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Open fracture

Sean Baran, Jeffrey G Belisle, Erin K Granger, Robert Z Tashjian
OBJECTIVES: To analyze the functional and radiographic outcomes of anatomic coracoclavicular ligament reconstruction (ACCR) using allograft tendon without interference screw fixation. DESIGN: Retrospective nonrandomized study. SETTING: Level I trauma center (University Hospital). PATIENTS: Seventeen patients (mean age of 44 years) with Rockwood III through V acromioclavicular joint disruptions. Twelve of 17 patients had a primary reconstruction, including 4 patients sustaining their injuries as part of a polytrauma incident...
April 2018: Journal of Orthopaedic Trauma
Jan Puetzler, Willem-Jan Metsemakers, Daniel Arens, Stephan Zeiter, Richard Kuehl, Michael J Raschke, Robert Geoff Richards, Thomas Fintan Moriarty
OBJECTIVES: The optimal duration of perioperative antibiotic prophylaxis (PAP) for open fractures remains controversial because of heterogeneous or unclear guidelines and highly variable prophylactic regimens in clinical practice. We aimed at testing different PAP durations under controlled conditions in a contaminated rabbit fracture model. METHODS: A complete humeral osteotomy in 18 rabbits was fixed with a 7-hole locking compression plate and inoculated with Staphylococcus aureus...
April 2018: Journal of Orthopaedic Trauma
Matthew Aizpuru, Christopher Staley, William Reisman, Michael B Gottschalk, Mara L Schenker
OBJECTIVES: To investigate the determinants of length of stay (LOS) for patients surgically treated for femur fractures. DESIGN: Retrospective medical record review. SETTING: Urban Level I Trauma Center. PARTICIPANTS: Three hundred twenty-one patients operatively treated for femur fractures between July 12, 2015 and July 12, 2016. INTERVENTION: Intramedullary nailing, open reduction internal fixation, arthroplasty, or other (percutaneous screw or multiple hardware/technique) definitive fixation of femur fracture...
April 2018: Journal of Orthopaedic Trauma
Joseph Christensen, Sean Spence, David Watson, Anjan Shah, Benjamin Maxson, Anthony Infante, Roy Sanders, Hassan R Mir
OBJECTIVE: To review the orthopaedic injuries from watercraft treated surgically at our institution and report the mechanisms, fractures, and complications encountered. DESIGN: Retrospective case series. SETTING: Level I trauma center. PATIENTS/PARTICIPANTS: There were 216 fractures from watercraft in 146 patients. Average age was 33 years (range 4-78 years), there were 68% males (99/146), and 16% of the injuries occurred in children...
April 2018: Journal of Orthopaedic Trauma
Ashwant Kumar Vadepally, Ramen Sinha, A V S S Subramanya Kumar
Background: Patients with limited mouth opening (LMO) often associated with difficult intubation. Retrograde intubation is an alternative technique of establishing definitive airway in these patients when blind nasal intubation fails and fiberoptic bronchoscope is not available. We tested the retrograde intubation through nasal route in patients with LMO less than 2 cm. Materials and methods: The procedure was performed with some modification with regard to retrograde guide on 18 patients requiring maxillofacial surgical procedures to increase mouth opening...
January 2018: Journal of Oral Biology and Craniofacial Research
Ahmad M Radaideh, Ziad A Audat, Abdullah A Saleh
BACKGROUND Fractures of the talus are uncommon injuries that usually involve the talar neck, rather than the talar body. This report is of a rare case of combined left talar neck fracture and adjacent joint dislocation with an ipsilateral bimalleolar ankle fracture. CASE REPORT A 37-year-old man presented with an injury to his left foot following a motor vehicle accident. When he presented to the hospital emergency department, his left foot and ankle were swollen, the overlying skin was intact but badly contused, and there was no neurovascular deficit...
March 20, 2018: American Journal of Case Reports
R Siboni, P Beaufils, P Boisrenoult, C Steltzlen, N Pujol
INTRODUCTION: Using locking plates in opening-wedge high tibial osteotomy (OWHTO) via a medial opening theoretically allows early weight-bearing without need for bone or bone-substitute grafting. It incurs a risk of non-consolidation in case of large correction (> 10°), although rates and risk factors of non-union are not known. The present retrospective study compared OWHTO with correction <10° versus >10°, with a view to determining: 1) complications rates (non-union) according to degree of correction, and 2) risk factors for such complications...
March 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Xi Liu, Hui Zhang, Shiqiang Cen, Fuguo Huang
BACKGROUND: Though several systematic reviews concerned have been published, controversy still exists. The current systematic review was designed to clarify the detailed advantages and disadvantages of the negative pressure wound therapy (NPWT) in treatment of open fractures in comparison with the conventional wound dressings. METHODS: A systematic search was performed in Pubmed, Cochrane Library, Embase, and Google Scholar for the published relevant clinical studies...
March 16, 2018: International Journal of Surgery
Amna Diwan, Kyle R Eberlin, Raymond Malcolm Smith
The principles of open fracture management are to manage the overall injury and specifically prevent primary contamination becoming frank infection. The surgical management of these complex injuries includes debridement & lavage of the open wound with combined bony and soft tissue reconstruction. Good results depend on early high quality definitive surgery usually with early stable internal fixation and associated soft tissue repair. While all elements of the surgical principles are very important and depend on each other for overall success the most critical element appears to be achieving very early healthy soft tissue cover...
February 21, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Seung Min Ryu, Han Seok Yang, Oog Jin Shon
Purpose: This study is to investigate clinical and radiological results of staged treatment using a temporary external fixator in bicondylar tibial plateau fractures (TPFs) and to evaluate correlation between prognostic factors and postoperative clinical outcomes. Materials and Methods: Twenty-four bicondylar TPF patients were selected. All patients were operated by a temporary external fixator first and then open reduction and internal fixation with dual plating...
March 19, 2018: Knee Surgery & related Research
Andreas Klinger, Patrick Sperling, Hendrik Jansen, Johannes Wirbelauer, Daniel Vergho, Florian Seitz, Norbert Roewer, Thomas Meyer, Ralf Michael Muellenbach
A 16-month-old boy suffers a massive trauma (open dislocated pelvic fracture and decollement with haemorrhagic shock) due to a traffic accident. We present the characteristics and obstacles in the prehospital and early hospital emergency care of this severe and rare trauma in a pediatric patient with an emphasis on medical-operational tactics.
March 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
Elavenil Panneerselvam, Sasikala Balasubramaniam, Aditi Rajendra Sharma, Pathumai Murugadoss, Saravanan Chellappazham, V B Krishnakumar Raja
PURPOSE: Mandibular trauma can result in stylomandibular complex (SMC) fractures with clinical symptoms including glossopharyngeal neuralgia, globus pharyngeus, otalgia, and dysphonia. Fracture of the styloid process is noteworthy because of its proximity to numerous vital structures. The study objectives were 1) to determine the incidence of SMC fractures and develop a clinical grading system and 2) to institute and assess a treatment protocol. MATERIALS AND METHODS: This prospective clinical trial involved 206 patients with mandibular trauma based on a set of inclusion and exclusion criteria...
February 22, 2018: Journal of Oral and Maxillofacial Surgery
Oren Schwartz, Itzik Malka, Cara H Olsen, Israel Dudkiewicz, Tarif Bader
Introduction: Integration of females in combat units poses a unique challenge for army commanders around the world. The purpose of this study is to provide a detailed up-to-date situation report regarding overuse injuries among combat female warriors in the IDF (Israeli Defense Forces) in order to enable evidence-based decision-making, prevention policy, and further research of this highly significant military public health issue. Methods: A cross-sectional descriptive study was conducted including 2,519 females recruited to combat duties during the year of 2013...
March 14, 2018: Military Medicine
David A Watters, Glenn D Guest, Viliami Tangi, Mark G Shrime, John G Meara
Progress in achieving "universal access to safe, affordable surgery, and anesthesia care when needed" is dependent on consensus not only about the key messages but also on what metrics should be used to set goals and measure progress. The Lancet Commission on Global Surgery not only achieved consensus on key messages but also recommended 6 key metrics to inform national surgical plans and monitor scale-up toward 2030. These metrics measure access to surgery, as well as its timeliness, safety, and affordability: (1) Two-hour access to the 3 Bellwether procedures (cesarean delivery, emergency laparotomy, and management of an open fracture); (2) Surgeon, Anesthetist, and Obstetrician workforce >20/100,000; (3) Surgical volume of 5000 procedures/100,000; (4) Reporting of perioperative mortality rate; and (5 and 6) Risk rates of catastrophic expenditure and impoverishment when requiring surgery...
April 2018: Anesthesia and Analgesia
Yashwant Singh Tanwar, Yatinder Kharbanda, Atin Jaiswal, Vikas Birla, Ramsagar Pandit
INTRODUCTION: Coronal plane distal humeral injuries are relatively rare. Numerous classification systems have been proposed as the complexity of these fractures has been realized. We in the present series of ten patients describe the surgical technique of Open Reduction and Internal Fixation of Coronal plane fractures of the distal humerus with headless compression screws performed using the anterolateral approach. MATERIAL AND METHOD: It was a retrospective study, the data collected from March 2010 to 2015 was analysed and the final outcome was assessed using the DASH score...
2018: SICOT-J
Young Woong Jang, DoHyung Lim, Hansol Seo, Myung Chul Lee, O-Sung Lee, Yong Seuk Lee
INTRODUCTION: Open-wedge high tibial osteotomy (OWHTO) is a well-established surgical option for medial compartment osteoarthritis of the varus knee. The initial strength of the fixation plate is critical for successful correction maintenance and healing of the osteotomy site. This study was conducted to verify if a newly designed anatomical plate (LCfit) improves the stability of both the medial implant and lateral hinge area, as well as to evaluate how the metal block contributes to both medial and lateral stability...
March 15, 2018: Archives of Orthopaedic and Trauma Surgery
Luciana Souza Jorge, Patrícia Silva Fucuta, Maria Gabriele L Oliveira, Marcelo Arruda Nakazone, Juliana Arruda de Matos, Alceu Gomes Chueire, Mauro José Costa Salles
Background: We hypothesized that polymicrobial posttraumatic osteomyelitis (PTO) may be associated with worse outcomes when compared to monomicrobial PTO. We therefore attempted to show the outcomes and predisposing factors associated with polymicrobial PTO. Methods: A single-center case-control study was carried out from 2007 to 2012. The outcome variables analyzed were: the need for additional surgical and antibiotic treatments, rates of amputation, and mortality associated with the infection. Univariate and multivariable analyses using multiple logistic regression were performed to identify risk factors associated with polymicrobial PTO, and p < 0...
2018: Journal of Bone and Joint Infection
Pablo Antonio Ureña-Torres, Mario Cozzolino, Jordi Bover
Secondary hyperparathyroidism (SHPT) is one of the most frequent and deleterious complication of chronic kidney disease (CKD). SHPT is also one of the principal components of the now called CKD-mineral and bone disorders (MBD) syndrome. It is usually prevented and treated by vitamin D derivatives. However, the rationale for the prescription of vitamin D sterols in those patients is still a matter of hotly debates, mainly because of unsatisfactory results from numerous observational and not well-controlled studies...
March 12, 2018: Néphrologie & Thérapeutique
Miltiadis Argyropoulos, Matthew Kent
Background: Open reduction internal fixation of displaced 3 and 4-part proximal humerus fractures is an effective treatment modality particularly for the younger age group, but it is not without complications. Fixed angled locking screw plates are the mainstay of fixation. The A.L.P.S. Proximal Humerus Plating System is a new implant that has smooth locking pegs in the place of humeral head screws to help reduce glenoid damage in the event of cut-out and is designed to sit low on the humerus in order to reduce the risk of subacromial impingement...
2018: Open Orthopaedics Journal
Poul Christoffersen, Marion Bougamont, Alun Hubbard, Samuel H Doyle, Shane Grigsby, Rickard Pettersson
Supraglacial lakes on the Greenland Ice Sheet are expanding inland, but the impact on ice flow is equivocal because interior surface conditions may preclude the transfer of surface water to the bed. Here we use a well-constrained 3D model to demonstrate that supraglacial lakes in Greenland drain when tensile-stress perturbations propagate fractures in areas where fractures are normally absent or closed. These melt-induced perturbations escalate when lakes as far as 80 km apart form expansive networks and drain in rapid succession...
March 14, 2018: Nature Communications
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