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https://www.readbyqxmd.com/read/28448706/-prognostic-factors-for-post-surgical-complications-in-bone-infection-and-pseudarthrosis
#1
A Cicero-Álvarez, S R León-Hernández, K Gutiérrez-Enríquez, S Zapata-Rivera
Bone infection and nonunion are the main orthopedic and traumatic complications whose treatment remains a challenge because multiple factors are involved in the rate of failures when you try to correct them. Knowing these factors were the problem that caused the research through a prospective longitudinal study of 83 patients of 43.3 ± 16.1 years old. They were treated for aseptic and septic nonunion, osteomyelitis, osteitis, malunion or infected joint replacement. The cases were classified with or without postoperative complications and outcome related to systemic and local factors taken prognostic model Cierny-Mader as factors affecting immune surveillance, metabolism and local vascularization...
September 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28444580/three-dimensional-virtual-planning-of-corrective-osteotomies-of-distal-radius-malunions-a-systematic-review-and-meta-analysis
#2
REVIEW
R J O de Muinck Keizer, K M Lechner, M A M Mulders, N W L Schep, D Eygendaal, J C Goslings
The purpose of this study was to summarize and evaluate results of three-dimensional (3D-) planned corrective osteotomies of malunited distal radius fractures. 3D-planning techniques provide the possibility to address 3D-deformity that conventional planning methods might not address. We systematically searched PubMed, EMBASE and the Cochrane library for studies that performed a 3D-planned corrective osteotomy on patients with a malunited distal radius fracture. Fifteen studies with a total of 68 patients were included in the analysis...
April 25, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28428916/extensor-carpi-ulnaris-instability-following-ulnar-shortening-osteotomy
#3
Mohamed Noureldin, Sanjeev Kakar
Background Ulnar shortening osteotomy (USO) is a well-established procedure for the treatment of ulnar impaction syndrome. Although uncommon, the procedure can be associated with complications including nonunion, malunion, and hardware irritation. Case Description We present a 56-year-old woman who developed extensor carpi ulnaris (ECU) tendon instability following an USO. Literature Review The etiology of such a complication can be multifactorial. Clinical Relevance The recurrence of ulnar pain following an USO should raise the suspicion of possible ECU instability within the differential diagnosis...
May 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28428037/conservative-treatment-of-displaced-distal-radius-fractures-leads-to-acceptable-functional-outcomes-however-at-the-expense-of-40-subsequent-surgeries
#4
Marjolein A M Mulders, Percy V van Eerten, J Carel Goslings, Niels W L Schep
BACKGROUND: Although secondary displacement following closed reduction and plaster immobilisation is high, several guidelines still recommend non-operative treatment for displaced distal radius fractures with an adequate closed reduction. PURPOSE: The purpose of this study was to evaluate functional outcomes, measured with the Disability of the Arm, Shoulder and Hand (DASH) questionnaire, in non-operative treated patients with displaced distal radius fractures with an adequate closed reduction confirmed on radiograph...
April 17, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28428034/near-anatomical-correction-using-a-ct-guided-technique-of-a-forearm-malunion-in-a-15-year-old-girl-a-case-report-including-surgical-technique
#5
Ralph M Jeuken, Roel P Hendrickx, Martijn G Schotanus, Edwin J Jansen
BACKGROUND: In this case report we describe a left-arm both-bone forearm fracture in a 15-year old girl who fell off of a swing. Conservative treatment with an above-elbow cast failed,resulting in a malunion with functional impairment. The pro- and supination were 90/0/10, respectively. The patient complained of difficulties performing daily activities. For this pediatric case a corrective osteotomy was proposed using a CT-guided technique aiming for maximum anatomical and functional outcome...
April 17, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28425054/can-a-three-component-prosthesis-be-used-for-conversion-of-painful-ankle-arthrodesis-to-total-ankle-replacement
#6
Markus Preis, Travis Bailey, Lucas S Marchand, Alexej Barg
BACKGROUND: In patients with painful ankle arthrodesis, the surgical treatment is challenging, and may include takedown of ankle arthrodesis and conversion to a total ankle replacement (TAR). This procedure is technically demanding given the altered anatomy after arthrodesis. Few studies have evaluated TAR in the setting of prior arthrodesis. QUESTIONS/PURPOSES: (1) What intraoperative and perioperative complications were observed in patients who underwent conversion of an ankle arthrodesis to a TAR? (2) Was durable fixation achieved at short term, and what was the alignment of the components? (3) What subsequent surgical procedures were performed, including revisions? (4) What improvements were observed in pain, tibiotalar range of motion (ROM), and quality of life? METHODS: Between January 2007 and December 2014, 18 patients with a painful ankle arthrodesis underwent conversion to TAR at our tertiary referral center...
April 19, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28422876/low-complication-rate-of-elastic-stable-intramedullary-nailing-esin-of-pediatric-forearm-fractures-a-retrospective-study-of-202-cases
#7
Christiane Kruppa, Pamela Bunge, Thomas A Schildhauer, Marcel Dudda
Elastic stable intramedullary nailing (ESIN) has been established as state of the art treatment for forearm fractures in children, if operative stabilization is required. Their use has been expanded to single bone shaft fractures, and also more complex injuries such as Monteggia fractures or Monteggia-like lesions. A wide range of complications has been reported in the literature, up to 70% in certain investigations. The purpose of this study was to assess the complication rate after ESIN treatment of forearm fractures in children and adolescents in a representative cohort of patients from a level 1 trauma center in Germany...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28417290/unilateral-external-fixator-in-the-treatment-of-humeral-shaft-fractures-results-of-a-single-center-retrospective-study
#8
M Basso, M Formica, L Cavagnaro, M Federici, M Lombardi, F Lanza, L Felli
BACKGROUND: The aim of our work is to evaluate and critically analyze long-term clinical and radiological data of a new unilateral external fixator (MIKAI KIT FEP©-Mikai S.p.A, Genoa, Italy), in the treatment of humeral shaft fractures. MATERIALS AND METHODS: We reviewed 47 patients affected by humeral fractures that underwent surgery from July 2010 to March 2016 with unilateral external fixator. Demographic characteristics of the patients were recorded, which included age, sex and baseline comorbidities and mechanism of injury...
April 17, 2017: Musculoskeletal Surgery
https://www.readbyqxmd.com/read/28399047/assessing-quality-and-safety-in-pediatric-supracondylar-humerus-fracture-care
#9
Christopher A Iobst, Matthew Stillwagon, Deidre Ryan, Eric Shirley, Steven L Frick
BACKGROUND: Recently, there has been an emphasis on improving quality, safety, and value in the delivery of health care in the United States. The American Board of Orthopedic Surgery (ABOS) has developed a performance improvement questionnaire (PIQ) for orthopaedic surgeons managing pediatric supracondylar humerus fracture (PSCHF). Using the supracondylar PIQ as a guide, this study evaluates the process of measuring the outcomes and variations in care to PSCHF patients among pediatric orthopaedic surgeons...
April 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28395943/computer-assisted-planning-and-patient-specific-guides-for-the-treatment-of-midshaft-clavicle-malunions
#10
Lazaros Vlachopoulos, Andreas Schweizer, Dominik C Meyer, Christian Gerber, Philipp Fürnstahl
BACKGROUND: The surgical treatment of malunions after midshaft clavicle fractures is associated with a number of potential complications and the surgical procedure is challenging. However, with appropriate and meticulous preoperative surgical planning, the surgical correction yields satisfactory results. The purpose of this study was to provide a guideline and detailed overview for the computer-assisted planning and 3-dimensional (3D) correction of malunions of the clavicle. METHODS: The 3D bone surface models of the pathologic and contralateral sides were created on the basis of computed tomography data...
April 7, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28389837/use-of-internal-lengthening-nails-in-post-traumatic-sequelae
#11
REVIEW
Hamza M Alrabai, Martin G Gesheff, Janet D Conway
External fixators are a well-established modality for treating fractures with bone defects, leg-length discrepancy, malunion, nonunion and other post-traumatic consequences. However, use of internal lengthening rods has remarkably increased recently for post-traumatic conditions. The main advantage of internal lengthening rods is eliminating pin-site complications. Internal lengthening rods are also associated with less pain. Motorised internal lengthening rods show promising performance in post-traumatic cases...
April 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28379937/treatment-of-post-traumatic-femoral-discrepancy-with-precice-magnetic-powered-intramedullary-lengthening-nails
#12
Ahmed I Hammouda, Julio J Jauregui, Martin G Gesheff, Shawn C Standard, Janet D Conway, John E Herzenberg
OBJECTIVE: Post traumatic limb length discrepancy (LLD) may present secondary to fracture shortening, malunion, or epiphyseal growth arrest. The purpose of this study was to evaluate the outcomes of lengthening post-traumatic femoral segments utilizing a recently available magnetic intramedullary (IM) lengthening system. DESIGN: Retrospective cohort study SETTING:: Urban Level II Trauma CenterPatients/Participants: This study was performed to review post-traumatic patients treated for femoral shortening at our institution between 2011 and 2015...
April 20, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28371500/joint-preserving-surgery-for-talar-malunions-or-nonuions
#13
Gang Chen, Mu Hu, Yang Xu, Yue-Huan Zhen, Yuan Hong, Xiang-Yang Xu
OBJECTIVE: To describe the technique and analyze the outcomes of joint-preserving surgical treatments which included anatomical reconstruction or alignment correction for talar malunions or nonunions, and avoid development of degenerative changes in the adjacent joints. METHODS: Eight patients who had painful talar malunions or nonunions treated between 2009 and 2015 were included in this retrospective study. The mean age of the patients was 35.6 years, with patients aged from 18 to 58 years...
February 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28360490/postoperative-outcomes-of-initial-varus-versus-initial-valgus-proximal-humerus-fracture-a-systematic-review-and-meta-analysis
#14
REVIEW
Mallikarjun Honnenahalli Chandrappa, Shahin Hajibandeh, Shahab Hajibandeh
OBJECTIVES: Our objective was to perform a systematic review of the literature and conduct a meta-analysis to investigate the effect of initial varus or valgus displacement of proximal humerus on the outcomes of patients with proximal humerus fractures treated with open reduction and internal fixation. METHODS: In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement standards, we performed a systematic review. Electronic databases MEDLINE, EMBASE, CINAHL and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify randomised and non-randomised studies comparing postoperative outcomes associated with initial varus versus initial valgus displacement of proximal humerus fracture...
January 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28359592/clinical-efficacy-and-safety-of-limited-internal-fixation-combined-with-external-fixation-for-pilon-fracture-a-systematic-review-and-meta-analysis
#15
Shao-Bo Zhang, Yi-Bao Zhang, Sheng-Hong Wang, Hua Zhang, Peng Liu, Wei Zhang, Jing-Lin Ma, Jing Wang
PURPOSE: To compare the clinical efficacy and complications of limited internal fixation combined with external fixation (LIFEF) and open reduction and internal fixation (ORIF) in the treatment of Pilon fracture. METHODS: We searched databases including Pubmed, Embase, Web of science, Cochrane Library and China Biology Medicine disc for the studies comparing clinical efficacy and complications of LIFEF and ORIF in the treatment of Pilon fracture. The clinical efficacy was evaluated by the rate of nonunion, malunion/delayed union and the excellent/good rate assessed by Mazur ankle score...
April 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28356152/mid-term-outcome-following-revision-surgery-of-clavicular-non-and-malunion-using-anatomic-locking-compression-plate-and-iliac-crest-bone-graft
#16
Marc Beirer, Ingo J Banke, Norbert Harrasser, Moritz Crönlein, Dominik Pförringer, Stefan Huber-Wagner, Peter Biberthaler, Chlodwig Kirchhoff
BACKGROUND: Treatment of clavicular non- and malunion is still challenging. Current surgical procedures often result in frustrating functional outcome along with high-grade subjective impairment and increased rates of revision surgery. However, the combination of biological augmentation with vital bone graft and a biomechanically sufficient fixation system seems to be a promising concept of treatment. METHODS: In this retrospective study, 14 patients with a mean age of 44 years (26-67 years) suffering from non-union (n = 11) and/or malunion (n = 3) of the clavicle were enrolled...
March 29, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28330797/flexible-intramedullary-nailing-for-treatment-of-proximal-humeral-and-humeral-shaft-fractures-in-children-a-retrospective-series-of-118-cases
#17
Z Pogorelić, S Kadić, K P Milunović, I Pintarić, M Jukić, D Furlan
BACKGROUND: The aim of this study was to analyze outcomes of treatment and complications in children treated with flexible intramedullary nailing (FIN) due to humeral fracture. HYPOTHESIS: The FIN for treatment of humeral fractures in children would allow an early functional and cast-free follow-up with a quick pain reduction and low complication rate. PATIENTS AND METHODS: From May 2002 until May 2016 case records of all children who underwent fixation with titanium intramedullary nails because of humeral fracture were retrospectively reviewed...
March 19, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28328742/treatment-of-proximal-humerus-fractures-in-children-with-a-modified-palm-tree-technique
#18
Ayman M Ali, Sallam I Fawzy, Medhat Moaty, Mohamed Abelaziz
Although most pediatric proximal humeral fractures can be successfully treated conservatively with satisfactory results, many operative techniques have been described for the treatment of displaced proximal humeral fractures. The aim of this study is to evaluate the efficacy of percutaneous fixation using a modified palm tree technique for proximal humerus fractures in children. Between March 2011 and May 2013, the modified palm tree technique was used for the management of 30 children (20 boys and 10 girls) with displaced proximal humeral fractures...
March 21, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28320508/staged-minimally-invasive-plate-osteosynthesis-of-proximal-tibial-fractures-with-acute-compartment-syndrome
#19
Joon-Woo Kim, Chang-Wug Oh, Jong-Keon Oh, Hee-Soo Kyung, Kyeong-Hyeon Park, Hee-June Kim, Jae-Wook Jung, Young-Soo Jung
PURPOSE: High-energy proximal tibial fractures often accompany compartment syndrome and are usually treated by fasciotomy with external fixation followed by secondary plating. However, the initial soft tissue injury may affect bony union, the fasciotomy incision or external fixator pin sites may lead to postoperative wound infections, and the staged procedure itself may adversely affect lower limb function. We assess the results of staged minimally invasive plate osteosynthesis (MIPO) for proximal tibial fractures with acute compartment syndrome...
March 11, 2017: Injury
https://www.readbyqxmd.com/read/28296780/type-iii-monteggia-fracture-with-posterior-interosseous-nerve-injury-in-a-child-a-case-report
#20
Jing Wang, Min Chen, Jiang Du
RATIONALE: Elbow injury in children by improper treatment or a delay of more than 3 weeks could lead to old unreduced Monteggia fracture, which are difficult to manage. Conservative or normal surgical methods usually fail. PATIENT CONCERNS: Herein, we present a 6-year-old boy with sustaining injury approximately 1 month to his left elbow. Activity in his elbow was restricted, and his ability to extend his wrist and fingers was impaired. DIAGNOSES: Type III Monteggia elbow fracture-dislocation consisting of radial head dislocation and malunion of the ulna associated with posterior interosseous nerve palsy were confirmed, which requiring surgical treatment...
March 2017: Medicine (Baltimore)
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