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Open tibia fractures

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https://www.readbyqxmd.com/read/29737002/lower-limb-reconstruction-with-chimeric-flaps-the-quad-flap
#1
Solomon M Azouz, Nikki A Castel, Aparna Vijayasekaran, Alanna M Rebecca, Salvatore C Lettieri
Early soft-tissue coverage is critical for treating traumatic open lower-extremity wounds. As free-flap reconstruction evolves, injuries once thought to be nonreconstructable are being salvaged. Free-tissue transfer is imperative when there is extensive dead space or exposure of vital structures such as bone, tendon, nerves, or blood vessels. We describe 2 cases of lower-extremity crush injuries salvaged with the quad flap. This novel flap consists of parascapular, scapular, serratus, and latissimus dorsi free flaps in combination on one pedicle...
May 7, 2018: Microsurgery
https://www.readbyqxmd.com/read/29688959/arthroscopic-management-of-tibial-spine-avulsion-fractures-principles-and-techniques
#2
Eric J Strauss, Daniel James Kaplan, Maxwell E Weinberg, Jonathan Egol, Laith M Jazrawi
Tibial spine fractures are uncommon injuries affecting the insertion of the anterior cruciate ligament on the tibia. They typically occur in skeletally immature patients aged 8 to 14 years and result from hyperextension of the knee with a valgus or rotational force. Diagnosis is based on history, physical examination, and standard radiographs. The use of MRI can identify entrapped soft tissue that may prevent reduction. Open or arthroscopic repair is indicated in patients with partially displaced fractures (>5 mm) with one third to one half of the avulsed fragment elevated, in patients who have undergone unsuccessful nonsurgical reduction and long leg casting or bracing, and in patients with completely displaced fractures...
May 15, 2018: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/29682282/a-pilot-hole-does-not-reduce-the-strains-or-risk-of-fracture-to-the-lateral-cortex-during-and-following-a-medial-opening-wedge-high-tibial-osteotomy-in-cadaveric-specimens
#3
K Bujnowski, A Getgood, K Leitch, J Farr, C Dunning, T A Burkhart
Aim: It has been suggested that the use of a pilot-hole may reduce the risk of fracture to the lateral cortex. Therefore the purpose of this study was to determine the effect of a pilot hole on the strains and occurrence of fractures at the lateral cortex during the opening of a high tibial osteotomy (HTO) and post-surgery loading. Materials and Methods: A total of 14 cadaveric tibias were randomized to either a pilot hole (n = 7) or a no-hole (n = 7) condition...
February 2018: Bone & Joint Research
https://www.readbyqxmd.com/read/29677093/a-prospective-randomized-trial-to-assess-fixation-strategies-for-severe-open-tibia-fractures-modern-ring-external-fixators-versus-internal-fixation-fixit-study-erratum
#4
(no author information available yet)
No abstract text is available yet for this article.
May 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29657482/functional-and-radiological-outcome-in-management-of-compound-tibia-diaphyseal-fracture-with-ao-monolateral-fixator-versus-limb-reconstruction-system
#5
Hitesh J Mangukiya, Neetin P Mahajan, Eknath D Pawar, Aakash Mane, Jitsen Manna
Introduction: Tibia being the most common fractured long bone represents 36.7% of all long bone fractures in adults with open fracture comprises 23.5% of all tibial shaft fracture. The lack of the muscular covering over anteromedial aspect of the tibia and poor blood supply predispose open tibial fractures to a 10-20 fold increased risk of developing infection than open fracture in any other anatomical areas and a nonunion rate as high as 28% has been reported in the literature. Methods: We did a prospective study at our institute from 2014-2016 comprising 40 patients with compound tibia diaphyseal fracture managed with AO monolateral external fixator (Group 1) (n = 20) and Limb reconstruction system (Group 2) (n = 20) as primary and definitive tool...
March 2018: Journal of Orthopaedics
https://www.readbyqxmd.com/read/29625505/proximal-versus-distal-recipient-vessels-in-lower-extremity-reconstruction-a-retrospective-series-and-systematic-review
#6
John T Stranix, Zachary M Borab, William J Rifkin, Adam Jacoby, Z-Hye Lee, Lavinia Anzai, Daniel J Ceradini, Vishal Thanik, Pierre B Saadeh, Jamie P Levine
BACKGROUND:  Recipient vessels proximal to the zone of injury have traditionally been preferred for lower extremity reconstruction. However, more recent data have shown mixed outcomes when performing anastomoses distal to the zone of injury. We investigated the impact of recipient vessel location on free flap outcomes. METHODS:  Retrospective review (1979-2016); 312 soft tissue free flaps for open tibia fractures met inclusion criteria. Flap characteristics and perioperative outcomes were examined...
April 6, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29598844/effect-of-bmi-on-outcomes-of-surgical-treatment-for-tibial-plateau-fractures-a-comparative-retrospective-case-series-study
#7
Yaşar Mahsut Dinçel, Ali Öner, Yavuz Arikan, Sever Çaglar, Raşit Özcafer, Mehmet Akif Güleç
PURPOSE: Tibia plateau fracture (TPF) treatment aims at achieving a stable, aligned, mobile, painless knee and preventing post-traumatic osteoarthritis. To achieve this goal, surgeons consider criteria such as patients' characteristics, severity, risk of complications, fracture displacement/depression, degree of soft tissue injury. However, body mass index (BMI) is not considered as a risk factor in literature. Our study was conducted to find out any possible correlation between BMI and functional scores or radiological score separately...
March 2, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/29595537/chronic-osteomyelitis-caused-by-haemophilus-parainfluenzae-a-case-report
#8
Vignesh Ramachandran, Lee S Haruno, Theodora S Browne, Laila E Woc-Colburn, Scott B Rosenfeld, Vinitha R Shenava
CASE: A 14-year-old boy presented with a pathologic fracture of the distal aspect of the tibia and a remote history of a dog bite near the injury site. Imaging studies, biopsy, and presentation corroborated the diagnosis of chronic osteomyelitis. Multiple diagnostic methods were negative until an open biopsy identified Haemophilus parainfluenzae, a fastidious oropharyngeal bacterium, with polymerase chain reaction analysis. The patient underwent extensive debridement, placement of external fixation, and a year-long antibiotic therapy regimen...
January 2018: JBJS Case Connector
https://www.readbyqxmd.com/read/29564211/complex-knee-injuries-treated-in-acute-phase-long-term-results-using-ligament-augmentation-and-reconstruction-system-artificial-ligament
#9
John Gliatis, Konstantinos Anagnostou, Pantelis Tsoumpos, Evdokia Billis, Maria Papandreou, Spyridon Plessas
AIM: To present the long-term results of complex knee injuries, treated early using the Ligament Augmentation and Reconstruction System (LARS) artificial ligament to reconstruct posterior cruciate ligament (PCL). METHODS: From September 1997 to June 2010, thirty-eight complex knee injuries were treated, where early arthroscopic PCL reconstructions were undergone, using the LARS (Surgical Implants and Devices, Arc-sur-Tille, France) artificial ligament. Exclusion criteria were: Late (> 4 wk) reconstruction, open technique, isolated PCL reconstruction, knee degenerative disease, combined fracture or vascular injury and use of allograft or autograft for PCL reconstruction...
March 18, 2018: World Journal of Orthopedics
https://www.readbyqxmd.com/read/29546620/role-of-an-anatomically-contoured-plate-and-metal-block-for-balanced-stability-between-the-implant-and-lateral-hinge-in-open-wedge-high-tibial-osteotomy
#10
Young Woong Jang, DoHyung Lim, Hansol Seo, Myung Chul Lee, O-Sung Lee, Yong Seuk Lee
INTRODUCTION: Open-wedge high tibial osteotomy (OWHTO) is a well-established surgical option for medial compartment osteoarthritis of the varus knee. The initial strength of the fixation plate is critical for successful correction maintenance and healing of the osteotomy site. This study was conducted to verify if a newly designed anatomical plate (LCfit) improves the stability of both the medial implant and lateral hinge area, as well as to evaluate how the metal block contributes to both medial and lateral stability...
March 15, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29535772/a-multicentric-open-label-randomized-comparative-clinical-trial-of-two-different-doses-of-expanded-hbm-mscs-plus-biomaterial-versus-iliac-crest-autograft-for-bone-healing-in-nonunions-after-long-bone-fractures-study-protocol
#11
Enrique Gómez-Barrena, Norma G Padilla-Eguiluz, Cristina Avendaño-Solá, Concepción Payares-Herrera, Ana Velasco-Iglesias, Ferran Torres, Philippe Rosset, Florian Gebhard, Nicola Baldini, Juan C Rubio-Suarez, Eduardo García-Rey, José Cordero-Ampuero, Javier Vaquero-Martin, Francisco Chana, Fernando Marco, Javier García-Coiradas, Pedro Caba-Dessoux, Pablo de la Cuadra, Philippe Hernigou, Charles-Henri Flouzat-Lachaniette, François Gouin, Didier Mainard, Jean Michel Laffosse, Miriam Kalbitz, Ingo Marzi, Norbert Südkamp, Ulrich Stöckle, Gabriela Ciapetti, Davide Maria Donati, Luigi Zagra, Ugo Pazzaglia, Guido Zarattini, Rodolfo Capanna, Fabio Catani
ORTHOUNION is a multicentre, open, comparative, three-arm, randomized clinical trial (EudraCT number 2015-000431-32) to compare the efficacy, at one and two years, of autologous human bone marrow-derived expanded mesenchymal stromal cell (hBM-MSC) treatments versus iliac crest autograft (ICA) to enhance bone healing in patients with diaphyseal and/or metaphysodiaphyseal fracture (femur, tibia, and humerus) status of atrophic or oligotrophic nonunion (more than 9 months after the acute fracture, including recalcitrant cases after failed treatments)...
2018: Stem Cells International
https://www.readbyqxmd.com/read/29534282/postoperative-complications-associated-with-external-skeletal-fixators-in-dogs
#12
Lee James Beever, Kirsty Giles, Richard Lawrence Meeson
OBJECTIVES:  To quantify and evaluate risks of complications attributable to external skeletal fixator (ESF) usage in dogs. METHODS:  A retrospective review of medical records following ESF placement. RESULTS:  Case records of 97 dogs were reviewed; fixator-associated complications occurred in 79/97 dogs. Region of ESF placement was significantly associated with complication development ( p  = 0.005), not complication type ( p  = 0...
February 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/29526160/basic-principles-of-fracture-treatment-in-children
#13
Hakan Ömeroğlu
This review aims to summarize the basic treatment principles of fractures according to their types and general management principles of special conditions including physeal fractures, multiple fractures, open fractures, and pathologic fractures in children. Definition of the fracture is needed for better understanding the injury mechanism, planning a proper treatment strategy, and estimating the prognosis. As the healing process is less complicated, remodeling capacity is higher and non-union is rare, the fractures in children are commonly treated by non-surgical methods...
April 2018: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/29490379/treatment-of-unstable-pediatric-tibia-shaft-fractures-in-finland
#14
Antti Stenroos, Jenni Jalkanen, Juha-Jaakko Sinikumpu, Sauli Palmu, Eeva Koskimies-Virta, Topi Laaksonen, Yrjänä Nietosvaara
BACKGROUND:  Surgical treatment of pediatric tibia shaft fractures has gained popularity despite closed reduction and cast-immobilization providing good long-term results. There is no consensus about optimal methods and satisfactory quality of treatment. MATERIALS AND METHODS:  During 2010 to 2014, 226 pediatric patients were treated under anesthesia for tibia shaft fractures in Finland's five university hospitals. A total of 164 (73%) patients had closed fractures of the tibia or both tibia and fibula without other injuries (62 tibia only and 102 both tibia and fibula)...
February 28, 2018: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29482793/intramedullary-nailing-of-fibular-fractures
#15
REVIEW
Justin J Fleming
The reamed intramedullary (IM) technique has many benefits. However, open plating is the most commonly used technique. Previously, IM stabilization was reserved for fibular fractures, which were given lower priority, and generally associated with injuries to the distal tibia or instances in which the soft tissue envelope was unsuitable for an open approach. This article reviews the literature and the level of evidence, and presents case examples and operative technique.
April 2018: Clinics in Podiatric Medicine and Surgery
https://www.readbyqxmd.com/read/29482791/minimally-invasive-plate-osteosynthesis-for-distal-tibia-fractures
#16
REVIEW
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
https://www.readbyqxmd.com/read/29453480/limited-open-reduction-and-percutaneous-plate-osteosynthesis-alternative-option-to-minimally-invasive-plate-osteosynthesis-in-management-of-distal-tibia-fractures
#17
Shambhu Sah, Bikash Kc, Sailoj Jung Dangi, Rem Kumar Rai, Roshan Yadav
INTRODUCTION: The management of distal tibia fracture is challenging because of the limited soft tissue coverage and poor vascularity around the bone in that area. Minimally invasive percutaneous plate osteosynthesis is a novel technique in this regard but needs fluoroscopy. In unavailability of fluoroscopy or its technical malfunction, limited open reduction percutaneous plate osteosynthesis becomes useful. The aim of this study is to compare the outcomes of distal tibia fractures treated by LORPPO and MIPPO techniques in terms of duration of hospital stay, full weight bearing, union time and complications...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29452810/interleukin-6-is-both-necessary-and-sufficient-to-produce-perioperative-neurocognitive-disorder-in-mice
#18
J Hu, X Feng, M Valdearcos, D Lutrin, Y Uchida, S K Koliwad, M Maze
BACKGROUND: Perioperative neurocognitive disorders (PND) result in long-term morbidity and mortality with no effective interventions available. Because interleukin-6 (IL-6), a pro-inflammatory cytokine, is consistently up-regulated by trauma, including after surgery, we determined whether IL-6 is a putative therapeutic target for PND in a mouse model. METHODS: Following institutional approval, adult (12-14 weeks) male C57/Bl6 mice were pretreated with the IL-6 receptor (IL6R) blocking antibody tocilizumab prior to open tibia fracture with internal fixation under isoflurane anaesthesia...
March 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29443862/red-tides-mass-casualty-and-whole-blood-at-sea-red-tides
#19
Benjamin T Miller, Andrew H Lin, Susan C Clark, Andrew P Cap, Joseph J Dubose
BACKGROUND: The U.S. Navy's casualty-receiving ships provide remote damage control resuscitation (RDCR) platforms to treat injured combatants deployed afloat and ashore. We report a significant mass casualty incident aboard the USS Bataan, and the most warm fresh whole blood (WFWB) transfused at sea for traumatic hemorrhagic shock since the Vietnam War. METHODS: Casualty-receiving ships have robust medical capabilities, including a frozen blood bank with packed red blood cells (pRBC) and fresh frozen plasma (FFP)...
February 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29432320/segmental-tibia-fractures-an-analysis-of-complication-and-healing-rates
#20
Robert M Corey, Nathan K Park, Lisa K Cannada
OBJECTIVES: To determine the most commonly associated injuries, complications, and healing rates of patients sustaining segmental tibial shaft fractures. DESIGN: Retrospective review. SETTING: Two Level I trauma centers. PATIENTS: One hundred and eight patients with segmental tibial shaft fractures were identified between 2005-2013. INTERVENTION: None. MAIN OUTCOME MEASURES: Demographics, injury characteristics, treatments, and complications...
January 24, 2018: Journal of Orthopaedic Trauma
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