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Fracture joint orthopaedics

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https://www.readbyqxmd.com/read/28952661/non-operative-management-of-a-patella-fracture-environmental-considerations-in-the-subantarctic
#1
Fraser John Gould
Injuries occurring in the remote environment present particular challenges to healthcare professionals, and decisions need to be carefully made on an individual basis. This report describes the successful management of a patella fracture sustained on the Subantarctic island of South Georgia. A 36-year-old boating officer presented to the island surgery after sustaining an isolated closed injury to his left knee. On physical examination there was a large effusion palpable within the joint, and on subsequent radiography an undisplaced transverse fracture of the patella was apparent...
2017: International Maritime Health
https://www.readbyqxmd.com/read/28942397/catastrophic-cement-reaction-following-cementation-for-megaprosthesis-for-proximal-femoral-fracture
#2
Muhammad Nouman Baig, William Curtin, Michael Andrew Callaghan, Colin G Murphy
Bone cement implantation syndrome (BCIS) is a well-described and potentially fatal complication of orthopaedic surgery involving pressurised bone cement. Although also described for certain spinal procedures, it is most commonly associated with cemented hip and knee arthroplasty and with cemented hemiarthroplasty following neck of femur fracture in particular.Donaldson et alproposed the definition of BCIS as a syndrome "characterized by hypoxia, hypotension or both and/or unexpected loss of consciousness occurring around the time of cementation, prosthesis insertion, reduction of the joint or, occasionally, limb tourniquet deflation in a patient undergoing cemented bone surgery"...
September 23, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28926384/effect-of-surgeon-and-hospital-volume-on-morbidity-and-mortality-after-hip-fracture
#3
Kanu Okike, Priscilla H Chan, Elizabeth W Paxton
BACKGROUND: Prior studies have examined the relationship between surgeon and hospital volumes and outcome following hip fracture surgical procedures, but the results have been inconclusive. The purpose of this study was to assess the hip fracture volume-outcome relationship by analyzing data from a large, managed care registry. METHODS: The Kaiser Permanente Hip Fracture Registry prospectively records information on surgically treated hip fractures within the managed health-care system...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28924020/microindentation-a-tool-for-measuring-cortical-bone-stiffness-a-systematic-review
#4
M Arnold, S Zhao, S Ma, F Giuliani, U Hansen, J P Cobb, R L Abel, O Boughton
OBJECTIVES: Microindentation has the potential to measure the stiffness of an individual patient's bone. Bone stiffness plays a crucial role in the press-fit stability of orthopaedic implants. Arming surgeons with accurate bone stiffness information may reduce surgical complications including periprosthetic fractures. The question addressed with this systematic review is whether microindentation can accurately measure cortical bone stiffness. METHODS: A systematic review of all English language articles using a keyword search was undertaken using Medline, Embase, PubMed, Scopus and Cochrane databases...
September 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28911888/postoperative-imaging-of-orthopaedic-hardware-in-the-hand-and-wrist-is-there-an-added-value-for-tomosynthesis
#5
A De Silvestro, K Martini, A S Becker, T D L Kim-Nguyen, R Guggenberger, M Calcagni, T Frauenfelder
AIM: To prospectively investigate digital tomosynthesis (DTS) as an alternative to digital radiography (DR) for postoperative imaging of orthopaedic hardware after trauma or arthrodesis in the hand and wrist. MATERIALS AND METHODS: Thirty-six consecutive patients (12 female, median age 36 years, range 19-86 years) were included in this institutional review board approved clinical trial. Imaging was performed with DTS in dorso-palmar projection and DR was performed in dorso-palmar, lateral, and oblique views...
September 11, 2017: Clinical Radiology
https://www.readbyqxmd.com/read/28888405/anatomic-locking-plate-for-displaced-intraarticular-calcaneal-fracture-design-and-application
#6
Chia-Hung Chu, Yan-Yu Chen, Kang-Ping Lin, Wen-Chuan Chen, Pei-Yuan Lee
Calcaneal fracture can lead to long-term disability and have a considerable economic effect. Most calcaneal fractures are intraarticular fractures involving the posterior facet of the subtalar joint. Treating displaced intraarticular calcaneal fractures is complicated because of the lack of an optimal treatment option. Internal fixation typically involves screw-and-plate implants, which can be unfavorable owing to the lack of an anatomic design and the intraoperative bending required for the plate to contour to the irregular surface of the calcaneus...
September 6, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28878537/arthroscopically-assisted-surgical-fixation-of-a-juvenile-tillaux-fracture-and-implant-removal-a-case-report
#7
Takahisa Ogawa, Sadanori Shimizu
Juvenile Tillaux fractures are Salter-Hallis III fractures of the distal tibial epiphysis that occur only when the tibial epiphyses are closing. Theoretically, arthroscopically assisted reduction and fixation of a juvenile Tillaux fracture can facilitate the accurate reconstruction of the articular surface, using arthroscopic visualization. We treated a girl aged 14 years who had a juvenile Tillaux fracture by using arthroscopically assisted reduction and fixation. In order to obtain articular congruency, the screw was inserted under arthroscopic visualization...
August 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28867992/analysis-of-locking-self-taping-bone-screws-for-angularly-stable-plates
#8
Radek Čada, Karel Frydrýšek, František Sejda, Jiří Demel, Leopold Pleva
Paper focuses on biomechanics, specifically on locking cortical bone screws in angularly stable plates used for the treatment of bone fractures in the medical fields of traumatology and orthopaedics. During extraction of titanium-alloy implants, problems are encountered in an effort to loosen some locking bone screws from the locking holes of an angularly stable plate and the subsequent stripping of the internal hexagon of the screw head. The self-locking of the screw-plate threaded joint was verified by calculation and the effect of the angle of the thread on the head of the locking cortical bone screw on self-locking was evaluated...
2017: Journal of Medical and Biological Engineering
https://www.readbyqxmd.com/read/28852336/tibial-plateau-fractures-a-new-rank-ordering-method-for-determining-to-what-degree-injury-severity-or-quality-of-reduction-correlate-with-clinical-outcome
#9
Katie Freeman, Jared L Michalson, Donald D Anderson, Thomas D Brown, Thomas A DeCoster, Douglas R Dirschl, Matthew D Karam, J Lawrence Marsh
BACKGROUND: Injury severity may be the most important factor in determining outcome after articular fractures, but there is a surprising paucity of clinical evidence to support this assertion. The purpose of this study was to utilize a new method for rank ordering a group of patient radiographs to assess the effect of injury severity and quality of reduction on patient outcomes after tibial plateau fractures. METHODS: Tibial plateau fractures in 64 patients were treated operatively or non-operatively based on physician preference from standard of care techniques...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28842287/determining-potential-of-pmma-as-a-depot-for-rifampin-to-treat-recalcitrant-orthopaedic-infections
#10
Stefanie M Shiels, David J Tennent, Kevin S Akers, Joseph C Wenke
BACKGROUND: Open fractures are often complicated by infection. In cases of severe soft tissue and vascular injury, systemic antibiotics may be ineffective due to their inability to reach and provide direct antimicrobial activity to the zone of injury. High antibiotic concentrations within the wound can be achieved with reduced systemic toxicity by using local antibiotic delivery. As bacteria associated with musculoskeletal injuries frequently form biofilms, antibiotic selection is important...
August 16, 2017: Injury
https://www.readbyqxmd.com/read/28790037/a-six-year-retrospective-analysis-of-cut-out-risk-predictors-in-cephalomedullary-nailing-for-pertrochanteric-fractures-can-the-tip-apex-distance-tad-still-be-considered-the-best-parameter
#11
G Caruso, M Bonomo, G Valpiani, G Salvatori, A Gildone, V Lorusso, L Massari
OBJECTIVES: Intramedullary fixation is considered the most stable treatment for pertrochanteric fractures of the proximal femur and cut-out is one of the most frequent mechanical complications. In order to determine the role of clinical variables and radiological parameters in predicting the risk of this complication, we analysed the data pertaining to a group of patients recruited over the course of six years. METHODS: A total of 571 patients were included in this study, which analysed the incidence of cut-out in relation to several clinical variables: age; gender; the AO Foundation and Orthopaedic Trauma Association classification system (AO/OTA); type of nail; cervical-diaphyseal angle; surgical wait times; anti-osteoporotic medication; complete post-operative weight bearing; and radiological parameters (namely the lag-screw position with respect to the femoral head, the Cleveland system, the tip-apex distance (TAD), and the calcar-referenced tip-apex distance (CalTAD))...
August 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28737630/first-in-the-nation-one-unit-s-journey-to-achieving-fragility-fracture-certification
#12
Audry McDonald, Samantha Church, Laura Hixon, Linda Vo, Martha Sleutel
Osteoporosis is related to more than 2 million fractures and $19 billion in healthcare costs each year (). A fragility fracture (FF) is a low-energy fracture of the distal radius, proximal humerus, ankle, or proximal femur (hip) from minimal trauma such as a fall from a standing height. In addition to cost, FFs often result in the loss of independence and productivity (). In 2015, our orthopaedic unit received the first certification ever awarded for FFs. Fragility fracture certification is a new certification demonstrating that a healthcare facility complies with national patient care standards and uses evidence-based practice guidelines to deliver quality outcomes...
July 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28733672/trainee-surgeons-affect-operative-time-but-not-outcome-in-minimally-invasive-total-hip-arthroplasty
#13
Markus Weber, Achim Benditz, Michael Woerner, Daniela Weber, Joachim Grifka, Tobias Renkawitz
Training of young surgeons in total hip arthroplasty (THA) is crucial, but might affect operative time and outcome especially in minimally invasive (MIS) THA. We asked whether the learning curve of orthopaedic residents trained on MIS THA has an impact on (1) operative time (2) complication rates and (3) early postoperative outcome. In a retrospective analysis of over 1000 MIS THAs from our institutional joint registry, operative time, complication rates, patient reported outcome measures (Western Ontario and McMaster Universities Arthritis Index [WOMAC] and Euro-Qol 5D-5L [EQ-5D]) within the first year and responder rates for positive outcome as defined by the Outcome Measures in Rheumatology and Osteoarthritis Research Society International consensus responder (OMERACT-OARSI) criteria were compared between trainee and senior surgeons...
July 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28723779/can-operations-achieve-good-outcomes-in-elderly-patients-with-sanders-ii-iii-calcaneal-fractures
#14
Jun Su, Xuecheng Cao
The aim of this study was to compare the clinical effect of operative treatment and nonoperative treatment for elderly patients with Sanders II-III calcaneal fractures.The study consisted of 60 patients with Sanders II-III calcaneal fractures who were treated in our institution from January 2007 to April 2012. The clinical effect between the operative treatment group of 32 patients and the nonoperative treatment group of 28 patients was studied. Böhler angle, Gissane angle, subtalar joint motion, calcaneal width, and calcaneal height were measured before and after treatment, and these indexes were also measured on the uninjured foot...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28706814/tibial-allograft-transfer-for-medial-tibial-plateau-resurfacing
#15
Jonathan A Godin, Salvatore Frangiamore, Jorge Chahla, Mark E Cinque, Nicholas N DePhillipo, Robert F LaPrade
A large cartilage lesion of the tibial plateau with a deficient meniscus in a young patient is a challenging pathology for the orthopaedic surgeon due to the limited options available. While hemiarthroplasty procedures can be an option, the risk of revision in a young patient is high, and therefore a reconstructive procedure is advocated. The purpose of this Technical Note is to describe our technique for tibial plateau resurfacing, including the preparation and implantation of a medial tibial plateau and medial meniscal allograft, in a patient with a post-traumatic KD-4 knee dislocation with a medial tibial plateau rim fracture, medial meniscus deficiency, and medial tibiofemoral joint subluxation...
June 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28660328/radiological-study-of-the-secondary-reduction-effect-of-early-functional-exercise-on-displaced-intra-articular-calcaneal-fractures-after-internal-compression-fixation
#16
Wei Chen, Bo Liu, Hongzhi Lv, Yanling Su, Xiao Chen, Yanbin Zhu, Chenguang Du, Xiaolin Zhang, Yingze Zhang
PURPOSE: Early post-operative exercise and weight-bearing activities are found to improve the functional recovery of patients with displaced intra-articular calcaneal fractures (DIACFs). We hypothesized that early functional exercise after surgery might have a secondary reduction effect on the subtalar joint, in particular the smaller fracture fragments that were not fixed firmly. A prospective study was conducted to verify this hypothesis. METHODS: From December 2012 to September 2013, patients with unilateral DIACFs were enrolled and received a treatment consisting of percutaneous leverage and minimally invasive fixation...
June 28, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28637185/a-novel-method-of-open-reduction-and-internal-fixation-of-a-displaced-manubrial-fracture-using-distal-clavicle-locking-plates
#17
Daniel Miller, M Adeel Akhtar, Jonathan Fergusson, James L McVie
A 52-year-old man sustained a sternal fracture after a blunt traumatic chest injury. He was in severe pain in the intensive care unit, which resulted in difficulty breathing and increased analgesic requirement, and a decision was made to stabilize his manubrial fracture. Orthopaedic and thoracic surgeons jointly performed open reduction and internal fixation of the displaced manubrial fracture using 2 distal clavicle locking plates. This resulted in improvement in patient's pain and helped with his subsequent recovery and discharge from the hospital...
June 20, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28606840/open-reduction-in-pilon-variant-posterior-malleolar-fractures-radiological-and-clinical-evaluation
#18
E Sukur, Y E Akman, H B Gokcen, E C Ozyurek, A Senel, Y Ozturkmen
BACKGROUND: Pilon variant posterior malleolar (PVPM) fractures significantly disrupt joint congruency and cause tibiotalar instability. They are often underestimated and inadequately treated. PURPOSE: This study assessed the outcomes of surgical treatment of this subtype of malleolar fracture, and examined the importance of computed tomography (CT) in diagnosis and surgical treatment. MATERIAL AND METHODS: CT images and radiographs of 67 patients with trimalleolar ankle fractures were retrospectively analyzed...
June 9, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28583671/biomechanical-behaviour-of-craniofacial-sutures-during-distraction-an-evaluation-all-over-the-entire-craniofacial-skeleton
#19
Fabio Savoldi, James K H Tsoi, Corrado Paganelli, Jukka P Matinlinna
OBJECTIVE: Sutures are fibrous joints connecting the bones of the head. Despite the fundamental role played by sutures in dentofacial orthopaedics, their biomechanical properties are not completely understood. This study evaluated anatomy, biomechanics, and acoustic emission (AE) during distraction of the sutural ligament (SL). METHODS: Seventy-two suture samples were removed from a twelve-months-old swine (Sus scrofa) head. Each volume was acquired using micro-computed tomography (μCT), and the linear interdigitation index was calculated on both planes (LIICOR and LIISAG)...
June 2, 2017: Dental Materials: Official Publication of the Academy of Dental Materials
https://www.readbyqxmd.com/read/28494480/implementation-and-effects-of-enhanced-recovery-after-surgery-for-hip-and-knee-replacements-and-fractured-neck-of-femur-in-new-zealand-orthopaedic-services
#20
Suzanne Proudfoot, Brandon Bennett, Simon Duff, Julie Palmer
AIM: The National Orthopaedic Enhanced Recovery After Surgery (ERAS) Collaborative was launched in November 2013 to implement ERAS protocols for hip and knee total joint arthroplasty (TJA) and fractured neck of femur (NOF) in participating district health boards (DHBs) by December 2014. This paper reports on the results. METHOD: ERAS protocols were developed for hip and knee TJA and fractured NOF. Breakthrough Series collaborative methodology was used to implement the ERAS protocols in 18 DHBs...
May 12, 2017: New Zealand Medical Journal
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