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https://www.readbyqxmd.com/read/28101590/-minimally-invasive-treatment-of-intra-articular-calcaneal-fractures-with-the-2%C3%A2-point-distractor
#1
G Mattiassich, W Litzlbauer, M Ponschab, R Ortmaier, C Rodemund
OBJECTIVE: Open treatment of calcaneus fractures often has an increased risk of wound healing. Minimally invasive treatment with small incisions reduces complications. INDICATIONS: Calcaneal fractures with malalignment/comminution >1-2 mm; broadening, varus alignment of the calcaneal length axis or shortening; emergency surgery for open fractures or compartment syndrome. CONTRAINDICATIONS: Local or general contraindications. SURGICAL TECHNIQUE: Standardised positioning; restoration of length/axis with 2‑point distractor under fluoroscopic control...
January 18, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28087118/open-lower-limb-fractures-in-major-trauma-centers-a-loss-leader
#2
Elizabeth K Tissingh, Arman Memarzadeh, Joseph Queally, Peter Hull
PURPOSE: Open lower limb fractures are resource intensive injuries. Regardless of the financing model, the cost of treatment is an important consideration for any healthcare provider. METHODS: Open lower limb fractures treated at our centre were identified over a six-month period. Isolated open femur or tibia fractures were included as well as cases with multiple fractures. Direct inpatient care costs were calculated and income was reviewed for each case according to 'Healthcare Resource Group' (HRG) cost codes...
December 28, 2016: Injury
https://www.readbyqxmd.com/read/28075437/comparison-of-irrigation-times-using-gravity-and-high-pressure-lavage
#3
Stefano Muscatelli, Andrea Howe, Nathan N O'Hara, Robert V O'Toole, Sheila A Sprague, Gerard P Slobogean
The benefits of high-pressure pulsatile lavage for open fracture irrigation have been controversial based on conflicting experimental animal research. Recently published data definitively demonstrated that irrigation pressure does not affect the incidence of reoperation for the treatment of open fractures. However, proponents of pulsatile lavage argue a faster irrigation time is an important benefit of the high-pressure treatment. The purpose of this study was to determine the difference in irrigation time between gravity and high-pressure lavage...
January 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28063676/early-predictors-for-massive-transfusion-in-older-adult-severe-trauma-patients
#4
Takao Ohmori, Taisuke Kitamura, Junko Ishihara, Hirokazu Onishi, Tsuyoshi Nojima, Kotaro Yamamoto, Ryu Tamura, Kentaro Muranishi, Toshiyuki Matsumoto, Takamitsu Tokioka
BACKGROUND: Many scoring systems for the early prediction of the need for massive transfusion (MT) have been reported; in most of these, vital signs are regarded as important. However, the validity of these scoring systems in older patients remains unclear because older trauma patients often present with normal vital signs. In this study, we investigated the effectiveness of previously described scoring systems, as well as risk factors that can provide early prediction of the need for MT in older severe trauma patients...
December 29, 2016: Injury
https://www.readbyqxmd.com/read/28057476/operative-treatment-of-early-infection-after-internal-fixation-of-limb-fractures-exclusive-of-severe-open-fractures
#5
REVIEW
P Bonnevialle
Early infection after open reduction and internal fixation (ORIF) of a limb bone is defined as bacteriologically documented, deep and/or superficial surgical-site infection (SSI) diagnosed within 6months after the surgical procedure. This interval is arbitrarily considered sufficient to obtain fracture healing. The treatment of early infection after ORIF should be decided by a multidisciplinary team. The principles are the same as for revision arthroplasty. Superficial SSIs should be differentiated from deep SSIs, based on the results of bacteriological specimens collected using flawless technique...
January 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28043849/clavicle-fractures
#6
REVIEW
M Ropars, H Thomazeau, D Huten
Management of clavicle fracture has progressed over the last decade, notably with wider use of surgery in midshaft fracture, and new techniques for lateral fracture. Midshaft clavicle fracture treatment needs to be personalized and adapted to the patient's activity level. Whichever the segment involved, treatment for non-displaced fracture is functional; elbow-to-body sling immobilization seems the best tolerated. Apart from regular surgical indications (shoulder impaction, floating shoulder, open fracture or fracture with neurovascular complications), surgery is recommended in case of bone shortening exceeding 1...
December 30, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28040299/reimplantation-of-a-large-extruded-segment-of-bone-in-an-open-fracture
#7
REVIEW
Ahmadreza Afshar
Replacing an extruded segment of bone in an open fracture imposes a challenging decision concerning the best and safest patient management. There are numerous advantages to restoring the patient's own extruded bone segment to its original location, particularly when the bone segment is of structural importance. However, reimplantation of contaminated and avascular extruded bone segments can potentially result in serious infection or nonunion. There is no conclusive evidence regarding the best decontamination protocol for the safest use of the recovered bone segment as an autologous graft...
December 28, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28040088/restoration-of-long-bone-defects-treated-with-the-induced-membrane-technique-protocol-and-outcomes
#8
Peter V Giannoudis, Paul J Harwood, Theodoros Tosounidis, Nikolaos K Kanakaris
This prospective study was undertaken at a regional tertiary referral centre to evaluate the results of treatment of bone defects managed with the induced membrane (IM) technique. Inclusion criteria were patients with bone defects secondary to septic non-union, chronic osteomyelitis and acute fracture with bone loss. Pathological fractures with bone loss were excluded. Data collection included patient demographics, pathology, previous surgical intervention, size of bone defect, type of graft implanted, time-to-union and complications/reinterventions...
December 2016: Injury
https://www.readbyqxmd.com/read/28040085/upper-limb-non-unions-treated-with-bmp-7-efficacy-and-clinical-results
#9
Rahul Singh, Sabri Bleibleh, Nikolaos K Kanakaris, Peter V Giannoudis
The management of upper limb non-unions can be challenging and often with unpredictable outcomes. In this study we present our experience with the use of BMP-7 in the treatment of upper limb non-unions. Between 2004 and 2011 all consecutive patients who were treated with BMP-7 were followed up prospectively until fracture union. Fracture union was assessed with regular radiological and clinical assessment. At the final follow up clinical assessment included the short Disabilities of the Arm, Shoulder and Hand (DASH) score...
December 2016: Injury
https://www.readbyqxmd.com/read/28040084/do-skeletal-muscle-mscs-in-humans-contribute-to-bone-repair-a-systematic-review
#10
Heather Owston, Peter V Giannoudis, Elena Jones
Mesenchymal stem cells (MSC) from bone marrow and periosteum are known to be heavily involved in fracture repair and bone regeneration is thought to be impaired when the surrounding skeletal muscle is damaged. Recent literature from mouse in vivo models suggest that cells originating from skeletal muscle can occupy a fracture callus during open fracture repair when periosteum is compromised. This systematic review set out to ascertain whether there are MSCs residing in human skeletal muscle and whether cells from human skeletal muscle are capable of forming bone in vitro and in vivo...
December 2016: Injury
https://www.readbyqxmd.com/read/28040079/prevalence-and-risk-factors-for-re-interventions-following-reamed-intramedullary-tibia-nailing
#11
Petros Z Stavrou, Vincenzo Ciriello, Stylianos Theocharakis, Suribabu Gudipati, Theodoros H Tosounidis, Nikolaos K Kanakaris, Peter V Giannoudis
INTRODUCTION: This study aimed to identify the prevalence and the risk factors for re-interventions following reamed intramedullary nailing (IMN) of tibial shaft fractures. PATIENTS AND METHODS: We retrospectively analysed a prospectively populated data of adult patients that underwent reamed intramedullary nailing for stabilization of tibial shaft fractures over a period of three years. Exclusion criteria were immature patients, pathological and periarticular fractures...
December 2016: Injury
https://www.readbyqxmd.com/read/28026722/non-union-in-upper-limb-fractures-clinical-evaluation-and-treatment-options
#12
M V Neumann, J Zwingmann, M Jaeger, T O Hammer, N P Südkamp
Although non-unions in the upper limb are rare different treatment options of this challenging situation are still affected with up to 20% of failure rate due to current literature. Risk factors for delayed and non-union of fractures are mainly the size of the fracture gap and bone loss of open fractures or in primary surgery followed by other relevant internal and external factors. In the upper limb non-unions of long bones are described with up to 30% after operative intervention. Especially in the upper limb range of motion is limited in non-union cases and disables adjacent joints like the shoulder, elbow and wrist hence reducing the total activity level of affected patients...
2016: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28018071/reimplantation-of-contaminated-extruded-segment-of-lateral-femoral-condyle-cleansed-with-10-povidine-iodine-in-complex-floating-knee-injury-with-excellent-outcome-case-report-with-2-year-follow-up
#13
Prahalad Kumar Singhi, R Sivakumar, V Somashekar, Vinayak Kusabi, T Vinoth
Traumatic extrusion of bone is a rare complication of high energy open fractures, and there are only few studies published in literature on reimplantation of the extruded bone segment. Studies with clear guidelines regarding timing of reimplantation, stabilisation of extruded bone segments, bone disinfection and disinfection techniques are very few. Previous reports describe disinfection using thermal or chemical methods. We present a case scenario of successful reimplantation of an extruded metaphyseal segment of distal femoral condyle following cleaning with copious saline and soaked in 10% povidine-iodine for 20 min in a 21 year old male patient of a complex floating knee injury with excellent outcome based on Karlstrom and Olerud criteria...
October 2016: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/27987018/-osteosynthesis-of-distal-fibular-fractures-with-illuminoss-video-article
#14
M Zyskowski, M Crönlein, E Heidt, P Biberthaler, C Kirchhoff
OBJECTIVE: The aim was minimally invasive osteosynthesis of a distal fibular fracture under the premises of poor soft tissue conditions and existing chronic comorbidities to enable rapid recovery and to reduce soft tissue stress in order to avoid postoperative infections and achieve early weight bearing. INDICATIONS: This involved a distal fibula fracture, classified as 44 B1.1, B1.2, B1.3 according to the working group for osteosynthesis (AO) or a B fracture after Danis and Weber with indications for surgery (cortical disruption and shaft offset > 5 mm), age > 65 years, poor soft tissue conditions and a Charlson score ≥ 1...
January 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/27984446/primary-wound-closure-after-open-fracture-a-prospective-cohort-study-examining-non-union-and-deep-infection
#15
Angela V Scharfenberger, Khaled Alabassi, Stephanie Smith, Donald Weber, Sukhdeep K Dulai, Joseph W Bergman, Lauren A Beaupre
OBJECTIVES: Determine the proportion of subjects developing deep infection or non-union following primary wound closure of open fractures (humerus, radius/ulna, femur, tibia/fibula). Secondarily, a matched-series analysis compared outcomes with subjects who underwent delayed wound closure. DESIGN: Prospective cohort between 2009 and 2013 of subjects undergoing primary closure. SETTING: Trauma centre PARTICIPANTS:: 83 (84 fractures) subjects were enrolled...
November 16, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27974929/crushing-injuries-of-the-foot-and-ankle-with-complex-open-fractures-result-of-a-prospective-study-with-a-3-year-follow-up
#16
Edelstein DA, Florescu I
The objective of this study was to determine the compared results of both the reconstruction surgery and the amputation in severe crushing of the foot, which led to open fractures. The type of study. Prospective. Background. Two major trauma hospitals (Floreasca Clinical Emergency Hospital and "Bagdasar Arseni" Clinical Emergency Hospital) from the university center in Bucharest. Patients. 21 patients, who sustained crushing of the foot with resulting Gustilo type III open fractures, were involved. The exclusion criteria were represented by open fractures that had very gross destructions of the neurovascular bundle, for which the amputation was the only solution, with no modality to reconstruct whatsoever...
July 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27969550/characterizing-flow-pathways-in-a-sandstone-aquifer-tectonic-vs-sedimentary-heterogeneities
#17
G Medici, L J West, N P Mountney
Sandstone aquifers are commonly assumed to represent porous media characterized by a permeable matrix. However, such aquifers may be heavy fractured when rock properties and timing of deformation favour brittle failure and crack opening. In many aquifer types, fractures associated with faults, bedding planes and stratabound joints represent preferential pathways for fluids and contaminants. In this paper, well test and outcrop-scale studies reveal how strongly lithified siliciclastic rocks may be entirely dominated by fracture flow at shallow depths (≤180m), similar to limestone and crystalline aquifers...
September 24, 2016: Journal of Contaminant Hydrology
https://www.readbyqxmd.com/read/27938394/complications-after-surgical-management-of-distal-lower-leg-fractures
#18
Mirjam V Neumann, Peter C Strohm, Kilian Reising, Joern Zwingmann, Thorsten O Hammer, Norbert P Suedkamp
BACKGROUND: Osseous healing of distal lower leg fractures can be prolonged and is often associated with wound healing problems because of the marginal soft - tissue and vascular supply in this area. Postoperative complications are frequent, and according to the literature, open reduction and plate fixation is thought to be associated with higher complication rates. The objective of this study was to evaluate the most common postoperative complications following intramedullary nailing or plate osteosynthesis of distal lower leg injuries with a focus on combined tibio-fibular fractures...
December 9, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/27929693/use-of-recycled-external-fixators-in-management-of-compound-injuries
#19
Swagat Mahapatra, Nandakumar Rengarajan
BACKGROUND: Compound fractures form a bulk of Orthopaedic Trauma cases in a developing country like India. External Fixation devices are the mainstays of treatment of these open fractures. They are generally used as a one use disposable device and add a great burden to the health care costs, especially in a developing country. In our study we evaluated the efficacy and complication rate of recycled external fixators with that of new external fixators. MATERIALS AND METHODS: This was a prospective randomised interventional study conducted in a tertiary care teaching hospital of a developing country...
January 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/27917816/effect-of-ankaferd-blood-stopper-on-muscle-healing
#20
Murat Uygun, Osman Y Yavuz, İsmail Uraş, İbrahim G Duman, Hacer Haltaş, Mahmut Kömürcü
PURPOSE: Ankaferd Blood Stopper (ABS), which is a standardized mixture of herbal extracts obtained from five plants, has been proven as an efficient hemostatic agent and is still used in emergency situations. It is not known exactly if decreased bleeding has positive or negative effects on muscle healing and fibrosis, so the purpose of this study was to test the effect of ABS on muscle healing and morphology. METHODS: A total of 66 outbred Wistar rats were divided into three control and three experimental subgroups...
December 1, 2016: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
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