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Open tibia fractures

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https://www.readbyqxmd.com/read/28087118/open-lower-limb-fractures-in-major-trauma-centers-a-loss-leader
#1
Elizabeth K Tissingh, Arman Memarzadeh, Joseph Queally, Peter Hull
PURPOSE: Open lower limb fractures are resource intensive injuries. Regardless of the financing model, the cost of treatment is an important consideration for any healthcare provider. METHODS: Open lower limb fractures treated at our centre were identified over a six-month period. Isolated open femur or tibia fractures were included as well as cases with multiple fractures. Direct inpatient care costs were calculated and income was reviewed for each case according to 'Healthcare Resource Group' (HRG) cost codes...
December 28, 2016: Injury
https://www.readbyqxmd.com/read/28079741/management-of-pediatric-open-tibia-fractures-with-supracutaneous-locked-plates
#2
Veerappa N Radhakrishna, Vrisha Madhuri
We evaluated the novel application of supracutaneous locked plates in pediatric open tibia fractures. Pediatric open tibia fractures stabilized with a locked supracutaneous plate from January 2011 to December 2014 were reviewed. Twenty-eight children, mean age 8.9 years, with 29 open tibia fractures were included. Nine of these children who had metaphyseal or metadiaphyseal fractures did not require joint spanning. The mean follow-up duration was 13.5 months. The mean time to uneventful union was 11.46 weeks, with no unacceptable malunion...
January 10, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28065957/the-effect-of-educational-internships-on-medical-students-perceptions-of-plastic-surgery
#3
Andac Aykan, Engin Kurt, Sedat Avsar, Muhitdin Eski, Serdar Ozturk
OBJECTIVE: To investigate the effects of plastic, reconstructive and aesthetic surgery educational internships on medical students' perceptions of the scope of plastic surgery. METHODS: This cross-sectional study was conducted at the Gulhane Medical Faculty, Ankara, Turkey, from 2012 to 2013, and comprised 4th-, 5th- and 6th-year medical students. Students were given a questionnaire consisting of 28 questions related to maxillofacial and upper and lower extremity medical conditions, and skin, aesthetic and congenital anomalies...
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28057011/functional-and-radiological-outcomes-of-a-minimally-invasive-surgical-approach-to-monostotic-fibrous-dysplasia
#4
Mamer S Rosario, Katsuhiro Hayashi, Norio Yamamoto, Akihiko Takeuchi, Shinji Miwa, Yuta Taniguchi, Hiroyuki Tsuchiya
BACKGROUND: Reports showing high recurrence rates for intralesional curettage and bone grafting have made the current treatment principle for fibrous dysplasia controversial. This study aimed to report the postoperative clinical outcomes from three minimally invasive surgical strategies we use for monostotic fibrous dysplasia (MFD). PATIENTS AND METHODS: Twelve patients with MFD presenting with no pathologic fracture or deformity and treated with one of three surgical strategies-plain open biopsy, plain alpha-tricalcium phosphate (ATP) reconstruction, and prophylactic bridge plating-were included...
January 5, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28040088/restoration-of-long-bone-defects-treated-with-the-induced-membrane-technique-protocol-and-outcomes
#5
Peter V Giannoudis, Paul J Harwood, Theodoros Tosounidis, Nikolaos K Kanakaris
This prospective study was undertaken at a regional tertiary referral centre to evaluate the results of treatment of bone defects managed with the induced membrane (IM) technique. Inclusion criteria were patients with bone defects secondary to septic non-union, chronic osteomyelitis and acute fracture with bone loss. Pathological fractures with bone loss were excluded. Data collection included patient demographics, pathology, previous surgical intervention, size of bone defect, type of graft implanted, time-to-union and complications/reinterventions...
December 2016: Injury
https://www.readbyqxmd.com/read/28040079/prevalence-and-risk-factors-for-re-interventions-following-reamed-intramedullary-tibia-nailing
#6
Petros Z Stavrou, Vincenzo Ciriello, Stylianos Theocharakis, Suribabu Gudipati, Theodoros H Tosounidis, Nikolaos K Kanakaris, Peter V Giannoudis
INTRODUCTION: This study aimed to identify the prevalence and the risk factors for re-interventions following reamed intramedullary nailing (IMN) of tibial shaft fractures. PATIENTS AND METHODS: We retrospectively analysed a prospectively populated data of adult patients that underwent reamed intramedullary nailing for stabilization of tibial shaft fractures over a period of three years. Exclusion criteria were immature patients, pathological and periarticular fractures...
December 2016: Injury
https://www.readbyqxmd.com/read/27986272/predictors-of-amputation-in-high-energy-forefoot-and-midfoot-injuries
#7
Zachary M Working, Iain Elliott, Lucas S Marchand, Lance G Jacobson, Angela P Presson, Ami Stuart, David L Rothberg, Thomas F Higgins, Erik N Kubiak
INTRODUCTION: High energy injuries to the midfoot and forefoot are highly morbid injury groups that are relatively unstudied in the literature. Patients sustaining injuries of this region are challenging to counsel at the time of injury because so little is known about the short and long term results of these injuries. The purpose of this study was to investigate injury specific factors that were predictive of amputation in patients sustaining high energy midfoot and forefoot injuries...
December 10, 2016: Injury
https://www.readbyqxmd.com/read/27984446/primary-wound-closure-after-open-fracture-a-prospective-cohort-study-examining-non-union-and-deep-infection
#8
Angela V Scharfenberger, Khaled Alabassi, Stephanie Smith, Donald Weber, Sukhdeep K Dulai, Joseph W Bergman, Lauren A Beaupre
OBJECTIVES: Determine the proportion of subjects developing deep infection or non-union following primary wound closure of open fractures (humerus, radius/ulna, femur, tibia/fibula). Secondarily, a matched-series analysis compared outcomes with subjects who underwent delayed wound closure. DESIGN: Prospective cohort between 2009 and 2013 of subjects undergoing primary closure. SETTING: Trauma centre PARTICIPANTS:: 83 (84 fractures) subjects were enrolled...
November 16, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27882147/molecular-profiling-of-a-simple-rat-model-of-open-tibial-fractures-with-hematoma-and-periosteum-disruption
#9
Jose Rafael Villafan-Bernal, Lorenzo Franco-De La Torre, Ana Soledad Sandoval-Rodriguez, Juan Armendariz-Borunda, Juan Luis Alcala-Zermeno, Jose Alfonso Cruz-Ramos, Gabriela Lopez-Armas, Blanca Estela Ramirez-Bastidas, Gracia Viviana González-Enríquez, Emerson Armando Collazo-Guzman, Raigam Jafet Martinez-Portilla, Sergio Sánchez-Enríquez
Bone fractures are a worldwide public health concern. Therefore, improving understanding of the bone healing process at a molecular level, which could lead to the discovery of potential therapeutic targets, is important. In the present study, a model of open tibial fractures with hematoma disruption, periosteal rupture and internal fixation in 6-month-old male Wistar rats was established, in order to identify expression patterns of key genes and their protein products throughout the bone healing process. A tibial shaft fracture was produced using the three-point bending technique, the hematoma was drained through a 4-mm incision on the medial aspect of the tibia and the fracture stabilized by inserting a needle into the medullary canal...
November 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/27861456/dynamic-stabilization-of-simple-fractures-with-active-plates-delivers-stronger-healing-than-conventional-compression-plating
#10
Michael Bottlang, Stanley Tsai, Emily K Bliven, Brigitte von Rechenberg, Philipp Kindt, Peter Augat, Julia Henschel, Daniel C Fitzpatrick, Steven M Madey
OBJECTIVES: Active plates dynamize a fracture by elastic suspension of screw holes within the plate. We hypothesized that dynamic stabilization with active plates delivers stronger healing relative to standard compression plating. METHODS: Twelve sheep were randomized to receive either a standard compression plate (CP) or an active plate (ACTIVE) for stabilization of an anatomically reduced tibial osteotomy. In the CP group, absolute stabilization was pursued by interfragmentary compression with six cortical screws...
November 16, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27843272/open-intramedullary-nailing-for-segmental-long-bone-fractures-an-effective-alternative-in-a-resource-restricted-environment
#11
Olasunkanmi M Babalola, Gbadebo Hakeem Ibraheem, Bola A Ahmed, Ayokunle Olawepo, Samuel B Agaja, Adebowale Adeniyi
BACKGROUND: Closed, locked intramedullary nailing has been accepted as the gold standard in the care of femoral fractures, with reported union rates as high as 98-100%. Closed, locked intramedullary nailing often requires expensive equipment which is a challenge in developing countries. Segmental long bone fractures are often a result of high-energy trauma and hence often associated with a lot of injuries to the surrounding soft tissues. This consequently results in higher rates of delayed or nonunion...
July 2016: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/27819005/is-hardware-removal-recommended-after-ankle-fracture-repair
#12
Hong-Geun Jung, Jin-Il Kim, Jae-Yong Park, Jong-Tae Park, Joon-Sang Eom, Dong-Oh Lee
The indications and clinical necessity for routine hardware removal after treating ankle or distal tibia fracture with open reduction and internal fixation are disputed even when hardware-related pain is insignificant. Thus, we determined the clinical effects of routine hardware removal irrespective of the degree of hardware-related pain, especially in the perspective of patients' daily activities. This study was conducted on 80 consecutive cases (78 patients) treated by surgery and hardware removal after bony union...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27810153/early-prediction-of-tibial-and-femoral-fracture-healing-are-we-reliable
#13
Emily R Squyer, Gregory D Dikos, David M Kaehr, Dean C Maar, Renn J Crichlow
INTRODUCTION: To evaluate the ability of orthopaedic trauma subspecialists to predict early bony union in femoral and tibia shaft fractures. MATERIALS AND METHODS: Eight orthopaedic trauma subspecialists prospectively predicted the probability of bony union at 6 and 12 weeks post-operatively for an aggregate of 48 femoral and tibial shaft fractures treated at a Level 1 trauma centre. An additional orthopaedic trauma subspecialist was blinded to treating surgeon and adjudicated healing at 18 weeks...
December 2016: Injury
https://www.readbyqxmd.com/read/27810033/fracture-of-the-os-trigonum-a-report-of-two-cases-and-review-of-the-literature
#14
Yet Yen Yan, Kinjal Vidyut Mehta, Tien Jin Tan
We report two cases of acute fractures of the os trigonum. The os trigonum fracture related to the first case was sustained following a hyper-plantar flexion injury during a game of soccer. The second case involved a patient who fell from height and also sustained open fractures of the left distal tibia and lateral malleolus as well as the right calcaneus. In both cases, a preliminary diagnosis of a posterior talar process fracture was made from the initial radiographs of the ankle. The correct diagnosis of an os trigonum fracture rather than a fracture of the posterior talar process was only made following further assessment with CT imaging...
December 2016: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27807487/tibiofibula-transposition-in-high-energy-fractures
#15
Peter R Loughenbury, Rebecca A Gledhill, Nick Evans
We report two cases of failed attempts at closed reduction of high-energy tibial fractures with an associated fibula fracture. The first case was a 39-year-old male involved in high-speed motorbike collision, while the second was a 14-year-old male who injured his leg following a fall of three metres. Emergency medical services at the scenes of the accidents reported a 90-degree valgus deformity of the injured limb and both limbs were realigned on scene and stabilized. Adequate alignment of the tibia could not be achieved by manipulation under sedation or anaesthesia...
2016: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/27796484/reamed-intramedullary-exchange-nailing-in-the-operative-treatment-of-aseptic-tibial-shaft-nonunion
#16
Christian Hierholzer, Jan Friederichs, Claudio Glowalla, Alexander Woltmann, Volker Bühren, Christian von Rüden
PURPOSE: The aim of this study was to evaluate a standardized treatment protocol regarding the rate of secondary bone union, complications, and functional outcome. METHODS: This study was started as a prospective study in a single Level I Trauma Centre between 2003 and 2012. The study group consisted of 188 patients with the diagnosis of an aseptic tibial shaft nonunion. Exchange nailing was performed following a standardized surgical protocol. Long-term follow-up was analyzed for rate of bone healing and functional outcome...
October 28, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27768630/definitive-management-of-distal-tibia-and-simple-plafond-fractures-with-circular-external-fixation
#17
Stephen Matthew Quinnan
Obtaining optimal results in the treatment of extraarticular distal tibia fractures can be challenging. Plate and screw and intramedullary fixation have proven to be effective treatments, but are associated with significant complication rates when used for open fractures and patient with severe medical comorbidities. External fixation is a third alternative that is less often employed, but provides a very effective means of treatment. Circular external fixation offers great flexibility in obtaining anatomic alignment and stable fixation for even the most challenging distal tibia fractures...
November 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27768627/intramedullary-tibial-nail-fixation-of-simple-intraarticular-distal-tibia-fractures
#18
John A Scolaro, Francis H Broghammer, Derek J Donegan
The optimal treatment strategy for distal tibia fractures, especially those with intraarticular extension, remains controversial. Although open reduction and internal fixation with a plate and screw device is commonly performed for these injuries, the risk of soft tissue complications using this approach is significant. Staged treatment protocols and alternative means of fixation have been proposed to address these undesired events. Although potentially more technically demanding than fixation of diaphyseal or extraarticular tibial fractures, intramedullary nail (IMN) fixation of simple intraarticular distal tibia fractures is a viable treatment alternative with unique advantages...
November 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27763961/no-incidence-of-postoperative-knee-sepsis-with-suprapatellar-nailing-of-open-tibia-fractures
#19
Phillip M Mitchell, Benjamin M Weisenthal, Cory A Collinge
OBJECTIVE: To evaluate the incidence of knee sepsis following suprapatellar nailing of open tibia fractures. DESIGN: Retrospective SETTING:: ACS Level 1 trauma centerPatients/Participants: We reviewed 139 open tibia fractures that underwent suprapatellar nailing as definitive treatment over a five-year period (January 1, 2011 to January 1, 2016). The majority of patients (90%, n=126) underwent intramedullary nailing at the time of their initial surgery. We defined knee sepsis as intra-articular infection requiring operative debridement, either open or arthroscopically, within one month's time...
October 1, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27763960/does-a-staged-posterior-approach-have-a-negative-effect-on-ota-43c-fracture-outcomes
#20
Daniel S Chan, Paul M Balthrop, Brian White, David Glassman, Roy W Sanders
OBJECTIVE: To determine whether multiple approaches pose an increased risk to fracture healing when compared to a standard single approach in the treatment of pilon (OTA 43C) fractures. DESIGN: Retrospective review of a prospective database. SETTING: Level I academic trauma center and level II community trauma center. METHODS: From January 1, 2005 to December 31, 2011, all records of patients treated for OTA 43C fractures of the distal tibia were reviewed...
October 1, 2016: Journal of Orthopaedic Trauma
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