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Tibial fractures

Nils Jan Bleeker, Megan Cain, Mariana Rego, Aimane Saarig, Andrew Chan, Inger Sierevelt, Job N Doornberg, Ruurd L Jaarsma
INTRODUCTION: The purpose of this study is to evaluate the intra- and inter-observer reliability of low-dose protocolled bilateral postoperative Computed Tomography (CT)-assessment of rotational malalignment after intramedullary nailing (IMN) of tibial shaft fractures. MATERIALS AND METHODS: 156 patients were prospectively included with tibial shaft fractures that were treated with IMN in a Level-I Trauma Centre. All patients underwent post-operative bilateral low-dose CT-assessment (effective dose of 0...
July 29, 2018: Injury
Xiao Chen, Hai-Tao Xu, Hong-Jun Zhang, Jing Chen
BACKGROUND: Numerous studies have compared suprapatellar (SP) nailing to infrapatellar (IP) nailing for treatment of tibial shaft fractures; however, the best strategy remains controversial. The aim of this meta-analysis is to assess whether SP or IP nailing is more effective for tibial shaft fractures in adults. METHODS: Literature searches of PubMed, Embase, OVID, Cochrane Library, Web of Science, Chinese Biomedical Literature, Wanfang, Weipu Journal, and CNKI databases were performed up to July 2017...
August 2018: Medicine (Baltimore)
Vanessa R Serratore, Matthew D Barnhart
OBJECTIVE: To describe the surgical technique and report the short-term results after removal of tibial tuberosity advancement (TTA) cages in dogs with surgical site infections (SSI). STUDY DESIGN: Retrospective clinical study. ANIMALS: Seventeen client-owned dogs. METHODS: Medical records of dogs treated for SSI by removal of a TTA cage between November 2012 and May 2015 were reviewed. Information collected included signalment, physical examination findings, affected stifle, cage size, date of SSI onset, time elapsed to implant removal, duration of procedure, culture results, any complications encountered, timing of follow-up recheck, and short-term results...
August 9, 2018: Veterinary Surgery: VS
Avinesh Agarwalla, Richard Puzzitiello, Grant H Garcia, Brian Forsythe
Anterior cruciate ligament (ACL) reconstruction with a bone-patellar tendon-bone autograft yields good clinical outcomes. Despite appropriate clinical outcomes, the most common complaint after reconstruction with a bone-patellar tendon-bone autograft is anterior knee pain at the donor graft sites. Synthetic bone grafts, such as beta-tricalcium phosphate (β-TCP), have been previously used to fill the bony defect in fractures as well as removal of bony tumors, and have shown positive utility in improving anterior knee pain after ACL reconstruction...
July 2018: Arthroscopy Techniques
Ji-Qi Wang, Bing-Jie Jiang, Wei-Jun Guo, Wei-Jiang Zhang, A-Bing Li, You-Ming Zhao
INTRODUCTION: Arthroscopic-assisted balloon tibioplasty is an emerging technology that has shown advantages in recovering depression of the articular surface. However, studies evaluating clinical outcomes between arthroscopic-assisted balloon tibioplasty and traditional open reduction internal fixation (ORIF) are sparse. This is the first randomised study to compare arthroscopic-assisted balloon tibioplasty with ORIF, and will provide guidance for treating patients with Schatzker types II, III and IV with depression of the medial tibial plateau only...
August 8, 2018: BMJ Open
Qiang Wei, Zhao Wang, Jeonghyun Woo, Jacobus Liebenberg, Sang-Kyoon Park, Jiseon Ryu, Wing-Kai Lam
BACKGROUND: The previous studies on basketball landing have not shown a systematic agreement between landing impacts and midsole densities. One plausible reason is that the midsole densities alone used to represent the cushioning capability of a shoe seems over simplified. The aim of this study is to examine the effects of different landing heights and shoes of different cushioning performance on tibial shock, impact loading and knee kinematics of basketball players. METHODS: Nineteen university team basketball players performed drop landings from different height conditions (0...
2018: PloS One
Seung Min Ryu, Chang Hyun Choi, Han Seok Yang, Wook Tae Park, Oog Jin Shon, Sam-Guk Park
PURPOSE: Treatment of a tibial plateau fracture (TPF) remains controversial and is generally challenging. Many authors report good results after conventional open reduction and internal fixation in TPF, but complications still occur. This study analyzed causes and outcomes of revision surgery for TPF. The usefulness of a flow chart for revision surgery in TPF was also evaluated. METHODS: We reviewed all patients who underwent more than two operations for a TPF between 2008 and 2015...
August 8, 2018: International Orthopaedics
Arnaud Diffo Kaze, Stefan Maas, Slawomir Kedziora, James Belsey, Alexander Haupert, Claude Wolf, Alexander Hoffmann, Dietrich Pape
BACKGROUND: Many different fixation devices are used to maintain the correction angle after medial open wedge high tibial osteotomy (MOWHTO). Each device must provide at least sufficient mechanical stability to avoid loss of correction and unwanted fracture of the contralateral cortex until the bone heals. In the present study, the mechanical stability of following different implants was compared: the TomoFix small stature (sm), the TomoFix standard (std), the Contour Lock, the iBalance and the second generation PEEKPower...
August 8, 2018: Journal of Experimental Orthopaedics
Harm Hoekstra, Jasper Vanhees, Juriaan van den Berg, Stefaan Nijs
We describe the operative management of extended lateral column fractures according to the revised three-column classification approach in a step-by-step fashion. We show that direct reduction and stable fixation of extended lateral column tibial plateau fractures via a limited arthrotomy and tibia condyle osteotomy, with the use of free subchondral 2.7 mm locking screws is a reliable technique. Subsequently, diverging VA-LCP locking screws further improve the structural properties. It is a straightforward technique and the single lateral approach (Lazy-S) facilitates direct reduction of the articular surface and stable fixation of the fracture fragments under direct vision with good radiological and fair functional outcome...
July 27, 2018: Injury
Tobias M Kraus, Charlotte Abele, Thomas Freude, Atesch Ateschrang, Ulrich Stöckle, Fabian M Stuby, Steffen Schröter
BACKGROUND: Tibial plateau fractures requiring surgery are severe injuries of the lower extremity. Tibial plateau fractures have an impact not only on physically demanding jobs but notably on general professional life too. The aim of this study was to assess how the professional activity of patients will be affected after a tibial plateau fracture. METHODS: 39 consecutive patients (ages 20-61 years) were retrospectively included in the study and were clinically examined at a minimum of 14 month postoperatively...
August 7, 2018: BMC Musculoskeletal Disorders
Peter Kloen, Olivier D R van Wulfften Palthe, Jorn Nützinger, Johanna C E Donders
OBJECTIVE: To describe patients' outcomes after revision of tibial plateau fracture fixation within 12 months of the initial surgical procedure. To assess differences in objective outcome scores (IKDC, SF-36, arthrosis score, physical examination) depending on whether patients were treated for mal-reduction, mal-union, or non-union. DESIGN: Retrospective case series. PATIENTS: Twenty-seven patients who underwent revision within 1 year of primary surgery and with a minimum follow up of 1 year...
July 30, 2018: Journal of Orthopaedic Trauma
Jonathan D Gillig, Russell D Goode, Brian Campfield, Julia R Crim, Brett D Crist
OBJECTIVES: To address the safety of obtaining magnetic resonance imaging (MRI) in patients with temporary knee-spanning external fixators placed for tibial plateau fractures. DESIGN: IRB approved retrospective review SETTING:: Level 1 trauma center PATIENTS/PARTICIPANTS:: Records were reviewed on patients with knee-spanning external fixators applied during staged management of tibial plateau fractures from 2009-2015 and who also had an MRI performed. MAIN OUTCOME MEASUREMENTS: complications associated with the MRI; secondary outcomes were pain scores, narcotic requirements, and fracture healing...
July 16, 2018: Journal of Orthopaedic Trauma
Jeffery J Biskup, Joseph P Weigel, Peter K Liaw, Xie Xie
OBJECTIVE To assess the contribution of antirotational pins (ARPs) and an intact fibula to the compressive strength of 4 tibial plateau leveling osteotomy (TPLO) constructs (bone and implants). SAMPLE 20 hind limbs from 10 canine cadavers. PROCEDURES Each hind limb was assigned to 1 of 4 TPLO constructs (construct in which the ARP was removed, constructs in which 1 or 2 ARPs were left in place, and construct in which the ARP was removed and the fibula was cut). Following TPLO completion, all limbs underwent mechanical testing that included 10,000 cycles of cyclic axial compression followed by testing to failure at a displacement rate of 1 mm/s...
June 2018: American Journal of Veterinary Research
Lauren C Leffler, Stephanie L Tanner, Michael L Beckish
While long leg casts have been historically recommended for immobilization of toddler's fractures, short leg casts are often used by treating physicians. Others question whether any immobilization is necessary because of the internal stability provided by the thickened periosteum of pediatric bones. The purpose of this study is to review the results of toddler's fractures treated with long leg casts, short leg casts, or without immobilization. Eighty-five patients were included in a retrospective review of nondisplaced spiral or oblique tibial shaft fractures in children under 6 years old from 2007 to 2012...
2018: Journal of Surgical Orthopaedic Advances
Yujin Suto, Katsuhiro Nagata, Syed Ahmed, Christina Jacovides, Kevin D Browne, John Cognetti, Victoria E Johnson, Ryan Leone, Lewis J Kaplan, Douglas H Smith, Jose L Pascual
Progression of severe TBI is associated with worsening cerebral inflammation but it is unknown how a concomitant bone fracture (FX) affects this progression. Enoxaparin (ENX), a low molecular weight heparin often used for venous thromboembolic prophylaxis, decreases penumbral leukocyte (LEU) mobilization in isolated TBI and improves neurological recovery. We investigated if TBI accompanied by a FX worsens leukocyte mediated cerebral inflammation and if ENX alters this process. CD1 male mice underwent controlled cortical impact (CCI) or sham craniotomy with or without an open tibial fracture, and received either ENX (1mg/kg, 3 times/day) or saline for 2 days following injury...
August 7, 2018: Journal of Neurotrauma
Susan A Hendrickson, Rosemary A Wall, Oliver Manley, William Gibson, Deirde Toher, Katy Wallis, Jayne Ward, David L Wallace, Michael Lamyman, Anna-Victoria Giblin, Thomas C Wright, Umraz Khan
BACKGROUND: Recent national (NICE) guidelines in England recommend that initial debridement and wound excision of open tibial fractures take place within 12 h of the time of injury, a change from the previous target of 24 h. This study aims to assess the effect of timing of the initial debridement and wound excision on major infective complications, the impact of the new guidance, and the feasibility of adhering to the 12 h target within the infrastructure currently existing in four major trauma centres in England...
July 27, 2018: Injury
Priscila R Oliveira, Marcos C Leonhardt, Vladimir C Carvalho, Kodi E Kojima, Jorge S Silva, Flavia Rossi, Ana Lucia L Lima
BACKGROUND: Diaphyseal fractures of femur and tibia are prominent due to its high incidence and high economic and social impact. Intramedullary nailing (IN) is the surgical procedure of choice. Surgical site infection (SSI) related to this procedure is considered a difficult to treat complication. AIMS: Determine the incidence of SSI after IN of femoral and tibial diaphyseal fractures and evaluate possible risk factors. METHODS: Prospective observational cohort study...
July 27, 2018: Injury
Christian Fischer, Tabea Haug, Marc-Andre Weber, Hans-Ulrich Kauczor, Thomas Bruckner, Gerhard Schmidmaier
PURPOSE:  To assess the value of CEUS in the evaluation of tibial fracture perfusion and its ability to differentiate between physiologic and abnormal fracture healing. MATERIALS AND METHODS:  From 2014 to 2017, 107 patients with tibial fractures or tibial non-unions underwent CEUS examination. CEUS was performed at the regular follow-up examination 26 weeks after osteosynthesis or before non-union surgery. Time-intensity curves (TICs) of the contrast enhancement in the fracture gap were generated, and volume parameters such as wash-in rate (WiR), peak enhancement (PE) and wash-in perfusion index (WiPI) were quantified...
August 6, 2018: Ultraschall in der Medizin
Linzhen Xie, Chunhui Chen, Yingying Zhang, Wenhao Zheng, Hua Chen, Leyi Cai
PURPOSE: The objective of this meta-analysis was to assess the influence of three dimensional printing technology on the open reduction and internal fixation (ORIF) of tibial plateau fractures from current randomized controlled trials and prospective comparative studies. METHODS: The electronic literature database of Pubmed, Embase, and Cochrane library were searched in January 2018. The data operation time, intraoperative blood loss, follow-up knee function (Rasmussen score, HSS) and complications (including infection, screw loosening, knee stiffness, knee instability, posttraumatic osteoarthritis, VTE) were extracted...
August 3, 2018: International Journal of Surgery
Rui Hu, Yi-Jun Ren, Li Yan, Xin-Cheng Yi, Fan Ding, Qiong Han, Wen-Jun Cheng
Background: Gustilo Anderson III B/C open tibial fractures are more difficult to manage than I, II, and III A fractures. These open tibial fractures are often associated with wound infection, soft tissue necrosis, bone nonunion, osteomyelitis or amputation. Staged treatment for this severe trauma is very necessary. Materials and Methods: 25 cases of Gustilo Anderson IIIB/C open tibial fractures with serious soft-tissue defects treated between January 2010 and January 2015 were included in this study...
July 2018: Indian Journal of Orthopaedics
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