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https://www.readbyqxmd.com/read/28725510/a-critical-appraisal-of-vascularized-bone-grafting-for-scaphoid-nonunion
#1
Ram K Alluri, Christine Yin, Matthew L Iorio, Hyuma Leland, Wendy J Mack, Ketan Patel
Background  Vascularized bone grafting (VBG) has the potential to yield reliable results in scaphoid nonunion; however, results across studies have been highly variable. This study critically evaluates surgical techniques, fracture location, and patient selection in relation to radiographic, clinical, and patient-centered outcomes after VBG for scaphoid nonunion. Methods  We conducted a systematic review of the literature for the use of VBG in scaphoid nonunion. Physical examination, radiographic, and patient-centered outcomes were assessed...
August 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28725498/percutaneous-transtrapezial-fixation-without-bone-graft-leads-to-consolidation-in-selected-cases-of-delayed-union-of-the-scaphoid-waist
#2
Matthias Vanhees, Roger R P van Riet, Annemieke van Haver, Radek Kebrle, Geert Meermans, Frederik Verstreken
Purpose  We evaluated clinical and radiographic outcome of percutaneous transtrapezial fixation of the scaphoid delayed union or nonunion using a headless bone screw without bone grafting. Methods  Sixteen patients with delayed union or nonunion of the scaphoid were included in this retrospective study between 2006 and 2011. All patients had a delayed presentation of scaphoid fracture, and none of them was treated conservatively elsewhere. Patients with bone graft, sclerotic bone debridement, or displacement of the fragment at the nonunion site were excluded...
August 2017: Journal of Wrist Surgery
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/28719987/corrective-osteotomy-of-malunited-diaphyseal-fractures-of-the-forearm-simplified-using-3-dimensional-ct-data-proposal-of-our-simple-strategy-through-case-presentation
#4
Yoshitaka Hamada, Hiroyuki Gotani, Kousuke Sasaki, Yoshitaka Tanaka, Hiroshi Egawa, Thepparat Kanchanathepsak
BACKGROUND: Reconstruction of malunited diaphyseal fractures of the forearm is one of the most difficult treatments due to its complicated structure. Widespread usage of Digital Imaging and Communications in Medicine (DICOM) data of 3-dimensional (3D) computed tomography (CT) and 3D printing can make estimating the true plane of the deformity easy. METHODS: A 21-year-old man with limited supination due to left forearm nonunion deformity initially treated by locking plate fixation was referred to our hospital...
March 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28719555/the-influence-of-shortening-on-clinical-outcome-in-healed-displaced-midshaft-clavicular-fractures-after-nonoperative-treatment
#5
E B Goudie, N D Clement, I R Murray, C R Lawrence, M Wilson, A J Brooksbank, C M Robinson
BACKGROUND: We aimed to evaluate the effect of clavicular shortening, measured with 3-dimensional computed tomography (3DCT), on functional outcomes and satisfaction in patients with healed displaced midshaft clavicular fractures up to 1 year following injury. METHODS: The data used in this study were collected as part of a multicenter, prospective randomized controlled trial of open reduction and plate fixation compared with nonoperative treatment for acute, displaced midshaft clavicular factures...
July 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28719554/treatment-of-displaced-midshaft-clavicle-fractures-figure-of-eight-harness-versus-anterior-plate-osteosynthesis-a-randomized-controlled-trial
#6
Marcel Jun Sugawara Tamaoki, Fabio Teruo Matsunaga, Adelmo Rezende Ferreira da Costa, Nicola Archetti Netto, Marcelo Hide Matsumoto, Joao Carlos Belloti
BACKGROUND: Most midshaft clavicle fractures affect the economically active population, which is negatively impacted by transient limb impairment during the treatment. There is still debate about the advantages and disadvantages of surgical treatment for these fractures. METHODS: In this prospective randomized controlled trial, 117 patients were allocated to 1 of 2 groups: nonsurgical treatment with a figure-of-eight harness or surgical treatment with anteroinferior plate osteosynthesis...
July 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28718308/ulnar-shortening-versus-distal-radius-corrective-osteotomy-in-the-management-of-ulnar-impaction-after-distal-radius-malunion
#7
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/28712710/%C3%A3-tcp-bone-substitutes-in-tibial-plateau-depression-fractures
#8
Tim Rolvien, Florian Barvencik, Till Orla Klatte, Björn Busse, Michael Hahn, Johannes Maria Rueger, Martin Rupprecht
BACKGROUND: The use of beta-tricalciumphospate (ß-TCP, Cerasorb®) ceramics as an alternative for autologous bone-grafting has been outlined previously, however with no study focusing on both clinical and histological outcomes of ß-TCP application in patients with multi-fragment tibial plateau fractures. The aim of this study was to analyze the long-term results of ß-TCP in patients with tibial plateau fractures. METHODS: 52 patients were included in this study...
July 13, 2017: Knee
https://www.readbyqxmd.com/read/28712173/surgical-site-infection-in-orthopaedic-implants-and-its-common-bacteria-with-their-sensitivities-to-antibiotics-in-open-reduction-internal-fixation
#9
Muhammad Qaisar Shah, Muhammad Shoib Zardad, Alamzeb Khan, Sajjad Ahmed, Abdus Saboor Awan, Taj Mohammad
BACKGROUND: Surgical site infection in orthopaedic implants is a major problem, causing long hospital stay, cost to the patient and is a burden on health care facilities. It increases rate of nonunion, osteomyelitis, implant failure, sepsis, multiorgan dysfunction and even death. Surgical site infection is defined as pain, erythema, swelling and discharge from wound site. Surgical site infection in orthopaedic implants is more challenging to the treating orthopaedic surgeon as the causative organism is protected by a biofilm over the implant's surface...
January 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28710911/a-novel-technique-for-reduction-malarplasty-by-inward-displacement-of-infractured-zygomatic-arch-without-fixation
#10
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/28708946/sports-participation-functional-outcome-and-complications-after-ankle-arthrodesis-midterm-follow-up
#11
Yvonne R A Kerkhoff, Noël L W Keijsers, Jan Willem K Louwerens
BACKGROUND: Ankle arthrodesis provides satisfactory functional outcome based on basic daily activities, but information regarding more demanding tasks is limited. Also, studies reporting longer term survival and complication rates are sparse and concern small study populations. This study reports functional outcome with more focus on demanding tasks and sports and reports the mid- to long-term union and complication rates in a large study population. METHODS: Between 2005 and 2010, an ankle arthrodesis was performed on 185 ankles...
July 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28708782/outcomes-of-distal-femur-nonunions-treated-with-a-combined-nail-plate-construct-and-autogenous-bone-grafting
#12
Basem Attum, Diana Douleh, Paul S Whiting, Gabrielle A White-Dzuro, Ashley C Dodd, Michelle S Shen, Hassan R Mir, William T Obremskey, Manish K Sethi
No abstract text is available yet for this article.
June 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28708781/fracture-site-mobility-at-six-weeks-following-humeral-shaft-fracture-predicts-nonunion-without-surgery
#13
Adam S Driesman, Nina Fisher, Raj Karia, Sanjit Konda, Kenneth A Egol
OBJECTIVES: To assess the presence of fracture site gross motion on physical examination to predict humeral shaft fracture progression to nonunion in patients managed non-operatively. DESIGN: Retrospective cohort study SETTING:: Single trauma level 1 institutional center PATIENTS:: Eighty-four consecutive patients undergoing non-operative treatment of a diaphyseal humeral shaft fracture were identified. The average age of the population was 48.3 years and 50% of the cohort was male...
July 8, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28708779/midshaft-fracures-of-the-clavicle-a-meta-analysis-comparing-surgical-fixation-via-anteroinferior-plating-versus-superior-plating
#14
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/28699149/is-the-clavicula-pro-humero-technique-of-value-for-reconstruction-after-resection-of-the-proximal-humerus-in-children
#15
Dominique Barbier, Benoît De Billy, Philippe Gicquel, Sophie Bourelle, Pierre Journeau
BACKGROUND: There are several options for reconstruction of proximal humerus resections after wide resection for malignant tumors in children. The clavicula pro humero technique is a biologic option that has been used in the past, but there are only scant case reports and small series that comment on the results of the procedure. Because the longevity of children mandates a reconstruction with potential longevity not likely to be achieved by other techniques, the clavicula pro humero technique may be a potential option in selected patients...
July 11, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28697083/multiple-rib-nonunion-open-reduction-and-internal-fixation-and-iliac-crest-bone-graft-aspirate
#16
Daniel J Kaplan, John Begly, Nirmal Tejwani
PURPOSE: Rib fractures are a common chest injury that can typically be treated nonoperatively. However, a percentage of these will go on to nonunion, either because of unique characteristics of the fracture itself or because of a variety of poor healing factors of the host. If a patient has continued symptomology beyond 3 months, surgeons may consider operative management. METHODS: Although isolated resection of fibrous scar tissue from the nonunion site may be sufficient in some cases, it may also be necessary to provide additional structural integrity to the rib depending on the extent of the fracture pattern and resection...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697082/primary-posterior-blade-plate-tibiotalar-arthrodesis-a-salvage-procedure-for-complex-nonreconstructable-pilon-fractures
#17
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/28697079/exchange-nailing-for-hypertrophic-femoral-nonunion
#18
Alejandro Marquez-Lara, T David Luo, Rebecca Senehi, Arun Aneja, Hoyt Randy Beard, Eben A Carroll
Exchange nailing has proven to be a reliable surgical technique for the management of aseptic femoral shaft nonunions. Similar to primary intramedullary nail fixation for femur fractures, exchange nailing for aseptic hypertrophic nonunions of the femur relies on successful navigation of the starting point and proper nail trajectory to minimize coronal and sagittal plane deformities. Compared with the supine position, the lateral decubitus position has the advantage of allowing gravity to displace the soft tissue around the piriformis start site to facilitate nail entry...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697077/femoral-nonunion-with-iliac-crest-bone-graft
#19
Sanjit R Konda, Anthony Christiano, Nina Fisher, Philipp Leucht, Kenneth A Egol
PURPOSE: Fracture nonunion is a common problem for today's orthopaedic surgeon. However, many techniques are currently available for the treatment of long-bone nonunion. This video demonstrates the use of iliac crest bone graft and plate stabilization in the setting of a hypertrophic femoral nonunion. METHODS: Treatment of femoral nonunion after intramedullary nail fixation using compression plating and bone grafting is a reliable technique for reducing pain, improving function, and achieving radiographic union...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697075/posterolateral-bone-grafting-for-distal-tibia-nonunion
#20
Sanjit Konda, Hesham Saleh, Nina Fisher, Kenneth A Egol
INTRODUCTION: This video demonstrates the technique of posterolateral bone grafting with iliac crest bone graft for a distal tibial nonunion. METHODS: The patient is a 42-year-old man who is 6 months status post an open distal tibia-fibula fracture treated surgically, and presents complaints of persistent right ankle pain. The fracture site was tender to palpation, and 3 consecutive plain radiographs spaced 6 weeks apart demonstrated no evidence of callus formation...
August 2017: Journal of Orthopaedic Trauma
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