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Fracture joint orthopaedics

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https://www.readbyqxmd.com/read/27909130/the-use-of-ultra-low-dose-ct-scans-for-the-evaluation-of-limb-fractures-is-the-reduced-effective-dose-using-ct-in-orthopaedic-injury-reduction-protocol-effective
#1
S R Konda, A M Goch, P Leucht, A Christiano, S Gyftopoulos, G Yoeli, K A Egol
AIMS: To evaluate whether an ultra-low-dose CT protocol can diagnose selected limb fractures as well as conventional CT (C-CT). PATIENTS AND METHODS: We prospectively studied 40 consecutive patients with a limb fracture in whom a CT scan was indicated. These were scanned using an ultra-low-dose CT Reduced Effective Dose Using Computed Tomography In Orthopaedic Injury (REDUCTION) protocol. Studies from 16 selected cases were compared with 16 C-CT scans matched for age, gender and type of fracture...
December 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27902166/is-intramedullary-nailing-applicable-for-distal-tibial-fractures-with-ankle-joint-extension
#2
Ozan Beytemür, Cem Albay, Oktay Adanır, Serdar Yüksel, Mehmet Akif Güleç
OBJECTIVES: This study aims to evaluate the functional and radiographic results and treatment complications of AO/OTA (Arbeitsgemeinschaft fur Osteosynthesefragen/Orthopaedic Trauma Association) type 43C1 and C2 fractures treated with intramedullary nailing. PATIENTS AND METHODS: We retrospectively evaluated 35 AO/OTA type 43C1 and C2 patients (26 males, 9 females; mean age 39.8±16.9 years; range 19 to 82 years) treated with intramedullary nailing. Two interfragmentary screws out of nail were applied in 10 patients (29%), while one interfragmentary screw out of nail was applied in 17 patients (49%)...
December 2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/27890891/mid-term-clinical-results-of-versys-hip-system-zimmer-uncemented-total-hip-replacement-arthroplasty
#3
Hidemi Kawaji, Takuya Uematsu, Naoya Hoshikawa, Hiroshi Watanabe, Shinro Takai
: Recent reports suggest that uncemented total hip replacement arthroplasty (THR) results in favorable short- to mid-term clinical results. In the present study, we assessed the mid-term clinical results of VerSys Hip System uncemented THR at our hospital. MATERIALS AND METHODS: We studied patients who received THR using VerSys Hip System and who could be followed-up more than 3 years. Clinical records were used to retrospectively identify patient characteristics, which included age, gender, disease requiring THR, preoperative and postoperative pain score of the Japan Orthopaedic Association scoring system, range of motion in flexion and abduction, operating time, intraoperative complication, and additional operation or revision surgery...
2016: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
https://www.readbyqxmd.com/read/27852383/-surgery-of-ipsilateral-hawkins-%C3%A2-talus-neck-and-ankle-joint-fractures-via-internal-and-lateral-approaches-with-herbert-screws
#4
P Zhang, Q R Dong, Z Y Wang, B Chen, J H Wan, L Wang
Objective: To explore the manual operation skills of operative treatment of ipsilateral Hawkins Ⅲ talus neck and ankle joint fractures via internal and lateral approaches with Herbert screws, and to study the clinical results. Method: From Jan 2009 to Dec 2014, the clinical data of 13 patients with ipsilateral Hawkins Ⅲ talus neck and ankle joint fractres via internal and lateral approaches with Herbert screws were retrospectively analyzed in our department.There were 10 males and 3 female, ranging in age from 20 to 60 years with an average age of 31...
November 8, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27814724/severe-open-lisfranc-injuries-one-stage-operation-through-internal-fixation-associated-with-vacuum-sealing-drainage
#5
Wenqing Qu, Shuqin Ni, Zhenhai Wang, Yong Zhao, Shimin Zhang, Yiheng Cheng, Tong Liu, Min Yu, Dan Wang
BACKGROUND: This study aimed to investigate the clinical feasibility of treating severe open Lisfranc injuries by means of one-stage internal fixation with k-wires associated with vacuum sealing drainage (VSD). METHODS: The clinical outcomes of 20 cases of severe open Lisfranc joint fracture-dislocation treated by using one-stage internal fixation with k-wires associated with VSD, after debridement and suturing during emergency treatment, were reviewed. RESULTS: At 6 and 12 months after surgery, the American Orthopaedic Foot and Ankle Society midfoot scores were 69...
November 4, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27803231/the-use-of-high-dose-dual-impregnated-antibiotic-laden-cement-with-hemiarthroplasty-for-the-treatment-of-a-fracture-of-the-hip-the-fractured-hip-infection-trial
#6
A P Sprowson, C Jensen, S Chambers, N R Parsons, N M Aradhyula, I Carluke, D Inman, M R Reed
AIMS: A fracture of the hip is the most common serious orthopaedic injury, and surgical site infection (SSI) is one of the most significant complications, resulting in increased mortality, prolonged hospital stay and often the need for further surgery. Our aim was to determine whether high dose dual antibiotic impregnated bone cement decreases the rate of infection. PATIENTS AND METHODS: A quasi-randomised study of 848 patients with an intracapsular fracture of the hip was conducted in one large teaching hospital on two sites...
November 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27796800/is-pes-cavus-alignment-associated-with-lisfranc-injuries-of-the-foot
#7
Jeremy D Podolnick, Daniel S Donovan, Nicholas DeBellis, Alejandro Pino
BACKGROUND: Lisfranc (tarsometatarsal joint) injuries are relatively rare, accounting for less than 1% of all fractures, and as many as 20% of subtle Lisfranc injuries are missed at the initial patient presentation. An undiagnosed Lisfranc injury can have devastating consequences to the patient. Therefore, any factor that can raise a clinician's index of suspicion to make this diagnosis is potentially important. The cavus foot has been associated with various maladies of the lower extremity, but to our knowledge, it has not been reported to be associated with Lisfranc injury...
October 28, 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27790530/a-randomized-controlled-study-to-compare-conventional-and-evidence-based-treatment-protocols-in-fresh-compound-fractures
#8
Kanika Mahajan, Vikas Verma, Girish Kumar Singh, Santosh Kumar, Sachin Avasthi
INTRODUCTION: A recent concept review in Journal of Bone and Joint Surgery (JBJS) outlines evidence to control peri-operative infections in compound fractures. However, evidence for impact of adopting a protocol combining measures that have some evidence is lacking in literature. The present method of treatment at King George's Medical University (KGMU) is representative of the conventional practice of managing compound fractures in India and is an appropriate control for trial against the Experimental Evidence Based Protocol (EBP)...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27769856/the-impact-of-helipad-designation-on-meeting-the-best-practice-tariff-for-fractured-neck-of-femur-cases-in-a-major-trauma-centre
#9
John Dabis, Aliyah Hussein, Mark Rickman
Hip fractures represent a significant burden to the NHS: the cost for all UK hip fractures is approximately £2 billion and in 2013, 64 838 people were admitted to hospital with a fractured neck of femur (FNOF). In April 2010 St George's NHS Hospital was designated one of four Major Trauma Centres (MTC) in London. Following MTC designation, in April 2014 St George's Hospital opened a helipad. This study aimed to assess the impact of the helipad designation on the Trust's ability to meet the Best Practice Tariff (BPT) criteria for FNOF patients...
October 18, 2016: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/27756739/defining-the-fracture-population-in-a-pragmatic-multicentre-randomised-controlled-trial-profher-and-the-neer-classification-of-proximal-humeral-fractures
#10
H H G Handoll, S D Brealey, L Jefferson, A Keding, A J Brooksbank, A J Johnstone, J J Candal-Couto, A Rangan
OBJECTIVES: Accurate characterisation of fractures is essential in fracture management trials. However, this is often hampered by poor inter-observer agreement. This article describes the practicalities of defining the fracture population, based on the Neer classification, within a pragmatic multicentre randomised controlled trial in which surgical treatment was compared with non-surgical treatment in adults with displaced fractures of the proximal humerus involving the surgical neck...
October 2016: Bone & Joint Research
https://www.readbyqxmd.com/read/27703943/slipped-distal-femoral-epiphysis-in-congenital-insensitivity-to-pain
#11
M Javed Shaikh, C Rex, R Vignesh, Madhav Chavan
INTRODUCTION: Congenital insensitivity to pain (CIP) is a rare disorder, and often presents to an orthopaedic surgeon as recurrent fractures, dislocations, pseudoarthrosis, osteomyelitis etc. Here, we report a case of congenital insensitivity to pain presenting with distal femoral physeal separation in a child. CASE REPORT: A 12-year-old girl child came with complaints of limp while walking and swelling in the left knee for past 5 weeks. Mother gave a history that the girl is a known case of congenital insensitivity to pain with clear history of no pain on intramuscular injection since birth...
April 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/27703940/salvage-of-a-below-knee-amputation-utilizing-rotationplasty-principles-in-a-patient-with-chronic-tibial-osteomyelitis
#12
Matthew R Moralle, Nicholas D Stekas, Mark C Reilly, Michael S Sirkin, Mark R Adams
INTRODUCTION: Chronic osteomyelitis is a disease that requires fastidious treatment to eliminate. However, when eradication is unable to be achieved through exhaustive modalities of antibiotic therapy and multiple debridements, significant resection of the infected bone and soft tissue must be considered, including amputation. Here we report of a salvage procedure for chronic osteomyelitis of the left tibia by employing a rotationplasty to avoid an above knee amputation and instead provide the patient with a below knee amputation...
April 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/27661423/infection-after-orthopaedic-trauma-prevention-and-treatment
#13
Heather C Yun, Clinton K Murray, Kenneth J Nelson, Michael J Bosse
Trauma to the extremities is disproportionately represented in casualties of recent conflicts, accounting for >50% of injuries sustained during operations in Iraq and Afghanistan. Infectious complications have been reported in >25% of those evacuated for trauma, and 50% of such patients were treated in the intensive care unit (ICU). Osteomyelitis has been reported in 9% (14% of intensive care unit patients), and deep-wound infection in 27% of type III open-tibia fractures. Infections complicating extremity trauma are frequently caused by multidrug-resistant bacteria and have been demonstrated to lead to failure of limb salvage, unplanned operative take-backs, late amputations, and decreased likelihood of returning to duty...
October 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27637569/orthopaedic-manifestations-of-congenital-indifference-to-pain-with-anhidrosis-hereditary-sensory-and-autonomic-neuropathy-type-iv
#14
Babar Kayani, Mathew David Sewell, Johnson Platinum, Andre Olivier, Timothy W R Briggs, Deborah M Eastwood
BACKGROUND: Congenital indifference to pain with anhidrosis (CIPA) is a rare hereditary neuropathy, which is associated with defective sensation to noxious stimuli and autonomic dysfunction. The objective of the study was to report on the orthopaedic manifestations of this condition and provide an evidence-based approach for management. METHODS: Retrospective review of 14 consecutive patients with CIPA referred to a single tertiary centre. Mean age of diagnosis was 2...
September 6, 2016: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/27620546/surgical-anatomy-of-the-knee-a-review-of-common-open-approaches
#15
Blaine T Manning, Rachel M Frank, Nathan G Wetters, Bernard R Bach, Aaron G Rosenberg, Brett R Levine
Knee-related complaints are among the most commonly encountered conditions by orthopaedic surgeons. Knee pathology varies widely and includes arthritis, deformities, fractures, infections, neuromuscular disorders, oncologic diseases, and soft-tissue injury. While nonoperative treatment modalities (activity modification, medications, injections, and physical therapy) are typically used as primary interventions, surgical treatment may ultimately become necessary. The purpose of this review is to discuss the most common open approaches to the knee, with an emphasis on surgically relevant anatomy for each approach...
September 2016: Bulletin of the Hospital for Joint Diseases
https://www.readbyqxmd.com/read/27612904/outcome-analysis-of-fernandez-osteotomy-in-malunited-extra-articular-fractures-of-distal-radius
#16
A Bhattacharyya, S Kumar
Deformity of wrist is very common after mal union of extra articular fractures over distal end of Radius. It causes limitation of movements too in different directions with or without pain. Deformity may be treated by different types of corrective osteotomy. We treated cases of this type of malunion with Fernandez osteotomy. This study is to observe the amount of correction and recovery of functional status in patients with malunited distal radius fractures treated with Fernandez osteotomy. This is a prospective study...
July 2016: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/27600487/pedobarographic-and-radiological-analysis-after-treating-a-talus-neck-fracture
#17
Tuğba Kuru Çolak, İlker Çolak, Eren Timurtaş, Güven Bulut, M Gülden Polat
Misalignment of the talar neck after surgical repair can redistribute the load among the posterior, middle, and anterior facets of the subtalar joints, which can change the joint biomechanics, cause arthritis, and impair function. However, we found no studies analyzing the plantar pressures after treatment of talus neck fracture. We determined the dynamic plantar pedobarographic and radiographic characteristics and ankle range of motion, function, and pain among patients after surgical repair of talar neck fractures...
September 2, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27581503/clinical-features-of-anaerobic-orthopaedic-infections
#18
Dan Lebowitz, Benjamin Kressmann, Shpresa Gjoni, Besa Zenelaj, Olivier Grosgurin, Christophe Marti, Matthieu Zingg, Ilker Uçkay
Some patient populations and types of orthopaedic surgery could be at particular risk for anaerobic infections. In this retrospective cohort study of operated adult patients with infections from 2004 to 2014, we assessed obligate anaerobes and considered first clinical infection episodes. Anaerobes, isolated from intra-operative samples, were identified in 2.4% of 2740 surgical procedures, of which half (33/65; 51%) were anaerobic monomicrobial infections. Propionibacterium acnes, a penicillin and vancomycin susceptible pathogen, was the predominantly isolated anaerobe...
August 31, 2016: Infectious Diseases
https://www.readbyqxmd.com/read/27578377/treatment-of-pediatric-femoral-shaft-fractures-by-stainless-steel-and-titanium-elastic-nail-system-a-randomized-comparative-trial
#19
Tank Gyaneshwar, Rustagi Nitesh, Tomar Sagar, Kothiyal Pranav, Nitesh Rustagi
PURPOSE: Literature suggests that the lower modulus of elasticity of titanium makes it ideal for use in children compared with stainless steel. Better fracture stability was observed in association with titanium nails on torsional and axial compression testing. However, stainless steel nails are stiffer than titanium counterparts, which may provide a rigid construct when fixing paediatric femoral shaft fractures. Complications have been observed more frequently by various researchers when titanium nails are used for fracture fixation in patients with increasing age or weight...
August 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/27567618/the-use-of-tightrope-fixation-for-ankle-syndesmosis-injuries-our-experience
#20
M Bondi, N Rossi, A Pizzoli, L Renzi Brivio
PURPOSE: Ten percentage of all ankle fractures sustain an associated syndesmotic injury. TightRope is a relatively new technique for syndesmosis fixation, characterized by a non-absorbable FibreWire held tight between two cortical metal buttons. The purpose of this study was to evaluate the results obtained with the use of this device. METHODS: From January 2011 to December 2015, 54 patients with ankle diastases were treated. Eighteen patients were excluded from the study...
December 2016: Musculoskeletal Surgery
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