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Fracture + healing

Jennifer Kurowicki, Enesi Momoh, Jonathan C Levy
Periprosthetic humerus fractures are relatively uncommon occurrence that can be difficult to manage nonoperatively. Locking plate technology has enhanced the surgical management of these fractures. However, adequate fixation around the stem remains of some concern. We describe an osteosynthesis technique using a locking plate utilizing eccentrically placed screw holes to place "skive screws" in the proximal end of the plate to achieve fixation around the stem of the implant. A clinical series of 5 consecutive patients treated with this technique is presented with an average follow-up of 29 months (range, 12-48)...
November 2016: Journal of Orthopaedic Trauma
Heather A Vallier
Displaced distal tibia shaft fractures are effectively treated with standard plates and intramedullary nails. Plate fixation performed with meticulous soft tissue handling results in minimal risks of infection and poor wound healing. Standard plates have high rates of primary union, whereas locking plates may delay union because of increased stiffness. Tibial healing may also be delayed after plating of the fibula, although fibula reduction and fixation may aid accuracy of reduction of the tibia. Malalignment occurs more often with infrapatellar intramedullary nailing versus plates, and early results of suprapatellar nailing appear promising in minimizing intraoperative malalignment...
November 2016: Journal of Orthopaedic Trauma
Marina Magnani, Giovanni Trisolino, Stefano Stilli
INTRODUCTION: Idiopathic posttraumatic nonunion is a rare condition in children; the treatment of this complication is still controversial in this peculiar population. CASE REPORT: We report a case of a subcapital type II femoral neck fracture, in a 12-year-old boy, which was initially treated by internal fixation and subsequently went on to a nonunion at the femoral neck, in absence of infection or other disease.1 year after index surgery we performed surgical debridement and refixation with plate and bone allograft, added with autologous bone marrow aspiration concentrate (BMAC) and platelet-rich fibrin (PRF)...
October 15, 2016: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Harish Kempegowda, Raveesh Richard, Amrut Borade, Akhil Tawari, Abby M Howenstein, Erik N Kubiak, Michael Suk, Daniel S Horwitz
OBJECTIVES: The purpose of this study was to evaluate the role and the necessity of radiographs and office visits obtained during follow-up of intertrochanteric hip injuries. DESIGN: Retrospective study SETTING:: Two level I trauma centers. PATIENTS: 465 elderly patients who were surgically treated for an intertrochanteric fracture of the femur at two level I trauma centers between January 2009 and August 2014 were retrospectively identified from orthopaedic trauma databases...
August 16, 2016: Journal of Orthopaedic Trauma
Daniel S Chan, Paul M Balthrop, Brian White, David Glassman, Roy W Sanders
OBJECTIVE: To determine whether multiple approaches pose an increased risk to fracture healing when compared to a standard single approach in the treatment of pilon (OTA 43C) fractures. DESIGN: Retrospective review of a prospective database. SETTING: Level I academic trauma center and level II community trauma center. METHODS: From January 1, 2005 to December 31, 2011, all records of patients treated for OTA 43C fractures of the distal tibia were reviewed...
October 1, 2016: Journal of Orthopaedic Trauma
Nevzat Dabak, Hasan Göçer, Alper Çıraklı
BACKGROUND: Giant Cell Tumor is considered a benign, local and aggressive tumor. Although considered a benign bone tumor, it is still the subject of discussion and research because of the associated local bone destruction, as well as high rates of recurrence and distant metastases. Options are being developed for both surgical techniques and adjuvant therapies. AIMS: The present study evaluated the administration of cryotherapy via a pressurized-spray technique in giant cell tumors of the bone...
September 2016: Balkan Medical Journal
Jianhua Wang, Yang Lu, Hong Xia, Qingshui Yin
PURPOSE: To investigate a unique procedure of joined transoral and retropharyngeal high cervical approach (JTRC) without mandibulectomy for treating upper cervical neoplasm involving both C2 and C3. METHOD: A 23-year-old male patient had neoplasma involving C2 and C3 that caused pathologic fracture of C2 and bony destruction of C3. The neoplasm excision and cervical spine reconstruction were performed through JTRC approach without splitting up the mandible. In this approach, there were two surgery windows that could be applied in turns by closing or opening the mouth to gain an ideal exposure...
October 18, 2016: European Spine Journal
Beigang Fu
OBJECTIVES: The aim of this study was to evaluate clinical results of a new design titanium elastic nail (TEN) for displaced midshaft clavicular fractures. PATIENTS AND METHODS: Between February 2012 and December 2013, a total 36 patients with displaced midshaft clavicular fractures were treated with intramedullary nailing stabilization with our new design TEN. Blood loss, mean times of operation, postoperative complications, hospital stays and time to bone union was recorded...
October 15, 2016: Acta Orthopaedica et Traumatologica Turcica
Shintaro Sukegawa, Takahiro Kanno, Daiki Nagano, Akane Shibata, Yuka Sukegawa-Takahashi, Yoshihiko Furuki
INTRODUCTION: In recent years, bioresorbable plates have undergone remarkable development. However, there has been no attendant improvement in their strength, because strength requires thickness, and complications such as palpability are related to the thickness of bioresorbable plate systems. In this clinical study, we compared the surgical management of zygomatic fractures using newly developed thinner bioresorbable materials or conventional titanium miniplates. METHODS: Twelve patients with zygomatic fractures were randomly divided equally into 2 groups (6 with new bioresorbable osteosynthesis materials and 6 with standard titanium miniplates)...
October 14, 2016: Journal of Craniofacial Surgery
Akif Türer, Mustafa Cenk Durmuşlar, Ismail Şener, Ahmet Ferhat Misir, Mehmet Emin Önger
Mandibular fracture is the most common injury seen in facial fractures and plays an important role for oral and maxillofacial surgery department. The purpose of this study is to investigate the potential of the local administration of rosuvastatin (RSV) on mandibular fracture healing in rats. Thirty-two rats were divided into 4 groups: group C-14 (control), group R-14, group C-28 (control), and group R-28. A unilateral standard vertical osteotomy was performed right side of the mandibula extending from the tooth to the mandibular basis for each animal...
October 14, 2016: Journal of Craniofacial Surgery
Steven F Shannon, Matthew T Houdek, Cody C Wyles, Brandon J Yuan, William W Cross, Joseph R Cass, Stephen A Sems
OBJECTIVE: The purpose of this study was to evaluate which primary wound closure technique for ankle fractures affords the most robust perfusion as measured by laser-assisted indocyanine green angiography (LA-ICGA): Allgöwer-Donati or vertical mattress. DESIGN: Prospective, randomized. SETTING: Level 1 Academic Trauma Center. PATIENTS/PARTICIPANTS: Thirty patients undergoing open reduction internal fixation (ORIF) for ankle fractures were prospectively randomized to Allgöwer-Donati (n=15) or vertical mattress (n=15) closure...
October 7, 2016: Journal of Orthopaedic Trauma
Enrico Bellato, Roberto Rotini, Alessandro Marinelli, Enrico Guerra, Shawn W O'Driscoll
BACKGROUND: Chronic coronoid deficiency can occur subsequent to coronoid fracture malunion/nonunion or to coronoid hypoplasia or dysplasia resulting from injury during development. Several surgical options have been described to treat this difficult condition, but results are equivocal. We hypothesized that a modified coronoid reconstruction using a radial head osteochondral graft could restore elbow stability and congruity and that a technique involving rigid internal fixation would promote graft union...
October 14, 2016: Journal of Shoulder and Elbow Surgery
Kerrin C DePeter, Stephen M Blumberg, Sarah Dienstag Becker, James A Meltzer
BACKGROUND: Despite being an effective analgesic for children with fractures, some clinicians may avoid prescribing ibuprofen due to its potentially harmful effect on bone healing. OBJECTIVE: To determine if exposure to ibuprofen is associated with an increased risk of bone healing complications in children with fractures. METHODS: We performed a retrospective study of children aged 6 months to 17 years who presented to the pediatric emergency department (PED) with a fracture of the tibia, femur, humerus, scaphoid, or fifth metatarsus and who followed up with the orthopedic service...
October 14, 2016: Journal of Emergency Medicine
Honglue Tan, Pengyi Dai, Yanhao Yuan
It was a retrospective case-control study. The aim of this study was to explore the clinical efficacy and complication of treatment using a modified Kirschner wire tension band (MKTB) or a cannulated screw tension band (CSTB) in transverse patellar fractures.In total, 55 patients with transverse patellar fractures were retrospectively reviewed and divided into 2 groups according to the surgical technique: 29 patients were in the MKTB group and 26 patients in the CSTB group. B[Latin Small Letter o with Caron]stman's clinical grading scale, including range of movement (ROM), pain, ability to work, atrophy of quadriceps femoris, assistance in walking, effusion, giving way, and stair-climbing, was used to evaluate the clinical results...
October 2016: Medicine (Baltimore)
Chun Bi, Qiugen Wang, Christopher Nagelli, Jianhong Wu, Qian Wang, Jiandong Wang
BACKGROUND The aim of this study was to assess the clinical results of treatment for unstable posterior pelvic fractures using a pedicle screw-rod fixator compared to use of a locking compression plate. MATERIAL AND METHODS A retrospective study was performed between June 2010 and May 2014 and the data were collected from 46 patients with unstable posterior pelvic ring fractures. All patients were treated using either a pedicle screw-rod fixator (study group, 24 patients) or locking compression plate (control group, 22 patients)...
October 17, 2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Lei Zhai, Xin-Long Ma, Chuan Jiang, Bo Zhang, Shui-Tao Liu, Geng-Yan Xing
BACKGROUND: Currently, the available treatments for long bone nonunion (LBN) are removing of focus of infection, bone marrow transplantation as well as Ilizarov methods etc. Due to a high percentage of failures, the treatments are complex and debated. To develop an effective method for the treatment of LBN, we explored the use of human autologous bone mesenchymal stems cells (hBMSCs) along with extracorporeal shock wave therapy (ESWT). MATERIALS AND METHODS: Sixty three patients of LBN were subjected to ESWT treatment and were divided into hBMSCs transplantation group (Group A, 32 cases) and simple ESWT treatment group (Group B, 31 cases)...
September 2016: Indian Journal of Orthopaedics
Jonathan J E White, John R Soothill, Marie Morgan, David I Clark, Marius P Espag, Amol A Tambe
BACKGROUND: A large metaphyseal volume shoulder hemiarthroplasty has been in use within our department since 2008; however, no clinical outcome data are available for this prosthesis apart from the designer surgeon series. MATERIALS AND METHODS: During a 5-year period, data were collected for 40 patients (30 women, 10 men) treated consecutively with the Zimmer Anatomical Shoulder Fracture hemiarthroplasty system (Zimmer, Warsaw, IN, USA). RESULTS: The final analysis included 26 patients...
October 10, 2016: Journal of Shoulder and Elbow Surgery
Paul Kostenuik, Faisal M Mirza
Delayed healing and nonunion of fractures represent enormous burdens to patients and healthcare systems. There are currently no approved pharmacological agents for the treatment of established nonunions, or for the acceleration of fracture healing, and no pharmacological agents are approved for promoting the healing of closed fractures. Yet several pharmacologic agents have the potential to enhance some aspects of fracture healing. In preclinical studies, various agents working across a broad spectrum of molecular pathways can produce larger, denser and stronger fracture calluses...
October 15, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Iqra Luqman, Harish Kurup
We present the case of fishtail deformity of distal humerus in a 13-year-old boy presenting with a refracture 8 years after the original surgically treated lateral condyle fracture. This unusual incomplete vertical fracture of distal humerus starting at the apex of fishtail was treated non-surgically and went on to union but refractured yet again 12 months later. This also went on to full healing with conservative treatment, however the fishtail deformity persists. We discuss the possibility that fishtail deformity reflects an inherent weakness in the distal humerus...
October 14, 2016: BMJ Case Reports
Byung-Jae Kang, Hak-Hyun Ryu, Sungsu Park, Yongsun Kim, Oh-Kyeong Kweon, Kei Hayashi
OBJECTIVES: To retrospectively evaluate the effectiveness of a novel 1.2 mm mini locking plate system in treating fractures of the radius and ulna in miniature breed dogs. METHODS: Medical records and radiographs of miniature breed dogs with fractures treated with a 1.2 mm mini locking plate system were reviewed. The inclusion criteria were: body weight of 2.5 kg or less, transverse or short oblique fracture of the radius and ulna, and treatment with mini locking plate system as the sole method of fixation...
October 14, 2016: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
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