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Alexander Trulson, Markus Alexander Küper, Inga Maria Trulson, Christian Minarski, Leonard Grünwald, Bernhard Hirt, Ulrich Stöckle, Fabian Stuby
BACKGROUND: Dislocated pelvic fractures which require surgical repair are usually operated on via open surgery. Approach-related morbidity is reported with a frequency of up to 30%. The aim of this anatomical study was to prove the feasibility of endoscopic visualisation of the relevant anatomical structures in pelvic surgery and to perform completely endoscopic plate osteosynthesis of the acetabulum with available standard laparoscopic instruments. METHOD: In four human cadavers, we established an endoscopic preparation of the complete pelvic ring, from the symphysis to the iliosacral joint, including the quadrilateral plate and the sciatic nerve, and performed endoscopic plate osteosynthesis along the iliopectineal line...
June 14, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
Carla Teresa Barbosa de Oliveira, Elpídio da Graça, Vânia Aparecida Fanelli
Objective: To evaluate patients diagnosed with posterior four-part fracture-dislocations of the proximal humerus, that were surgically treated with osteosynthesis, regarding their clinical and functional outcomes. Methods: A prospective observational study of eight patients from the same hospital institution in the interior of São Paulo State (Brazil), through individual interviews using the UCLA, DASH, and Constant international scores. The active movements included in the scores plus the range of motion of the affected and non-affected limb were measured...
May 2018: Revista Brasileira de Ortopedia
Sandro Hodel, Tobias Koller, Björn-Christian Link, Marco Rossi, Reto Babst, Frank J P Beeres
INTRODUCTION: Temporary external fixation is a viable option for numerous conditions and fixations in orthopaedic and trauma surgery. If the external fixator is left in place it is necessary to disinfect it prior to surgery, yet the subsequent risk for bacterial contamination of the surgical site originating from the external fixator remains unknown. MATERIAL AND METHODS: In a prospective study, samples were taken at the time of definitive osteosynthesis to assess bacterial contamination of the surgical site and the external fixator in twenty consecutive patients treated with temporary external fixation for closed fractures from October 2016 until March 2017...
June 4, 2018: Injury
You Jiong-Ming, Wu Yin-Sheng, Wang Yong
BACKGROUND: Anterior chest wall numbness after plate fixation of clavicular shaft fractures is a common complication. This is usually related to damage of the branches of the supraclavicular nerve in conventional open plating. We investigated whether the use of minimally invasive plate osteosynthesis could reduce the incidence of post-operative numbness and improve patients' satisfaction compared to open plating. METHODS: Between August 2012 and October 2015, 73 patients with acute clavicle shaft fracture (Robinson classification 2A2-2B2) were treated with plate fixation at our institution...
June 8, 2018: International Journal of Surgery
Sarina E C Pichardo, Frans Willem Ten Broek, J P Richard van Merkesteyn
PURPOSE: The treatment of pathologic fractures in stage III medication-related osteonecrosis of the jaw (MRONJ) remains challenging. The treatment in the literature is controversial, varying from extensive and aggressive surgery with resections and musculocutaneous free flap reconstruction to conservative treatment with only mouth rinses and/or antimicrobial treatment. The purpose of this study was to analyse the results of the treatment protocol in the Leiden University Medical Center in the Netherlands...
June 6, 2018: Journal of Cranio-maxillo-facial Surgery
Matthias Krause, Gunnar Müller, Karl-Heinz Frosch
Intra-articular tibial plateau fractures can present a surgical challenge due to complex injury patterns and compromised soft tissue. The treatment goal is to spare the soft tissue and an anatomical reconstruction of the tibial articular surface. Depending on the course of the fracture, a fracture-specific access strategy is recommended to provide correct positioning of the plate osteosynthesis. While the anterolateral approach is used in the majority of lateral tibial plateau fractures, only one third of the joint surface is visible; however, posterolateral fragments require an individual approach, e...
June 6, 2018: Der Unfallchirurg
Amir Adham Ahmad, Liew Mei Yi, Abdul Rauf Ahmad
Fractures of the distal radius are one of the most common types of injuries encountered in hand surgery. Plate osteosynthesis is recommended for unstable fractures. Because distal radius fracture fixation is usually performed under general or regional anesthesia with the use of a tourniquet, this exposes patients, especially elderly people with extensive comorbidities, to adverse effects commonly associated with these forms of anesthesia. As such, many of these patients are unable to undergo surgery in a timely manner until they are deemed medically fit for surgery or anesthesia, and some may still be treated nonsurgically...
June 1, 2018: Journal of Hand Surgery
Firat Seyfettinoğlu, Hasan Ulaş Oğur, Ümit Tuhanioğlu, Hakan Çiçek, Ahmet Kapukaya
Background: To evaluate the treatment efficacy and complications of the lateral minimally invasive plate osteosynthesis (MIPO) method in geriatric patients with a humerus diaphyseal fracture with proximal extension. Patients and methods: The study included a total of 21 patients (18 females, 3 males; mean age 74±6.3 years, range 65-89 years) who underwent surgery with the lateral MIPO technique for a humerus diaphyseal fracture with proximal extension during the period January 2011 to December 2016...
2018: Clinical Interventions in Aging
Kazuhiko Udagawa, Yasuo Niki, Kengo Harato, Shu Kobayashi, So Nomoto
Retrograde intramedullary nailing (RIMN) has been used for periprosthetic fracture of the distal femur after total knee arthroplasty (TKA), yielding good fracture union rates and satisfactory outcomes. However, RIMN for posterior-stabilized- (PS-) TKA risks malpositioning the entry point and disturbing the post of the tibial insert, and the surgeon therefore usually requires knee joint arthrotomy. We report a case of a 79-year-old male who was involved in bicycle accident resulting in periprosthetic fracture of the distal femur after PS-TKA...
2018: Case Reports in Orthopedics
Davor Mijatović, Sanda Smuđ Orehovec, Tomislav Đapić, Vilena Vrbanović Mijatović, Marko Mance
The challenges of managing Gustilo IIIB tibial fractures (ie, high energy trauma with a contaminated wound >10 cm in length, severe comminution ["crumbling"] or segmental fractures, and periosteal stripping) in children are unique in part because no clear guidelines exist and the injuries may cause short-term and long-term complications. Repeated wound debridement and secondary reconstruction are required in approximately 20% of these cases in both adults and children. A 13-year-old girl presented with severe polytrauma including an open Gustilo type IIIB fracture of the left lower leg...
May 2018: Ostomy/wound Management
Gautham Prabhakar, Nicholas Kusnezov, Nicholas Rensing, Amr Abdelgawad
Despite timely and appropriate management, displaced femoral neck fractures are often devastating injuries for the young patient. The risk of negative sequelae is further amplified with increasing displacement and vertical fracture patterns. Open anatomic reduction with rigid internal fixation is essential to maximize the healing potential in displaced fractures of the femoral neck. Successful primary osteosynthesis of significantly displaced femoral neck fractures in the young patient has been reported in the literature...
2018: Case Reports in Orthopedics
Valeriy Shubinets, Christine McAndrew, Jaclyn Mauch, Alyssa Ricker Glennon, Stephen J Kovach, Benjamin L Gray, David R Steinberg, David J Bozentka, Laurent Lantieri, Benjamin Chang, L Scott Levin, Ines C Lin
As the field of vascularized composite allotransplantation continues to expand, new upper extremity transplant candidates are being considered. We recently evaluated a bilateral amputee who had a mid-forearm amputation and a contralateral metacarpal hand amputation. In the latter limb, a "partial" hand transplant that preserved the majority of the patient's existing hand, including a partially severed thumb with intact thenar muscle function, was proposed. The feasibility of this partial hand transplant was studied in fresh-frozen cadaver limbs...
May 25, 2018: Journal of Hand Surgery
Byung-Woo Min, Chul-Hyun Cho, Eun-Suck Son, Kyung-Jae Lee, Si-Wook Lee, Kyung-Keun Min
BACKGROUND: Periprosthetic femoral fractures (PFF) following total hip arthroplasty (THA) remain one of the most challenging complications to address. Although the principal treatment modalities for Vancouver type B1 fractures are open reduction and internal fixation (ORIF), surgeons have not yet reached a consensus on the optimal method for reduction and fixation. We therefore investigated whether minimally invasive plate osteosynthesis (MIPO) using locking compression plate (LCP) would lead to favorable outcomes for patients with Vancouver type B1 PFFs...
May 22, 2018: Injury
F Chana Rodríguez, R Pérez Mañanes, F J Narbona Cárceles, P Gil Martínez
INTRODUCTION: Preoperative 3D modelling enables more effective diagnosis and simulates the surgical procedure. MATERIAL AND METHODS: We report twenty cases of acetabular fractures with preoperative planning performed by pre-contouring synthesis plates on a 3D printed mould obtained from a computarized tomography (CT) scan. The mould impression was made with the DaVinci 1.0 printer model (XYZ Printing). After obtaining the printed hemipelvis, we proceeded to select the implant size (pelvic Matta system, Stryker® ) that matched the characteristics of the fracture and the approach to be used...
May 25, 2018: Revista Española de Cirugía Ortopédica y Traumatología
Rubén Davó, Pietro Felice, Roberto Pistilli, Carlo Barausse, Carlos Marti-Pages, Ada Ferrer-Fuertes, Daniela Rita Ippolito, Marco Esposito
PURPOSE: To compare the clinical outcome of immediately loaded cross-arch maxillary prostheses supported by zygomatic implants vs conventional implants placed in augmented bone. MATERIALS AND METHODS: In total, 71 edentulous patients with severely atrophic maxillas without sufficient bone volumes for placing dental implants, or when it was possible to place only two implants in the anterior area (minimal diameter 3.5 mm and length of 8 mm) and less than 4 mm of bone height subantrally, were randomised according to a parallel group design to receive zygomatic implants (35 patients) to be loaded immediately vs grafting with a xenograft, followed after 6 months of graft consolidation by placement of six to eight conventional dental implants submerged for 4 months (36 patients)...
2018: European Journal of Oral Implantology
Christina Marie Joseph, Thilak Samuel Jepegnanam
Head preservation of an infected neck of femur fracture appears to be extremely rare with no described cases in literature till date. We present the outcome of head salvage in a young adult with an infected neck of femur nonunion who in addition had chronic osteomyelitic sequelae of his entire femur with reactivation of latent infection in the distal femoral diaphysis. Osteosynthesis was performed by means of cancellous screw fixation augmented with bone substitute following a failed attempt at salvage with a valgus intertrochanteric osteotomy...
May 23, 2018: Archives of Orthopaedic and Trauma Surgery
Hideko Minami-Sugaya, Débora A Lentini-Oliveira, Fernando R Carvalho, Marco Antonio C Machado, Clóvis Marzola, Humberto Saconato, Gilmar F Prado
BACKGROUND: Prominent lower front teeth may be associated with a large or prognathic lower jaw (mandible) or a small or retrusive upper jaw (maxilla). Edward Angle, who may be considered the father of modern orthodontics, classified the malocclusion in this situation as Class III. The individual is described as having a negative or reverse overjet as the lower front teeth are more prominent than the upper front teeth. OBJECTIVES: The purpose of this systematic review was to evaluate different treatments of Angle Class III malocclusion in adults...
May 23, 2018: Cochrane Database of Systematic Reviews
P Codesido-Vilar, A Mejía-Casado, J Riego-Fernández, N Rodriguez-Casas, S García-Cabanas, J Rivas-Felice, L García-Quevedo
OBJECTIVE: To compare results in terms of orthopaedic complications and quality of life in elderly patients with subtrochanteric fracture treated with intramedullary nailing according to fracture reduction status. PATIENTS AND METHODS: A prospective cohort study including 90 elderly patients with subtrochanteric fractures of the femur treated with a cephalomedullary nail, with a minimum 1-year follow up. The inclusion criteria were: aged 60 years or older, without severe cognitive dysfunction and independent ambulatory capability before the fracture...
May 18, 2018: Revista Española de Cirugía Ortopédica y Traumatología
Daniel Handy Eone, Prudence Christelle Danielle Ngono, Marie Josée Essi, Gaël Leckpa, Kennedy Olivier Muluem, Farikou Ibrahima, Maurice Aurélien Sosso
CONTEXT: Humeral plating osteosynthesis is controversial, particularly regarding the choice between anterior and lateral approach, data for which in the context of a low-income country are lacking. HYPOTHESIS: The anterior approach is an easy surgical technique, allowing good anatomic reconstruction. We hypothesize that the anterior approach is associated with fewer neurovascular lesions and functional sequelae than the lateral approach. MATERIALS AND METHODS: A retrospective study with assessment update was carried out over a period of 6 years 4 months from January 2010 to June 2016, with consecutive recruitment in the city of Yaoundé, Cameroon...
May 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Haiyue Zu, Xueting Yi, Dewei Zhao
Biodegradable magnesium (Mg) materials are considered ideal as osteosynthesis implants. However, clinical application has proven complex. This is primarily associated with the issue of reducing the extent of implant degradation to a range acceptable for the human body, while simultaneously enhancing osteogenesis or osteoinduction. In the present study, a combination of Mg ions and low‑intensity pulsed ultrasound (LIPUS) treatment was applied in hFOB 1.19 human osteoblast cells as a potential strategy to resolve this issue...
May 11, 2018: Molecular Medicine Reports
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