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https://www.readbyqxmd.com/read/28544676/robotic-distal-locking-of-intramedullary-nailing-technical-description-and-cadaveric-testing
#1
Martin Panzica, Eduardo M Suero, Ralf Westphal, Musa Citak, Emmanouil Liodakis, Nael Hawi, Max Petri, Christian Krettek, Timo Stuebig
Interlocked intramedullary nailing is the treatment of choice for femoral shaft fractures. However, distal locking is a technically challenging part of the procedure that can result in distal femoral malrotation and high radiation exposure. We have tested a robotic procedure for robotic distal locking based on the computation of a drilling trajectory on two calibrated fluoroscopic images. Twenty distal holes were attempted in ten cadaveric femur specimens. Successful screw hole drilling was achieved at the first attempt in each of the ten specimens (20 drill holes in total)...
May 23, 2017: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28541431/emerging-safety-of-intramedullary-transplantation-of-human-neural-stem-cells-in-chronic-cervical-and-thoracic-spinal-cord-injury
#2
Allan D Levi, David O Okonkwo, Paul Park, Arthur L Jenkins, Shekar N Kurpad, Ann M Parr, Aruna Ganju, Bizhan Aarabi, Dong Kim, Steven Casha, Michael G Fehlings, James S Harrop, Kim D Anderson, Allyson Gage, Jane Hsieh, Stephen Huhn, Armin Curt, Raphael Guzman
BACKGROUND: Human central nervous system stem cells (HuCNS-SC) are multipotent adult stem cells with successful engraftment, migration, and region-appropriate differentiation after spinal cord injury (SCI). OBJECTIVE: To present data on the surgical safety profile and feasibility of multiple intramedullary perilesional injections of HuCNS-SC after SCI. METHODS: Intramedullary free-hand (manual) transplantation of HuCNS-SC cells was performed in subjects with thoracic (n = 12) and cervical (n = 17) complete and sensory incomplete chronic traumatic SCI...
May 24, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28541152/biomechanical-comparison-of-a-3-5-mm-conical-coupling-plating-system-and-a-3-5-mm-locking-compression-plate-applied-as-plate-rod-constructs-to-an-experimentally-created-fracture-gap-in-femurs-of-canine-cadavers
#3
Giovanni Tremolada, Daniel D Lewis, Ken Luka Paragnani, Bryan P Conrad, Stanley E Kim, Antonio Pozzi
OBJECTIVE To compare stiffness and resistance to cyclic fatigue of two 3.5-mm locking system plate-rod constructs applied to an experimentally created fracture gap in femurs of canine cadavers. SAMPLE 20 femurs from cadavers of 10 mixed-breed adult dogs. PROCEDURES 1 femur from each cadaver was stabilized with a conical coupling plating system-rod construct, and the contralateral femur was stabilized with a locking compression plate (LCP)-rod construct. An intramedullary Steinmann pin was inserted in each femur...
June 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28540999/do-cerclage-cables-delay-the-time-to-bone-union-in-patients-with-an-unstable-humeral-shaft-fracture-treated-with-intramedullary-nails
#4
Kyeong Jin Han, Doo Hyung Lee, Joon Young Bang
PURPOSE: To evaluate the time to bone union after open reduction and internal fixation with cerclage cables followed by intramedullary nailing (IMN) for unstable humeral shaft fractures. MATERIALS AND METHODS: Patients with a humeral shaft fracture treated by IMN were enrolled. One group of patients was treated via open reduction and internal fixation with cables followed by IMN (cable group; n=32), while the other group was treated with a conventional closed IMN (non-cable group; n=64)...
July 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28540566/-osteosynthesis-associated-infections-epidemiology-definition-and-diagnosis
#5
REVIEW
N Renz, S Feihl, C E Dlaska, M A Schütz, A Trampuz
Osteosynthesis-associated infections occur in 1-5% after closed and in up to 30% after open fractures. There are three different descriptions of implant-associated infections after fracture fixation, which are crucial for the selection of the adequate treatment strategy; temporal appearance from the index surgery (early versus late), pathogenesis of the infection (exogenous, hematogenous and contiguous from an adjacent focus), duration of infection symptoms (acute versus chronic). Diagnosis of osteosynthesis-associated infection is challenging, as chronic low-grade infections often present only with unspecific and subtle clinical symptoms...
May 24, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28540126/neurological-complications-of-lumbar-and-cervical-dural-punctures-with-a-focus-on-epidural-injections
#6
Nancy E Epstein
BACKGROUND: Various types of lumbar dural punctures may contribute to neurological injury. The etiologies of dural injury include; inadvertent dural punctures due to epidurals placed for labor anesthesia, epidural steroid injections (ESI/transforaminal TESI; approximately 9 million ESI performed in the US per year), deliberate placement of intradural pain devices, and spontaneous cerebrospinal fluid (CSF) fistulas. Resulting neurological complications may include; spinal headaches/intracranial hypotension, subdural hematomas, and 6(th) nerve cranial palsies...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28540122/presurgical-role-of-mri-tractography-in-a-case-of-extensive-cervicothoracic-spinal-ependymoma
#7
Francesca Granata, Sergio Racchiusa, Enricomaria Mormina, Valeria Barresi, Giada Garufi, Giovanni Grasso, Francesco Maria Salpietro, Marcello Longo, Concetta Alafaci
BACKGROUND: Intramedullary spinal ependymoma is a tumor, hardly characterizable with conventional magnetic resonance (MR) imaging only. MR diffusion tensor imaging (DTI) with three-dimensional fiber-tracking reconstructions allows the evaluation of the relationship between neoplasm and white matter fiber tracts, being a powerful tool in presurgical planning. We present DTI findings in a case of a young female with an extensive cervicothoracic spinal ependymoma. CASE DESCRIPTION: The patient complained of a 2-month history of acute urinary retention, weakness and numbness on the lower limbs and the upper left limb...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28539054/anatomic-structures-at-risk-when-utilizing-an-intramedullary-nail-for-distal-fibular-fractures-a-cadaveric-study
#8
David A Goss, Christopher W Reb, Terrence M Philbin
BACKGROUND: Retrograde intramedullary fibular nail fixation is being utilized with increasing frequency, particularly in patients at higher risk of wound complications. The purpose of this anatomic study was to assess the relative risk to nearby anatomic structures when implanting a contemporary retrograde locked intramedullary fibular nail. METHODS: Ten human cadaveric lower extremities were instrumented with a fibular nail. The cadavers were dissected. The shortest distance, in millimeters (mm), between the site of procedural steps and nearby named structures of interest (ie, sural nerve, superficial peroneal nerve, and the peroneal tendons) was measured and recorded...
May 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28538453/does-concurrent-tibial-intramedullary-nailing-and-fibular-fixation-increase-rates-of-tibial-nonunion-a-matched-cohort-study
#9
Michael Githens, Justin Haller, Julie Agel, Reza Firoozabadi
OBJECTIVES: To determine if there is a difference in rates of tibial nonunion in patients undergoing tibial intramedullary (IM) nailing and fibular fixation as compared to a matched cohort undergoing tibial IM nailing alone. DESIGN: Retrospective matched cohort study. SETTING: Single Level 1 academic trauma center. PATIENTS: Consecutive patients 18 years and older with a tibia and fibula fracture treated with tibial IM nailing and fibular fixation who were determined radiographically and clinically healed or had a minimum 1-year follow-up were included...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28538288/the-trajectory-of-short-and-long-term-recovery-of-tibial-shaft-fractures-following-intramedullary-nail-fixation
#10
Sebastian J Ko, Peter J O'Brien, Pierre Guy, Henry M Broekhuyse, Piotr A Blachut, Kelly A Lefaivre
OBJECTIVE: To determine the trajectory of recovery following tibial shaft fracture treated with intramedullary nail over the first five years, and to evaluate the magnitude of the changes in functional outcome at various time intervals. DESIGN: Prospective cohort study. SETTING: A level 1 trauma center. PATIENTS/PARTICIPANTS: 132 patients with tibial shaft fracture (OTA 42-A,B,C) were enrolled into the Center's prospectively enrolled orthopaedic trauma database between January 2005 and February 2010...
May 17, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28538286/any-cortical-bridging-predicts-healing-of-supracondylar-femur-fractures-after-treatment-with-locked-plating
#11
Patrick K Strotman, Madhav A Karunakar, Rachel Seymour, William D Lack
OBJECTIVES: To determine the accuracy and reliability of radiographic cortical bridging criteria in predicting the final healing of supracondylar femur fractures after treatment with locked plating. DESIGN: Retrospective review SETTING:: Two level 1 trauma centers PATIENTS/PARTICIPANTS:: We retrospectively reviewed the records at two level 1 trauma centers for patients who presented with supracondylar femur fractures (AO/OTA 33A, C) and were treated with locking plate fixation between 1/1/2004 and 1/1/2011...
May 17, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28537526/composite-biomaterial-as-a-carrier-for-bone-active-substances-for-metaphyseal-tibial-bone-defect-reconstruction-in-rats
#12
Peter Frederik Horstmann, Deepak Raina, Hanna Isaksson, Werner Hettwer, Lars Lidgren, Michael Mørk Petersen, Magnus Tägil
Restoring lost bone is a major challenge in orthopedic surgery. Currently available treatment-strategies all have shortcomings, like risk of infection, non-union and excessive resorption. Our primary aim was to study if a commercially available gentamicin-containing composite calcium sulphate/hydroxyapatite biomaterial (GBM) could serve as a carrier for local delivery of bone morphogenic protein-2 (BMP-2) and zoledronic acid (ZA) in a tibia defect-model in rats. Empty and allograft-filled defects were used as controls...
May 24, 2017: Tissue Engineering. Part A
https://www.readbyqxmd.com/read/28534175/-aseptic-loosening-of-total-ankle-replacement-two-stage-revision-with-bone-augmentation-of-osseous-defects-and-secondary-prosthesis-implantation
#13
A Barg, M Wiewiorski, V Valderrabano
OBJECTIVE: To remove loosened ankle prosthesis components, perform osseous defect augmentation, and reimplant definitive prosthesis components to preserve ankle range of motion. INDICATIONS: Aseptic loosening of the tibial and/or talar ankle prosthesis components with substantial bone defect. CONTRAINDICATIONS: General surgical/anesthesiological risks, infections, critical soft tissue conditions, nonmanageable hindfoot instability, neurovascular impairment of the lower extremity, neuroarthropathy, substantial nonreconstructable osseous defects with or without cysts on the tibial and/or talar side, noncompliance, primary total ankle replacement (TAR) using intramedullary fixation (stem fixation), severely reduced bone quality, insulin-dependent diabetes mellitus, smoking, unrealistic patients' expectations, high activity in sports...
May 22, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28532916/spinal-intramedullary-tuberculosis-with-concurrent-supra-and-infratentorial-intracranial-disease-in-a-9-month-old-boy-case-report-and-review-of-the-literature
#14
REVIEW
Michael George Zaki Ghali, Visish M Srinivasan, C J Kim, Archana Malik
Tuberculous involvement of the spinal cord parenchyma is an exceedingly rare clinical entity; even more so is concurrent intracranial tuberculosis (TB). Spinal intramedullary TB presents with a characteristic subacute myelopathy, with slowly progressive paraplegia, sensory deficits, and/or bowel and bladder dysfunction. Diagnosis is strongly suspected with a clinical history of known TB in conjunction with characteristic findings on magnetic resonance imaging. Management involves multi-agent antitubercular chemotherapy without or with operative intervention...
May 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28530778/a-comparison-of-the-treatment-results-of-dpen-reduction-internal-fixation-and-intramedullary-nailing-in-adult-forearm-diaphyseal-fractures
#15
Ahmet Köse, Ali Aydın, Naci Ezirmik, Ömer Selim Yıldırım
BACKGROUND: We compared the union and functional results of intramedullary nailing and open reduction internal fixation treatment applied to adults with a forearm diaphysis fracture (fracture of the radius and/or ulna). METHODS: We retrospectively examined 90 patients with completed skeletal maturation who were surgically treated for a forearm diaphyseal fracture. Patients with a Monteggia Galeazzi and ipsilateral upper extremity fracture and those with an open epiphyseal line, Type 3 open fracture, pathological fracture, or brain trauma were excluded from the study...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28529010/aneurysmal-bone-cyst-healing-response-with-intramedullary-lengthening-nail
#16
Ahmet Emrah Acan, Onur Basci, Hasan Havitcioglu
We report the treatment process of a pediatric patient with deformity and shortening in the arm after a recurrent aggressive aneurysmal bone cyst (ABC) in the proximal humerus. The patient was treated with curettage of the lesion and lengthening on an intramedullary nail following an osteotomy just distal to the ABC. The period of lengthening was approximately 50 days. At the end of the treatment the lengthening goal was achieved without any neurovascular complication. There was a minimal loss in shoulder hyperabduction due to the deformity of the humeral head...
May 18, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28527519/-adult-intramedullary-gliomas
#17
C Campello, F Parker, S Slimani, A Le Floch, A Herbrecht, N Aghakhani, C Lacroix, H Loiseau, J P Lejeune, G Perrin, J Honnorat, H Dufour, O Chinot, D Figarella, L Bauchet, H Duffau, M Lonjon, P Labauge, M Messerer, J P Daures, P Fabbro, B Ducot
OBJECTIVES: Intramedullary gliomas are rare tumors accounting for less than 4% of all primary central nervous system tumors. The aims of this retrospective multicenter study were to assess their natural outcome as well as management. METHODS AND MATERIALS: We studied 332 patients from 1984 to 2011. Histopathological examination revealed 72% ependymomas (94% were low grade tumors), 24% astrocytomas (29% were high grade tumors), 2.4% mixed gliomas and 1.7% oligodendrogliomas...
May 17, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28526323/-18-f-fdg-pet-ct-helps-in-unmasking-the-great-mimicker-a-case-of-neurosarcoidosis-with-isolated-involvement-of-the-spinal-cord
#18
A Gholamrezanezhad, L Mehta
A 36 year-old male with no significant past medical history presented with lower extremity numbness, gait instability, and urinary and bowel retention of 4 weeks onset. Spine MRI revealed diffuse oedema of cervicothoracic spinal cord with several solid enhancing intramedullary lesions, suggestive of metastases. The (18)F-FDG PET/CT performed to identify the primary malignancy demonstrated mild hypermetabolic foci within the cervicothoracic cord, as well as a mildly hypermetabolic bilateral hilar lymphadenopathy and a mildly hypermetabolic pulmonary nodule, suggestive of sarcoidosis versus metastasis...
May 16, 2017: Revista Española de Medicina Nuclear e Imagen Molecular
https://www.readbyqxmd.com/read/28524753/continuous-mapping-of-the-corticospinal-tracts-in-intramedullary-spinal-cord-tumor-surgery-using-an-electrified-ultrasonic-aspirator
#19
Ori Barzilai, Zvi Lidar, Shlomi Constantini, Khalil Salame, Yifat Bitan-Talmor, Akiva Korn
Intramedullary spinal cord tumors (IMSCTs) represent a rare entity, accounting for 4%-10% of all central nervous system tumors. Microsurgical resection of IMSCTs is currently considered the primary treatment modality. Intraoperative neurophysiological monitoring (IONM) has been shown to aid in maximizing tumor resection and minimizing neurological morbidity, consequently improving patient outcome. The gold standard for IONM to date is multimodality monitoring, consisting of both somatosensory evoked potentials, as well as muscle-based transcranial electric motor evoked potentials (tcMEPs)...
May 19, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28520582/intramedullary-nailing-for-pilon-nonunions
#20
Justin M Haller, Michael Githens, Robert Dunbar
No abstract text is available yet for this article.
May 16, 2017: Journal of Orthopaedic Trauma
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