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Open tibia fractures

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https://www.readbyqxmd.com/read/28323803/patient-response-to-an-integrated-orthotic-and-rehabilitation-initiative-for-traumatic-injuries-the-prioriti-mtf-study
#1
Joseph R Hsu, Johnny G Owens, Jennifer DeSanto, John R Fergason, Kevin M Kuhn, Benjamin K Potter, Daniel J Stinner, Robert G Sheu, Sandra L Waggoner, Jason M Wilken, Yanjie Huang, Daniel O Scharfstein, Ellen J MacKenzie
Although limb salvage is now possible for many high-energy open fractures and crush injuries to the distal tibia, ankle, hindfoot, and midfoot, orthotic options are limited. The Intrepid Dynamic Exoskeletal Orthosis (IDEO) is a custom, energy-storing carbon fiber orthosis developed for trauma patients undergoing limb salvage. The IDEO differs from other orthoses in that it allows patients with ankle weakness to have more normal ankle biomechanics and increased ankle power. This article describes the design of a study to evaluate the effectiveness of the IDEO when delivered together with a high-intensity, sports medicine-based approach to rehabilitation...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323796/a-prospective-randomized-trial-to-assess-fixation-strategies-for-severe-open-tibia-fractures-modern-ring-external-fixators-versus-internal-fixation-fixit-study
#2
Robert V OʼToole, Joshua L Gary, Lisa Reider, Michael J Bosse, Wade T Gordon, James Hutson, Stephen M Quinnan, Renan C Castillo, Daniel O Scharfstein, Ellen J MacKenzie
The treatment of high-energy open tibia fractures is challenging in both the military and civilian environments. Treatment with modern ring external fixation may reduce complications common in these patients. However, no study has rigorously compared outcomes of modern ring external fixation with commonly used internal fixation approaches. The FIXIT study is a prospective, multicenter randomized trial comparing 1-year outcomes after treatment of severe open tibial shaft fractures with modern external ring fixation versus internal fixation among men and women of ages 18-64...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323795/assessment-of-severe-extremity-wound-bioburden-at-the-time-of-definitive-wound-closure-or-coverage-correlation-with-subsequent-postclosure-deep-wound-infection-bioburden-study
#3
Michael J Bosse, Clinton K Murray, Anthony R Carlini, Reza Firoozabadi, Theodore Manson, Daniel O Scharfstein, Joseph C Wenke, Mary Zadnik, Renan C Castillo
Infection remains the most common and significant complication after high-energy fractures. The Bioburden Study is a multicenter, prospective, observational cohort study of wound bacterial bioburden and antibiotic care in severe open lower extremity fractures. The aims of this study are to (1) characterize the contemporary extremity wound "bioburden" at the time of definitive wound closure; (2) determine the concordance between polymerase chain reaction results and hospital microbiology; (3) determine, among those who develop deep infections, the concordance between the pathogens at wound closure and at deep infection; and (4) compare the probability of deep infection between those who did and did not receive an appropriate course of antibiotics based on bioburden at the time of wound closure...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28302305/absolute-or-relative-stability-in-minimal-invasive-plate-osteosynthesis-of-simple-distal-meta-or-diaphyseal-tibia-fractures
#4
R Wenger, F Oehme, J Winkler, S M Perren, R Babst, F J P Beeres
INTRODUCTION: Minimal invasive plate osteosynthesis in simple distal meta or diaphyseal tibia fractures can be applied using absolute (lag screw and neutralisation plate; LSN) or relative stability (bridge plate; BP). The primary aim of the study was to compare time to radiological union and time to full weight bearing in the two groups (LSN vs. BP). Reduction was performed either percutaneously or by a minimally open approach (mini open). Secondary aim was to analyse the number of complications between both groups...
March 6, 2017: Injury
https://www.readbyqxmd.com/read/28288080/management-of-pediatric-type-i-open-fractures-in-the-emergency-department-or-operating-room-a-multicenter-perspective
#5
Jenna Godfrey, Paul D Choi, Lior Shabtai, Sarah B Nossov, Amy Williams, Antoinette W Lindberg, Selina Silva, Michelle S Caird, Mathew D Schur, Alexandre Arkader
BACKGROUND: The management of pediatric type I open fractures remains controversial. The aim of this study is to compare outcomes in type I open fractures managed with superficial wound debridement and antibiotics in the emergency department (ED) (nonoperative management) to patients managed with operative debridement and antibiotics (operative management). METHODS: A multicenter retrospective review was performed of all pediatric type I open forearm, wrist, and tibia fractures treated at 4 high volume pediatric centers between 2000 and 2015...
March 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28272857/management-of-acute-complex-traumatic-wound-with-a-dermal-regeneration-template-case-report
#6
R R V Patel, M Giaquinto-Cillers, J Kotze, R S Hartnick, L W van der Merwe, E B Holford
BACKGROUND: Acute complex traumatic wounds of the lower limbs are usually managed by a combination of multiple debridements, dressing changes, and specialized surgical procedures which may include tissue transfers for the reconstruction of the soft tissue injury. The recovery is lengthy, and the outcome dependent on the initial injury, the surgical procedures undertaken and rehabilitation programs with a multidisciplinary team. METHOD: A nine-year-old male patient presented to Kimberly Hospital with an extensive soft tissue injury of the leg associated with a tibia fracture caused by a high velocity pedestrian vehicle accident...
November 2016: South African Journal of Surgery. Suid-Afrikaanse Tydskrif Vir Chirurgie
https://www.readbyqxmd.com/read/28216752/management-of-gustilo-anderson-iii-b-open-tibial-fractures-by-primary-fascio-septo-cutaneous-local-flap-and-primary-fixation-the-fix-and-shift-technique
#7
P R Ramasamy
BACKGROUND: Open fractures of tibia have posed great difficulty in managing both the soft tissue and the skeletal components of the injured limb. Gustilo Anderson III B open tibial fractures are more difficult to manage than I, II, and III A fractures. Stable skeletal fixation with immediate soft tissue cover has been the key to the successful outcome in treating open tibial fractures, in particular, Gustilo Anderson III B types. If the length of the open wound is larger and if the exposed surface of tibial fracture and tibial shaft is greater, then the management becomes still more difficult...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28203271/a-review-of-the-epidemiology-and-treatment-of-orthopaedic-injuries-after-earthquakes-in-developing-countries
#8
REVIEW
James S MacKenzie, Bibek Banskota, Norachart Sirisreetreerux, Babar Shafiq, Erik A Hasenboehler
BACKGROUND: Earthquakes in developing countries are devastating events. Orthopaedic surgeons play a key role in treating earthquake-related injuries to the extremities. We describe orthopaedic injury epidemiology to help guide response planning for earthquake-related disasters. METHODS: Several databases were searched for articles reporting primary injury after major earthquakes from 1970 to June 2016. We used the following key words: "earthquake" AND "fracture" AND "injury" AND "orthopedic" AND "treatment" AND "epidemiology...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28198794/open-tibia-shaft-fractures-and-soft-tissue-coverage-the-effects-of-management-by-an-orthopedic-trauma-microsurgical-team
#9
James VandenBerg, Daniel Osei, Martin I Boyer, Michael J Gardner, William M Ricci, Amanda Spraggs-Hughes, Christopher McAndrew
OBJECTIVES: To compare the timing of soft-tissue (flap) coverage and occurrence of complications before and after the establishment of an integrated orthopedic trauma/microsurgical team. DESIGN: Retrospective Cohort StudySETTING:: A single level 1 trauma centerPATIENTS:: 28 subjects (13 pre- and 15 post-integration) with open tibia shaft fractures (OTA/AO 42A, 42B, 42C) treated with flap coverage between January 2009 and March 2015. INTERVENTION: Flap coverage for open tibia shaft fractures treated before ("pre-integration") and after ("post-integration") implementation of an integrated orthopedic trauma/microsurgical team...
February 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28173978/the-effects-of-tibia-profile-distraction-angle-and-knee-load-on-wedge-instability-and-hinge-fracture-a-finite-element-study
#10
Pei-Wei Weng, Chia-Hsien Chen, Chu-An Luo, Jui-Sheng Sun, Yang-Hwei Tsuang, Cheng-Kung Cheng, Shang-Chih Lin
Several plate systems for high tibial osteotomy (HTO) have been developed to stabilize the opening wedge of an osteotomized tibia. Among them, the TomoFix system, having a quasi-straight and T-shaped design, has been widely adopted in the literature. However, this system is implemented by inserting a lag (i.e., cortical) screw through the proximal combi-hole, to deform the plate and pull the distal tibia toward the plate. This process potentially induces plate springback and creates an elastic preload on the osteotomized tibia, especially at the lateral hinge of the distracted wedge...
February 4, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28169938/percutaneous-or-open-reduction-of-closed-tibial-shaft-fractures-during-intramedullary-nailing-does-not-increase-wound-complications-infection-or-nonunion-rates
#11
Darryl A Auston, Jordan Meiss, Rafael Serrano, Thomas Sellers, Gregory Carlson, Timothy Hoggard, Michael Beebe, Jonathan Quade, David Watson, Robert Bruce Simpson, Brian Kistler, Anjan Shah, Roy Sanders, Hassan R Mir
OBJECTIVE: To compare the incidence of complications (wound, infection, and nonunion) among those patients treated with closed, percutaneous, and open intramedullary nailing for closed tibial shaft fractures. DESIGN: Retrospective review. SETTING: Multiple trauma centers. PATIENTS: Skeletally mature patients with closed tibia fractures amenable to treatment with an intramedullary device. INTERVENTION: Intramedullary fixation with closed, percutaneous, or open reduction...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28167879/early-revision-surgery-for-tibial-plateau-non-union-and-mal-union
#12
Dominic L Van Nielen, Christopher S Smith, David L Helfet, Peter Kloen
BACKGROUND: Although relatively rare, non-unions and mal-unions of tibial plateau fractures present significant challenges for the orthopedic surgeon. With careful pre-operative planning, tibial plateau mal-union or non-union revision surgery with intra-articular and varus opening osteotomies can provides good functional results when performed early (within 1 year) after primary surgical procedure. QUESTIONS/PURPOSES: We present our treatment algorithm for approaching and treating non-union or mal-union of tibial plateau fractures...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28151885/single-cortex-is-better-than-double-cortex-in-fibula-grafts-for-large-tibia-bone-defect-in-a-2-year-old-child-a-case-report-of-a-successful-surgery-and-discussion-of-bone-graft-choices
#13
Jianbin Li, Zhijun Pan, Shigui Yan, Xiang Zhao
BACKGROUND: Large bone defect in infant or small patients has been little reported and the management of such a patient is difficult. Considering the little knowledge of this area, we present this special case of a successful single-cortex fibula graft for the treatment of a large tibia bone defect in a 2-year-old patient to share our experience. CASE SUMMARY: A 2-year-old male patient presented to our hospital with history of leg pain for 4 months. According to his medical records, he was involved in a traffic accident and diagnosed with open tibia fracture...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28137303/delayed-methicillin-resistant-staphylococcus-aureus-induced-osteomyelitis-of-the-tibia-after-pin-tract-infection-two-case-reports
#14
Kosuke Hamahashi, Yoshiyasu Uchiyama, Yuka Kobayashi, Masahiko Watanabe
BACKGROUND: Pin tract infection is a common complication of external fixation. It usually heals after treatment with debridement, antibiotics, and/or pin removal, only rarely developing into delayed osteomyelitis. We treated two patients with delayed methicillin-resistant Staphylococcus aureus-induced osteomyelitis of the tibia following pin tract infection. CASE PRESENTATION: One patient, a diabetic 60-year-old Japanese man, underwent definitive external fixation using an Ilizarov fixator for postoperative osteomyelitis of an open fracture of his left ankle...
January 31, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28116272/management-of-large-bone-defects-in-diaphyseal-fractures-by-induced-membrane-formation-by-masquelet-s-technique
#15
R Sivakumar, M Gulam Mohideen, M Chidambaram, T Vinoth, Prahalad Kumar Singhi, V Somashekar
INTRODUCTION: Management of the large gap in long bone fractures is a challenging problem after compound injuries. A novel technique called as Masquelet's technique of "induced membrane formation", is used to bridge a gap of more than 5 cm using bone cement as a spacer in first stage and autologous cancellous bone graft to fill the gap in second stage. CASE PRESENTATION: We present two different and difficult cases with bone defects after open injuries associated with long bone fractures in this paper...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28116268/pseudoaneurysm-of-the-posterior-tibial-artery-following-removal-of-tibial-plate-a-rare-case
#16
Salman Ghaffari, Hossein Farsavian, Seyed Mohamad Mehdi Daneshpoor, Masoud Shayesteh
INTRODUCTION: Pseudoaneurysm is a rare complication reported after any surgery such as ORIF of fracture, plate removal, ankle or knee arthroscopy or arthroplasty. To our knowledge, pseudoaneurysms of the posterior tibial artery after tibial plate removal are a rare phenomenon. We report a case of a 18-year-old male patient who had pseudoaneurysm of posterior tibial artery following plate removal. CASE PRESENTATION: A 18-year-old male was referred to our outpatient clinic because of mass-like lesion in his left calf...
July 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28087118/open-lower-limb-fractures-in-major-trauma-centers-a-loss-leader
#17
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...
February 2017: Injury
https://www.readbyqxmd.com/read/28079741/management-of-pediatric-open-tibia-fractures-with-supracutaneous-locked-plates
#18
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
#19
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
#20
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
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