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https://www.readbyqxmd.com/read/29791703/biological-intercalary-reconstruction-with-bone-grafts-after-joint-sparing-resection-of-the-lower-limb-is-this-an-effective-and-durable-solution-for-joint-preservation
#1
Francesco Muratori, Francesca Totti, Antonio D'Arienzo, Maurizio Scorianz, Guido Scoccianti, Giovanni Beltrami, Francesco Rosario Campo, Carmine Citarelli, Rodolfo Capanna, Domenico Andrea Campanacci
Due to advances in neoadjuvant therapies and preoperative imaging modalities, joint-sparing resections have become appealing in bone tumor surgery. However, the intercalary reconstruction of metadiaphyseal bone defects of the femur and the tibia after juxta-articular tumor resection remains challenging. Both biological and prosthetic reconstructions have been used for joint-sparing resections, but little is known about the long-term outcome of these procedures. The authors reviewed a consecutive series of 64 patients treated with joint-sparing intercalary resection and reconstruction with bone grafts...
June 1, 2018: Surgical Technology International
https://www.readbyqxmd.com/read/29789188/fractures-after-multimodality-treatment-of-soft-tissue-sarcomas-with-isolated-limb-perfusion-and-radiation-likely-to-occur-and-hard-to-heal
#2
J M Seinen, P C Jutte, L B Been, E Pras, H J Hoekstra
OBJECTIVES: Treatment associated fractures (TAFs) are known severe side effects after surgery and radiotherapy for soft tissue sarcoma (STS). There is no literature about TAF after multimodality treatment with isolated limb perfusion (ILP) for locally advanced STS. This study aimed to analyze predictive factors, treatment and outcome for TAF after multimodality treatment with ILP. METHOD: Out of 126 consecutive patients undergoing ILP after 1991 till now, 25 patients were excluded due to no surgery or direct amputation at initial surgery...
April 24, 2018: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/29788992/comparing-case-control-study-for-treatment-of-proximal-tibia-fractures-with-a-complete-metaphyseal-component-in-two-centers-with-different-distinct-strategies-fixation-with-ilizarov-frame-or-locking-plates
#3
Haakon Berven, Michael Brix, Kaywan Izadpanah, Eva Johanna Kubosch, Hagen Schmal
BACKGROUND: The purpose of this study was to compare two methods of stabilization for proximal tibia fractures (AO 41) with a complete metaphyseal component, external fixation with the Ilizarov wire frame, and internal fixation with locking plates. METHODS: Patients from two level 1 trauma centers treated between 2009 and 2015 were included in a retrospective comparing cohort study. The first center stabilized the non-pathological, proximal tibia fractures exclusively with external fixation and the second with internal plating...
May 22, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29786823/application-of-hybrid-external-fixation-by-the-joystick-method-in-bicondylar-tibial-plateau-fractures-technical-note
#4
Ersin Kuyucu, Adnan Kara, Ferhat Say, Mehmet Erdil, Murat Bülbül, Barış Gülenç
BACKGROUND: This study aimed to present clinical outcomes in patients with tibial plateau fractures who were treated with hybrid external fixators and describe the details of our technique. Schanz screws were synchronously applied and used as a joystick for fracture reduction. METHODS: The study population included 72 patients with bicondylar tibial plateau fractures classified as type 41-C2 according to the AO classification. Joint reduction was maintained using Schanz screws transmitted through tibial condyles as a joystick under fluoroscopy...
May 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29786041/fixation-versus-excision-of-osteochondral-fractures-after-patellar-dislocations-in-adolescent-patients-a-retrospective-cohort-study
#5
Hui Kang, Jian Li, Xu-Xu Chen, Tao Wang, Shi-Chang Liu, Hong-Chuan Li
Background: Patellar dislocation is one of the most common knee injuries in the adolescent population. It is often combined with osteochondral fracture. The purpose of this study was to compare the outcomes between fixation and excision of osteochondral fractures not involving the bearing surface in adolescent patients with patellar dislocations. Methods: Patients who underwent surgery for osteochondral fracture following patellar dislocation in our institution from 2007 to 2014 were retrospectively evaluated...
June 5, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29785447/posterior-cortical-breakage-leads-to-posterior-tibial-slope-change-in-lateral-hinge-fracture-following-opening-wedge-high-tibial-osteotomy
#6
Sung-Sahn Lee, Kyung-Wook Nha, Dae-Hee Lee
PURPOSE: This study was designed to analyze the relationship between changes in posterior tibial slope and the absence or presence of lateral hinge fracture, diagnosed in the sagittal and axial planes, as well as the coronal plane, by computed tomography (CT) following opening wedge high tibial osteotomy (HTO). METHODS: This study involved 55 patients (55 knees) undergoing opening wedge HTO for primary medial osteoarthritis. Lateral hinge fractures were evaluated on CT scans according to the Takeuchi classification and were also classified as subtypes A, B, and C, depending on anterior, posterior, and both anterior and posterior cortical disruptions, respectively, as determined by the sagittal and axial planes of CT scans which corresponded to the fracture line visible on coronal CT scans...
May 21, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29782242/case-254-posttraumatic-migrating-fat-embolus-causing-fat-emboli-syndrome
#7
Sébastien Molière, Stéphane Kremer, Guillaume Bierry
History An otherwise healthy 18-year-old man was admitted to the emergency department with a closed displaced fracture of the left femoral shaft ( Fig 1 ) after a high-velocity motorbike accident. At admission, other physical examination findings were unremarkable. Initial unenhanced and contrast material-enhanced (120 mL of Iomeron 400; Bracco Imaging, Milan, Italy) computed tomography (CT) was performed in the arterial and venous phases from the head to the knees. No abnormalities were noted in the brain or chest at initial CT...
June 2018: Radiology
https://www.readbyqxmd.com/read/29780621/thromboembolism-prophylaxis-in-orthopaedics-an-update
#8
Dimitrios A Flevas, Panayiotis D Megaloikonomos, Leonidas Dimopoulos, Evanthia Mitsiokapa, Panayiotis Koulouvaris, Andreas F Mavrogenis
Venous thromboembolism (VTE) is a serious complication during and after hospitalization, yet is a preventable cause of in-hospital death.Without VTE prophylaxis, the overall VTE incidence in medical and general surgery hospitalized patients is in the range of 10% to 40%, while it ranges up to 40% to 60% in major orthopaedic surgery. With routine VTE prophylaxis, fatal pulmonary embolism is uncommon in orthopaedic patients and the rates of symptomatic VTE within three months are in the range of 1.3% to 10%.VTE prophylaxis methods are divided into mechanical and pharmacological...
April 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29776853/outcomes-of-a-fixed-bearing-medial-cemented-unicondylar-knee-arthroplasty-design-survival-analysis-and-functional-score-of-460-cases
#9
Philip Winnock de Grave, Justine Barbier, Thomas Luyckx, Alexander Ryckaert, Paul Gunst, Luc Van den Daelen
BACKGROUND: Unicompartmental knee arthroplasty (UKA) is an alternative to total knee arthroplasty in isolated medial osteoarthritis (OA). However, despite satisfactory reports on the clinical performance, UKA revision rates are still concerning. This retrospective study reports on the long-term survivorship, functional outcomes, and reasons for revision in fixed-bearing UKA implant. METHODS: Between 2005 and 2013, 460 consecutive patients were treated with medial UKA in one center using a fixed-bearing UKA system...
April 24, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29776736/trabecular-bone-score-at-the-distal-femur-and-proximal-tibia-in-individuals-with-spinal-cord-injury
#10
Stacey Lobos, Anne Cooke, Gillian Simonett, Chester Ho, Steven K Boyd, W Brent Edwards
Rapid declines in bone mineral density (BMD) at the knee after spinal cord injury (SCI) are associated with an increased risk of fracture. Evaluation of bone quality using the trabecular bone score (TBS) may provide a complimentary measure to BMD assessment to examine bone health and fracture risk after SCI. The purpose of this study was to assess bone mineral density (BMD) and trabecular bone score (TBS) at the knee in individuals with and without SCI. Nine individuals with complete SCI (mean time since SCI 2...
April 24, 2018: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/29776439/concurrence-of-symmetrical-peripheral-gangrene-and-venous-limb-gangrene-following-polytrauma-a-case-report
#11
Jih Huei Tan, Yuzaidi Mohamad, Chor Lip Henry Tan, Mahazir Kassim, Theodore E Warkentin
BACKGROUND: Symmetrical peripheral gangrene is characterized as acral (distal extremity) ischemic limb injury affecting two or more extremities, without large vessel obstruction, typically in a symmetrical fashion. Risk factors include hypotension, disseminated intravascular coagulation, and acute ischemic hepatitis ("shock liver"). In contrast, venous limb gangrene is characterized by acral ischemic injury occurring in a limb with deep vein thrombosis. Both symmetrical peripheral gangrene and venous limb gangrene present as acral limb ischemic necrosis despite presence of arterial pulses...
May 19, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29775976/-are-there-any-differences-in-quality-or-complication-rate-in-total-knee-arthroplasty-after-establishing-a-centre-for-endoprosthesis
#12
Muzaffer Düzgünoglu, Wolfgang Hönle, Alexander Scheller, Alexander Schuh
BACKGROUND: The aim of the study is to show whether there are any changes in quality or incidence of complications in total knee arthroplasty (TKA) after establishing a centre for endoprothesis (EPZ). MATERIAL AND METHODS: We conducted a retrospective study comparing 100 TKAs one year before establishing an EPZ (Group I) with 100 TKAs one year after establishing an EPZ (group II). Data were collected by analysing our electronic documentation system, and the report of the rehabilitation hospital...
May 18, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29775918/determining-gender-by-taking-measurements-from-magnetic-resonance-images-of-the-patella
#13
Hacer Yasar Teke, Özge Ünlütürk, Elif Günaydin, Semra Duran, Sait Özsoy
BACKGROUND: A key step in making a positive identification in forensic medicine is the establishment of a biological profile, which involves determining factors such as gender, age, ancestry, and stature. The goal of this study was to determine if gender could be established by taking various measurements of the patella taken from magnetic resonance imaging (MRI) images and analyzing the variations by gender. METHODS: The sample group consisted of 220 patients (110 male and 110 female) whose patella were measured using MRI images of their left knee...
May 8, 2018: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/29770583/angle-stable-interlocking-intramedullary-nails-for-tibial-plateau-fractures
#14
Peng Jia, Feng-Cheng Lu, Kifayat Ullah, Man Zhang, Yan-Sheng Dong, Chao Xiong, Zhi-Hui Zhao, Jin-Feng Wang, Ju-Wen Chen, Yong-Qing Wang
OBJECTIVE: Angle stable interlocking intramedullary nail (ASIN), a novel technique, has rarely been used for treatment of tibial plateau fractures (TPF). This retrospective study was designed to introduce this novel technique, ASIN, as well as to describe the initial experience and verify the effectiveness when ASIN was used for the management for TPF. METHODS: A cohort of 19 cases with closed TPF aged from 18-70 years with at least 23 months follow-up from November 2008 to September 2013 was analyzed retrospectively...
May 16, 2018: Orthopaedic Surgery
https://www.readbyqxmd.com/read/29770342/fibular-collateral-ligament-varus-stress-radiographic-analysis-using-3-different-clinical-techniques
#15
Patrick W Kane, Mark E Cinque, Gilbert Moatshe, Jorge Chahla, Nicholas N DePhillipo, Matthew T Provencher, Robert F LaPrade
Background: Fibular collateral ligament (FCL) tears are challenging to diagnose. Left untreated, FCL tears lead to residual ligament instability and increased joint loading on the medial compartment of the knee. Additionally, when a concomitant anterior cruciate ligament (ACL) reconstruction is performed, increased forces on reconstruction grafts occur, which may lead to premature graft failure. Stress radiographs constitute a reliable and validated technique for the objective assessment of a complete grade III FCL tear...
May 2018: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29749378/frequency-and-associated-factors-of-bone-fractures-in-russians-the-ural-eye-and-medical-study
#16
Mukharram M Bikbov, Rinat R Fayzrakhmanov, Gyulli M Kazakbaeva, Rinat M Zainullin, Venera F Salavatova, Timur R Gilmanshin, Inga I Arslangareeva, Nikolai A Nikitin, Songhomitra Panda-Jonas, Svetlana R Mukhamadieva, Dilya F Yakupova, Renat I Khikmatullin, Said K Aminev, Ildar F Nuriev, Artur F Zaynetdinov, Yulia V Uzianbaeva, Jost B Jonas
With information about frequency of bone fractures in Russia mostly missing, we assessed the frequency of previous bone fractures in a Russian population. The population-based study Ural Eye and Medical Study included 5899 (80.5%) out of 7328 eligible individuals (mean age: 59.0 ± 10.7 years; range: 40-94 years). The history of previous bone fractures was assessed in a standardized interview for 5397 (91.5%) individuals. Mean frequency of any previous bone fracture was 1650/5397 (30.6%; 95% confidence interval (CI): 29, 3, 31...
May 10, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29729819/one-year-after-proximal-or-distal-periprosthetic-fracture-of-the-femur-two-conditions-with-divergent-outcomes
#17
D Eschbach, B Buecking, H Kivioja, M Fischer, T Wiesmann, R Zettl, L Oberkircher, J Barthel, R Aigner, S Ruchholtz, C Bliemel
INTRODUCTION: Arthroplasty of the hip and knee is 1 of the 20 most frequent operations in Germany. Periprosthetic fracture is one of the most feared complications following primary or revision arthroplasty. Present publication aims to analyse differences between patients with periprosthetic fracture around total knee arthroplasty (PFTKA) and patients with periprosthetic fracture around total hip arthroplasty (PFTHA) concerning demographics, clinical course, complications and return to pre-fracture mobility...
April 24, 2018: Injury
https://www.readbyqxmd.com/read/29727334/primary-and-secondary-total-knee-arthroplasty-for-tibial-plateau-fractures
#18
Iain Stevenson, Tristan E McMillan, Santosh Baliga, Emil H Schemitsch
The surgical management of tibial plateau fractures can be technically demanding. In younger patients, the mainstay is fixation with cartilage preservation. In older patients with osteoporotic bone, this method has higher rates of fixation failure; in addition, it requires prolonged bed rest or protected weight bearing, which are major challenges in this group. In contrast, total knee arthroplasty performed acutely for primary treatment of tibial plateau fractures has potential advantages for elderly patients, such as immediate stability, early mobilization, and positive functional outcomes with decreased rates of reoperation...
June 1, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29725516/surgical-fixation-of-a-comminuted-inter-trochanteric-fracture-in-a-patient-with-bilateral-below-knee-amputation
#19
B H Lee, S W Ho, C Y Kau
Surgical fixation of hip fractures in patients with below knee amputation is challenging due to the difficulty in obtaining optimal traction for reduction of the fracture. Surgeons may face difficulty in positioning such patients on the traction table due to the absence of the foot and distal lower limb. There are several techniques described to overcome this technical difficulty. In this case report, we present a case of a 64-year old gentleman with bilateral below knee amputation presenting with a comminuted right intertrochanteric fracture...
March 2018: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29719874/reducing-the-rate-of-post-surgical-urinary-tract-infections-in-orthopedic-patients
#20
Amit Thakker, Natasha Briggs, Azusa Maeda, Julie Byrne, John Roderick Davey, Timothy D Jackson
Urinary tract infection (UTI) is the fourth leading cause of healthcare-associated infections, with approximately 70%-80% being attributed to the inappropriate use of indwelling catheters. In many cases, indwelling catheters are used inappropriately without any valid indication, creating potentially avoidable and significant patient distress, discomfort, pain and activity restrictions, together with substantial care burden, cost and hospitalisation. In the Division of Orthopedic Surgery at Toronto Western Hospital (TWH), we identified UTI rate reduction as a quality improvement priority...
2018: BMJ Open Quality
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