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https://www.readbyqxmd.com/read/29126601/an-international-cross-sectional-survey-of-the-management-of-vancouver-type-b1-periprosthetic-femoral-fractures-around-total-hip-arthroplasties
#1
Brent D Bates, David W Walmsley, Milena R Vicente, Paul R Kuzyk, Aaron Nauth, James P Waddell, Michael D McKee, Emil H Schemitsch
INTRODUCTION: The incidence of periprosthetic femoral fractures around total hip arthroplasties is increasing. Fractures around a stable implant stem (Vancouver type B1) are among the most common of these fractures. Various fixation strategies for Vancouver type B1 periprosthetic fractures have been reported in the literature; however, little high-level evidence exists. This study was designed to determine the current management strategies and opinions among orthopaedic surgeons treating Vancouver type B1 periprosthetic femoral fractures, and to evaluate the need for a large prospective randomized controlled trial for the management of these injuries...
October 26, 2017: Injury
https://www.readbyqxmd.com/read/29109841/mandibular-reconstruction-with-lateral-tibial-bone-graft-an-excellent-option-for-oral-and-maxillofacial-surgery
#2
Ana Lucia Carpi Miceli, Livia Costa Pereira, Thiago da Silva Torres, Mônica Diuana Calasans-Maia, Rafael Seabra Louro
Autogenous bone grafts are the gold standard for reconstruction of atrophic jaws, pseudoarthroses, alveolar clefts, orthognathic surgery, mandibular discontinuity, and augmentation of sinus maxillary. Bone graft can be harvested from iliac bone, calvarium, tibial bone, rib, and intraoral bone. Proximal tibia is a common donor site with few reported problems compared with other sites. The aim of this study was to evaluate the use of proximal tibia as a donor area for maxillofacial reconstructions, focusing on quantifying the volume of cancellous graft harvested by a lateral approach and to assess the complications of this technique...
December 2017: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/29082791/embedding-the-lateral-end-of-the-lag-screw-within-the-lateral-wall-in-the-repair-of-reverse-obliquity-intertrochanteric-femur-fracture
#3
Ken Hiragami, Jyunji Ishii
Objective The management of reverse oblique intertrochanteric femoral fractures is difficult because such fractures have unique biomechanical characteristics. This study was performed to review the results of treating reverse oblique intertrochanteric femoral fractures with a long cephalomedullary nail by embedding the lateral end of the lag screw to secure axial compression. Methods We herein report the surgical outcomes in seven patients with reverse oblique intertrochanteric fractures treated with our procedure...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29081855/the-effects-of-body-mass-index-on-treatment-of-paediatric-femur-fractures-managed-with-flexible-intramedullary-nails
#4
E Nielsen, L M Andras, N Bonsu, R Y Goldstein
PURPOSE: Traditionally, flexible intramedullary nails (FINs) are not to be used to fix femur fractures in patients > 50 kg (110 lbs). However, studies have not examined the efficacy of this technique in overweight and obese patients who may be under this 'weight cutoff'. The purpose of this study was to assess how patient body mass index (BMI) impacts the treatment of paediatric femur fractures managed with FINs. METHODS: Retrospective data was collected on all paediatric patients treated with FINs for diaphyseal femur fractures at a single tertiary care institution over a ten-year period...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29065038/provisional-plating-of-subtrochanteric-femur-fractures-prior-to-intramedullary-nailing-in-the-lateral-decubitus-position
#5
Ryan Robertson, Michael Tucker, Thomas Jones
Subtrochanteric femur fractures remain a challenge for surgeons to obtain and maintain adequate reduction and stable fixation. For this reason multiple techniques have been described but we are unaware of a detailed contemporary description of the combination of provisional plating prior to intramedullary fixation in the lateral decubitus position. We present our technique as it was used from 2011-2015 to treat 22 fractures and how it compared clinically to the other 48 subtrochanteric femur fractures treated during that period...
October 14, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29055572/prescription-of-antibiotics-does-it-alter-the-outcome-for-patients-who-have-fractures-of-the-angle-of-the-mandible
#6
D Hammond, S Parmar, J Whitty, M McPhillips, R Wain
We retrospectively studied 708 consecutive patients at the Queen Elizabeth Hospital, Birmingham, to find out whether one of the four antibiotic protocols in use conferred any advantage (or disadvantage) on a patient who had a fractured angle of the mandible, and there was none. However, the time from initial injury until the time of the first dose of antibiotic was important. Clinically, if patients waited more than 72hours after the injury before the first dose of antibiotic was given, they had a three times higher rate of postoperative infection than patients who were given their first dose between 24 and 72hours after the injury...
November 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29054685/corrective-osteotomy-for-malunion-of-proximal-humerus-using-a-custom-made-surgical-guide-based-on-three-dimensional-computer-planning-case-report
#7
Maximiliano Ranalletta, Agustin Bertona, Juan M Rios, Luciano A Rossi, Ignacio Tanoira, Gastón D Maignón, Carlos F Sancineto
No abstract text is available yet for this article.
November 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29053501/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-tibia-fracture-pearls-and-pitfalls
#8
Steven A Lovejoy, Charles T Mehlman
Tibial fractures in children present a wide array of challenges to the managing orthopaedic surgeon. Injuries cover a spectrum from subtle tibial spine fractures to comminuted high-energy shaft fractures requiring free flap coverage. Significant risks range from malunion and leg length discrepancy to infected nonunions and Volkmann ischemic contracture. This article offers evidence and experience-based advice that is aimed at helping the community orthopaedic surgeon taking call.
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29053498/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-forearm-shaft-fracture-pearls-and-pitfalls
#9
Martin J Herman, Matthew Simon, Charles T Mehlman
Pediatric forearm shaft fractures are the third most common fracture in children, and the forearm is the third most mobile joint in the body (with a nearly 180 degree arc of motion). The goals of treatment are aimed squarely at achieving satisfactory anatomic alignment (within defined parameters) as the consequences of malunion can be permanent forearm stiffness and deformity. Nonoperative treatment approaches still dominate care of the youngest age groups while surgical intervention has become increasingly common in older children...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29049196/three-dimensional-reduction-and-finite-element-analysis-improves-the-treatment-of-pelvic-malunion-reconstructive-surgery-a-case-report
#10
Sascha Kurz, Philipp Pieroh, Maximilian Lenk, Christoph Josten, Jörg Böhme
RATIONALE: Pelvic malunion is a rare complication and is technically challenging to correct owing to the complex three-dimensional (3D) geometry of the pelvic girdle. Hence, precise preoperative planning is required to ensure appropriate correction. Reconstructive surgery is generally a 2- or 3-stage procedure, with transiliac osteotomy serving as an alternative to address limb length discrepancy. PATIENT CONCERNS: A 38-year-old female patient with a Mears type IV pelvic malunion with previous failed reconstructive surgery was admitted to our department due to progressive immobilization, increasing pain especially at the posterior pelvic arch and a leg length discrepancy...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29039128/distal-femoral-flexion-deformity-from-growth-disturbance-treated-with-a-two-level-osteotomy-and-internal-lengthening-nail
#11
Austin T Fragomen, Fiona R Fragomen
Salter Harris fractures of the distal femur can lead to growth disturbance with resulting leg length inequality and knee deformity. We have looked at a case series (3) of patients who presented with a distal femur flexion malunion and shortening treated with a distal femoral osteotomy and plating and a proximal femoral osteotomy with a magnetic internal lengthening nail. Does a two-level osteotomy and internal fixation approach provide a reliable result both radiographically and functionally? The average knee extension loss was 12°, LLD 47 mm, PDFA 65°, MAD 2 mm...
November 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/29031702/complications-following-open-reduction-and-internal-fixation-versus-external-fixation-in-treating-unstable-distal-radius-fractures-grading-the-evidence-through-a-meta-analysis
#12
Z Yuan, Z Yang, Q Liu, Y M Liu
BACKGROUND: The common fixation techniques for unstable distal radius fractures include open reduction and internal fixation (ORIF) with plates and closed reduction and external fixation (EF). There is controversy over the choice of surgical approach in treating unstable distal radius fractures. HYPOTHESIS: This meta-analysis was performed to compare complication rates in patients treated with ORIF or EF for unstable distal radius fractures and to develop GRADE (Grading of Recommendations, Assessment, Development, and Evaluation)-based recommendations for using the procedures to treat unstable distal radius fractures...
October 11, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29022039/paediatric-supracondylar-humeral-fractures-a-technique-for-safe-medial-pin-passage-with-zero-incidence-of-iatrogenic-ulnar-nerve-injury
#13
Chin Yee Woo, Han Loong Ho, Mohammad Bin Zainuddin Ashik, Kevin Boon Leong Lim
INTRODUCTION: The cross Kirschner wire (k-wire) configuration in closed reduction and percutaneous pinning of paediatric supracondylar humeral fracture afford superior stability. However, medial pin placement presents a risk of iatrogenic ulnar nerve injury. This study describes, in step-by-step detail, another safe method of percutaneous medial pin insertion. METHODS: The technique involved placing the patient's arm in external rotation, with elbow flexed no more than 45° after closed reduction...
October 12, 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28991579/arthroscopic-management-of-intra-articular-malunion-in-fractures-of-the-distal-radius
#14
REVIEW
Francisco Del Piñal, James Clune
Treatment of intra-articular malunion of the distal radius has evolved over the past 20 years, from open treatment to wet then dry arthroscopic techniques that provide excellent results with less morbidity than open approaches. Dry wrist arthroscopy provides a well-visualized surgical space in treating intra-articular malunion and results in less edema than wet techniques. The best results are attained in the first 3 months after injury. Alternative methods for avoiding total wrist arthrodesis in those who present later have been developed...
November 2017: Hand Clinics
https://www.readbyqxmd.com/read/28988807/increased-risk-for-complications-following-removal-of-hardware-in-patients-with-liver-disease-pilon-or-pelvic-fractures-a-regression-analysis
#15
Bryan D Brown, Justin N Steinert, John W Stelzer, Richard S Yoon, Joshua R Langford, Kenneth J Koval
PURPOSE: Indications for removing orthopedic hardware on an elective basis varies widely. Although viewed as a relatively benign procedure, there is a lack of data regarding overall complication rates after fracture fixation. The purpose of this study is to determine the overall short-term complication rate for elective removal of orthopedic hardware after fracture fixation and to identify associated risk factors. MATERIALS AND METHODS: Adult patients indicated for elective hardware removal after fracture fixation between July 2012 and July 2016 were screened for inclusion...
October 3, 2017: Injury
https://www.readbyqxmd.com/read/28984654/joint-denervation-in-the-digits-technique-and-patient-satisfaction
#16
Russell J Madsen, Lindsay A Stone, Jeremiah B Knapp, Joel S Solomon
BACKGROUND: Traditional approaches to treating painful osteoarthritis of the fingers include arthrodesis and arthroplasty. Although highly effective for pain control, arthrodesis sacrifices joint motion and can be complicated by nonunion, malunion, and infection.Implant arthroplasty preserves motion but is likewise subject to complications-particularly at the level of the proximal interphalangeal joint. In contrast, finger joint denervation is a simple outpatient procedure that maintains joint motion...
October 3, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28965120/comparative-results-of-external-fixation-plating-or-nonoperative-management-for-diaphyseal-clavicle-fractures-br
#17
Barış Özkul, Mehmet Selçuk Saygılı, Mahsut Dinçel, Ilhan Bayhan, Deniz Akbulut, Bilal Demir
OBJECTIVE: The aim of this study was to compare the treatment outcomes of mid-diaphyseal clavicular fractures between external fixator and more widely selected treatment options such as plate osteosynthesis or conservative methods. MATERIAL AND METHOD: From 2009 and 2013, the medical records of 64 patients were reviewed. İnclusion criterion was mid-diaphyseal closed clavicular fractures with shortening of more than 2 cm . The Constant and (disabilities of the arm, shoulder and hand DASH) scores at the final follow-up, initial displacement, non-union and complication rates were compared...
October 1, 2017: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/28951636/management-of-unstable-pertrochanteric-fractures-with-proximal-femoral-locking-compression-plates-and-affect-of-neck-shaft-angle-on-functional-outcomes
#18
Emrah Kovalak, Cenk Ermutlu, Tolga Atay, Özgür Başal
BACKGROUND: Management of unstable pertrochanteric fractures remains a challenge with various implant choices. Intramedullary devices are usually preferred for the management of the unstable fractures. When nailing is unsuitable for the configuration of the fracture extra medullary procedures are preferred. PFLCP is a contact limited implant that allows multiple angularly stable fixations with preserving more bone stock after implantation as an extramedullary implant. There are only a few reports in the literature about the osteosynthesis of unstable trochanteric fractures with proximal femoral locking compression plates and their results are conflicting...
July 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28928953/treatment-of-femoral-shaft-fractures-with-monoaxial-external-fixation-in-polytrauma-patients
#19
Gianluca Testa, Domenico Aloj, Alessandro Ghirri, Eraclite Petruccelli, Vito Pavone, Alessandro Massé
Background: Femoral shaft fractures, typical in younger people, are often associated with polytrauma followed by traumatic shock. In these situations, despite intramedullary nailing being the treatment of choice, external fixation could be used as the definitive treatment. The aim of this study is to report evidence regarding definitive treatment of femoral shaft fractures with monoaxial external fixation. Methods: Between January 2006 and December 2015, 83 patients with 87 fractures were treated at the Department of Orthopaedics and Traumatology CTO of Turin, with a monoaxial external fixation device...
2017: F1000Research
https://www.readbyqxmd.com/read/28895433/corrective-osteotomies-of-phalangeal-and-metacarpal-malunions-using-patient-specific-guides-ct-based-evaluation-of-the-reduction-accuracy
#20
Stefanie Hirsiger, Andreas Schweizer, Junichi Miyake, Ladislav Nagy, Philipp Fürnstahl
BACKGROUND: Surgical planning of corrective osteotomies is traditionally based on conventional radiographs and clinical findings. In the past 10 years, 3-dimensional (3D) preoperative planning approaches with patient-specific guides have been developed. However, the application of this technology to posttraumatic deformities of the metacarpals and phalangeal bones has not yet been investigated. Our goal was to evaluate the feasibility of the surgical application to the latter and to evaluate the extent and precision of correction...
September 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
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