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Open tibia fractures

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https://www.readbyqxmd.com/read/28438417/comparing-hospital-outcomes-between-open-and-closed-tibia-fractures-treated-with-intramedullary-fixation
#1
Evan J Smith, Xiangyu Kuang, Rajeev Pandarinath
INTRODUCTION: Tibial shaft fractures comprise a large portion of operatively treated long bone fractures, and present with the highest rate of open injuries. Intramedullary fixation has become the standard of care for both open and closed injuries. The rates of short term complications and hospital length of stay for open and closed fractures treated with intramedullary fixation is not fully known. Previous series on tibia fractures were performed at high volume centers, and data were not generalizable, further they did not report on length of stay and the impact of preoperative variables on infections, complications and reoperation...
March 30, 2017: Injury
https://www.readbyqxmd.com/read/28420623/externalised-locking-compression-plate-as-an-alternative-to-the-unilateral-external-fixator-a-biomechanical-comparative-study-of-axial-and-torsional-stiffness
#2
B F H Ang, J Y Chen, A K S Yew, S K Chua, S M Chou, S L Chia, J S B Koh, T S Howe
OBJECTIVES: External fixators are the traditional fixation method of choice for contaminated open fractures. However, patient acceptance is low due to the high profile and therefore physical burden of the constructs. An externalised locking compression plate is a low profile alternative. However, the biomechanical differences have not been assessed. The objective of this study was to evaluate the axial and torsional stiffness of the externalised titanium locking compression plate (ET-LCP), the externalised stainless steel locking compression plate (ESS-LCP) and the unilateral external fixator (UEF)...
April 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28410572/incidence-of-infection-following-internal-fixation-of-open-and-closed-tibia-fractures-in-india-infiniti-a-multi-centre-observational-cohort-study
#3
Prakash Doshi, Hitesh Gopalan, Sheila Sprague, Chetan Pradhan, Sunil Kulkarni, Mohit Bhandari
BACKGROUND: Trauma is a major public health problem, particularly in India due to the country's rapid urbanization. Tibia fractures are a common and often complicated injury that is at risk of infection following surgical fixation. The primary objectives of this cohort study were to determine the incidence of infection within one year of surgery and to describe the distribution of infections by location and time of diagnosis for tibia fractures in India. METHODS: We conducted a multi-center, prospective cohort study...
April 14, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28394750/impact-of-body-mass-index-and-bacterial-resistance-in-osteomyelitis-after-antibiotic-prophylaxis-of-open-lower-extremity-fractures
#4
Derek Bremmer, Brandon Bookstaver, Mark Cairns, Kenneth Lindley, Martin Durkin, David Koon, April Miller Quidley
BACKGROUND: We investigated the clinical effectiveness of antimicrobial prophylaxis in lower-extremity open fractures following the Eastern Association for the Surgery of Trauma Guidelines. METHODS: This observational, retrospective, single-center study included adults with lower-extremity open fractures of the ankle, tibia, fibula, or femur. The primary endpoint was the incidence of osteomyelitis within 12 months of the fracture. Secondary endpoint comparisons were the time of antibiotic initiation and drug selection...
April 2017: Surgical Infections
https://www.readbyqxmd.com/read/28387196/bone-grafting-via-reamer-irrigator-aspirator-for-nonunion-of-open-gustilo-anderson-type-iii-tibial-fractures-treated-with-multiplanar-external-fixator
#5
Nicholas Kusnezov, Gautham Prabhakar, Matthew Dallo, Ahmed M Thabet, Amr A Abdelgawad
INTRODUCTION: The purpose of this investigation was to evaluate the outcomes following reamer-irrigator-aspirator (RIA) autogenous bone grafting (ABG) of high-grade open tibia fracture nonunions stabilized via multiplanar external fixation. METHODS: We retrospectively reviewed all patients with Gustilo-Anderson type III open tibia fractures treated with multiplanar external fixation and who underwent RIA ABG for nonunion at our institutional Level 1 Trauma Center between 2008 and 2015...
2017: SICOT-J
https://www.readbyqxmd.com/read/28385946/the-management-of-open-tibial-fractures-in-children-a-retrospective-case-series-of-eight-years-experience-of-61-cases-at-a-paediatric-specialist-centre
#6
R S Nandra, F Wu, A Gaffey, C E Bache
AIMS: Following the introduction of national standards in 2009, most major paediatric trauma is now triaged to specialist units offering combined orthopaedic and plastic surgical expertise. We investigated the management of open tibia fractures at a paediatric trauma centre, primarily reporting the risk of infection and rate of union. PATIENTS AND METHODS: A retrospective review was performed on 61 children who between 2007 and 2015 presented with an open tibia fracture...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28377261/an-inception-cohort-analysis-to-predict-nonunion-in-tibia-and-17-other-fracture-locations
#7
Robert Zura, J Tracy Watson, Thomas Einhorn, Samir Mehta, Gregory J Della Rocca, Ze Xiong, Zhe Wang, John Jones, R Grant Steen
INTRODUCTION: The epidemiology of fracture nonunion has been characterized so it is potentially possible to predict nonunion using patient-related risk factors. However, prediction models are currently too cumbersome to be useful. We test a hypothesis that nonunion can be predicted with ≤10 variables, retaining the predictive accuracy of a full model with 42 variables. METHODS: We sought to predict nonunion with prospectively-acquired inception cohort data for 18 different bones, using the smallest possible number of variables that did not substantially decrease prediction accuracy...
March 27, 2017: Injury
https://www.readbyqxmd.com/read/28348110/low-intensity-pulsed-ultrasound-for-bone-healing-systematic-review-of-randomized-controlled-trials
#8
REVIEW
Stefan Schandelmaier, Alka Kaushal, Lyubov Lytvyn, Diane Heels-Ansdell, Reed A C Siemieniuk, Thomas Agoritsas, Gordon H Guyatt, Per O Vandvik, Rachel Couban, Brent Mollon, Jason W Busse
Objective To determine the efficacy of low intensity pulsed ultrasound (LIPUS) for healing of fracture or osteotomy.Design Systematic review and meta-analysis.Data sources Medline, Embase, CINAHL, Cochrane Central Register of Controlled Trials, and trial registries up to November 2016.Study selection Randomized controlled trials of LIPUS compared with sham device or no device in patients with any kind of fracture or osteotomy.Review methods Two independent reviewers identified studies, extracted data, and assessed risk of bias...
February 22, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28342545/distal-tibial-nonunion-using-a-contralateral-anterior-l-shaped-locking-compression-plate-through-a-posterior-lateral-approach-a-retrospective-case-series
#9
Chuanlu Lin, Lixiang Lin, Lutchooman Vinesh, Xiwen Shao, Xiaolang Lu, Jianjun Hong
BACKGROUND: Distal tibial nonunion is usually due to severe open distal tibial fractures with high energy injury. The best surgical treatment is not well established because of the poor soft tissue condition. We retrospectively analyzed a series of patients with distal tibial nonunion after severe open distal tibial fractures; our purpose was to introduce a treatment using a contralateral anterior L-shaped locking compression plate through a posterior-lateral approach with Iliac crest bone graft and evaluate the outcomes of patients...
March 19, 2017: Injury
https://www.readbyqxmd.com/read/28323803/patient-response-to-an-integrated-orthotic-and-rehabilitation-initiative-for-traumatic-injuries-the-prioriti-mtf-study
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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