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Open tibia fractures

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https://www.readbyqxmd.com/read/28913406/long-term-results-of-a-porous-tantalum-monoblock-tibia-component-clinical-and-radiographic-results-at-follow-up-of-10-years
#1
Daniel Gerscovich, Catherine Schwing, Anthony Unger
BACKGROUND: The purpose of this study is to assess the long-term follow-up of cementless total knee arthroplasty with the trabecular metal (TM) monoblock tibial component at an average 10-year follow-up. This report is an extension of our previously reported series of 108 TM tibias reported in 2011 (Unger and Duggan, 2011). METHODS: Fifty-eight of the original 108 knees were available for review. Each follow-up patient was evaluated by radiologic and clinical Knee Society Scores...
September 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28906305/risk-of-knee-sepsis-following-treatment-of-open-tibia-fractures-a-multicenter-comparison-of-suprapatellar-and-infrapatellar-approaches
#2
Geoffrey S Marecek, Luke T Nicholson, Frances H Broghammer, Michael Talerico, Caroline Tougas, Derek J Donegan, John A Scolaro
OBJECTIVES: The suprapatellar approach for medullary nailing of the tibia is increasing. This requires intra-articular passage of instruments, which theoretically places the knee at risk for postoperative sepsis in the setting of open fracture. We hypothesized that the risk of knee sepsis is similar after suprapatellar or infrapatellar nailing of open tibia fractures. DESIGN: Retrospective, multicenter. SETTING: Three urban Level-1 trauma centers PATIENTS:: All patients treated with medullary nailing for open diaphyseal tibia fractures (OTA 42) from 2009 to 2015...
September 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28904724/treatment-of-high-energy-pilon-fractures-using-the-ilizarov-treatment
#3
Walid Osman, Zeineb Alaya, Hamdi Kaziz, Lassad Hassini, Meriem Braiki, Nader Naouar, Mohamed Laaziz Ben Ayeche
The management of high-energy pilon fractures is still controversial. Open reduction and internal fixation are often associated with serious complications. Various methods have been used to treat these injuries, with variable results. The aim of this retrospective study was to analyze the clinical and radiographic outcome of the ILIZAROV technique in patients with high-energy pilon fractures. Thirty cases of distal tibia epiphysis fractures (pilon fractures) were managed from 1999 to 2012. The study group included 5 cases of open fractures...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28893227/damage-control-surgery-experiences-from-a-level-i-trauma-center
#4
Bernhard Gasser, Thomas M Tiefenboeck, Sandra Boesmueller, Danijel Kivaranovic, Adam Bukaty, Patrick Platzer
BACKGROUND: There is still no evidence in literature for damage control orthopaedics (DCO), early total care (ETC) or using external fixation solely in fractures of the long bones in multi-system-trauma. The aim of this study was to determine parameters influencing the choice of treatment in clinical routine (DCO, ETC, or EF) in femoral or tibial shaft fractures in combination with multi-system-trauma, severe soft tissue damage or both. METHODS: Data of 236 patients with 280 fractures of long bones of the lower extremities treated at a level I trauma center were analysed...
September 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28888404/expert-tibial-nails-for-treating-distal-tibial-fractures-with%C3%A2-soft%C3%A2-tissue%C3%A2-damage-a-patient-series
#5
Zhenhai Wang, Yiheng Cheng, Dajiang Xin, Tong Liu, Wenqing Qu, Dan Wang, Yong Zhao, Jingjing Zhao
Distal tibial fractures with soft tissue damage are relatively difficult to treat. We assessed the outcomes of patients with these fractures treated with Expert Tibial Nails(®) (DePuy Synthes, Raynham, MA) from March 2012 to December 2014. At 6 months postoperatively, the general health quality of patients was assessed using operative time, interval to return to work, American Orthopaedic Foot and Ankle Society ankle scale score, pain measured using a visual analog scale, and short-form health outcomes 36-item survey physical functioning and mental health dimension scores...
September 7, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28876274/a-prospective-randomized-trial-to-assess-fixation-strategies-for-severe-open-tibia-fractures-modern-ring-external-fixators-versus-internal-fixation-fixit-study-erratum
#6
(no author information available yet)
No abstract text is available yet for this article.
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28875130/ipsilateral-femur-and-tibia-fractures-in-pediatric-patients-a-systematic-review
#7
Jason B Anari, Alexander L Neuwirth, B David Horn, Keith D Baldwin
AIM: To better understand how pediatric floating knee injuries are managed after the wide spread use of new orthopaedic technology. METHODS: We searched EMBASE, COCHRANE and MEDLINE computerized literature databases from the earliest date available in the databases to February 2017 using the following search term including variants and pleural counterparts: Pediatric floating knee. All studies were thoroughly reviewed by multiple authors. Reference lists from all articles were scrutinized to identify any additional studies of interest...
August 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28862056/the-use-of-engineered-bilayered-skin-myderm-tm-in-the-management-of-massive-skin-defect-in-grade-iii-gustilo-anderson-open-fracture
#8
Nor Hazla Mohamed Haflah, Min Hwei Ng, Mohd Heikal Mohd Yunus, Amaramalar Selvee Naicker, Ohnmar Htwe, Muhammad Fahmi, Mohamad Fikeri Ishak, Wan Tai Seet, Khairul Anuar Khairoji, Manira Maarof, Kien Hui Chua, Sharen Aini Shamsuddin, Ruszymah Idrus
Open fracture Gustilo-Anderson grade IIIC is associated with higher risk of infection and problems with soft tissue coverage. Various methods have been used for soft tissue coverage in open fractures with large skin defect. We report a case of a patient who had grade IIIC open fracture of the tibia with posterior tibial artery injury. The patient underwent external fixation and reduction. Because of potential compartment syndrome after vascular repair, fasciotomy of the posterior compartment was performed. This wound, however, became infected and because of further debridement, gave rise to a large skin defect...
September 1, 2017: International Journal of Lower Extremity Wounds
https://www.readbyqxmd.com/read/28852347/marjolin-s-ulcer-of-the-tibia-with-pelvic-lymph-node-metastasis
#9
Craig C Akoh, Justin Chang, Joseph Buckwalter
Marjolin's ulcer, a form of squamous cell carcinoma, is a rare complication of a chronic wound infection. To date, there have not been any detailed reports of lymphatic spread of Marjolin's ulcer from an extremity. This report describes a 44-year old male with a history of an open tibia fracture at age 15, who presented with chronic osteomyelitis, increasing bloody wound drainage, and an enlarging vascular exophytic masses in the region of drainage. Biopsy of the mass showed squamous cell carcinoma. Initial staging with computed tomography (CT) was negative for metastatic disease...
2017: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/28827506/incidence-of-vacuum-phenomenon-related-intra-articular-or-subfascial-gas-found-on-computer-assisted-tomography-ct-scans-of-closed-lower-extremity-fractures
#10
Tyler Noble, Nicholas M Romeo, Christopher T LeBrun, Thomas DiPasquale
OBJECTIVES: To determine the incidence of vacuum phenomenon related intra-articular or subfascial gas found on computer assisted tomography (CT) scans of closed lower extremity fractures. DESIGN: Retrospective Review SETTING:: Level I Trauma CenterPatients/Participants: One hundred and fifty three patients with closed lower extremity fractures. INTERVENTION: CT scans of identified individuals were reviewed for the presence or absence of gaseous accumulations...
August 15, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28819607/a-gustilo-type-3b-open-tibial-fracture-treated-with-a-proximal-flexor-hallucis-longus-flap-a-case-report
#11
Tomohiro Yasuda, Masayuki Arai, Kaoru Sato, Koji Kanzaki
INTRODUCTION: In the treatment of Gustilo Type 3B open tibial fractures, it is important to perform soft tissue reconstruction and bone reconstruction simultaneously. Gastrocnemius muscle and soleus muscle flaps are generally used as rotational flaps for the tibia. The distal third of the tibia can often not be covered with the gastrocnemius muscle and soleus muscle flaps. Treatment distal to the distal third of the tibia is difficult because fewer flap options are available. In the present report, we describe our experience with a Gustilo Type 3B open tibial fracture treated by gastrocnemius muscle and soleus muscle flaps, along with an additional proximally based flexor hallucis longus flap, which is a rare procedure...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28818324/the-treatment-of-segmental-tibial-fractures-does-patient-preference-differ-from-surgeon-choice
#12
Z Little, T O Smith, S E McMahon, C Cooper, A Trompeter, M Pearse, S Britten, B Rogers, H Sharma, B Narayan, M Costa, D J Beard, C B Hing
INTRODUCTION: Segmental tibial fractures are complex injuries with a prolonged recovery time. Current definitive treatment options include intramedullary fixation or a circular external fixator. However, there is uncertainty as to which surgical option is preferable and there are no sufficiently rigorous multi-centre trials that have answered this question. The objective of this study was to determine whether patient and surgeon opinion was permissive for a randomised controlled trial (RCT) comparing intramedullary nailing to the application of a circular external fixator...
August 9, 2017: Injury
https://www.readbyqxmd.com/read/28814102/minimally-invasive-plate-osteosynthesis-using-locking-plates-for-ao-43-type-fractures-lessons-learnt-from-a-prospective-study
#13
Rajeev Shukla, Nikhil Jain, Ravi Kant Jain, Shravan Patidar, Vivek Kiyawat
INTRODUCTION: Managing fractures of distal tibia is still a subject of debate for orthopaedic surgeons in terms of both, reduction and fixation. Subcutaneous location and soft tissue anatomy predisposes it to angular and rotational instability as well as other bony and soft tissue complexities. Minimally invasive plating offers many advantages over conventional open techniques. It causes minimal soft tissue dissection and surgical trauma to the bone. Minimally invasive plate osteosynthesis(MIPO) maintains biological configuration of distal tibia and fracture hematoma and also provides a construct, which is biomechanically more stable...
August 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28810567/factors-related-to-infection-after-fixation-in-the-process-of-late-healed-bone-fracture
#14
Xiaoming Zhang, Xuebin Zhan, Peng Zou, Huixia An
We studied the factors related to infection after fixation in the process of bone late healed fracture and explored the factors that could predict the risk of postoperative infection. A total of 100 patients with open fractures of the tibia and fibula diagnosed in Zhengzhou No. 7 People's Hospital from 2007 to 2016 were enrolled in this study. Patients were subjected to staging surgery treatment. We divided them into the infection group (n=52) and the non-infection group (n=48) according to whether or not infection occurred after operation...
August 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28777278/elastic-intramedullary-nailing-versus-open-reduction-internal-fixation-of-pediatric-tibial-shaft-fractures
#15
Andrew T Pennock, Tracey P Bastrom, Vidyadhar V Upasani
BACKGROUND: The optimal fixation strategy for unstable pediatric tibia fractures is unclear with some favoring elastic intramedullary nails (EIN) and others favoring plate and screws [open reduction internal fixation (ORIF)]. The purpose of this study was to compare outcomes and complications of skeletally immature patients undergoing surgical stabilization of the tibia with either EIN or ORIF. METHODS: A retrospective review was performed on all patients undergoing EIN or ORIF of a diaphyseal fracture at a single pediatric level I trauma center between 2010 and 2016...
October 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28747511/autologous-minced-muscle-grafts-improve-endogenous-fracture-healing-and-muscle-strength-after-musculoskeletal-trauma
#16
Brady J Hurtgen, Catherine L Ward, Chrissy M Leopold Wager, Koyal Garg, Stephen M Goldman, Beth E P Henderson, Todd O McKinley, Sarah M Greising, Joseph C Wenke, Benjamin T Corona
The deleterious impact of concomitant muscle injury on fracture healing and limb function is commonly considered part of the natural sequela of orthopedic trauma. Recent reports suggest that heightened inflammation in the surrounding traumatized musculature is a primary determinant of fracture healing. Relatedly, there are emerging potential therapeutic approaches for severe muscle trauma (e.g., volumetric muscle loss [VML] injury), such as autologous minced muscle grafts (1 mm(3) pieces of muscle; GRAFT), that can partially prevent chronic functional deficits and appear to have an immunomodulatory effect within VML injured muscle...
July 2017: Physiological Reports
https://www.readbyqxmd.com/read/28742790/invited-commentary-related-to-cost-utility-analysis-of-reconstruction-compared-with-primary-amputation-for-patients-with-severe-lower-limb-trauma-in-colombia
#17
Joseph Borrelli
No abstract text is available yet for this article.
September 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28742785/an-effective-negative-pressure-wound-therapy-1-compatible-local-antibiotic-delivery-device
#18
Ben C C Rand, Joseph C Wenke
OBJECTIVES: The current clinical standard for local antibiotic depot is polymethylmethacrylate (PMMA) beads. Unfortunately, these are not ideal and negative pressure wound therapy (NPWT) reduces their limited effectiveness. Recently, a chitosan sponge has been shown to be an effective carrier of antibiotics. Since it acts as a delivery vehicle with increased wound contact area instead of an antibiotic depot, it may be more effective. The objectives of this study are to determine if 1) a chitosan sponge would be more effective than PMMA beads as a local antibiotic delivery device and 2) the chitosan sponge remains an effective method of delivery when used in conjunction with NPWT...
July 24, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28737011/a-distinctive-patchy-osteomalacia-characterises-phospho1-deficient-mice
#19
Alan Boyde, Katherine A Staines, Behzad Javaheri, Jose Luis Millan, Andrew A Pitsillides, Colin Farquharson
The phosphatase PHOSPHO1 is involved in the initiation of biomineralisation. Bones in Phospho1 knockout (KO) mice show histological osteomalacia with frequent bowing of long bones and spontaneous fractures: they contain less mineral, with smaller mineral crystals. However, the consequences of Phospho1 ablation on the microscale structure of bone are not yet fully elucidated. Tibias and femurs obtained from wild-type and Phospho1 null (KO) mice (25-32 weeks old) were embedded in PMMA, cut and polished to produce near longitudinal sections...
August 2017: Journal of Anatomy
https://www.readbyqxmd.com/read/28736122/treatment-of-tibial-nonunion-with-posterolateral-bone-grafting
#20
Michael J Foster, Robert V O'Toole, Theodore T Manson
OBJECTIVES: Posterolateral bone grafting to treat nonunions of the distal two-thirds of the tibia avoids the often traumatized and more tenuous anterior soft-tissue envelope. Few modern reports of its effectiveness are available. We assessed whether posterolateral bone grafting leads to high union and low complication rates. METHODS: We conducted a retrospective review at a Level I trauma center. Our study group was 59 patients with distal two-thirds tibial fractures treated with posterolateral bone grafting...
May 3, 2017: Injury
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