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https://www.readbyqxmd.com/read/28214061/open-physeal-fracture-of-the-distal-phalanx-of-the-hallux-case-study-diagnosis-and-management
#1
Brandon Morris, Scott Mullen, Paul Schroeppel, Bryan Vopat
Open physeal fractures of the distal phalanx of the hallux are the lesser described counterpart to the same fracture of the finger, known by its eponym as a "Seymour fracture". Displaced Salter-Harris phalangeal fractures present with a concomitant nailbed or soft tissue injury. Often these fractures occur in the summer months when open-toe footwear can be worn, however, they may occur indoors as well. Frequently, the injury results from direct axial load of the toe, or "stubbing", which causes the fracture and associated soft tissue injury...
February 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28213747/bone-morphogenetic-protein-2-for-the-treatment-of-congenital-pseudarthrosis-of-the-tibia-or-persistent-tibial-nonunion-in-children-and-adolescents-a-retrospective-study-with-a-minimum-2-year-follow-up
#2
Tim N Hissnauer, Norbert Stiel, Kornelia Babin, Martin Rupprecht, Michael Hoffmann, Johannes M Rueger, Ralf Stuecker, Alexander S Spiro
There is a lack of studies reporting on rhBMP-2 application in pediatric orthopaedics, although few reports demonstrated promising results of the use of rhBMP-2 in children, especially for spine fusion and for the treatment of congenital pseudarthrosis of the tibia. The objectives of this study were (1) to examine clinical and radiographic healing after rhBMP-2 application for the treatment of congenital pseudarthrosis of the tibia (CPT) or persistent tibial nonunion in children and adolescents, and (2) to investigate the safety of rhBMP-2 use in these cases...
April 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28211679/site-directed-immobilization-of-bmp-2-two-approaches-for-the-production-of-innovative-osteoinductive-scaffolds
#3
Barbara Tabisz, Werner Schmitz, Michael Schmitz, Tessa Luehmann, Eva Heusler, Jens-Christoph Rybak, Lorenz Meinel, Juliane E Fiebig, Thomas D Mueller, Joachim Nickel
The regenerative potential of bone is strongly impaired in pathological conditions, such as nonunion fractures. To support bone regeneration various scaffolds have been developed in the past, which have been functionalized with osteogenic growth factors such as bone morphogenetic proteins (BMPs). However, most of them required supra-physiological levels of these proteins leading to burst releases, thereby causing severe side effects. Site-specific, covalent coupling of BMP2 to implant materials might be an optimal strategy in order to overcome these problems...
February 17, 2017: Biomacromolecules
https://www.readbyqxmd.com/read/28211303/proposal-of-new-classification-of-femoral-trochanteric-fracture-by-three-dimensional-computed-tomography-and-relationship-to-usual-plain-x-ray-classification
#4
Etsuo Shoda, Shimpei Kitada, Yu Sasaki, Hitoshi Hirase, Takahiro Niikura, Sang Yang Lee, Atsushi Sakurai, Keisuke Oe, Takeharu Sasaki
PURPOSE: Classification of femoral trochanteric fractures is usually based on plain X-ray findings using the Evans, Jensen, or AO/OTA classification. However, complications such as nonunion and cut out of the lag screw or blade are seen even in stable fracture. This may be due to the difficulty of exact diagnosis of fracture pattern in plain X-ray. Computed tomography (CT) may provide more information about the fracture pattern, but such data are scarce. In the present study, it was performed to propose a classification system for femoral trochanteric fractures using three-dimensional CT (3D-CT) and investigate the relationship between this classification and conventional plain X-ray classification...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28210649/predictive-surgical-reasons-for-failure-after-coracoid-process-transfers
#5
Gregory Gasbarro, Juan Marcelo Giugale, Gilles Walch, Albert Lin
BACKGROUND: Recurrent anterior shoulder instability after coracoid process transfers may be caused by trauma, sports injury, or technical failure of the index procedure. Surgical techniques vary with regard to graft orientation and positioning and number of screws utilized for fixation. PURPOSE: To identify surgical and patient-related factors associated with failure, defined as the need for revision surgery. We hypothesized that failures will occur more commonly with single-screw fixation and graft malposition...
December 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28205469/valgus-instability-of-the-elbow-due-to-medial-epicondyle-nonunion-treatment-by-fragment-excision-and-medial-collateral-ligament-reconstruction
#6
Yasunori Kaneshiro, Noriaki Hidaka, Koichi Yano, Makoto Fukuda, Hideki Sakanaka
BACKGROUND: The medial epicondyle nonunion becomes symptomatic valgus instability with medial elbow pain and joint instability due to dysfunction of the medial collateral ligament (MCL), thus requiring surgical treatment. The purpose of the present study is to report the clinical result of the fragment excision and ligament reconstruction by free tendon graft in the treatment of symptomatic medial epicondyle nonunion. METHODS: A retrospective study of five consecutive patients was performed...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28205468/vascularized-medial-femoral-condyle-bone-graft-for-resistant-nonunion-of-the-distal-radius
#7
Mark Henry
BACKGROUND: Nonunion involving the metaphyseal region of the distal radius is exceedingly rare, usually involving co-morbidity. Patients that have failed multiple prior conventional surgical interventions represent an even more difficult subset to treat; this investigation examined the utility of a specially designed free vascularized medial femoral condyle flap consisting of a central structural block graft with an extended corticoperiosteal sleeve to wrap around the junctions. METHODS: Six patients (5 males, 1 female) with a mean age of 52 years had failed to achieve union involving the distal radius metaphysis after a mean of 3...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28199292/management-of-open-tibial-shaft-fractures-does-the-timing-of-surgery-affect-outcomes
#8
Oscar A Duyos, David Beaton-Comulada, Ariel Davila-Parrilla, Jose Carlos Perez-Lopez, Krystal Ortiz, Christian Foy-Parrilla, Francisco Lopez-Gonzalez
BACKGROUND: Open tibial shaft fractures require emergent care. Treatment with intravenous antibiotics and fracture débridement within 6 to 24 hours is recommended. Few studies have examined outcomes when surgical treatment is performed >24 hours after occurrence of the fracture. METHODS: This retrospective study included 227 patients aged ≥18 years with isolated open tibial shaft fractures in whom the time to initial débridement was >24 hours. The statistical analysis was based on time from injury to surgical débridement, Gustilo-Anderson classification, method of fixation, union status, and infection status...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28198795/presence-of-failed-fracture-implants-in-association-with-lower-extremity-long-bone-nonunion-does-not-portend-worse-outcome-following-nonunion-repair
#9
Deirdre K Regan, Roy I Davidovitch, Sanjit Konda, Arthur Manoli, Philipp Leucht, Kenneth A Egol
OBJECTIVE: The purpose of this study was to determine whether the finding of failed fracture implants in association with lower extremity long bone fracture nonunion portends worse clinical or functional outcome following surgical nonunion repair. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Academic Medical Center. PATIENTS: One hundred eighty-one patients who presented to our institution over a 10-year period and underwent surgical repair of a lower extremity fracture nonunion...
February 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28196543/the-3-dimensional-miniplate-is-more-effective-than-the-standard-miniplate-for-the-management-of-mandibular-fractures-a-meta-analysis
#10
Yong Liu, Bo Wei, Yuxiang Li, Dawei Gu, Guochao Yin, Bo Wang, Dehui Xu, Xuebing Zhang, Daliang Kong
PURPOSE: The study aimed to determine the superiority between 3-dimensional (3D) miniplate and standard miniplate for mandibular fractures (MFs) treatment. BACKGROUND: Controversial results on the use of standard miniplate and 3D miniplate have remained for management of MFs. METHODS: Several electronic databases were retrieved up to September 2014 to identify eligible studies. The quality of studies was assessed, and the relative risk (RR) with its corresponding 95% confidence interval (CI) was assessed to measure the effect size...
February 14, 2017: European Journal of Medical Research
https://www.readbyqxmd.com/read/28194348/analysis-of-bone-fixation-methods-in-digital-replantation
#11
Seung Woo Lee, Dong Chul Lee, Jin Soo Kim, Si Young Roh, Kyung Jin Lee
BACKGROUND: Adequate fixation of replanted digits is essential not only for short-term healing but for long-term function. Various bony fixation methods using Kirschner (K-) and intraosseous wire are available in replantation. We examined clinical and radiographic outcomes of fixation methods on bone union after digital replantation. METHODS: A single institutional retrospective review identified 992 patients who had undergone 1,247 successful replantations between July 2009 and September 2015...
January 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28192827/the-use-of-mesh-plates-for-difficult-fractures-of-the-patella
#12
David Volgas, Tina K Dreger
Patella fractures present some of the more complicated fracture patterns in orthopaedic trauma care. This is partially due to the small size of the fragments but also the articular nature of each fragment. Fixation methods such as cerclage wiring, excision of smaller fragments, and screw fixation of larger fragments all have their own challenges. Our study examined our Level I trauma center's experience with variable angle locked 2.7 mm titanium plates for treatment of comminuted patella fractures or treatment of patellar nonunion...
February 13, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28192826/the-management-of-bone-defects-in-periarticular-knee-injuries-a-review-article
#13
Brian Buck, Yvonne M Murtha
Traumatic bone defects of the distal femur and proximal tibia present treatment challenges for the orthopaedic traumatologist. In addition to bone loss, significant soft tissue compromise and cartilage defects leave the patient and surgeon with few reconstructive options for proper long-term joint function. These injuries are often complicated by delayed healing, nonunion, malunion, infection, and poor subjective patient outcomes. There are a variety of clinical problems associated with the treatment of periarticular fractures about the knee...
February 13, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28178133/does-the-fracture-fragment-at-the-anterior-column-in-thoracolumbar-burst-fractures-get-enough-attention
#14
Luo Deqing, Lian Kejian, Li Teng, Zou Weitao, Lin Dasheng
Prospective cohort study. To evaluate whether failure of the fracture fragment at the anterior column reduction in thoracolumbar fracture has an influence on the final radiologic and clinical outcomes.Cervical teardrop fracture has caused wide concern in spinal surgery field. Although similar fracture fragment at the anterior column was also observed in thoracolumbar burst fractures, the conception of teardrop fracture in thoracolumbar fractures was rarely mentioned in the literature, let alone a study.Fifty patients who suffered from thoracolumbar burst fractures with a fracture fragment at the anterior column were prospectively analyzed...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28169938/percutaneous-or-open-reduction-of-closed-tibial-shaft-fractures-during-intramedullary-nailing-does-not-increase-wound-complications-infection-or-nonunion-rates
#15
Darryl A Auston, Jordan Meiss, Rafael Serrano, Thomas Sellers, Gregory Carlson, Timothy Hoggard, Michael Beebe, Jonathan Quade, David Watson, R Bruce Simpson, Brian Kistler, Anjan Shah, Roy Sanders, Hassan Mir
OBJECTIVE: To compare the incidence of complications (wound, infection, nonunion) among those patients treated with closed, percutaneous, and open intramedullary nailing for closed tibial shaft fractures. DESIGN: Retrospective Review. SETTING: Multiple trauma centers. PATIENTS: Skeletally mature patients with closed tibia fractures amenable to treatment with an intramedullary device. INTERVENTION: Intramedullary fixation with closed, percutaneous, or open reduction...
December 26, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28169937/outcomes-of-distal-femur-nonunions-treated-with-a-combined-nail-plate-construct-and-autogenous-bone-grafting
#16
Basem Attum, Diana Douleh, Paul S Whiting, Gabrielle A White-Dzuro, Ashley C Dodd, Michelle S Shen, William T Obremskey, Manish K Sethi
SummaryIn this study, we sought to retrospectively evaluate union and infection rates after treatment of distal femur nonunions using a combined nail/plate construct with autogenous bone grafting. 10 patients treated at a Level I Trauma Center for nonunion of a femoral fracture using a combined nail/plate construct from 2004 to 2014 were included in the study. Union rate and postoperative infection rate were recorded.10 patients underwent treatment for nonunion of the distal femur. Mean interval from index surgery to nonunion repair was 12 months (range 4-36 months)...
December 26, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28167875/locking-plate-arthrodesis-compares-favorably-with-lrti-for-thumb-trapeziometacarpal-arthrosis-early-outcomes-from-a-longitudinal-cohort-study
#17
Nikolas H Kazmers, K J Hippensteel, Ryan P Calfee, Lindley B Wall, Martin I Boyer, Charles A Goldfarb, Richard H Gelberman, Daniel A Osei
BACKGROUND: Trapeziometacarpal arthrodesis (TMA) has been complicated by nonunion and hardware failure. QUESTIONS/PURPOSES: We hypothesized that modification of the TMA technique with a locking cage plate construct would afford reliable bony union while producing greater hand function than trapeziectomy with ligament reconstruction and tendon interposition (LRTI) at early follow-up. METHODS: We enrolled 36 consecutive patients with trapeziometacapal osteoarthritis (14 TMA patients (15 thumbs), 22 LRTI patients (22 thumbs))...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28167062/treatment-of-peripheral-talus-fractures
#18
REVIEW
John R Shank, Stephen K Benirschke, Michael P Swords
Peripheral talus fractures include injuries to the lateral process, posteromedial talar body, and talar head. These injuries are rare and are often missed. Nonunion with conservative treatment is high and excision can lead to joint instability, rapid arthrosis, and earlier need for arthrodesis. Open reduction internal fixation of most peripheral talus fractures is critical to achieving a good outcome. Open reduction leads to more rapid union and ability to mobilize the ankle and subtalar joints, quicker revascularization of the talus, and lower rates of arthrosis...
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28164051/modified-boyd-s-dual-onlay-bone-graft-technique-for-15-years-old-neglected-nonunion-fracture-both-bone-forearm-with-severe-angular-deformity-case-report
#19
Dhurvas Ramlal Ramprasath, Vasudevan Thirunarayanan, Duraisamy Ezhilmaran
INTRODUCTION: Neglected case of nonunion of fracture both bones forearm with deformity is very difficult to manage. Treatment options are minimal. Identifying such a case in literature is also very rare. One such rare case is discussed here. CASE REPORT: Here, we present a case of a 65-year-old male patient, who was operated 15 years back for fracture both bones forearm, with 3.5 mm dynamic compression plate. Fracture went into nonunion and plate was broken. The patient presented to us 15 years later in August 2013 with nonunion, broken, and loosened implants and varus deformity of 90°...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28159050/subtalar-arthroscopic-arthrodesis-technique-and-outcomes
#20
Jesús Vilá-Rico, María Angeles Mellado-Romero, Beatriz Bravo-Giménez, Verónica Jiménez-Díaz, Cristina Ojeda-Thies
PURPOSE: The goal of this study was to describe the surgical technique and our results with arthroscopic posterior subtalar arthrodesis. MATERIAL AND METHODS: Retrospective case series of 65 patients (38 men and 27 women) averaging 50 years of age (range 21-72 years) undergoing posterior arthroscopic subtalar arthrodesis using one or two percutaneous 6.5-7.3mm screws between May 2004 and February 2011, with a mean follow-up of 57.5 months (range 24-105 months). RESULTS: We achieved a 95...
March 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
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