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https://www.readbyqxmd.com/read/27923219/nonoperative-versus-operative-treatment-of-displaced-ankle-fractures-in-diabetics
#1
Andrew J Lovy, James Dowdell, Aakash Keswani, Steven Koehler, Jaehon Kim, Steven Weinfeld, David Joseph
BACKGROUND: Diabetes is a risk factor for complications related to displaced ankle fractures. Limited literature exists comparing complication rates in nonoperative versus operative treatment of displaced ankle fractures in diabetics. No study has highlighted the natural history of nonoperative treatment of displaced ankle fractures in diabetics. METHODS: We retrospectively reviewed all adult ankle fractures from September 2011 through December 2014. Inclusion was limited to ambulatory adults (>18 years) with closed, displaced (widened mortise) ankle fractures with diabetes mellitus...
November 14, 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/27870672/the-clinical-and-economic-impact-of-generic-locking-plate-utilization-at-a-level-ii-trauma-center
#2
Austin Mcphillamy, Taylor P Gurnea, Alastair E Moody, Christopher G Kurnik, Minggen Lu
OBJECTIVES: In today's climate of cost containment and fiscal responsibility, generic implant alternatives represent an interesting area of untapped resources. As patents have expired on many commonly used trauma implants, generic alternatives have recently become available from a variety of sources. The purpose of this study was to examine the clinical and economic impact of a cost containment program using high quality, generic orthopaedic locking plates. The implants available for study were anatomically precontoured plates for the clavicle, proximal humerus, distal radius, proximal tibia, distal tibia, and distal fibula...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27852383/-surgery-of-ipsilateral-hawkins-%C3%A2-talus-neck-and-ankle-joint-fractures-via-internal-and-lateral-approaches-with-herbert-screws
#3
P Zhang, Q R Dong, Z Y Wang, B Chen, J H Wan, L Wang
Objective: To explore the manual operation skills of operative treatment of ipsilateral Hawkins Ⅲ talus neck and ankle joint fractures via internal and lateral approaches with Herbert screws, and to study the clinical results. Method: From Jan 2009 to Dec 2014, the clinical data of 13 patients with ipsilateral Hawkins Ⅲ talus neck and ankle joint fractres via internal and lateral approaches with Herbert screws were retrospectively analyzed in our department.There were 10 males and 3 female, ranging in age from 20 to 60 years with an average age of 31...
November 8, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27825761/comparison-of-intramedullary-nailing-and-minimal-invasive-plate-osteosynthesis-in-the-treatment-of-simple-intra-articular-fractures-of-the-distal-tibia-ao-ota-type-43-c1-c2
#4
Ozan Beytemür, Alican Barış, Cem Albay, Serdar Yüksel, Sever Çağlar, Ender Alagöz
OBJECTIVE: The aim of this study was to compare midterm functional and radiographic results of minimal invasive plate osteosynthesis (MIPO) with intramedullary nailing (IMN) of simple intra-articular distal tibial fractures (AO-OTA type 43 C1-C2). METHODS: Seventy-three simple intra-articular distal tibial fracture patients were evaluated retrospectively. All were treated between 2009 and 2014. The average age of the patients was 40.3 years. Thirty-seven patients were treated with IMN and 36 patients were treated with MIPO...
November 5, 2016: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/27770336/a-prospective-multi-center-study-of-intramedullary-nailing-vs-casting-of-stable-tibial-shaft-fractures
#5
William T Obremskey, Norele Cutrera, Christopher M Kidd
BACKGROUND: The purpose of this study was to determine optimal treatment of stable tibial shaft fractures using intramedullary nailing (IMN) or casting. MATERIALS AND METHODS: We performed a multi-center prospective study cohort. Patients with stable tibia shaft fractures meeting Sarmiento's criteria (isolated closed fractures with less than 12 mm of shortening and 10° of angulation) were enrolled prospectively and treated with either a reamed IMN with static interlocking screws or closed reduction followed by long-leg casting...
October 21, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/27735787/the-ankle-injury-management-aim-trial-a-pragmatic-multicentre-equivalence-randomised-controlled-trial-and-economic-evaluation-comparing-close-contact-casting-with-open-surgical-reduction-and-internal-fixation-in-the-treatment-of-unstable-ankle-fractures-in
#6
David J Keene, Dipesh Mistry, Julian Nam, Elizabeth Tutton, Robert Handley, Lesley Morgan, Emma Roberts, Bridget Gray, Andrew Briggs, Ranjit Lall, Tim Js Chesser, Ian Pallister, Sarah E Lamb, Keith Willett
BACKGROUND: Close contact casting (CCC) may offer an alternative to open reduction and internal fixation (ORIF) surgery for unstable ankle fractures in older adults. OBJECTIVES: We aimed to (1) determine if CCC for unstable ankle fractures in adults aged over 60 years resulted in equivalent clinical outcome compared with ORIF, (2) estimate cost-effectiveness to the NHS and society and (3) explore participant experiences. DESIGN: A pragmatic, multicentre, equivalence randomised controlled trial incorporating health economic evaluation and qualitative study...
October 2016: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/27727383/close-contact-casting-vs-surgery-for-initial-treatment-of-unstable-ankle-fractures-in-older-adults-a-randomized-clinical-trial
#7
RANDOMIZED CONTROLLED TRIAL
Keith Willett, David J Keene, Dipesh Mistry, Julian Nam, Elizabeth Tutton, Robert Handley, Lesley Morgan, Emma Roberts, Andrew Briggs, Ranjit Lall, Timothy J S Chesser, Ian Pallister, Sarah E Lamb
Importance: Ankle fractures cause substantial morbidity in older persons. Surgical fixation is the contemporary intervention but is associated with infection and other healing complications. Objective: To determine whether initial fracture treatment with close contact casting, a molded below-knee cast with minimal padding, offers outcome equivalent to that with immediate surgery, with fewer complications and less health resource use. Design, Setting, and Participants: This was a pragmatic, equivalence, randomized clinical trial with blinded outcome assessors...
October 11, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27684849/elastic-stable-intramedullary-nailing-for-severely-displaced-distal-tibial-fractures-in-children
#8
Kaiying Shen, Haiqing Cai, Zhigang Wang, Yunlan Xu
Elastic stable intramedullary nailing (ESIN) has became a well-accepted method of osteosynthesis of diaphyseal fractures in the skeletally immature patient for many advantages, the purpose of this study is to evaluate the preliminary results of this minimally invasive treatment for severely displaced distal tibial diaphyseal metaphyseal junction (DTDMJ) fractures.This study was carried out over a 6-year period. Twenty-one severely displaced DTDMJ fractures treated using ESIN were evaluated clinically and radiographically...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27640930/medial-displacement-calcaneal-osteotomy-a-comparison-of-screw-versus-locking-plate-fixation
#9
Amol Saxena, Rajan Patel
Locking plate fixation is becoming more popular for fixation of lower extremity osteotomies. The present study evaluated locking plate fixation compared with screw fixation in the medial displacement calcaneal osteotomy procedure, measuring the outcomes and rate of hardware removal. The procedure was performed on 30 patients, 31 times, with 17 undergoing single screw fixation and 14 undergoing locking plate fixation. The return to activity was 6.87 ± 1.43 months, including some patients for whom running was their main activity...
September 15, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27613815/preoperative-anemia-in-hindfoot-and-ankle-arthrodesis
#10
Brian Dix, Lisa Grant-McDonald, Alan Catanzariti, Karl Saltrick
: This is a retrospective study (n = 39) evaluating the postoperative outcomes of patients with mild to moderate preoperative anemia who underwent a hindfoot and/or ankle arthrodesis. In the study, 32 patients did not have preoperative anemia, and 7 had preoperative anemia. Mortality, length of hospital stay, blood transfusions, deep-vein thrombosis, infection, time to union, malunion, delayed union, nonunion, and ulceration were of particular interest. Comparative analyses between patients with preoperative anemia and those without were performed utilizing the independent samples t-test or by the nonparametric Mann-Whitney U-test...
September 9, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27612414/an-innovative-approach-to-the-repair-of-distal-tibia-nonunion-using-a%C3%A2-retrograde-buried-tibio-talar-calcaneal-nail-a-case-report
#11
Peter Van Steyn, Michael Romash
We report a case using retrograde tibial nailing as treatment of nonunion of a distal tibial osteotomy, which was performed as part of a complex reconstruction of distal tibial malunion with ankle arthritis. Although retrograde nailing has classically been used for tibial-talar-calcaneal arthrodesis, this method spares the subtalar joint. Preservation of some hindfoot motion by subtalar mobility allows for a decrease in the loss of function typically seen with tibial-talar-calcaneal arthrodesis.
September 6, 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27380279/hindfoot-arthrodesis-with-the-blade-plate-increased-risk-of-complications-and-nonunion-in-a-complex-patient-population
#12
Troy M Gorman, Timothy C Beals, Florian Nickisch, Charles L Saltzman, Mikayla Lyman, Alexej Barg
BACKGROUND: Previous hindfoot surgeries present a unique challenge to hindfoot arthrodesis, as the patients may have multiple incisions around the hindfoot. In high-risk patients with compromised soft tissues, a posterior approach can provide an alternative for a fresh soft tissue plane for the surgery. The use of a blade plate construct is widely accepted; however, there are limited data supporting the use of a posterior approach. QUESTIONS/PURPOSES: We asked (1) what proportion of patients treated with this technique achieved osseous union; (2) what complications were observed; (3) were any patient-demographic or health-related factors associated with the likelihood that a patient would have a complication develop? METHODS: Between December 2001 and July 2014, 42 patients received a posterior blade plate...
October 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27358264/categorization-and-surgical-management-of-posttraumatic-midfoot-malunion
#13
Chun-Guang Li, Guang-Rong Yu, Yun-Feng Yang, Bing Li
OBJECTIVE: To assess a classification system for midfoot injury that was based on the characteristics of the foot malunion and to evaluate the suggested treatment strategies. METHODS: This retrospective review of data from patients with posttraumatic midfoot malunion categorized each foot deformity into one of three types based on the foot arch and then separated these categories into one of three subtypes based on the forefoot deformity. According to the types of malunion, fascio-cutaneous flap, osteotomy, joint arthrodesis or realignment was used to correct the deformity...
August 2016: Journal of International Medical Research
https://www.readbyqxmd.com/read/27301726/surgically-treated-talar-fractures-a-retrospective-study-of-50-patients
#14
Ingrid Kvello Stake, Jan Erik Madsen, Kjetil Hvaal, Elena Johnsen, Elisabeth Ellingsen Husebye
BACKGROUND: Talar fractures are associated with a high incidence of avascular necrosis (AVN), osteoarthritis (OA) and malunion. The aim of this study was to evaluate the complications, the functional outcome, and the need for secondary surgery following surgically treated talar fractures. METHODS: Fifty patients with 52 talar fractures were included in the study. The health related quality of life was evaluated using visual analogue scale (VAS). The ankle function was scored using the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score...
June 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27135084/-retrospective-analysis-of-ao-42a-b-type-tibia-fractures-treated-with-percutaneus-locked-plating-and-intramedullary-nailing
#15
Fuat Bilgili, Ayhan Kılıç, Sami Sökücü, Atilla Sancar Parmaksızoğlu, Kamil Serdar Çepni, Yavuz Selim Kabukçuoğlu
BACKGROUND: In this study, the results of AO 42A and 42B type tibia fractures treated with intramedullary nail (IMN) and percutaneus locking plate (PLP) were evaluated. The complications were examined, and it was questioned whether the type of fixation had an effect on union time and functional results. METHODS: Forty-two patients with extraarticular distal tibial fractures were enrolled in this retrospective study. Eighteen patients were treated with closed IMN (Group I) and 24 patients were treated with PLP fixation (Group II)...
January 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27135079/surgical-treatment-of-distal-tibia-fractures-open-versus-mipo
#16
Deniz Gülabi, Halil İbrahim Bekler, Fevzi Sağlam, Zeki Taşdemir, Gültekin Sıtkı Çeçen, Nurzat Elmalı
BACKGROUND: Treatment of the distal tibial fractures are challenging due to the limited soft tissue, subcutaneous location and poor vascularity. In this control-matched study, it was aimed to compare the traditional open reduction and internal fixation with minimal invasive plating (MIPO). We hypothesized that superior results may be achieved with MIPO technique. METHODS: 22 patients treated with traditional open reduction and internal fixation were matched with 22 patients treated with closed reduction and MIPO on the basis of age (±3), gender, and fracture pattern (AO classification)...
January 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/27086178/the-mau-reverdin-osteotomy-a-short-term-retrospective-analysis
#17
Nicolas Arcuri, Tzvi Bar-David, Simcha Pollack
We reviewed 33 consecutive Mau-Reverdin osteotomies in 23 patients performed for correction of hallux abducto valgus from November 2010 to May 2013. All patients were followed up and evaluated for a mean of 401 days and median of 360 days after surgery. In each foot, the preoperative first intermetatarsal angle, hallux abductus angle, and proximal articular set angle were obtained. The mean correction of these angles was as follows: intermetatarsal angle 10.5° ± 3.31°, hallux abductus angle 24.4° ± 8...
July 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27009078/fibular-strut-graft-for-revisional-tibiotalocalcaneal-arthrodesis
#18
Spencer J Monaco, Nick Lowery, Brandon Crim
: Tibiotalocalcaneal arthrodesis with an intramedullary nail is a procedure reserved for patients who have conditions affecting the ankle joint and subtalar joint. The most common complications include nonunion, malunion, delayed union, infection, periprosthetic fracture, hardware failure, lateral plantar nerve injury, and wound healing. Significant bone void may result if the hardware requires removal secondary to one of these complications. The purpose of this article is to report on 2 cases of infected intramedullary nails, which were revised with fibular inlay strut grafts...
March 23, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/26981239/clinical-audit-of-ankle-fracture-management-in-the-elderly
#19
Langhit Kurar
INTRODUCTION: Ankle fractures in the osteoporotic patient are challenging injuries to manage, due to a combination of poor soft tissue, peripheral vascular disease and increased bone fragility, often resulting in more complex fracture patterns. I aim to audit current practice and introduce change by producing recommendations to help improve longer-term functional outcomes. PATIENTS AND METHODS: A retrospective 3-week audit was conducted reviewing results of ankle fracture management in 50 patients aged between 50 and 80 years...
March 2016: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/26961415/do-broken-toes-need-follow-up-in-the-fracture-clinic
#20
Timothy B Eves, Michael J Oddy
Most toe phalangeal fractures can be successfully treated nonoperatively without any residual deformity and are usually clinically asymptomatic. Toe phalangeal fractures are nevertheless common fracture clinic referrals. Our aim was to evaluate the injury characteristics of patients with toe fractures attending a fracture clinic and to understand how current management affects the fracture clinic workload. We retrospectively evaluated all new referrals to a subspecialized foot and ankle fracture clinic during a 12-month period at our institution under the care of 1 consultant...
May 2016: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
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