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Said Algan, Murat Kara, Mehmet Akif Cakmak, Onder Tan, Hakan Cinal, Ensar Zafer Barin, Akin Inaloz
OBJECTIVE: Condylar and subcondylar fractures (CSFs) are among the most common mandible fractures. If reduction of these fractures is not carried out correctly, serious complications can result, including infection, damage to temporomandibular joint (TMJ) function, malocclusion, nonunion, malunion, and ankylosis of the TMJ. METHODS: We used a preauricular, mini-incision, open technique (PMIOT) for CSF of the mandible. 66 patients (48 males, 18 females), with a total of 72 CSFs of the mandible, were repaired with PMIOT between 2011 and 2016...
February 8, 2018: Journal of Cranio-maxillo-facial Surgery
Francisco Del Piñal, Eduardo Moraleda, Jaime S Rúas, Ana Rodriguez-Vega, Alexis Studer
PURPOSE: To present a new arthroscopic method for treating supination losses. METHODS: Six patients (15-71 y) were eligible for this study. All had a history of trauma to the wrist more than 6 months previously. Five of them had sustained a distal radius fracture: 3 had been treated with a volar plate (1 of them for an extra-articular malunion), 1 with an external fixator and K-wires, and 1 had been treated in a cast. One of these patients underwent a further operation for correcting an intra-articular malunion...
March 6, 2018: Journal of Hand Surgery
Ena Nielsen, David L Skaggs, Deirdre Ryan, Lindsay M Andras
BACKGROUND: Femur fractures in young children are frequently treated with spica casting. Texts recommend molding spica casts into valgus and recurvatum to counter deforming muscular forces, but how much overcorrection to aim for has not been evaluated. Our goal was to determine how much valgus and recurvatum is optimal at the time of casting to end up with anatomic alignment. METHODS: Patients 1 to 6 years old with femur fractures treated with spica casts between January 1, 2008 and January 31, 2014 who were followed until radiographic union were included in the study...
March 8, 2018: Journal of Pediatric Orthopedics
Jae Jin Kim, Eun Young Lee, Hyun Seok, Ji Yeon Kang
Zygoma reduction malarplasty is a standard procedure primarily performed in Asia on patients who prefer an oval facial shape. The technique is well established and standardized. However, the esthetic results are frequently unsatisfactory or accompanied by complications such as nonunion, malunion, and cheek drooping. These complications are generally attributed to postoperative bone fragment movement. In this study, we present an improvement to this standard procedure that involves modifying the surgical technique...
February 2, 2018: Journal of Cranio-maxillo-facial Surgery
Tony Bryant, David M Beck, Joseph N Daniel, David I Pedowitz, Steven M Raikin
BACKGROUND: There have been very few studies related to the treatment of first, second, third, and fourth (MT) metatarsal shaft and neck fractures. In order to reduce metatarsal fracture malunion, many surgeons have turned from K-wire to plate fixation of these fractures. This study reports the healing rates, final fracture angulation, and need for hardware removal of operatively treated first to fourth MT shaft and neck fractures with plate fixation. METHODS: A retrospective review was performed on all metatarsal fractures at our institution between 2008 and 2014 to identify all first to fourth MT shaft and neck fractures...
March 2018: Foot & Ankle International
Asit Kumar Sikary, Mahesh Kumar, Shivani Dhaka, Arulselvi Subramanian
Ilizarov process is used for the management of multiple fractures, polytrauma conditions, cosmetic limb lengthening, and fracture malunion. Complications associated with the process are nerve palsy, joint contracture, premature or delayed osseous consolidation, a nonunion and permanent stiffness of the joint, pin tract infection, edema, and transient paresthesia, etc. In our case, there was a fatal complication. A 25-year-old African lady underwent the Ilizarov procedure for femur lengthening in a hospital in New Delhi, India...
March 1, 2018: Journal of Forensic Sciences
Iftikhar H Wani, Naseem Ul Gani, Mohammad Yaseen, Adil Bashir, Mohammad Shahid Bhat, Munir Farooq
BACKGROUND: The ideal treatment of distal tibial extra articular fractures remains controversial. Minimally invasive percutaneous plate osteosynthesis and intramedullary nailing are the two most commonly used methods. We did a prospective randomized controlled study to assess the functional outcome of distal tibial extra articular tibial fractures by comparing these treatment methods. MATERIALS AND METHODS: Sixty patients with distal tibial extra articular fractures were randomly assigned to an IMN (intramedullary nailing) group and a MIPPO (minimally invasive percutaneous plate osteosynthesis) group...
December 30, 2017: Ortopedia, Traumatologia, Rehabilitacja
Antti Stenroos, Jenni Jalkanen, Juha-Jaakko Sinikumpu, Sauli Palmu, Eeva Koskimies-Virta, Topi Laaksonen, Yrjänä Nietosvaara
BACKGROUND:  Surgical treatment of pediatric tibia shaft fractures has gained popularity despite closed reduction and cast-immobilization providing good long-term results. There is no consensus about optimal methods and satisfactory quality of treatment. MATERIALS AND METHODS:  During 2010 to 2014, 226 pediatric patients were treated under anesthesia for tibia shaft fractures in Finland's five university hospitals. A total of 164 (73%) patients had closed fractures of the tibia or both tibia and fibula without other injuries (62 tibia only and 102 both tibia and fibula)...
February 28, 2018: European Journal of Pediatric Surgery
A R Saied, M Sabet Jahromi
INTRODUCTION: For extraarticular proximal phalanx fractures, two methods are employed, transarticular fixation in which the metacarpophalangeal joint is crossed and the extraarticular method in which the pins are introduced through the base of the proximal Phalanx. MATERIALS AND METHODS: This study was a prospective one on patients with proximal phalanx transverse or short oblique fractures. In one of the groups we used parallel pins from metacarpal head through MCP joint to proximal phalanx...
February 27, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Nikola Bulatović, Miroslav Kezunović, Čedomir Vučetić, Nermin Abdić, Ivan Benčić, Tomislav Čengić
The rate of periprosthetic femoral fractures following total hip replacement has been growing steadily in the last 20 years and ranges from 0.1% to 2.1%. These fractures are mostly related to older patients with the presence of chronic diseases and frequently poor bone quality. The treatment is surgically very complex and demanding, followed by a series of complications. The evaluation in this retrospective study included 23 patients who were medically treated from January 2004 to December 2015 with the mean follow-up of 14...
September 2017: Acta Clinica Croatica
Daniel J Hackett, Jason E Hsu, Frederick A Matsen
BACKGROUND: Primary shoulder hemiarthroplasty is used to address a range of glenohumeral disorders, including fracture, arthritis, avascular necrosis, and capsulorrhaphy arthropathy; some patients with hemiarthroplasties undergo revision surgery for persistent pain or residual shoulder dysfunction. The literature does not clarify the features of the hemiarthroplasties having repeat surgery in a way that can guide surgeons' efforts to minimize the need for revision. To help address this gap, we analyzed the characteristics of patients from our region for whom we performed surgical revision of a prior humeral hemiarthroplasty QUESTIONS/PURPOSES: (1) What are the common characteristics of shoulder hemiarthroplasties having a revision? (2) What are the common characteristics of the subset of revised shoulder hemiarthroplasties that were performed for fracture? (3) What are characteristics of the subset of all revised hemiarthroplasties that were associated with glenoid bone erosion? METHODS: Data for 983 patients for whom we performed a surgical revision of any type of shoulder arthroplasty between January 1991 and January 2017 were identified in our longitudinally maintained institutional arthroplasty revision database...
February 21, 2018: Clinical Orthopaedics and related Research
Michele Bisaccia, Andrea Cappiello, Luigi Meccariello, Giuseppe Rinonapoli, Gabriele Falzarano, Antonio Medici, Cristina Ibáñez Vicente, Luigi Piscitelli, Verdiana Stano, Olga Bisaccia, Auro Caraffa
INTRODUCTION: Distal tibial fractures are the most common long bone fractures. Several studies focusing on the methods of treatment of displaced distal tibial fractures have been published. To date, locked plates, intramedullary nails and external fixation are the three most used techniques. The aim of our study was to compare intramedullary nail (IMN) and locked plate (LP) for treatment of this kind of fracture. MATERIALS AND METHODS: We collected data on 81 patients with distal tibial fractures (distance from the joint between 40 and 100 mm) and we divided into two groups: IMN and LP...
2018: SICOT-J
A Marzouki, B Soumare, A S Diarra, K Lahrach, F Boutayeb
The aim of this study was to evaluate the results of percutaneous screw fixation of scaphoid waist fractures in our surgery unit by comparing them with recent data from the literature. This was a retrospective, descriptive study conducted between January 2010 and September 2016. Patients operated due to a recent scaphoid fracture and treated by percutaneous anterograde screw fixation with a Herbert screw were included in this study. Our cohort was a sub-set from a scaphoid fracture group; other fracture sites, other treatment techniques and fractures associated with scapholunate ligament lesions were excluded...
February 17, 2018: Hand Surgery and Rehabilitation
Yu-Cheng Zhou, Lin-Xin Yu, Hong Duan, Jie Min, Xiao-Feng Yuan, Peng Yu, Bang-Xu Nie, Jun Hu
OBJECTIVE: To investigate the clinical results of scapula fractures with lateral incision combined with bridge internal fixation system. METHODS: From October 2012 to December 2016, 20 cases of scapular fractures were treated through the lateral incision combined with bridge fixation system, including 15 males and 5 females, with an average age of 31.6 years old(ranged, 21 to 52 years old). Fourteen cases were scapular body fracture, 10 were scapular neck fracture, 6 were scapular fracture, 1 was acromion fracture, 1 was coracoid fracture, 4 were the glenoid rim fracture, 3 were the glenoid fossa fracture...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
E Nielsen, N Bonsu, L M Andras, R Y Goldstein
Purpose: Traditional teaching for fixation of paediatric femur fractures recommends 80% nail diameter/medullary canal diameter ratio (ND/MCD) for successful maintenance of reduction. Prior studies have investigated this with stainless steel Enders nails. Our aim was to assess the impact of ND/MCD on maintenance of reduction and malunion rates in paediatric femur fractures treated with flexible intramedullary nails (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...
February 1, 2018: Journal of Children's Orthopaedics
P Persiani, M Murgia, F M Ranaldi, O Mazza, M Mariani, M Crostelli, C Villani
OBJECTIVE: The purpose of this study is to retrospectively evaluate a group of children affected by cerebral palsy with a recent femoral fracture, and to analyse the results and complications in relation to the treatment used. MATERIALS AND METHODS: The analysis was performed on 36 children (21 M, 15 F, 8-14 years old) with cerebral palsy (7 diplegia, 28 tetraparesis, 1 hemiplegia) with a metaphyseal or a diaphyseal femoral fracture. The patients were subdivided into two groups according to their Gross Motor Function Classification System (GMFCS) level: level 2-3 (9 patients) and level 4-5 (27 patients), evaluating the presence of complications and malunions for each group at the end of each follow up...
January 2018: La Clinica Terapeutica
Robert M Corey, Nathan K Park, Lisa K Cannada
OBJECTIVES: To determine the most commonly associated injuries, complications, and healing rates of patients sustaining segmental tibial shaft fractures. DESIGN: Retrospective review. SETTING: Two Level I trauma centers. PATIENTS: One hundred and eight patients with segmental tibial shaft fractures were identified between 2005-2013. INTERVENTION: None. MAIN OUTCOME MEASURES: Demographics, injury characteristics, treatments, and complications...
January 24, 2018: Journal of Orthopaedic Trauma
Gabrielle M Paci, Kali R Tileston, John S Vorhies, Julius A Bishop
OBJECTIVES: After-hours surgery for pediatric supracondylar humerus fractures may be suboptimal due to surgeon fatigue, limited resources, and variations in comfort with pediatric fracture care. This study compared the outcomes of pediatric supracondylar humerus fractures treated during daytime hours to those treated after-hours. DESIGN: Retrospective SETTING:: Academic level I trauma centerPatients/Participants: 298 pediatric patients treated with surgical reduction and fixation of closed supracondylar fractures were included...
February 9, 2018: Journal of Orthopaedic Trauma
Rajesh Govindasamy, Ramkumar Gnanasundaram, Saravanan Kasirajan, Syed Ibrahim, Jimmy Joseph Melepuram
Background: Femoral shaft fractures are an incapacitating pediatric injury accounting for 1.6% of all pediatric bony injuries. Management of these fractures is largely directed by age, fracture pattern, associated injuries, built of the child and socioeconomic status of the family. We retrospectively evaluated the use of elastic stable intramedullary nail (ESIN) in surgical management of femoral shaft fractures in children and its complications. Methods: Fifty two children were treated with titanium elastic nails (TEN) from June 2009 to June 2014 at our institution...
January 2018: Archives of Bone and Joint Surgery
Christina Salas, Justin A Brantley, James Clark, Mahmoud Reda Taha, Orrin B Myers, Deana Mercer
PURPOSE: "Damage" is an engineering term defining a period between a state of material perfection and the onset of crack initiation. Clinically, it is a loss of fixation due to microstructural breakdown, indirectly measured as a reduction of stiffness of the bone-implant construct, normalized by the cross-sectional area and length of the bone. The purpose of this study was to characterize damage in a cadaver model of extra-articular distal radius fracture with dorsal comminution treated using 2-column volar distal radius plates...
February 6, 2018: Journal of Hand Surgery
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