wound Journal
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