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open distal femur fracture

Martin Pietsch, Markus Hochegger, Martin Winkler, Sabrina Sandriesser, Thomas Freude, Peter Augat
PURPOSE: Valgus malalignment of the distal femur may be treated with corrective osteotomy. The purpose of this study was to compare the primary stability of a lateral opening-wedge osteotomy (LOWO) using a uniplanar compared to a biplanar technique. A study was carried out to test both surgeries, with both an intact medial cortex and with a deliberate attached cut of the medial cortex simulating a fracture. The primary hypothesis was that the biplanar technique provides higher axial and torsional stiffness...
December 13, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Tomasz Nizegorodcew, Giuseppe Palmieri, Marco Peruzzi, Marco Galli
BACKGROUND: Open articular fractures are an important issue due to their increasing incidence, along with the rise in motorcycle accidents. Oncology experience with allograft in orthopedics may be extended to cases of traumatic bone loss. CLINICAL CASE: A 37-year-old man with an open fracture of the distal femur and proximal tibia presented a massive bone loss of the lateral femoral condyle after a motorcycle accident. Following Damage Control Surgery, a considerable lateral femoral condyle allograft was used to restore the joint anatomy...
December 2018: Injury
Charles M Court-Brown, Andrew D Duckworth, Nicholas D Clement, Margaret M McQueen
INTRODUCTION: It is accepted that the incidence of fractures in patients aged ≥ 65 years is increasing but little is known about which fractures are becoming more common in this group of patients. Virtually all research has concentrated on the classic fragility fractures of the proximal femur, proximal humerus, pelvis, spine and distal radius but it is likely that other fractures are becoming more common. METHODS: We have examined two prospectively collected databases 10 years apart to see which fractures are becoming more common in ≥ 65 year old patients...
December 2018: Injury
M S Islam, M T Hossain, M N Uddin, M R Chowdhury, M S Hasan
We conducted a study to evaluate the reliability of the medial hemi-soleus muscle flap for wound coverage of infected open fracture of distal third of tibia. Wound coverage of exposed lower third tibia and ankle region remains a difficult task. Muscle flaps are preferred for infected wounds especially where there are exposed bone, joint and/or tendons. Soleus muscle is a good option for local reconstruction. Soleus being the prime ankle plantar flexor and stabilizer of the ankle in ambulation cannot be sacrificed without significant morbidity...
October 2018: Mymensingh Medical Journal: MMJ
Hazem A Farouk, Mostafa Saladin, Wessam Abu Senna, Walid Ebeid
PURPOSE: Assessment of the functional and oncologic outcomes regarding endoscopic curettage of different benign bone tumor types within variable anatomic locations. PATIENTS AND METHODS: During the period between February 2012 and December 2016, 26 patients with symptomatic intra-osseous benign bony lesions were included. The age ranged from 3 up to 49 years (mean 20), of 14 females and 12 males. The follow-up duration ranged from 26 up to 58 months (mean 41). Functional scoring was done according to the Revised Musculoskeletal Tumour Society Rating Scale...
2018: SICOT-J
Hosam E Matar, Paula Stritch, Nicholas Emms
Interprosthetic femur fractures between total hip and total knee replacements are challenging injuries with rising incidence. Stability of the either implants, quality, and quantity of remaining bone as well as patients' comorbidities play an important role in operative management. Open reduction and internal fixation, advanced revision arthroplasty techniques, and megaprostheses are available options. In more complex cases, custom-made implants maybe necessary to achieve immediate weight-bearing and restore function...
2018: Journal of Long-term Effects of Medical Implants
Khang H Dang, Connor A Armstrong, Ravi A Karia, Boris A Zelle
PURPOSE: Given the recent controversy in the literature and the alarming reports of early mechanical failure associated with the use of the Synthes 4.5 mm VA-LCP Curved Condylar Plate in acute distal femur fractures, the goal of our study was to examine the outcomes and mechanical failure rates of this implant in a larger patient population. METHODS: Patients 18 years of age and older who underwent plate fixation of their acute distal femoral fracture using the Synthes 4...
September 29, 2018: International Orthopaedics
Alexander B Christ, Harshvardhan Chawla, Elizabeth B Gausden, Jordan C Villa, David S Wellman, Dean G Lorich, David L Helfet
OBJECTIVES: To report outcomes and complications of periprosthetic distal femur fractures (PPDFF) treated with open reduction internal fixation (ORIF) using a plate construct, with or without endosteal augmentation. DESIGN: Retrospective Case Series. SETTING: One Level I trauma center and one tertiary care hospital. PATIENTS/PARTICIPANTS: Forty patients with PPDFFs, treated by 3 surgeons, were identified using an institutional trauma registry...
October 2018: Journal of Orthopaedic Trauma
Bi O Jeong, Duke Whan Chung, Jong Hun Baek
RATIONALE: Calcific myonecrosis is a very rare late sequela that occurs in patients who have had trauma accompanied by vascular compromise, in which a single muscle or entire muscles in a compartment undergoes necrosis and form a calcified mass. It is mostly a benign entity, but some cases cause bone destruction and form non-healing chronic sinuses. In such cases, wound management becomes difficult and there is a potential risk of secondary infection. PATIENT CONCERNS: A 60-year-old male was referred for evaluation of a pain, erythematous changes, and draining sinus of the anterolateral aspect of his left leg...
September 2018: Medicine (Baltimore)
Derrick M Knapik, Lewis G Zirkle, Raymond W Liu
BACKGROUND: Retrograde femoral nailing in skeletal immature patients would broaden the surgical options for fracture care and reconstructive procedures but involves violation of the open, active distal femoral physis with the potential for growth disturbance. The tolerance for putting a large diameter metal implant across the physis is largely unknown. The purpose of this pilot investigation was to define the upper limit of cross-sectional violation with a metal implant before causing premature growth arrest or inhibition using a sheep model...
November 2018: Journal of Pediatric Orthopedics
Seth R Yarboro
In this case, a lateral locking plate is used for fixation of a periprosthetic distal femur fracture in a 68-year-old woman. Modern implants with locking screw options and soft-tissue-sparing surgical techniques have improved the care of periprosthetic distal femur fractures. Although much debate about the working length and technical variables of plating exists, it is generally accepted that longer (>10 hole) plates with adequate working length and careful soft-tissue handling are preferred. This case outlines a stepwise approach to distal femur fractures to achieve appropriate plate position and restoration of alignment while avoiding excessive surgical exposure or soft-tissue dissection...
August 2018: Journal of Orthopaedic Trauma
Dax Varkey, Robert F Ostrum
Fractures of the distal femur with intercondylar extension and comminution are challenging cases and demand a thorough preoperative evaluation and execution of proper surgical technique. Identification of the intra-articular fractures, including coronal fractures of the lateral condyle, is important in planning surgery and emphasizes the need for computerized tomography scans. Recent advances with anatomic, locking plates have made minimally invasive surgery easier, but joint reduction needs to be performed meticulously in an open manner, and restoration of the mechanical alignment through plate fixation is essential for a good clinical outcome...
August 2018: Journal of Orthopaedic Trauma
Mattia Loppini, Guido Grappiolo
Over the last two decades, several conservative femoral prostheses have been designed. The goals of conservative stems include: the spearing of the trochanteric bone stock; a more physiological loading in the proximal femur reducing the risk of stress shielding; and to avoid a long stem into the diaphysis preventing impingement with the femoral cortex and thigh pain.All stems designed to be less invasive than conventional uncemented stems are commonly named 'short stems'. However, this term is misleading because it refers to a heterogeneous group of stems deeply different in terms of design, biomechanics and bearing...
May 2018: EFORT Open Reviews
Victoria Schlanser, Andrew Dennis, Katarina Ivkovic, Kimberly Joseph, Matthew Kaminsky, Thomas Messer, Stathis Poulakidas, Frederic Starr, Faran Bokhari
Reconstruction of skin and soft tissue wounds can pose a unique surgical challenge. This is especially true for cases of exposed bone and tendon where soft tissue loss is extensive and opportunities for tissue advancement or rotation are limited. A clinical case is presented describing an experience with dehydrated human amnion/chorion membrane (dHACM, EpiFix®/AmnioFix®, MiMedx Group, Marietta, GA) graft to obtain granulation over an open fracture with desiccated bone. The 22-year-old female trauma patient presented with high-grade bilateral lower extremity soft tissue loss after being run over and dragged by a semitruck...
December 5, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
Tao Ji, Wei Guo, Rongli Yang, Xiaodong Tang, Dasen Li, Yi Yang
Objective: To investigate the surgical characteristics and preliminary effectiveness of Orthofix unilateral external fixator in the treatment of musculoskeletal tumors. Methods: Twenty-two patients received Orthofix unilateral external fixator treatment for bone defect after tumor excision or complications after limb salvage surgery between June 2011 and March 2016. There were 11 males and 11 females with a median age of 23.5 years (range, 4-57 years). The bone defect or limb length discrepancy after tumor resection was at proximal femur in 6 cases, distal femur in 8 cases, diaphysis of femur in 3 cases, proximal tibia in 2 cases, and diaphysis of tibia in 3 cases...
October 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
Philip K Lim, Bharat Sampathi, Nathan M Moroski, John A Scolaro
Traumatic through-knee or transfemoral amputations with concomitant ipsilateral femoral fractures are extremely rare injuries. The initial goal of management is patient resuscitation and stabilization. Subsequent interventions focus on limb salvage and the creation of a residual limb that can be fitted successfully for a functional lower extremity prosthesis. We present the case of a patient who sustained a traumatic through-knee amputation ipsilateral to an open comminuted femoral fracture. Soft tissue injury prohibited initial primary closure over the distal femoral condyles...
May 23, 2018: Strategies in Trauma and Limb Reconstruction
Luis Grau, Kevin Collon, Ali Alhandi, David Kaimrajh, Maria Varon, Loren Latta, Fernando Vilella
INTRODUCTION: The aim of this study is to evaluate the biomechanical effect of filling locking variable angle (VA) screw holes at the area of metaphyseal fracture comminution in a Sawbones® (Sawbones USA, Vashon, Washington) model (AO/OTA 33A-3 fracture) using a Synthes VA locking compression plate (LCP) (Depuy Synthes, Warsaw, Indiana). MATERIALS AND METHODS: Seven Sawbones® femur models had a Synthes VA-LCP placed as indicated by the manufacturers technique...
June 1, 2018: Surgical Technology International
D Eschbach, B Buecking, H Kivioja, M Fischer, T Wiesmann, R Zettl, L Oberkircher, J Barthel, R Aigner, S Ruchholtz, C Bliemel
INTRODUCTION: Arthroplasty of the hip and knee is 1 of the 20 most frequent operations in Germany. Periprosthetic fracture is one of the most feared complications following primary or revision arthroplasty. Present publication aims to analyse differences between patients with periprosthetic fracture around total knee arthroplasty (PFTKA) and patients with periprosthetic fracture around total hip arthroplasty (PFTHA) concerning demographics, clinical course, complications and return to pre-fracture mobility...
June 2018: Injury
Paul M Lichstein, John P Kleimeyer, Michael Githens, John S Vorhies, Michael J Gardner, Michael Bellino, Julius Bishop
BACKGROUND: A well-reduced femoral neck fracture is more likely to heal than a poorly reduced one, and increasing the quality of the surgical exposure makes it easier to achieve anatomic fracture reduction. Two open approaches are in common use for femoral neck fractures, the modified Smith-Petersen and Watson-Jones; however, to our knowledge, the quality of exposure of the femoral neck exposure provided by each approach has not been investigated. QUESTIONS/PURPOSES: (1) What is the respective area of exposed femoral neck afforded by the Watson-Jones and modified Smith-Petersen approaches? (2) Is there a difference in the ability to visualize and/or palpate important anatomic landmarks provided by the Watson-Jones and modified Smith-Petersen approaches? METHODS: Ten fresh-frozen human pelvi underwent both modified Smith-Petersen (utilizing the caudal extent of the standard Smith-Petersen interval distal to the anterosuperior iliac spine and parallel to the palpable interval between the tensor fascia lata and the sartorius) and Watson-Jones approaches...
July 2018: Clinical Orthopaedics and related Research
Greta S Pavarotti, Randy J Boudrieau
OBJECTIVE:  The aim of this article was to describe the surgical re-alignment technique and stabilization of a distal femoral deformity in a 6-week-old, male, Foxhound. METHODS:  A healing metaphyseal fracture, resulting in a valgus deformity with internal rotation, was observed just proximal to the distal femoral physis. The deformity was treated by an opening wedge osteotomy with lateral translation and external rotation of the distal epiphysis using a guide-wire technique; a corticocancellous allograft bridged the defect, which was stabilized with a 2...
May 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
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