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Peter Kloen, Johanna C E Donders, E Marelise W Eekhoff, Reggie C Hamdy
This is a retrospective review of two adult siblings with osteogenesis imperfecta (OI) type III (according to Sillence classification), who sustained a spontaneous femoral neck fracture and subsequent nonunion. The diagnosis of OI in these two patients was made based on clinical, radiological and genetic findings. The fracture was most likely caused by femoroacetabular impingement secondary to OI induced acetabular protrusio. A valgus osteotomy according to Pauwels'principles and fixation of the osteotomy and nonunion with a locking plate resulted in healing despite compromised bone quality and limited bone stock...
March 2018: Hip & Pelvis
Jong Ho Noh, Sung Jun Koh, Kee Haeng Lee
Antibiotic cement-coated intramedullary nails maintain a locally high antibiotic concentration while contributing to bone stability. We present a case of femoral subtrochanteric fracture in a patient with an infected nonunion who was successfully treated for an infection and nonunion using an antibiotic cement-coated tibial intramedullary nail. A 79-year-old woman with a right femoral subtrochanteric fracture underwent internal fixation using proximal femoral nail antirotation (PFNA). She developed osteomyelitis with nonunion at the surgical site 10 months postoperatively...
March 2018: Hip & Pelvis
Christiane Kruppa, Gabriele Wiechert, Thomas A Schildhauer, Marcel Dudda
Purpose of the study was to retrospectively analyze the complication rates after operatively treated femoral shaft fractures in childhood and adolescence. Retrospective evaluation of 42 children with operatively treated femoral shaft fractures between 2000 and 2014. Fractures were classified as 27 A type, 12 B type and 3 C type fractures according the OTA/AO classification. 8 (19.05%) fractures were open. Age averaged 10.2 years (3-16). Fracture treatment was recorded as temporary or definitive external fixation, ESIN, plate fixation or IMN...
December 14, 2017: Orthopedic Reviews
Joseph Christensen, Sean Spence, David Watson, Anjan Shah, Benjamin Maxson, Anthony Infante, Roy Sanders, Hassan R Mir
OBJECTIVE: To review the orthopaedic injuries from watercraft treated surgically at our institution and report the mechanisms, fractures, and complications encountered. DESIGN: Retrospective case series. SETTING: Level I trauma center. PATIENTS/PARTICIPANTS: There were 216 fractures from watercraft in 146 patients. Average age was 33 years (range 4-78 years), there were 68% males (99/146), and 16% of the injuries occurred in children...
April 2018: Journal of Orthopaedic Trauma
Alexej Barg, Clayton C Bettin, Albert H Burstein, Charles L Saltzman, Jeremy Gililland
BACKGROUND: In the last 2 decades, total ankle replacement has gained greater acceptance as a treatment option in patients with end-stage ankle osteoarthritis. However, there is a lack of literature on total ankle replacement using a lateral transfibular approach. Therefore, we sought to report early clinical and radiographic results for a patient cohort treated with total ankle replacement using a lateral transfibular approach, performed by a single surgeon. METHODS: From October 2012 to December 2014, 55 primary total ankle arthroplasties using the Zimmer Trabecular Metal Total Ankle implant were performed in 54 patients (29 male and 25 female; mean age, 67...
March 21, 2018: Journal of Bone and Joint Surgery. American Volume
Chaowei Guo, Jianxiong Ma, Xinlong Ma, Ying Wang, Lei Sun, Bin Lu, AiXian Tian, Yan Wang, BenChao Dong
BACKGROUND: Intramedullary nailing (IMN) and plate have been reported as two effective devices for treating distal extra-articular fractures. However, reports of complications after fractures with use of different tibial fixation techniques in literatures are controversial. Thus, we performed a meta-analysis of randomized controlled trials (RCTs) to compare IMN with plate for evaluating the safety and efficacy. METHODS: The studies were searched from PubMed, Embase, Web of science and the Cochrane Central Register of Controlled Trials by two reviewers up to August 2017...
March 16, 2018: International Journal of Surgery
James M Hartford, Bradley P Graw, Sara B Knowles, Dominick L Frosch
BACKGROUND: To identify the incidence, contributing factors, and outcomes of perioperative greater trochanter fractures associated with the direct anterior approach. METHODS: This is a retrospective analyses of 1401 primary THAs. Age, side, height, weight, body mass index, preoperative ambulatory status, discharge status, and hospital length of stay were identified. Radiographs were evaluated for femoral neck angle, femoral neck cut ratio (FNCR), and DORR ratio...
February 21, 2018: Journal of Arthroplasty
Yashwant Singh Tanwar, Yatinder Kharbanda, Atin Jaiswal, Vikas Birla, Ramsagar Pandit
INTRODUCTION: Coronal plane distal humeral injuries are relatively rare. Numerous classification systems have been proposed as the complexity of these fractures has been realized. We in the present series of ten patients describe the surgical technique of Open Reduction and Internal Fixation of Coronal plane fractures of the distal humerus with headless compression screws performed using the anterolateral approach. MATERIAL AND METHOD: It was a retrospective study, the data collected from March 2010 to 2015 was analysed and the final outcome was assessed using the DASH score...
2018: SICOT-J
Christopher Klifto, Austin Ramme, Anthony Sapienza, Nader Paksima
Scaphoid nonunions are challenging injuries to manage and the optimal treatment algorithm continues to be debated. Most scaphoid fractures heal when appropriately treated; however, when nonunions occur, they require acute treatment to prevent future complications like scaphoid nonunion advanced collapse. Acute nonunion treatment technique depends on nonunion location, vascular status of the proximal pole, fracture malalignment, and pre-existing evidence of arthrosis. Bone grafting and vascular grafts are common in nonunion management...
March 2018: Bulletin of the Hospital for Joint Diseases
Ying-Zhou Li, Feng Ye, Lei Wan, Yong-Bo Yang, Yuan-Sheng Chen, Xiao Wang
OBJECTIVE: To investigate the preliminary effects of modified percutaneous compression plate in treating femoral neck fractures of Pauwels type III. METHODS: From March 2012 to March 2016, 35 patients with femoral neck fracture were treated by closed reduction and internal fixation with a modified percutaneous compression plate, including 21 males and 14 females with an average age of 45 years old ranging from 23 to 62 years old. The anatomical position of fracture was divided into 8 cases of lower head type, 27 cases of head and neck...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Xiang Hu, Bao-Jian Liu, Xiao-Ming Wen, Yong-Hao Zheng, Ke Jia
OBJECTIVE: To investigate the clinical effect of internal fixation with closed reduction and hollow compression screws for the treatment of femoral neck fracture in young and middle-aged patients. METHODS: From June 2013 to December 2016, 33 young and middle-aged patients with femoral neck fractures were treated with hollow compression screws fixation including 17 males and 16 females with an average age of 38.5 years old ranged from 19 to 59 years old; 20 cases were on the left side and 13 cases on the right side;the time from injury to operation ranged from 2 to 5 days with an average of 3 days...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Enrique Gómez-Barrena, Norma G Padilla-Eguiluz, Cristina Avendaño-Solá, Concepción Payares-Herrera, Ana Velasco-Iglesias, Ferran Torres, Philippe Rosset, Florian Gebhard, Nicola Baldini, Juan C Rubio-Suarez, Eduardo García-Rey, José Cordero-Ampuero, Javier Vaquero-Martin, Francisco Chana, Fernando Marco, Javier García-Coiradas, Pedro Caba-Dessoux, Pablo de la Cuadra, Philippe Hernigou, Charles-Henri Flouzat-Lachaniette, François Gouin, Didier Mainard, Jean Michel Laffosse, Miriam Kalbitz, Ingo Marzi, Norbert Südkamp, Ulrich Stöckle, Gabriela Ciapetti, Davide Maria Donati, Luigi Zagra, Ugo Pazzaglia, Guido Zarattini, Rodolfo Capanna, Fabio Catani
ORTHOUNION is a multicentre, open, comparative, three-arm, randomized clinical trial (EudraCT number 2015-000431-32) to compare the efficacy, at one and two years, of autologous human bone marrow-derived expanded mesenchymal stromal cell (hBM-MSC) treatments versus iliac crest autograft (ICA) to enhance bone healing in patients with diaphyseal and/or metaphysodiaphyseal fracture (femur, tibia, and humerus) status of atrophic or oligotrophic nonunion (more than 9 months after the acute fracture, including recalcitrant cases after failed treatments)...
2018: Stem Cells International
K N Li, H Lan, Z Y He, X J Wang, J Yuan, P Zhao, J S Mu
Objective: To explore the characteristics and methods of different fixation methods and prevention of open knee joint fracture. Methods: The data of 86 cases of open knee joint fracture admitted from January 2002 to December 2015 in Department of Orthopaedics, Affiliated Hospital of Chengdu University were analyzed retrospectively.There were 65 males and 21 females aged of 38.6 years. There were 38 cases treated with trans articular external fixation alone, 48 cases were in the trans articular external fixation plus auxiliary limited internal fixation group...
March 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Joseph J Knapik, Sheryl A Bedno
Surveys indicated that 24% of military personnel are current cigarette smokers. Smoking is well known to increase the risk of cancers, cardiovascular and respiratory diseases, reproductive problems, and other medical maladies, but one of the little known effects of smoking is that on injuries. There is considerable evidence from a variety of sources that (1) smoking increases overall injury risk, (2) the greater the amount of smoking, the higher is the injury risk, and (3) smoking is an independent injury risk factor...
2018: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Luis A Aponte-Tinao, Jose I Albergo, Miguel A Ayerza, D Luis Muscolo, Federico Milano Ing, German L Farfalli
BACKGROUND: Preservation of limb function after resection of malignant bone tumors in skeletally immature children is challenging. Resection of bone sarcomas and reconstruction with an allograft in patients younger than 10 years old is one reconstructive alternative. However, long-term studies analyzing late complications and limb length discrepancy at skeletal maturity are scarce; this information would be important, because growth potential is altered in these patients owing to the loss of one physis during tumor resection...
March 2018: Clinical Orthopaedics and related Research
Germán L Farfalli, Jose I Albergo, Nicolas S Piuzzi, Miguel A Ayerza, D Luis Muscolo, Lucas E Ritacco, Luis A Aponte-Tinao
BACKGROUND: The treatment of locally aggressive bone tumors is a balance between achieving local tumor control and surgical morbidity. Wide resection decreases the likelihood of local recurrence, although wide resection may result in more complications than would happen after curettage. Navigation-assisted surgery may allow more precise resection, perhaps making it possible to expand the procedure's indications and decrease the likelihood of recurrence; however, to our knowledge, comparative studies have not been performed...
March 2018: Clinical Orthopaedics and related Research
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
Joel B Huleatt, Carl W Nissen, Matthew D Milewski
The treatment of sports injuries in the skeletally immature has a unique set of complications. Growth deformity may occur after anterior cruciate ligament reconstruction; therefore, skeletal age is used to help guide the choice between physeal sparing and transphyseal techniques. Arthrofibrosis after tibial spine fracture fixation can be reduced by initiating immediate range of motion, and should be treated early and cautiously to avoid iatrogenic fracture. Nonunions of medial epicondyle elbow fractures are more common with nonoperative treatment, but seldom lead to clinical problems outside of certain athletes...
April 2018: Clinics in Sports Medicine
Michel D Crema, Catherine Phan, Anne Miquel, Celine Quach, Lionel Arrivé, Yves Menu
OBJECTIVES: Our primary aim was to evaluate the distribution and severity of cartilage damage in a sample of patients with scaphoid nonunion advanced collapse (SNAC), assessed on MDCT arthrography, with regard to two well-known SNAC staging systems. Secondarily, we wanted to see if the degree of cartilage damage varied with the location of the nonunion. METHODS: We retrospectively included 35 patients with a history of SNAC who had undergone MDCT arthrography. The location of the fracture was defined as the proximal, middle, or distal third of the scaphoid...
March 8, 2018: Skeletal Radiology
M Gurger, M Yilmaz, E Yilmaz, S Altun
Background: Percutaneous screw fixation is widely used in acute fractures of the scaphoid. In this study, we aimed to present our results with volar percutaneous screw fixation in patients with scaphoid nonunions. Methodology: A total of 12 patients with scaphoid nonunion (≥13 weeks) that underwent volar percutaneous screw fixation were evaluated retrospectively. Two of the patients were female, and 10 were male. Mean age was 27 years (range = 19-41). The mean time that elapsed between the fracture and surgical procedure was 7...
March 2018: Nigerian Journal of Clinical Practice
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