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Tibial fractures

Corinne E Metzger, Sammy Gong, Miriam Aceves, Susan A Bloomfield, Michelle A Hook
Profound bone loss occurs following spinal cord injury (SCI) resulting in a high incidence of fractures. While likely caused in part by loss of weight-bearing, there is greater bone loss following SCI when compared to that observed in other disuse animal models. Patients with SCI have a protracted inflammatory response, with elevated circulating levels of pro-inflammatory markers. This chronic inflammation could compound the bone loss attributed to disuse and the loss of neural signaling. To assess this, we examined inflammatory markers and bone turnover regulators in osteocytes from rats with a moderate spinal contusion injury (SCI) and intact controls (CON)...
December 11, 2018: Bone
Kingsley O Asiedu, Munira Ferdousi, Phuongnga T Ton, Stephen S Adler, Peter L Choyke, Noriko Sato
BACKGROUND: Bone fracture healing is dependent upon the rapid migration and engraftment of bone marrow (BM) progenitor and stem cells to the site of injury. Stromal cell-derived factor-1 plays a crucial role in recruiting BM cells expressing its receptor CXCR4. Recently, a CXCR4 antagonist, plerixafor, has been used to mobilize BM cells into the blood in efforts to enhance cell migration to sites of injury presumably improving healing. In this study, we employed zirconium-89 (89 Zr)-oxine-labeled BM cells imaged with positron emission tomography (PET)/computed tomography (CT) to visualize and quantitate BM cell trafficking following acute bone injury and to investigate the effect of plerixafor on BM cell homing...
December 13, 2018: EJNMMI Research
Heath P Melugin, Vishal S Desai, Christopher L Camp, Todd A Milbrandt, Diane L Dahm, Bruce A Levy, Michael J Stuart, Aaron J Krych
Background: Avulsion fractures involving the tibial eminence are considered equivalent in terms of the cause to anterior cruciate ligament (ACL) tears; however, there are limited data comparing the outcomes of adolescent patients undergoing surgical fixation of a tibial eminence fracture (TEF) with those undergoing ACL reconstruction. Purpose: To compare the clinical outcomes, subsequent ACL injury rates, and activity levels between adolescent patients who underwent TEF fixation with patients with midsubstance ACL tears who required acute reconstruction...
December 2018: Orthopaedic Journal of Sports Medicine
Eric Kim, Carl T Talmo, Marie C Anderson, Olivia J Bono, James V Bono
During cruciate retaining (CR) total knee arthroplasty (TKA), the posterior cruciate ligament (PCL) may avulse at its insertion. The incidence of PCL avulsion fracture has not been previously studied. The aim of this study is to report on the incidence and clinical significance of intraoperative PCL avulsion during primary CR TKA and to identify potential risk factors. Our institutional joint registry was retrospectively reviewed for PCL avulsion occurring during CR TKA implanted between April 2008 and April 2016...
December 13, 2018: Journal of Knee Surgery
Daryl Sudasena, Dinu Valentin Balanescu, Teodora Donisan, Saamir Hassan, Nicolas Palaskas, Peter Kim, Kaveh Karimzad, Juan Lopez-Mattei, Salman Arain, K Lance Gould, Cezar Iliescu
The use of vascular endothelial growth factor inhibitors such as sorafenib is limited by a risk of severe cardiovascular toxicity. A 28-year-old man with acute myeloid leukemia treated with prednisone, tacrolimus, and sorafenib following stem cell transplantation presented with severe bilateral lower extremity claudication. The patient was discharged against medical advice prior to finalizing a cardiovascular evaluation, but returned 1 week later with signs suggestive of septic shock. Laboratory tests revealed troponin I of 12...
December 12, 2018: Cardiovascular Toxicology
Kenichi Goshima, Takeshi Sawaguchi, Kenji Shigemoto, Shintaro Iwai, Akira Nakanishi, Daisuke Inoue, Yosuke Shima
PURPOSE: To evaluate bone formation in the osteotomy gap after open-wedge high tibial osteotomy (OWHTO), including after plate removal, and to investigate risk factors for delayed bone healing. METHODS: Ninety-three patients (102 knees) who underwent OWHTO without bone grafting were enrolled. The osteotomy gap was divided into the lateral hinge and the four zones on anteroposterior radiographs, and we defined the zone in which trabecular bone continuity could be observed as gap filling...
December 11, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
V Schütte, A Schmidt-Hebbel, A B Imhoff, A Achtnich
OBJECTIVE: Transosseous augmentation of patellar sleeve fractures (PSF) with suture tape in young athletes. INDICATIONS: Acute avulsions of the proximal or distal patellar pol with clinical relevant deficit of knee extension. CONTRAINDICATIONS: Local infections, severe soft tissue damage (relative contraindication), fractures of the patella or tibial tuberosity. SURGICAL TECHNIQUE: Direct longitudinal anterior approach to the patella...
December 11, 2018: Operative Orthopädie und Traumatologie
Yuanjun Teng, Xiaohui Zhang, Chongwen Ma, Haosen Wu, Rui Li, Hong Wang, Hua Han, Yayi Xia
INTRODUCTION: Excessive angle of the tibial tunnel may cause breakage of the posterior cortex in transtibial anatomic posterior cruciate ligament (PCL) reconstruction. However, a few studies have determined the permissible maximum angle of the tibial tunnel. The purpose of this study was to determine the permissible maximum angle of the tibial tunnel relative to the tibial plateau in transtibial anatomic PCL reconstruction and characterize the anatomic parameters of the tibial PCL attachment position...
December 8, 2018: Archives of Orthopaedic and Trauma Surgery
Hiroshi Watanabe, Tokifumi Majima, Kenji Takahashi, Norishige Iizawa, Yasushi Oshima, Shinro Takai
PURPOSE: Flexion-type Salter-Harris (SH) II fractures of the proximal tibia, also described as Watson-Jones (WJ) IV fractures, are rare injuries reported among adolescent athletes who are close to skeletal maturity and remain elusive. Due to this classification disagreement, the various treatments range from nonoperative to operative types, and no previous studies have explained the mechanisms of injury or the source of the fracture forces. This retrospective matched case-control study aimed to identify radiological factors that are associated with the fracture forces and to elucidate the mechanisms of these injuries...
December 10, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Hoon-Sang Sohn, Jong-Keon Oh, Ha Sol Yang, Hyeong Rang Kim
Background: The treatment of comminuted tibia plafond fractures remains clinically challenging due to the complexity of the articular fracture pattern despite using the anatomically precontoured locked plates. This study describes the morphologic characteristics of the anterolateral fragment and to evaluate the fixability of the anterolateral fragment with the anatomically precontoured locked plate in the pilon fracture. Materials and Methods: One hundred and twenty five cases of AO 43-B and C fracture were evaluated using the computed tomography (CT) scan...
November 2018: Indian Journal of Orthopaedics
Maria Tuca, Nazira Bernal, Eva Luderowski, Daniel W Green
PURPOSE OF REVIEW: The purpose of this review is to summarize and clarify the current framework for treating tibial spine avulsion fractures (TSAFs). We will discuss how these fractures are classified both on plain radiographs and MRI as well as report the incidence of concomitant soft tissue injury, an important consideration that guides treatment. We will also compare guidelines for nonsurgical versus surgical treatment and summarize frequently used surgical techniques. Finally, we will review outcomes following treatment, including common complications...
December 3, 2018: Current Opinion in Pediatrics
Fei Xiao, Liaobin Chen
BACKGROUND: The aim of the study was to investigate the effects of extracorporeal fucosylation of CD44 on the homing ability of rabbit bone marrow mesenchymal stem cells (BMSCs). METHODS: The rabbit BMSCs were extracorporeal fucosylated using alpha-(1,3)-fucosyltransferase VI (FTVI), then the positive rate of sialyl-LewisX (sLeX ) and the binding rate of E-selectin were detected by flow cytometry, as well as the fluid adhesion of rabbit BMSCs were detected by the parallel flow chamber adhesion test...
December 5, 2018: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Silvio Demitri, Giovanni Vicenti, Massimiliano Carrozzo, Davide Bizzoca, Dania De Franceschi, Biagio Moretti
The treatment of open distal tibia fractures remains challenging, particularly when the fracture involves severe soft tissue damage and segmental bone loss. We present the case of a 33-year-old woman who sustained an open distal tibia fracture type 43-A3.3, with segmental bone loss, and a closed bifocal fibular fracture. The fractures were initially fixed with a temporary external fixator. The open distal tibial fracture underwent an intramedullary nailing on day six post-trauma, while the segmental bone loss was refilled with a temporary cement spacer, in order to create a biologic chamber, according to the technique by Masquelet et al...
December 2018: Injury
Mauricio Kfuri, Joseph Schatzker
Tibial plateau fractures have a broad spectrum of presentations, depending on the mechanism and energy of the trauma. Many classification systems are currently available to describe these injuries. In 1974, Schatzker proposed a classification based on a two-dimensional representation of the fracture. His classification with the six-principles types became one of the most utilized classification systems for tibial plateau fractures. More than four decades after this original publication, we are revisiting each fracture type in the light of information made available by computed tomography, which today comprises a standard tool in assessing articular fractures...
December 2018: Injury
Pishtiwan Hassan Shaker Kalmet, Yvette Y Van Horn, Sebastian Sanduleanu, Henk A M Seelen, Peter R G Brink, Martijn Poeze
INTRODUCTION: A Dutch survey among orthopedic surgeons and trauma surgeons showed that almost 90% of the surgeons do not follow protocols regarding the weight bearing aftercare for tibial plateau fractures. Clinical studies comparing permissive weight bearing (PWB) versus restricted weight bearing (RWB) after surgically treated tibial plateau fractures are not available. The aim of this study was to inventory potential differences in quality of life and pain, and number of complications in patients with surgically treated tibial plateau fractures who followed a PWB regime, relative to those that followed a RWB regime...
December 6, 2018: Archives of Orthopaedic and Trauma Surgery
Sefa Giray Batıbay, İsmail Türkmen, Sedat Duman, Savaş Çamur, Necdet Sağlam, Sevilay Batıbay
BACKGROUND: The aim of this study was to determine if the use of tranexamic acid (TXA) during intramedullary reaming treatment for tibial diaphyseal fractures was safe, reduced blood loss, or affected cost effectiveness. METHODS: A total of 70 patients with a tibia diaphysis fracture were randomized into 2 groups and prospectively followed for data on blood loss, thrombosis, and fracture healing. Preoperative TXA was administered intravenously to Group A, and Group B served as the control group...
November 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
Gerard A Sheridan, Kevin Clesham, S R Kearns
Introduction The purpose of this study is to evaluate the factors that impact the clinical and radiographic outcomes in a patient cohort undergoing external fixation for tibial fractures. We also aim to investigate the use of autograft, allograft, and synthetic bone graft in varying combinations in the setting of tibial bone loss with respect to optimal times to union. Methods This was a retrospective study, including 46 patients treated with a circular external fixator for the management of acute tibial fractures...
September 25, 2018: Curēus
Jae Gyoon Kim
Lateral hinge fracture (LHF) is a common complication after opening wedge high tibial osteotomy. Such a fracture can be caused by many factors such as osteotomy level, amount of opening, hinge position, and kind of plate. In particular, long locking plates have superior biomechanical stability in cases of LHF compared with short plates. Therefore, these long locking plates should be used in cases of LHF after opening wedge high tibial osteotomy.
December 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Deepak Nanda, Shamendra Anand Sahu, Durga Karki, Sanjay Kumar, Amrita Mandal
Background: Despite advances in surgical skills, adipofascial flaps are still less preferred option for coverage of leg defect. We evaluate the use of perforator-based adipofascial flap in small-to-medium-sized soft-tissue defects in the lower limb. Patients and Methods: After localisation of perforators along the major axial vessels in the lower limb using handheld Doppler, adipofascial flap based on the nearest best perforator of anterior tibial artery, posterior tibial artery and peroneal artery was raised to cover soft-tissue defect in 21 patients...
May 2018: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Seung-Beom Han, Yong In, Kwang Jun Oh, Kwang Yun Song, Seok Tae Yun, Ki-Mo Jang
BACKGROUND: The aim of this study is to investigate complications following medial opening-wedge high tibial osteotomy using a locking plate. In addition, we aimed to compare postoperative outcomes between the complicated and the uncomplicated group. METHODS: This study enrolled 209 patients who underwent medial opening-wedge high tibial osteotomy between 2010 and 2015. Patients with a follow-up period of at least 2 years were enrolled. Medical records and radiologic data were retrospectively reviewed...
November 14, 2018: Journal of Arthroplasty
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