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Tibial stress fracture

Mahmoud Jabalameli, Hossein A Hadi, Abolfazl Bagherifard, Mohammad Rahbar, Mohammadreza Minator Sajjadi
Background: Presentation of proximal tibia stress fracture is not infrequent among elderly patients due to their poor bone stock. Optimal management of patients with severe gonarthrosis of the knee and concurrent tibial stress fracture is not known yet. In this study we report the outcome of primary total knee arthroplasty (TKA) using stemmed components in elderly patients. Methods: Between 2009 and 2014, a total of 16 elderly patients with proximal tibial stress fractures and concurrent gonarthrosis were treated with TKA using long stemmed components...
September 2018: Archives of Bone and Joint Surgery
Rathin Maity, Santanu Majumder, Amit Roychowdhury, Subrata Saha
The goal of this finite element study is to reduce the stress shielding effect in tibial fracture fixation. Five different plates with modified geometry have been modeled. The fracture gap is assumed to be filled with callus, which is new born healing tissue. The effect of different plate modifications in four different healing stages has been compared to the nonmodified plate. It has been observed that all the modified models have higher callus stress than the nonmodified model, and the best modified plate has reduced the stress shielding effect by 117% for the first healing stage...
2018: Journal of Long-term Effects of Medical Implants
Omar M Albtoush, Marius Horger, Fabian Springer, Jan Fritz
The Segond fracture is a tibial avulsion injury of the insertion of the middle third of the lateral capsular ligament that is typically associated with anterior cruciate ligament and meniscal tears. The classically assigned mechanism of injury is a combination of internal rotation and varus stress. We report two cases of Segond fractures that presented with a variant pattern including osseous avulsion injuries of the medial collateral ligament at the femoral origin, anterior cruciate ligament tear, and pivot shift-type osseous contusion pattern, suggesting an alternative mechanism of injury that includes dominant valgus stress and external rotation components...
September 11, 2018: Clinical Imaging
Dale L Robinson, Hongyuan Jiang, Qichun Song, Christopher Yates, Peter Vee Sin Lee, John D Wark
Fracture risk assessment using dual-energy X-ray absorptiometry (DXA) frequently fails to diagnose osteoporosis amongst individuals who later experience fragility fractures. Hence, more reliable techniques that improve the prediction of fracture risk are needed. In this study, we evaluated a finite element (FE) modelling framework based on clinical peripheral quantitative computed tomography (pQCT) imaging of the tibial epiphysis and diaphysis to predict the stiffness at these locations in compression, shear, torsion and bending...
October 6, 2018: Biomechanics and Modeling in Mechanobiology
Philostratos Klidaras, Jacqueline Severt, Deborah Aggers, Jason Payne, Paul D Miller, Steven W Ing
Infants and children with hypophosphatasia (HPP) treated with asfotase alfa show improvement in bone mineralization and motor function, but it is unclear whether the medication can affect fracture healing in adult HPP patients. We present the course of fracture healing in two adults with HPP on enzyme replacement. Case 1 is a 41-year-old female with infantile-onset HPP who was wheelchair-bound due to a nonhealing tibial fragility fracture sustained 3 years before and also had nonhealing femoral pseudofracture sustained 17 years before starting asfotase alfa therapy in December 2015...
September 2018: JBMR Plus
Takumi Matsumoto, Song Ho Chang, Ryutaro Takeda, Sakae Tanaka, Takuo Juji
Adult-acquired flatfoot deformity is a progressive flattening of the arch of the foot that results from posterior tibial tendon insufficiency with a predilection for middle-aged women. A lateralized force vector associated with hindfoot valgus in adult-acquired flatfoot produces lateral ankle pain due to impingement at the lateral hindfoot, which can even lead to stress fractures of the distal fibula. Here, we present the rare case of a 73-year-old woman who presented with stress fractures of the bilateral taluses and unilateral distal fibula accompanied by severe adult-acquired flatfoot deformities...
2018: Case Reports in Orthopedics
Kelly R Sheerin, Duncan Reid, Thor F Besier
BACKGROUND: Impact loading in runners, assessed by the measurement of tibial acceleration, has attracted substantial research attention. Due to potential injury links, particularly tibial fatigue fractures, tibial acceleration is also used as a clinical monitoring metric. There are contributing factors and potential limitations that must be considered before widespread implementation. AIM: The objective of this review is to update current knowledge of the measurement of tibial acceleration in runners and to provide recommendations for those intending on using this measurement device in research or clinical practice...
September 14, 2018: Gait & Posture
Nirav K Patel, Joanna Horstman, Victoria Kuester, Senthil Sambandam, Varatharaj Mounasamy
Tibial shaft fractures are one of the most common pediatric fractures. They require appropriate diagnosis and treatment to minimize complications and optimize outcomes. Diagnosis is clinical and radiological, which can be difficult in a young child or with minimal clinical findings. In addition to acute fracture, Toddler's and stress fractures are important entities. Child abuse must always be considered in a nonambulatory child presenting with an inconsistent history or suspicious concomitant injuries. Treatment is predominantly nonoperative with closed reduction and casting, requiring close clinical and radiological followup until union...
September 2018: Indian Journal of Orthopaedics
Anouk H van der Vossen, Mario Maas
A 23-year-old female athlete presented with progressive pain in her right lower leg since 3 months. Conventional radiography did not reveal a fracture. However, a CT-scan showed a proximal posteromedial tibial stress fracture, matching with the localisation of the pain.
August 16, 2018: Nederlands Tijdschrift Voor Geneeskunde
Jun Komatsu, Atsuhiko Mogami, Hideaki Iwase, Osamu Obayashi, Kazuo Kaneko
Posterior tibial stress fractures are more frequent than anterior tibial stress fractures, and they are considered to have a good prognosis for returning to sports; cases leading to a complete fracture are rare. A 17-year-old male involved in high school athletics middle-distance running had a 3-week history of pain with training. He was running up to 300 km/week on streets and cross-country in an even distribution. He had posterior tibial stress fractures, but despite the lower leg pain, he continued running...
September 7, 2018: Archives of Orthopaedic and Trauma Surgery
Yan Xiong, Xueliang Zhao, Hongyi Xiang, Yunjiao Wang, Zhikang Liao, Xiyan Zhu, Hui Zhao
Background and Objective: Knee joint collision injuries occur frequently in military and civilian scenarios, but there are few studies assessing longitudinal impacts on knee joints. In this study, the mechanical responses and damage characteristics of knee longitudinal collisions were investigated by finite element analysis and human knee impact tests. Materials and methods: Based on a biocollision test plateau, longitudinal impact experiments were performed on 4 human knee joints (2 in the left knee and 2 in the right knee) to measure the impact force and stress response of the bone...
2018: Applied Bionics and Biomechanics
Wenjie Pan, Yan He, Jianbing Ma, Lin Xiao, Kuo Jang
Abstract: To evaluate the early effectiveness of one-stage total knee arthroplasty (TKA) with tibial stem extender for knee arthritis complicated with tibial stress fractures. Methods: Between January 2014 and November 2016, 12 patients (12 knees) with knee arthritis and tibial stress fractures underwent one-stage TKA with tibial stem extender. There were 5 males and 7 females with an average age of 71.5 years (range, 60-77 years). There were 8 cases with osteoarthritis and 4 cases with rheumatoid arthritis...
September 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Paola Chivers, Timo Rantalainen, Fleur McIntyre, Beth Hands, Benjamin Weeks, Belinda Beck, Sophia Nimphius, Nicolas Hart, Aris Siafarikas
BACKGROUND: Australian adolescents with low motor competence (LMC) have higher fracture rates and poorer bone health compared to European normative data, but currently no normative data exists for Australians. AIMS: To examine whether there were bone health differences in Australian adolescents with LMC or Developmental Coordination Disorder (DCD) when compared to typically developing age-matched Australian adolescents. METHODS AND PROCEDURES: Australian adolescents aged 12-18 years with LMC/DCD (n = 39; male = 27; female = 12) and an Australian comparison sample (n = 188; boys = 101; girls = 87) undertook radial and tibial peripheral Quantitative Computed Tomography (pQCT) scans...
August 14, 2018: Research in Developmental Disabilities
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
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
Denise R Ramponi, Tara McSwigan
Tibial plateau fractures can result from direct trauma or indirect compressive forces. These injuries often result in significant soft tissue disruption, ligamentous disturbance in addition to bone fractures. Diagnostic imaging findings in plain radiographs include fat-fluid level in the suprapatellar bursa, malalignment of the femoral condyles and tibial edges, and increased trabecular density in the lateral epicondyle. Patients in whom a tibial plateau fracture is suspected with negative radiographs should have computerized tomography imaging performed...
July 2018: Advanced Emergency Nursing Journal
Martins Back Netto, Aloir Neri de Oliveira Junior, Mariana Goldim, Khiany Mathias, Maria Eduarda Fileti, Naiana da Rosa, Ana Olivia Laurentino, Bianca Xavier de Farias, Ana Beatriz Costa, Gislaine Tezza Rezin, Jucelia Jeremias Fortunato, Amanda Della Giustina, Tatiana Barichello, Felipe Dal-Pizzol, Fabricia Petronilho
Postoperative cognitive dysfunction (POCD) is defined by cognitive impairment determined by neuropsychological tests from before to after surgery. Several mechanisms have been proposed in this bidirectional communication between the immune system and the brain after surgery. We aimed at understanding the mechanisms underlying POCD elderly rats in an experimental tibial fracture model. Elderly male Wistar rats were subjected to tibial fracture (TF) model. Control (sham) and fracture (TF) groups were followed to determine nitrite/nitrate concentration; oxidative damage to lipids and proteins; the activity of antioxidant enzymes (superoxide dismutase-SOD and catalase-CAT), mitochondrial respiratory chain enzymes, and creatine kinase (CK); and BDNF levels in the hippocampus and prefrontal cortex (at 24 h and at seven days) and cognitive function through habituation to the open field task and novel object recognition task (only at seven days)...
October 2018: Brain, Behavior, and Immunity
Pamela B Lachniet, Jeffery A Taylor-Haas, Mark V Paterno, Christopher A DiCesare, Kevin R Ford
Background: Lower extremity overuse injuries, including bone stress injuries (BSI), are common in runners and may result in prolonged recovery and time off from running. Identifying risk factors for running-related overuse injuries may have a clinically relevant role in prevention of these injuries. Purpose: The purpose of this study was to compare an adolescent and young adult population of male runners known to have a history of BSI with an injury-free cohort and retrospectively assess for kinematic differences that may differentiate the two cohorts...
June 2018: International Journal of Sports Physical Therapy
Fatih Duygun, Cengiz Aldemir
OBJECTIVES: This study aims to investigate the effects of different amounts of compression used in intramedullary nailing on the stress values of the fracture surface and time of the union process in tibia diaphysis fractures treated with intramedullary nails. PATIENTS AND METHODS: Seventy patients (50 males, 20 females; mean age 34.0±10.7 years; range, 20 to 56 years) who had suffered from tibial shaft fractures between January 2007 and December 2015 were included in the study...
August 2018: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
Jennifer Kurowicki, Samuel J Mease, Steven Palacios, Anthony Festa, Vincent K McInerney, Anthony J Scillia
Recurrent patella instability is a common condition that may potentiate substantial knee dysfunction resulting in loss of time from work and sports. There are numerous factors that contribute to recurrent patella instability including tearing of the medial patellofemoral ligament (MPFL), shallow trochlea, valgus alignment, externally rotated tibia tubercle, ligamentous laxity, elevated Q angle, and increased tibial tuberosity trochlear groove distance. Reconstruction of the MPFL has been shown to restore patella stability where concomitant pathology is within acceptable limits...
June 2018: Arthroscopy Techniques
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