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Open tibia fractures

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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
#1
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
#2
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
#3
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
#4
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
#5
Darryl A Auston, Jordan Meiss, Rafael Serrano, Thomas Sellers, Gregory Carlson, Timothy Hoggard, Michael Beebe, Jonathan Quade, David Watson, R Bruce Simpson, Brian Kistler, Anjan Shah, Roy Sanders, Hassan Mir
OBJECTIVE: To compare the incidence of complications (wound, infection, 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...
December 26, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28167879/early-revision-surgery-for-tibial-plateau-non-union-and-mal-union
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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...
February 2017: Injury
https://www.readbyqxmd.com/read/27984446/primary-wound-closure-after-open-fracture-a-prospective-cohort-study-examining-nonunion-and-deep-infection
#18
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 nonunion after primary wound closure of open fractures (humerus, radius/ulna, femur, and 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 center. PARTICIPANTS: Eighty-three (84 fractures) subjects were enrolled...
March 2017: 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
#19
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
#20
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 6 cortical screws...
February 2017: Journal of Orthopaedic Trauma
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