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https://www.readbyqxmd.com/read/28742788/computer-assisted-corrective-osteotomy-of-malunited-pediatric-radial-neck-fractures-three-dimensional-postoperative-accuracy-and-clinical-outcome
#1
Lizzy Weigelt, Philipp Fürnstahl, Andreas Schweizer
Neglected or incorrect treatment of pediatric radial neck fractures may lead to symptomatic malunions. Computer-assisted corrective osteotomies with patient-specific guides have been proposed as a promising technique for the reconstruction of malunited long bone deformities. The aim of this study was to evaluate the accuracy and clinical outcome of this technique in children with malunited fractures of the radial neck. Four children (two male, two female; mean age 12 (10-16) years) underwent computer-assisted closing wedge osteotomy of the radial neck...
July 24, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28733846/implementation-of-a-standardized-protocol-to-manage-elderly-patients-with-low-energy-pelvic-fractures-can-service-improvement-be-expected
#2
Nikolaos K Kanakaris, Tess Greven, Robert M West, Arie B Van Vugt, Peter V Giannoudis
PURPOSE: The incidence of low energy pelvic fractures (FPFs) in the elderly is increasing. Comorbidities, decreased bone-quality, problematic fracture fixation and poor compliance represent some of their specific difficulties. In the absence of uniform management, a standard operating procedure (SOP) was introduced to our unit, aiming to improve the quality of services provided to these patients. METHODS: A cohort study was contacted to test the impact of (1) using a specific clinical algorithm and (2) using different antiosteoporotic drugs...
July 21, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28720982/single-incision-pediatric-flexible-intramedullary-tibial-nailing
#3
John G Coury, Zachary C Lum, Nicholas P O'Neill, Joseph A Gerardi
BACKGROUND: There has been a trend towards flexible intramedullary nailing for unstable tibial shaft fractures in the pediatric population, traditionally, utilizing a 2-incision technique with passage of one nail medially and one nail laterally. Our study aims to compare a single incision approach for flexible nailing of unstable tibial shaft fractures in pediatric patients to the traditional 2-incision approach. METHODS: Patients were selected for operative fixation if they had a length unstable tibial shaft fracture confirmed by fluoroscopy...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28718308/ulnar-shortening-versus-distal-radius-corrective-osteotomy-in-the-management-of-ulnar-impaction-after-distal-radius-malunion
#4
William R Aibinder, Ali Izadpanah, Bassem T Elhassan
BACKGROUND: Distal radius malunions lead to functional deficits. This study compares isolated ulnar shortening osteotomy (USO) to distal radius osteotomy (DRO) for the treatment of ulnar impaction syndrome following distal radius malunion. METHODS: We retrospectively reviewed 11 patients with extra-articular distal radius malunions treated for ulnar impaction with isolated USO. This group was compared to a 1:1 age- and sex-matched cohort treated with isolated DRO for the same indication...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28716512/results-of-the-dubert-procedure-for-chronic-painful-fracture-dislocations-of-the-fifth-carpometacarpal-joint-a-report-of-6-cases
#5
N Meraghni, G Bacle, E Marteau, Y Bouju, J Laulan
Carpometacarpal (CMC) fracture-dislocations of the fifth ray are common. For chronic injuries, Dubert proposed combining resection arthroplasty of the base of the fifth metacarpal (M5) with synostosis with the fourth metacarpal (M4). Our aim was to evaluate the results of this procedure. Between 1994 and 2014, 7 men and 1 woman with an average age of 36 years (range, 27 to 45) were operated on. The right hand was involved in 6 of the 8 cases. All patients had symptomatic osteoarthritis secondary to isolated articular malunion and subluxation of the 5th CMC joint...
July 14, 2017: Hand Surgery and Rehabilitation
https://www.readbyqxmd.com/read/28710911/a-novel-technique-for-reduction-malarplasty-by-inward-displacement-of-infractured-zygomatic-arch-without-fixation
#6
Qingfeng Li, Bowen Gao, Ke Li, Feng Xie, Hainan Zhu, Liang-Gang Yu
PURPOSE: Reduction malarplasty is one of the most common esthetic surgical procedures performed in the Asian population. Traditional procedures have several complications, such as bone nonunion, malunion, cheek drooping, and damage to the infraorbital nerve and maxillary sinus. Therefore, a more straightforward and effective method of reducing the width of the midface is needed. In this study, we introduce an infracture technique using inward displacement of the zygomatic arch without fixation...
June 24, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28708779/midshaft-fracures-of-the-clavicle-a-meta-analysis-comparing-surgical-fixation-via-anteroinferior-plating-versus-superior-plating
#7
Alex Nourian, Satvinder Dhaliwal, Sitaram Vangala, Peter S Vezeridis
OBJECTIVE: Tto compare the outcomes of clavicle fracture fixation using anteroinferior versus superior plate placement. METHODS: We performed a meta-analysis of studies that have reported on outcomes following superior or anteroinferior plate fixation for acute midshaft clavicle fractures (OTA 15-B). A computerized literature search in the Pubmed, Scopus, and Cochrane Library databases was utilized to identify relevant articles. Only full text articles without language restrictions were evaluated...
June 22, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28705216/surgical-management-of-hawkins-type-iii-talar-neck-fracture-through-the-approach-of-medial-malleolar-osteotomy-and-mini-plate-for-fixation
#8
Hui Liu, Zhida Chen, Wenrong Zeng, Yuanfei Xiong, Yongzhi Lin, Huacheng Zhong, Jin Wu
BACKGROUND: Fractures of the talar neck are relatively uncommon yet current interventions suffer from a high incidence of complications and poor functional outcomes. In the present study, we report a surgical treatment of Hawkins type III talar neck fracture through the approach of medial malleolar osteotomy and mini-plate for fixation and discuss the therapeutic effects after long-term follow-up. METHODS: From January 2010 to January 2015, 21 patients with 22 fractures were treated using this approach within days of sustaining the injury...
July 14, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28697082/primary-posterior-blade-plate-tibiotalar-arthrodesis-a-salvage-procedure-for-complex-nonreconstructable-pilon-fractures
#9
Ermias Abebe, Dana J Farrell, Boris Zelle, Gary Gruen
A subset of C2/C3 pilon fractures, open pilon injuries, metaphyseal bone comminution, and those involving substantial soft tissue or vascular injury may be nonreconstructable. Such injuries are at risk of progress to nonunion and failing open reduction internal fixation (ORIF). The risk of infection, malunion, and nonunion is relatively high with such injury patterns. In such cases, tibiotalar arthrodesis is performed after ORIF fails as a salvage procedure. Overall, the literature agrees that all pilon fractures will develop posttraumatic osteoarthritis, and these patients are ultimately treated with an arthrodesis or in narrow population with total ankle arthroplasty...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28681229/late-reconstruction-of-severe-open-book-deformities-of-the-pelvis-tips-and-tricks
#10
Christian Fang, Hatem Alabdulrahman, Roman Pfeifer, Ivan S Tarkin, Hans-Christoph Pape
BACKGROUND: The primary goal of treatment for open book pelvic injuries after high-energy trauma is to control haemorrhage and to close the pelvic ring anatomically. Less commonly, patients may present late with malunion or non-union. METHODS: We reviewed five operatively treated patients with delayed severe open book deformities who had a diastasis of more than 6 cm. We describe the pre-operative workup, surgical strategy and challenges experienced. They specifically include: extensive scar and contracture formation, malunion, urogenital prolapse and difficult reduction of vertical shear element...
July 5, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28668219/three-dimensional-correction-of-complex-ankle-deformities-with-computer-assisted-planning-and-patient-specific-surgical-guides
#11
Lizzy Weigelt, Philipp Fürnstahl, Stefanie Hirsiger, Lazaros Vlachopoulos, Norman Espinosa, Stephan H Wirth
Three-dimensional computer-assisted preoperative planning, combined with patient-specific surgical guides, has become an effective technique for treating complex extra- and intraarticular bone malunions by corrective osteotomy. The feasibility and accuracy of such a technique has not yet been evaluated for ankle deformities. Four surgical cases of varying complexity and location were selected for evaluation. Three-dimensional bone models of the affected and contralateral healthy lower limb were generated from computed tomography scans...
June 28, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28666042/primary-total-knee-arthroplasty-for-distal-femur-fractures-a-systematic-review-of-indications-implants-techniques-and-results
#12
Foster Chen, Robert Li, Ajay Lall, Evan M Schwechter
Distal femur fractures (DFFs) in elderly patients historically were difficult to treat because of osteoporotic bone, comminution, and intra-articular involvement. Current surgical treatment options, including intramedullary nailing, internal fixation, and external fixation, are complicated by prolonged immobility, malunion, and nonunion. Furthermore, fixation increases the complexity of subsequent arthroplasty. Primary total knee arthroplasty (TKA) is a rarely used treatment for acute DFF but may be of benefit in select patients...
May 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28660786/cost-and-complications-of-percutaneous-fixation-of-hand-fractures-in-a-procedure-room-versus-the-operating-room
#13
Mark T Garon, Patrick Massey, Andreas Chen, Trevor Carroll, Bradley G Nelson, Anne M Hollister
BACKGROUND: The purpose of this study was to compare closed reduction and percutaneous pinning of metacarpal and phalanx fractures performed in the operating room (OR) versus the procedure room of the emergency department with primary outcomes being infection rate, radiographic union, and monetary cost. METHODS: From January 2006 to December 2010, all closed reduction and percutaneous pinnings of metacarpal and phalanx fractures (CPT codes: 26608; 26727) by a single board-certified hand surgeon (A...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28660434/decortication-and-osteotomy-for-the-correction-of-multiplanar-deformity-in-the-treatment-of-malunion-in-adult-diaphyseal-femoral-deformity-a-case-series-and-technique-description
#14
S Middleton, R W Walker, M Norton
AIM: To review patients that have undergone correction of a symptomatic femoral malunion using osteotomy combined with decortication. METHODS: A retrospective review of all patients who have undergone decortication and multiplanar osteotomy, looking at the pre-operative deformity, correction achieved, time to union and complications. RESULTS: Seven patients underwent correction under the senior author from 2003 to 2012. Average age was 46 years (range 32-60 years)...
June 28, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28651579/total-knee-arthroplasty-with-corrective-osteotomy-for-knee-osteoarthritis-associated-with-malunion-after-tibial-plateau-fracture-a-case-report
#15
Toshihiro Hosokawa, Yuji Arai, Shuji Nakagawa, Toshikazu Kubo
BACKGROUND: When surgeons perform total knee arthroplasty in patients with knee osteoarthritis due to malunion following fractures around the knee joint, corrective osteotomy is recommended for severe deformities. Most such deformities are coronal plane varus or valgus deformities, and reports of sagittal plane flexion or extension deformities are rare. We describe a case in which a one-stage total knee arthroplasty was performed with extension corrective osteotomy in the sagittal plane...
June 26, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28650942/open-supracondylar-intercondylar-fractures-of-the-femur-treatment-with-taylor-spatial-frame
#16
Francesco Sala, Ahmed M Thabet, Paolo Capitani, Federico Bove, Amr A Abdelgawad, Giovanni Lovisetti
OBJECTIVES: Evaluate the Taylor spatial frame (TSF) for primary and definitive fixation of open supracondylar-intracondylar femoral (SIF) fractures. DESIGN: Retrospective. SETTING: Level I trauma center. PATIENTS: Subset of 20 SIF open fractures treated with TSF extracted from a consecutive series of 80 SIF fractures treated between 2007 and 2013. INTERVENTION: Eighteen (90%) fractures underwent definitive fixation with the TSF; 2 were treated primarily within 24 hours of injury...
June 15, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28639532/diminished-abductor-muscular-strength-in-patients-with-valgus-impacted-femoral-neck-fractures-treated-by-internal-fixation-clinical-study-and-biomechanical-considerations
#17
Mitsuaki Noda, Yasuhiro Saegusa, Masayasu Takahashi, Yuichi Kuroda, Yuma Takada, Chihiro Yoshikawa, Mimami Wakabayashi, Kazuhiko Adachi, Yukiko Nakamura
BACKGROUND: Valgus-impacted femoral neck fractures treated with internal fixation occasionally result in unsatisfactory postoperative locomotive function, partially due to muscle shortening and a decrease in the moment arm. This study quantifies the degree of diminished abduction strength both clinically and biomechanically. METHODS: Fifteen patients were enrolled in this study. Twelve patients with fracture healed in valgus-impacted position were further evaluated...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28638948/does-socioeconomic-status-influence-the-epidemiology-and-outcome-of-distal-radial-fractures-in-adults
#18
N D Clement, A D Duckworth, N R Wickramasinghe, C M Court-Brown, M M McQueen
PURPOSE: The aim of this study in adult patients with a distal radial fracture was to determine whether socioeconomic status influenced the epidemiology, mechanism of injury, fracture severity, or the outcome according to function, radiographic assessment, and rate of associated complications. METHODS: We identified 3983 distal radial fractures over a 7-year period. Socioeconomic status was assigned using the Carstairs score, and the population was divided into quintiles depending on deprivation...
June 21, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28633784/complications-of-talar-neck-fractures-by-hawkins-classification-a%C3%A2-systematic-review
#19
REVIEW
Richard K Jordan, Kunaal R Bafna, Jiayong Liu, Nabil A Ebraheim
The goal of the present study was to perform a systematic review of the published data on talar neck fractures for a better understanding of the postoperative clinical outcomes using open reduction and internal fixation stratified by Hawkins type. A PubMed search was performed using the keywords "talar," "neck," and "fracture." This search identified 209 potential studies, which were reviewed to yield 16 studies that met the criteria. The surgical outcomes of talar neck fractures stratified by the Hawkins classification analyzed in the present study were as follows: American Orthopaedic Foot and Ankle Society scale score was 77...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28628579/distal-humeral-flexion-osteotomy-for-the-treatment-of-supracondylar-extension-type-malunions-in-children
#20
Sebastian Farr, Rudolf Ganger, Werner Girsch
Distal humeral extension-type malunions may occur as a complication following improper reduction of supracondylar humerus fractures. We evaluated results after distal humeral flexion osteotomies for sagittal realignment of the humeral condyle in children. Medical records and radiographs of all patients younger than 18 years of age, who underwent this procedure because of a clinically relevant lack of elbow flexion, were evaluated. In a cohort of 18 children with a mean age of 8 years at the time of surgery and a mean follow-up duration of 1 year, elbow flexion increased significantly from a mean of 101° preoperatively to 126° at the final follow-up; established radiographic parameters (e...
June 16, 2017: Journal of Pediatric Orthopedics. Part B
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