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Ezio Lanza, Riccardo Muglia, Luigi Alessandro Solbiati, Marco Tramarin, Dario Poretti, Vittorio Pedicini
BACKGROUND: The aim of this study is to report the results of transarterial embolization (TAE) in the setting of postoperative bleeding after hip surgery. METHODS: We retrospectively evaluated 40 patients (male:female = 15:25, median age = 68 years) who underwent TAE from 2006 to 2016: 77.5% underwent total hip arthroplasty, 20% open reduction internal fixation, and 2.5% external fixation. Preangiographic multidetector computed tomography angiography was performed in 20 (49%) cases, and 9 of them showed arterial extravasation...
February 15, 2018: Journal of Arthroplasty
Miltiadis Argyropoulos, Matthew Kent
Background: Open reduction internal fixation of displaced 3 and 4-part proximal humerus fractures is an effective treatment modality particularly for the younger age group, but it is not without complications. Fixed angled locking screw plates are the mainstay of fixation. The A.L.P.S. Proximal Humerus Plating System is a new implant that has smooth locking pegs in the place of humeral head screws to help reduce glenoid damage in the event of cut-out and is designed to sit low on the humerus in order to reduce the risk of subacromial impingement...
2018: Open Orthopaedics Journal
Qing-Feng Shen, Xin Wen, Sheng-Wu Yang, Xin Chen, Wei-Xing Fan, Guo-Zhu Xu, Fang-Zheng Yu, Jun-Yi Zhu, Jian Wang
OBJECTIVE: To compare the clinical efficacy of minimally invasive percutaneous plate osteosynthesis(MIPPO)and open reduction and internal fixation (ORIF) in treating senile NEER IIproximal humerus fractures. METHODS: From March 2014 to March 2016, 46 elderly patients with Neer II proximal humerus fractures were retrospectively reviewed. Among them, 20 patients in MIPPO group included 9 males and 11 females with an average age of (70.4±4.4) years old; while 26 patients in ORIF group included 11 males and 15 females with an average age of (70...
February 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Jen-Ta Shih, Chun-Lin Kuo, Tsu-Te Yeh, Hsain-Chung Shen, Ru-Yu Pan, Chia-Chun Wu
BACKGROUND: The ideal treatment for comminuted intraarticular calcaneal fractures is still debated. Open reduction and internal fixation (ORIF) is the most popular surgical procedure; however, wound complications, implant choice, and infection remain major concerns. This study aimed to demonstrate the results of an innovative, minimally invasive surgical procedure, namely, a closed reduction technique using large-diameter Steinmann pins and percutaneous calcaneoplasty using injectable calcium sulfate cement (MIIG X3, Wright Medical Technology, Inc...
March 9, 2018: BMC Musculoskeletal Disorders
Mohammed Saquib Hussain, Steven Kyle Dailey, Frank R Avilucea
With an aging population, treatment of interprosthetic femur fractures continues to pose a challenge to the orthopedic surgeon. Retrograde IMN combined with open reduction internal fixation utilizing a tissue-preserving plating technique was used in our series of 9 patients with non-comminuted, distal femur fractures. No interfragmentary screws, cables, cerclage wires, or supplemental bone grafts of any type were used. Each patient initiated weight-bearing as tolerated following operative intervention. Every fracture healed at an average of 20 weeks (range 18 to 24 weeks)...
February 23, 2018: Journal of Orthopaedic Trauma
Okan W Bastian, Mikolaj H Mrozek, Marco Raaben, Luke P H Leenen, Leo Koenderman, Taco J Blokhuis
A controlled local inflammatory response is essential for adequate fracture healing. However, the current literature suggests that local and systemic hyper-inflammatory conditions after major trauma induce increased influx of neutrophils into the fracture hematoma (FH) and impair bone regeneration. Inhibiting neutrophil chemotaxis towards the FH without compromising the hosts' defense may therefore be a target of future therapies that prevent impairment of fracture healing after major trauma. We investigated whether chemotaxis of neutrophils towards the FH could be studied in vitro...
March 6, 2018: Inflammation
Oisín Conaty, Leah Gaughan, Colum Downey, Noreen Carolan, Megan Joanne Brophy, Ruth Kavanagh, Deborah A A McNamara, Edmond Smyth, Karen Burns, Fidelma Fitzpatrick
Purpose The purpose of this paper is to improve surgical antimicrobial prophylaxis (SAP) prescribing in orthopaedic surgery using the model for improvement framework. Design/methodology/approach Orthopaedic patients receiving joint replacements, hip fracture repairs or open-reduction internal-fixation procedures were included. Antimicrobial(s); dose, time of administration and duration of SAP were evaluated for appropriateness based on the local SAP guidelines. After baseline data collection, a driver diagram was constructed with interventions devised for plan-do-study-act cycles...
March 12, 2018: International Journal of Health Care Quality Assurance
Avijit Barai, Bruce Lambie, Conor Cosgrave, Joanne Baxter
OBJECTIVE: Distal radius fracture (DRF) is a common presentation to the ED. However, little is known about the long-term functional outcome of these patients following their initial management in the ED. METHODS: In order to evaluate the long-term functional outcome of DRF, we collected the Disabilities of Arm, Shoulder and Hand (DASH) scores from the patients who attended our ED with DRF between January 2014 and June 2015. We divided the patients into two groups based on their overall management: (i) conservative group who did not have any surgical interventions; and (ii) open reduction internal fixation (ORIF) group who needed surgical interventions in the theatre...
February 28, 2018: Emergency Medicine Australasia: EMA
Aimee Marie Charnell, Emma Ferriman, Rozalia Dimitriou, Michalis Panteli, Peter V Giannoudis
In this case, we opted for dual surgery combining caesarean section and internal fixation of acetabular fracture in late pregnancy, which allowed safe foetal delivery, fracture repair and early ambulation of the mother. In similar cases, this method could be potentially considered in the armamentarium of treatment options, aiming to facilitating prompt motherhood input and early hospital discharge, as well as minimising the risk of post-traumatic arthritis of the hip.
February 2018: JRSM Open
Ted C Lai, Justin J Fleming
Surgical treatment of distal tibia fractures can present as a difficult task. Intramedullary nailing (IMN), external fixation, and open reduction internal fixation (ORIF) have displayed various complications ranging from a high rate of knee morbidity with IMN to wound complications and infection with ORIF. Minimally invasive plate osteosynthesis (MIPO) has been used to decrease development of these complications. MIPO respects the soft tissue envelope along with maintaining the biological environment needed for proper osseous healing...
April 2018: Clinics in Podiatric Medicine and Surgery
Graham A Hamilton, Matthew D Doyle, Francesca M Castellucci-Garza
The indications for arthroscopy have expanded over the years. Arthroscopic-assisted open reduction internal fixation in the setting of acute trauma is gaining popularity with foot and ankle surgeons. It serves to facilitate direct visualization of fracture fragments and allows for precise articular reduction with minimal soft tissue insult. Current evidence reports a high incidence of chondral injury with ankle fractures. Arthroscopy performed at the time of open reduction internal fixation allows for joint inspection and potential treatment of these posttraumatic defects...
April 2018: Clinics in Podiatric Medicine and Surgery
Jorge G Boretto, Ezequiel E Zaidenberg, Gerardo L Gallucci, Alejandro Sarme, Pablo De Carli
BACKGROUND: Acute management of fractures of the distal ulna that are associated with fractures of the distal radius remains difficult, particularly in the elderly. METHODS: In this study, we investigated whether internal fixation of the distal ulna is associated with a higher rate of complications than resection of the distal ulna in patients older than 70 years. Twenty-four consecutive patients were included in this study, 12 of whom had undergone open reduction and internal fixation (ORIF) of the distal ulna, and 12 who had undergone distal ulna resection...
February 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Patrick D G Henry, Sam Si-Hyeong Park, J Michael Paterson, Hans J Kreder, Richard Jenkinson, David Wasserstein
OBJECTIVES: To determine what proportion of operatively treated acetabular fracture patients proceeded to total hip arthroplasty (THA), over what time period, and quantify the influence of patient, provider, and surgical factors on rates of THA. DESIGN: Retrospective matched cohort prognostic study using administrative data. SETTING: This study used the large population database of Ontario (population 13,125,000 in 2010), Canada. PARTICIPANTS: Patients who underwent open reduction internal fixation (ORIF) of an acetabulum fracture between 1996 and 2010 in the province of Ontario were identified from administrative health databases...
March 2018: Journal of Orthopaedic Trauma
Philip Myers, Patrick Laboe, Kory J Johnson, Peter D Fredericks, Renn J Crichlow, Dean C Maar, Timothy G Weber
OBJECTIVES: To estimate 1-year mortality rates in elderly patients who undergo operative treatment for distal femur fractures and identify potential risk factors for mortality. DESIGN: Retrospective chart review. SETTING: Level 1 and Level 2 trauma centers. PATIENTS/PARTICIPANTS: Two hundred eighty-three elderly patients (average age 76.0 years ± 9.8) who sustained distal femur fractures between 2002 and 2012. INTERVENTION: Fracture fixation of the distal femur...
March 2018: Journal of Orthopaedic Trauma
Benjamin R Williams, Dylan L McCreary, Michael Chau, Brian P Cunningham, Fernando Pena, Marc F Swiontkowski
BACKGROUND: Orthopedic implant removal following open reduction internal fixation of a fracture is a common procedure, especially in the foot and ankle. The purpose of this study was to evaluate functional change after the removal of symptomatic implants following ankle fracture open reduction internal fixation (ORIF) using the Short Musculoskeletal Function Assessment (SMFA) outcome score. We hypothesized that implant removal after ankle fracture would result in improved functional outcomes...
February 1, 2018: Foot & Ankle International
S Cohen, X Flecher, S Parratte, M Ollivier, J N Argenson
INTRODUCTION: The incidence of periprosthetic femoral fracture is constantly increasing, with high associated morbidity and mortality. Surgical treatment is guided by the Vancouver classification, but the influence of type of treatment on morbidity and mortality has been little analyzed. The theoretic advantage of implant revision over internal fixation is that it should allow earlier weight-bearing, although the impact of this on morbidity and mortality and autonomy has not been demonstrated...
February 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
P Persiani, M Murgia, F M Ranaldi, O Mazza, M Mariani, M Crostelli, C Villani
OBJECTIVE: The purpose of this study is to retrospectively evaluate a group of children affected by cerebral palsy with a recent femoral fracture, and to analyse the results and complications in relation to the treatment used. MATERIALS AND METHODS: The analysis was performed on 36 children (21 M, 15 F, 8-14 years old) with cerebral palsy (7 diplegia, 28 tetraparesis, 1 hemiplegia) with a metaphyseal or a diaphyseal femoral fracture. The patients were subdivided into two groups according to their Gross Motor Function Classification System (GMFCS) level: level 2-3 (9 patients) and level 4-5 (27 patients), evaluating the presence of complications and malunions for each group at the end of each follow up...
January 2018: La Clinica Terapeutica
Zhenshuang Yue, Yanghua Tang, Zhongqing Hu, Wenjie Zheng
RATIONALE: The calcaneal fracture without broken lateral wall is rare and the open anatomic reduction and internal fixation (ORIF) is necessary when the subtalar joint articular surface is broken and collapsed. PATIENT CONCERNS: A 45-year-old male was admitted to our department with complaints of heel pain and swelling after falling down from 1-m-high stone. He was unable to bear weight on his right foot. DIAGNOSES: Imaging studies confirmed that it was a sanders type IIIAB calcaneal fracture without broken lateral wall and the middle part of the posterior calcaneal articular facet collapsed...
February 2018: Medicine (Baltimore)
Yaning Sun, Huijuan Wang, Yuchao Tang, Haitao Zhao, Shiji Qin, Lihui Xu, Zhiyong Xia, Fengqi Zhang
Information on surgical site infection (SSI) after surgical treatment of ankle fracture is limited and remains controversial. The purpose of the present study was to determine the incidence and risk factors for SSI after open reduction and internal fixation (ORIF) of ankle fracture. Patients who underwent ORIF for ankle fracture at 3 centers between January 2015 and December 2016 were included. The potential risk factors for SSI included demographic variables, including age, sex, body mass index (BMI), hypertension, diabetes mellitus, heart disease, smoking, and excessive alcohol intake; blood test variables including preoperative white blood cell count, neutrophil count, red blood cell count, hemoglobin, total protein, albumin and globulin; injury- and surgery-related variables, including duration of operation (minutes), intraoperative blood loss, surgeon level, fracture site, accompanied dislocation, use of a drainage tube, and antibiotic use...
February 2018: Medicine (Baltimore)
E Q Pang, J Truntzer, L Baker, A H S Harris, M J Gardner, R N Kamal
AIMS: The aim of this study was to test the null hypothesis that there is no difference, from the payer perspective, in the cost of treatment of a distal radial fracture in an elderly patient, aged > 65 years, between open reduction and internal fixation (ORIF) and closed reduction (CR). MATERIALS AND METHODS: Data relating to the treatment of these injuries in the elderly between January 2007 and December 2015 were extracted using the Humana and Medicare Advantage Databases...
February 2018: Bone & Joint Journal
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