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https://www.readbyqxmd.com/read/29203201/combat-related-acetabular-fractures-outcomes-of-open-versus-closed-injuries
#1
Richard L Purcell, Michael A Donohue, Sameer K Saxena, Wade T Gordon, Louis L Lewandowski
INTRODUCTION: Since the onset of the Global War on Terror close to 50,000 United States service members have been injured in combat, many of these injuries would have previously been fatal. Among these injuries, open acetabular fractures are at an increased number due to the high percentage of penetrating injuries such as high velocity gunshot wounds and blast injuries. These injuries lead to a greater degree of contamination, and more severe associated injuries. There is a significantly smaller proportion of the classic blunt trauma mechanism typically seen in civilian trauma...
December 1, 2017: Injury
https://www.readbyqxmd.com/read/29201204/a-rabbit-model-of-implant-related-osteomyelitis-inoculated-with-biofilm-after-open-femoral-fracture
#2
Xiang Zhang, Yun-Fei Ma, Lei Wang, Nan Jiang, Cheng-He Qin, Yan-Jun Hu, Bin Yu
Currently, animal models used in research on implant-associated osteomyelitis primarily use intramedullary fixation and initial inoculum of planktonic bacterial cells. However, these techniques have certain limitations, including lack of rotational stability and instable inoculation. To improve these models, the present study aimed to establish a novel rabbit model of implant-associated osteomyelitis using biofilm as the initial inoculum following plate fixation of the femoral fracture. A total of 24 New Zealand White rabbits were randomly divided into two equal groups...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29200488/a-newly-designed-intramedullary-nail-for-the-treatment-of-diaphyseal-forearm-fractures-in-adults
#3
Ibrahim Azboy, Abdullah Demirtaş, Celil Alemdar, Mehmet Gem, Kadir Uzel, Huseyin Arslan
Background: The treatment of diaphyseal forearm fractures using open reduction and plate fixation is generally accepted as the best choice in many studies. However, periosteal stripping, haematoma evacuation may result in delayed union, nonunion and infection. Refracture after plate removal is another concern. To overcome these problems intramedullary nails (IM) with different designs have been used with various outcomes. However previous IM nails have some shortcomings such is rotational instability and interlocking difficulties...
November 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29192344/pulseless-supracondylar-humeral-fractures-in-children-vascular-complications-in-a-ten%C3%A2-year-series
#4
Adeline Cambon-Binder, Pascal Jehanno, Laurent Tribout, Philippe Valenti, Anne-Laure Simon, Brice Ilharreborde, Keyvan Mazda
PURPOSE: The management of pulseless supracondylar fractures remains controversial. The aims of this study were to: (1) analyse functional and vascular outcomes of conservative treatment for cases with absent pulse before reduction, whether patients showed limb ischaemia or not; and (2) identify factors associated with vascular complications. METHODS: Twenty-seven children with absent pulses on presentation were treated consecutively between 1999 and 2009. The brachial artery was surgically explored in cases of persistent signs of ischaemia after reduction...
November 30, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29182126/a-comparison-of-ketamine-sedation-and-general-anaesthesia-for-manipulation-of-paediatric-forearm-fractures
#5
R W Jordan, A Aquilina, D J Westacott, S Cooke
The purpose of the study was to compare the use of ketamine sedation and general anaesthesia for manipulation of paediatric wrist and forearm fractures. A retrospective analysis was performed of patients under 16 years treated at our centre between October 2014 and October 2015. Exclusion criteria were open fractures and fractures with complete displacement. Outcomes measured were fracture reduction, the quality of the cast, fracture redisplacement, further surgical intervention and use of theatre time. 66 children were manipulated over the study period; 31 received ketamine sedation and 35 general anaesthesia...
December 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29169601/antibiotic-management-and-operative-debridement-in-open-fractures-of-the-hand-and-upper-extremity-a-systematic-review
#6
REVIEW
William J Warrender, Christopher J Lucasti, Talia R Chapman, Asif M Ilyas
Open fractures of the hand are thought to be less susceptible to infection than other open fractures because of the increased blood supply to the area. Current evidence for all open fractures shows that antibiotic use and the extent of contamination are predictive of infection risk, but time to debridement is not. We reviewed in a systematic review the available literature on open fractures of the hand and upper extremity to determine infection rates based on the timing of debridement and antibiotic administration...
February 2018: Hand Clinics
https://www.readbyqxmd.com/read/29169591/radial-nerve-palsy-after-humeral-shaft-fractures-the-case-for-early-exploration-and-a-new-classification-to-guide-treatment-and-prognosis
#7
REVIEW
Gerard Chang, Asif M Ilyas
Radial nerve palsies are a common complication associated with humeral shaft fractures. The authors propose classifying these injuries into 4 types based on intraoperative findings: type 1 stretch/neuropraxia, type 2 incarcerated, type 3 partial transection, and type 4 complete transection. The initial management of radial nerve palsies associated with closed fractures of the humerus remains a controversial topic, with early exploration reserved for open fractures, fractures that cannot achieve an adequate closed reduction requiring fracture repair, fractures with associated vascular injuries, and polytrauma patients...
February 2018: Hand Clinics
https://www.readbyqxmd.com/read/29169590/open-fractures-of-the-hand-review-of-pathogenesis-and-introduction-of-a-new-classification-system
#8
REVIEW
Jacob E Tulipan, Asif M Ilyas
Open fractures of the hand are a common and varied group of injuries. Although at increased risk for infection, open fractures of the hand are more resistant to infection than other open fractures. Numerous unique factors in the hand may play a role in the altered risk of postinjury infection. Current systems for the classification of open fractures fail to address the unique qualities of the hand. This article proposes a novel classification system for open fractures of the hand, taking into account the factors unique to the hand that affect its risk for developing infection after an open fracture...
February 2018: Hand Clinics
https://www.readbyqxmd.com/read/29158651/soft-tissue-complications-in-distal-tibial-fractures-managed-with-medial-locking-plates-a-myth-or-reality
#9
Deepak Jain, Harpal Singh Selhi, Mohammad Yamin, Pankaj Mahindra
Background: Distal tibial fractures are common injuries that are prone to complications and require careful management. The use of medial periarticular locking plates is an established modality in the treatment if these fractures. These plates are inserted using the minimally invasive plate osteosynthesis (MIPO) or open technique. Our study looks at the soft tissue complications associated with the use of medial locking plates in the management of these fractures. Methods: This was a retrospective study carried out at a tertiary care university hospital in an urban setting...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29153449/the-changing-epidemiology-of-open-fractures-in-vehicle-occupants-pedestrians-motorcyclists-and-cyclists
#10
Dennis Winkler, Stuart T Goudie, Charles M Court-Brown
AIMS: To investigate the changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists. MATERIALS AND METHODS: Data on all non-spinal open fractures admitted to the Royal Infirmary of Edinburgh after a road traffic accident between 1988 and 2010 were collected and analysed to provide information about the changing epidemiology in different patient groups. Demographic information was collected on all patients with the severity of injury being analysed with the Injury Severity Score (ISS), Musculoskeletal Index (MSI) and the number of open fractures...
November 14, 2017: Injury
https://www.readbyqxmd.com/read/29136444/effect-of-locking-plate-fixation-vs-intramedullary-nail-fixation-on-6-month-disability-among-adults-with-displaced-fracture-of-the-distal-tibia-the-uk-fixdt-randomized-clinical-trial
#11
Matthew L Costa, Juul Achten, James Griffin, Stavros Petrou, Ian Pallister, Sarah E Lamb, Nick R Parsons
Importance: The best treatment for fractures of the distal tibia remains controversial. Most such fractures require surgical fixation but outcomes are unpredictable and complications are common. Objective: To assess disability, quality of life, and complications in patients with displaced tibial fracture treated with intramedullary nail fixation vs locking plate fixation. Design, Setting, and Participants: A multicenter randomized trial recruiting 321 patients 16 years or older with an acute, displaced, extra-articular fracture of the distal tibia from April 2013 through April 2016 with final follow-up in February 2017...
November 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29107555/forearm-diaphyseal-fractures-in-children-intramedullary-kirschner-s-wire-fixation-treatment
#12
M Mahecha-Toro, E Vergara-Amador, M González Ramírez
INTRODUCTION: Diaphyseal fractures of the forearm comprise 6%-10% of all fractures in children. The treatment depends on the age and type of displacement, and conservative and surgical management with fixation of intramedullary nails, among other techniques, is valid. The aim is to show the radiological and functional outcomes, and complications of intramedullary fixation with Kirschner nails in children. MATERIALS AND METHODS: A retrospective descriptive case series of patients treated with intramedullary fixation of forearm fractures...
October 26, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29098965/orthopedic-injuries-in-pediatric-trauma
#13
Eman Loubani, Rodrick Lim, Debra Bartley
Trauma remains the leading cause of death in children, of which the majority of patients have orthopedic injuries. The range of injured bones is various, each requiring knowledge and expertise to appropriately manage in a timely fashion. The importance of a systematic approach to the pediatric polytrauma patient is paramount. This chapter will highlight orthopedic issues important to the pediatric polytrauma patient including the unique anatomy and properties of pediatric bone. A systematic approach to the pediatric polytrauma patient will also be discussed...
September 11, 2017: Current Pediatric Reviews
https://www.readbyqxmd.com/read/29079370/impact-of-an-emergency-medicine-pharmacist-on-initial-antibiotic-prophylaxis-for-open-fractures-in-trauma-patients
#14
Somer Harvey, A Brad Hall, Kayla Wilson
BACKGROUND: Targeted antibiotic treatment reduces the infection risk of open fractures when soft tissue and bone are exposed to the environment. The risk of infection increases with higher degrees of injury. The Gustilo-Anderson system was developed to identify the degree of injury of open fractures and can be utilized to guide initial antibiotic therapy. Few studies have been published evaluating the potential impact of emergency medicine pharmacists in trauma, and currently no study has evaluated a pharmacist's influence on antibiotic selection and timing for open fractures...
October 17, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29078226/soft-tissue-coverage-in-distal-lower-extremity-open-fractures-comparison-of-free-anterolateral-thigh-and-free-latissimus-dorsi-flaps
#15
Cécile Philandrianos, Pierre Moullot, André M Gay, Baptiste Bertrand, Régis Legré, Nathalie Kerfant, Dominique Casanova
No abstract text is available yet for this article.
October 27, 2017: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29065899/upper-extremity-open-fractures-in-hospitalized-road-traffic-accident-patients-adult-versus-pediatric-cases
#16
Guy Rubin, Kobi Peleg, Adi Givon, Nimrod Rozen
BACKGROUND: Fractures in pediatrics show epidemiological characteristics which are different from fractures in adults. The objective of this study was to examine the injury profiles of open upper extremity fractures (UEFs) in all modes of injury related to road traffic accidents (RTAs) in adult and pediatric hospitalized patients. METHODS: Data on 103,465 RTA patients between 1997 and 2013 whose records were entered in a centralized country trauma database were reviewed...
October 24, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29062818/infection-rate-in-adult-patients-with-open-fractures-treated-at-the-emergency-hospital-and-at-the-ulbra-university-hospital-in-canoas-rio-grande-do-sul-brazil
#17
Marcelo Teodoro Ezequiel Guerra, Fernando Machado Gregio, Adriane Bernardi, Cyntia Cordeiro de Castro
OBJECTIVE: To identify the infection rate in adult patients with open fractures treated at two tertiary hospitals in the city of Canoas, Rio Grande do Sul, Brazil. METHODS: This quantitative descriptive study was conducted at Hospital de Pronto Socorro de Canoas. Eligible participants were adults aged 18-60 years with open fractures who were admitted to the orthopedic trauma service from January to May 2014 and followed-up for one year. RESULTS: A total of 133 patients with open fractures were included; most were men (92...
September 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/29062214/analysis-of-the-variables-affecting-outcome-in-fractures-of-the-tibial-pilon-treated-by-open-reduction-and-internal-fixation
#18
Rafael Carbonell-Escobar, Juan C Rubio-Suarez, Aitor Ibarzabal-Gil, E Carlos Rodriguez-Merchan
OBJECTIVE: To assess variables that could be related to outcomes in fractures of the tibial pilon treated by open reduction and internal fixation (ORIF). DESIGN: Retrospective. SETTING: University Hospital. PATIENTS: A total 92 fractures of the tibial pilon treated by ORIF in a 5-year period. The minimum follow-up was 1 year (mean: 3.3 years; range: 1-5). INTERVENTION: ORIF with LCP-LISS plate...
October 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29053543/decreased-time-to-antibiotic-prophylaxis-for-open-fractures-at-a-level-one-trauma-center
#19
Joey P Johnson, Avi D Goodman, Adam M Haag, Roman A Hayda
OBJECTIVE: To determine whether time to administration of antibiotics decreased after the implementation of an open fracture working group and antibiotic prophylaxis protocol. DESIGN: Retrospective cohort study. SETTING: One Level 1 Trauma Center. PATIENTS: Patients 18 years of age and older who sustained an open fracture and presented directly to our emergency department. INTERVENTION: Prompt irrigation and debridement in the operating room and fracture stabilization dictated by the treating surgeon...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053497/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-phalangeal-fracture-pearls-and-pitfalls
#20
Joshua M Abzug, Charles T Mehlman
Pediatric phalangeal fractures are extremely common, especially among toddlers and older children/adolescents involved in sporting activities. The physical examination must include an assessment for deviation and malrotation. In addition, concomitant injuries must be assessed for such as tendon and/or neurovascular injuries. Plain radiographs are typically sufficient to make the diagnosis and determine the treatment. The majority of pediatric and adolescent phalangeal fractures can be treated with immobilization...
November 2017: Journal of Orthopaedic Trauma
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