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Open tibia fractures

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https://www.readbyqxmd.com/read/29310377/fat-grafting-for-resurfacing-an-exposed-implant-in-lower-extremity-a-case-report
#1
Yun-Nan Lin, Chieh-Han Chuang, Shih-Hao Huang, Shu-Hung Huang, Tsai-Ming Lin, I-Wen Lin, Sin-Daw Lin, Yur-Ren Kuo
RATIONALE: Although numerous reconstruction protocols have been reported for lower leg trauma, those for distal leg trauma remain few. We present the case of a woman with an implant exposure wound, who was successfully treated through fat grafting, without major flap surgery. PATIENT CONCERNS: An 83-year-old woman with an exposed implant in lower extremity received reconstruction surgery once and the surgery failed. She refused additional major surgery and negative pressure wound therapy...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29273837/diaphyseal-long-bone-nonunions-types-aetiology-economics-and-treatment-recommendations
#2
REVIEW
Markus Rupp, Christoph Biehl, Matthäus Budak, Ulrich Thormann, Christian Heiss, Volker Alt
The intention of the current article is to review the epidemiology with related socioeconomic costs, pathophysiology, and treatment options for diaphyseal long bone delayed unions and nonunions. Diaphyseal nonunions in the tibia and in the femur are estimated to occur 4.6-8% after modern intramedullary nailing of closed fractures with an even much higher risk in open fractures. There is a high socioeconomic burden for long bone nonunions mainly driven by indirect costs, such as productivity losses due to long treatment duration...
December 22, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/29242795/head-on-allograft-transplantation-a-unique-case-report-where-a-large-piece-of-femoral-bone-was-extruded-from-one-patient-s-body-and-impaled-another-patient-s-tibia
#3
Stephen R Rossman, M Kareem Shaath, Kenneth W Graf
Introduction: Open femoral fractures are relatively uncommon occurrences, with few reports addressing their management. They are caused by high-energy mechanisms, and bone loss is a possible, but infrequent occurrence. We present a case in which two friends, 20- and 21-year-old males, were involved in a motorcycle collision. A large piece of bone was ejected from one patient's femur as a bony projectile and impaled the other patient's tibia, resulting in an open tibial plateau fracture...
September 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29232748/-combined-posteromedial-and-anterolateral-approach-in-the-floating-position-two-column-fracture-of-the-tibia-head
#4
Maike Reul, Harm Hoekstra
Background The posterior tibial plateau is often affected in intra-articular tibial fractures. Moreover, treating these posterior fractures is recognised as an important prognostic factor. Open reduction and internal fixation of lateral and posterior two column tibial plateau fractures can be achieved via a combined reversed L-shape approach and an anterolateral approach in the floating position without intraoperative repositioning of the patient. Material and Methods The operative procedure starts in the posterior position with visualisation of the posterior column after lateral retraction of the medial head of the M...
December 2017: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29226199/effectiveness-of-minimally-invasive-plate-osteosynthesis-mipo-on-comminuted-tibial-or-femoral-fractures
#5
Ali Andalib, Erfan Sheikhbahaei, Zeynab Andalib, Mohammad A Tahririan
Background: Comminuted fractures happen frequently due to traumas. Fixation without opening the fracture site, known as minimally invasive plate osteosynthesis (MIPO), has recently become prevalent. This study has been designed to assess the outcomes of this treatment for tibial and femoral comminuted fractures. Methods: A total of 60 patients with comminuted femoral or tibial fractures were operated with MIPO method in this cross-sectional study at Alzahra university hospital in 2015...
September 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29222607/static-and-fatigue-strength-of-a-novel-anatomically-contoured-implant-compared-to-five-current-open-wedge-high-tibial-osteotomy-plates
#6
Arnaud Diffo Kaze, Stefan Maas, James Belsey, Alexander Hoffmann, Dietrich Pape
BACKGROUND: The purpose of the present study was to compare the mechanical static and fatigue strength of the size 2 osteotomy plate "Activmotion" with the following five other common implants for the treatment of medial knee joint osteoarthritis: the TomoFix small stature, the TomoFix standard, the Contour Lock, the iBalance and the second generation PEEKPower. METHODS: Six fourth-generation tibial bone composites underwent a medial open-wedge high tibial osteotomy (HTO), according to standard techniques, using size 2 Activmotion osteotomy plates...
December 8, 2017: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/29216705/-functional-results-of-open-wedge-osteotomies-in-lower-limb-angular-deformities-in-teenagers
#7
C Orellana-Reta, L A Valdez-Jiménez
OBJECTIVE: The aim of this study was to evaluate the functional and radiographic results of adolescent patients with angular deformities of the pelvic limbs treated with an open wedge osteotomy system. MATERIAL AND METHODS: Observational, prospective, analytical and cross-sectional study of patients with angular deformity of the pelvic limbs treated with an open wedge osteotomy. We made a radiographic evaluation of the femorotibial angle, MAD angle, lower limb discrepancy, and pre- and postoperative degrees of the rotational center of deformity (CORA), as well as a telephone survey of the postoperative functional evaluation IKDC 2000...
May 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/29158651/soft-tissue-complications-in-distal-tibial-fractures-managed-with-medial-locking-plates-a-myth-or-reality
#8
Deepak Jain, Harpal Singh Selhi, Mohammad Yamin, Pankaj Mahindra
Background: Distal tibial fractures are common injuries that are prone to complications and require careful management. The use of medial periarticular locking plates is an established modality in the treatment if these fractures. These plates are inserted using the minimally invasive plate osteosynthesis (MIPO) or open technique. Our study looks at the soft tissue complications associated with the use of medial locking plates in the management of these fractures. Methods: This was a retrospective study carried out at a tertiary care university hospital in an urban setting...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29158644/injury-mechanism-fracture-characteristics-and-clinical-treatment-of-pilon-fracture-with-intact-fibula-a-retrospective-study-of-23-pilon-fractures
#9
Jiang Liangjun, Zheng Qiang, Li Hang, Pan Zhijun
Objective: The effect of intact fibula on pilon fracture is not completely elucidated. We retrospectively analysed pilon fractures with intact fibula at our hospital over a 4 year period to understand the injury mechanism, fracture characteristics, treatment strategy and prognosis of this fracture. Methods: Pilon fracture patients with intact fibula treated in our hospital from January 2010 to December 2014 were observed. OA/ATO fracture type, Ruedi-Allgower classification and fracture characteristics were summarised...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29136444/effect-of-locking-plate-fixation-vs-intramedullary-nail-fixation-on-6-month-disability-among-adults-with-displaced-fracture-of-the-distal-tibia-the-uk-fixdt-randomized-clinical-trial
#10
RANDOMIZED CONTROLLED TRIAL
Matthew L Costa, Juul Achten, James Griffin, Stavros Petrou, Ian Pallister, Sarah E Lamb, Nick R Parsons
Importance: The best treatment for fractures of the distal tibia remains controversial. Most such fractures require surgical fixation but outcomes are unpredictable and complications are common. Objective: To assess disability, quality of life, and complications in patients with displaced tibial fracture treated with intramedullary nail fixation vs locking plate fixation. Design, Setting, and Participants: A multicenter randomized trial recruiting 321 patients 16 years or older with an acute, displaced, extra-articular fracture of the distal tibia from April 2013 through April 2016 with final follow-up in February 2017...
November 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29135041/risk-factors-for-tibial-damage-associated-with-the-modified-maquet-technique-in-174-stifles
#11
Michael D Lefebvre, Olivier R Broux, Nicolas P Barthélémy, Martin Hamon, Evelyne V Moyse, Bernard M Bouvy, Marc H Balligand
OBJECTIVE: To identify risk factors for tibial damage associated with the modified Maquet technique (MMT) in dogs with cranial cruciate ligament (CCL) disease. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: One hundred and seventy-four stifles from 147 client-owned dogs. METHODS: Medical records of dogs diagnosed with CCL disease and treated with the current version of MMT were reviewed. Dogs were included if immediate postoperative radiographs were available...
November 14, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29122411/comparative-investigation-of-percutaneous-plating-and-intramedullary-nailing-effects-on-il-6-production-in-patients-with-tibia-shaft-fracture
#12
Adel Ebrahimpour, Mohammad-Ali Okhovatpour, Mehrdad Sadighi, Amir-Hossein Sarejloo, Mohammad-Reza Minator Sajjadi
OBJECTIVE: The aim of this study was to analyze the effect of intramedullary nailing (IMN), open plating and percutaneous plating on the induction of IL-6 in patients with tibia fractures. METHODS: A total of 30 patients with tibia shaft fracture underwent either intramedullary nailing (IMN, n = 15; 14 males and 1 female; mean age: 32.1 ± 15.6), ORIF plating (n = 8; 5 males and 3 females; mean age: 60.0 ± 17.8), or percutaneous plating (n = 7; 6 males and 1 female; mean age: 43...
November 6, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29113159/treatment-of-osteosarcoma-around-the-knee-in-skeletally-immature-patients
#13
Weitao Yao, Qiqing Cai, Jiaqiang Wang, Songtao Gao
Limb sparing surgery in growing young patients with malignant tumors is difficult as invasion of the physis by the tumor or surgical resection through the metaphysis may cause significant limb discrepancy following surgery. At present, hinged tumor prosthesis or biological reconstructions are the main methods following tumor resection in these patients. The aim of the present study was to assess different procedures for the treatment of osteosarcoma around knee joints in immature patients. A retrospective study of 56 patients (<15 years old, open physis) who had been treated for osteosarcoma around the knee joint between January 2007 and December 2015 was performed...
November 2017: Oncology Letters
https://www.readbyqxmd.com/read/29107133/physeal-fractures-of-the-lower-leg-in-children-and-adolescents-therapeutic-results-pitfalls-and-suggested-management-protocol-based-on-the-experience-of-the-authors-and-contemporary-literature
#14
Marcin Karlikowski, Jerzy Sułko
INTRODUCTION: Physeal fractures in children frequently give rise to concerns about the condition of the growth plate. Our observations have proven that the dysfunction of the growth plate is less frequent complication in those cases than misdiagnosed interposition of the periosteum. The aim of this paper is to familiarize the readers with the issue of treatment of physeal fractures of the distal tibia and fibula in the growing skeleton. MATERIALS AND METHODS: We analyzed the group of 75 patients - children and adolescents - with surgically treated physeal fractures of the lower leg...
October 26, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/29079366/quality-of-fracture-reduction-assessed-by-radiological-parameters-and-its-influence-on-functional-results-in-patients-with-pilon-fractures-a-prospective-multicentre-study
#15
Christoph Sommer, Sean E Nork, Matthew Graves, Michael Blauth, Mark Rudin, Karl Stoffel
INTRODUCTION: The management of pilon fractures remains a challenging issue. Due to the complexity of factors that influence the outcome, it has been questioned if anatomical reductions of articular fracture are relevant. The lack of a commonly accepted assessment of quality of fracture reduction compounded the uncertainty of the importance of anatomical reduction in pilon fracture. The current study aimed to define parameters that can better assess the reduction quality and to investigate the influence of reduction quality on functional outcomes...
October 20, 2017: Injury
https://www.readbyqxmd.com/read/29079233/posterolateral-approach-with-buttress-plates-and-cannulated-screw-fixation-for-large-posterior-malleolus-fractures
#16
Qiang Zhou, Hua Lu, Zhanchao Wang, Siming Yu, Haojie Zhang
The present study retrospectively reviewed the clinical efficacy of open reduction and internal fixation with buttress plates and cannulated screws via a posterolateral approach for the treatment of large posterior malleolus fractures. From July 2009 to April 2012, 34 patients (15 males and 19 females; mean age 41.2 years) with posterior malleolus fractures involving >25% of the distal articular tibia, were treated by cannulated screw and buttress plate fixation. All the patients were followed for ≥24 months...
November 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29078816/open-versus-minimally-invasive-fixation-of-a-simulated-syndesmotic-injury-in-a-cadaver-model
#17
Adam C Shaner, Norachart Sirisreetreerux, Babar Shafiq, Lynne C Jones, Erik A Hasenboehler
BACKGROUND: Malreduction of unstable syndesmotic ankle fractures is common. This study compared the reduction quality of an anterolateral open technique (OT) versus a conventional minimally invasive technique (MIT). METHODS: Fourteen fresh-frozen lower torso specimens with 28 matched lower extremities underwent computed tomography (CT) to measure syndesmosis position before dissection. Reduction was performed using direct visualization and fluoroscopy for the OT group (right-sided specimens) and fluoroscopy only for the MIT group (left-sided specimens)...
October 27, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29068940/not-all-gustilo-type-iiib-fractures-are-created-equal-arterial-injury-impacts-limb-salvage-outcomes
#18
John T Stranix, Z-Hye Lee, Adam Jacoby, Lavinia Anzai, Tomer Avraham, Vishal D Thanik, Pierre B Saadeh, Jamie P Levine
BACKGROUND: Open tibia fractures are commonly stratified by the Gustilo classification, an orthopedic grading system that does not incorporate the presence of arterial injury when limb perfusion is intact. In the authors' experience, however, the presence of arterial injury appears to negatively impact microsurgical outcomes. METHODS: In a retrospective review of 806 lower extremity reconstructions between 1979 and 2016, 361 soft-tissue flaps performed for Gustilo type IIIB/C coverage met inclusion criteria...
November 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29065036/is-it-safe-to-prep-the-external-fixator-in-situ-during-second-stage-pilon-surgical-treatment
#19
Paul J Nielsen, Leonid S Grossman, Justin C Siebler, Elizabeth R Lyden, Lori K Reed, Matthew A Mormino
OBJECTIVE: To evaluate the infection rate of our protocol of prepping the external fixator in situ during definitive second stage pilon fracture open reduction internal fixation. DESIGN: Retrospective clinical investigation. SETTING: Academic Level 1 Trauma Center. PATIENTS/PARTICIPANTS: Out of 229 patients with distal tibia fractures presenting to our institution from 1999-2014, 100 were treated in a two-stage fashion utilizing this protocol...
October 14, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29052010/open-versus-closed-treatment-of-distal-tibia-physeal-fractures-a-systematic-review-and-meta-analysis
#20
Waleed A Asad, Manaf H S Younis, Abdulaziz F Ahmed, Talal Ibrahim
AIMS: Distal tibia physeal fractures can lead to growth complications such as premature physeal closure (PPC), angular deformity and leg length discrepancy. The aim of our study was to systematically review the literature to assess whether open reduction and internal fixation (ORIF) is associated with lower rates of PPC compared to closed treatment. MATERIALS AND METHODS: We searched several databases from 1966 to 2016 for studies that evaluated ORIF versus closed treatment of distal tibia physeal fractures...
October 19, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
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