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https://www.readbyqxmd.com/read/29081855/the-effects-of-body-mass-index-on-treatment-of-paediatric-femur-fractures-managed-with-flexible-intramedullary-nails
#1
E Nielsen, L M Andras, N Bonsu, R Y Goldstein
PURPOSE: Traditionally, flexible intramedullary nails (FINs) are not to be used to fix femur fractures in patients > 50 kg (110 lbs). However, studies have not examined the efficacy of this technique in overweight and obese patients who may be under this 'weight cutoff'. The purpose of this study was to assess how patient body mass index (BMI) impacts the treatment of paediatric femur fractures managed with FINs. METHODS: Retrospective data was collected on all paediatric patients treated with FINs for diaphyseal femur fractures at a single tertiary care institution over a ten-year period...
October 1, 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/29053500/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-femoral-shaft-fracture-pearls-and-pitfalls
#2
J Eric Gordon, Charles T Mehlman
Pediatric femoral shaft fractures present many challenging patient care decisions. Nonoperative treatment approaches still dominate care of the youngest age groups while surgical intervention is commonplace in virtually all older children. Treatment is determined primarily by patient age as modified by clinical factors including mechanism of injury, weight, and skeletal maturity. Infants can be successfully treated by placement into a Pavlik harness, whereas children younger than 5 years are most commonly treated by early reduction and spica cast immobilization...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28817981/the-use-of-flexible-intramedullary-nails-in-limb-lengthening
#3
Arnold Popkov, Patrick Foster, Alexander Gubin, Dmitry Borzunov, Dmitry Popkov
Lower and upper limb length discrepancy and deformity, congenital or acquired, are amongst the most common conditions in children for orthopaedic referral. Over the last twenty years, surgical techniques have evolved in an attempt to decrease Healing Index and minimise these complications. Areas covered: The flexible intramedullary nailing (FIN) is a minimally invasive intramedullary osteosynthesis. In combination with an external fixator, it is appropriated for pediatric bone lengthenings and lengthening of bones of small diameter in adults...
September 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28817534/radius-regeneration-after-open-fracture-and-extrusion-a-case-report
#4
Kristopher B McCall, David Y Chong
A pediatric patient presenting with an open forearm fracture with segmental defect is rare, and the pediatric orthopedic literature to guide treatment is sparse. There are several described methods to treat the defect, including bone grafting and bone transport techniques. In addition, there are reports of fibular regeneration after resection if the periosteum is left intact. We present a case report of complete regeneration of over half of a pediatric radial shaft with an intact periosteum, after traumatic extrusion from an open fracture...
August 16, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28777276/redefining-optimal-nail-to-medullary-canal-diameter-ratio-in-stainless-steel-flexible-intramedullary-nailing-of-pediatric-femur-fractures
#5
James S Shaha, Jason M Cage, Sheena R Black, Robert L Wimberly, Steven H Shaha, Anthony I Riccio
PURPOSE: The ideal canal fill for flexible intramedullary fixation of pediatric femoral shaft fractures is considered to be 80% based upon relatively few clinical studies. The purpose of this study is to assess the relationship between the summed nail to intramedullary canal diameter (ND/MCD) ratio and alignment at radiographic union following flexible intramedullary nailing (FIMN) of pediatric femoral shaft fractures. METHODS: An Internal Review Board approved, retrospective review of a consecutive series of patients who sustained a femoral shaft fracture treated by retrograde, stainless steel FIMN was performed at a single level 1 pediatric trauma center from 2005 to 2012...
October 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28742328/attachable-pulse-sensors-integrated-with-inorganic-optoelectronic-devices-for-monitoring-heart-rates-at-various-body-locations
#6
Juho Kim, Namyun Kim, Minjeong Kwon, Jongho Lee
Monitoring cardiovascular signals such as heart rate and blood flow provides critically important healthcare information about patients under medical care. However, when the sensors are worn for extended times, the sensors sometimes require higher mechanical compatibility with soft deformable tissues. In this paper, we report an attachable and flexible pulse sensor (bending radius: 2.4 mm), integrated with micro-inorganic photodetectors (thickness: 4.1 μm, photocurrent: 8.99 μA under 1.5 mW/cm(2)) and a red light emitting diode (620 nm), to monitor vital signals for extended times...
August 9, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28720982/single-incision-pediatric-flexible-intramedullary-tibial-nailing
#7
John G Coury, Zachary C Lum, Nicholas P O'Neill, Joseph A Gerardi
BACKGROUND: There has been a trend towards flexible intramedullary nailing for unstable tibial shaft fractures in the pediatric population, traditionally, utilizing a 2-incision technique with passage of one nail medially and one nail laterally. Our study aims to compare a single incision approach for flexible nailing of unstable tibial shaft fractures in pediatric patients to the traditional 2-incision approach. METHODS: Patients were selected for operative fixation if they had a length unstable tibial shaft fracture confirmed by fluoroscopy...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28719990/radiographic-and-clinical-assessment-of-intramedullary-nail-fixation-for-the-treatment-of-unstable-metacarpal-fractures
#8
Ather Mirza, Justin Mirza, Chris Healy, Vishaaq Mathew, Brian Lee
BACKGROUND: The purpose of the article was to evaluate clinical and radiographic outcomes in a case series of unstable metacarpal fractures treated with flexible intramedullary nail (IMN) fixation. METHODS: A total of 55 patients with unstable metacarpal fractures between 2003 and 2010 were treated with IMN fixation and followed for a minimum of 1 year. The outcomes were assessed via a radiological study of longitudinal and angular collapse, Disabilities of the Arm, Shoulder, and Hand (DASH) score, total active range of motion (ROM) of the wrist, and grip strength testing...
March 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28719546/fracture-table-application-for-pediatric-femur-fractures-incidence-and-risk-factors-associated-with-adverse-outcomes
#9
Brian A Kelly, Manahil Naqvi, Emily S Rademacher, Patricia E Miller, Daniel J Hedequist, Michael P Glotzbecker, Travis H Matheney, Benjamin J Shore
BACKGROUND: Flexible elastic nails, submuscular plating, and rigid locked intramedullary nails are common methods of fixation for pediatric femur fractures (PFF) in which the fracture table is used to aid reduction. Little is known about complications associated with fracture table application in PFF. The purpose of this study was to determine the incidence and risk factors associated with adverse outcomes related to fracture table application for the treatment of PFF. METHODS: A retrospective chart review of all children (younger than 18 y) treated for a femur fracture with the use of the fracture table between 2004 and 2015 at a single tertiary pediatric hospital was performed...
July 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28645423/a-technique-for-extraction-of-the-distal-segment-of-a-broken-femoral-nail-using-a-flexible-reamer
#10
C Zhao, G J R Slater
INTRODUCTION: Extraction of broken femoral nails in peri-implant fractures is becoming an increasingly common problem faced by orthopaedic surgeons. Different closed and open techniques for removal of broken nails have been previously described but due to variations in equipment and fracture configurations these methods are not always easily reproducible. We describe an open surgical technique using simple equipment that can be utilised when other methods of extraction have failed. CASE PRESENTATION AND SURGICAL TECHNIQUE: We present a case of a peri-implant fracture secondary to non-union involving a short cephalomedullary nail where the broken distal segment of nail was significantly more distal to the femoral fracture site...
August 2017: Injury
https://www.readbyqxmd.com/read/28630854/stacked-flexible-nailing-for-radius-ulna-fractures-revival-of-a-lost-technique
#11
Qaed Dhariwal, Parvez Inamdar, Pankush Arora, Ashok Shyam
INTRODUCTION: Simultaneous radius and ulna fractures are common in adults and generally osteosynthesis with plating is the treatment of choice. Nailing of such fractures is infrequently advocated. We present our unique technique of radius ulna nailing in adults to achieve closed reduction and early predictable union with minimal or no complications. CASE REPORT: Case 1: 22 year old male with midshaft both bones forearm fracture was treated with stacked nailing. Two 2...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28499812/modeling-of-the-interaction-between-grip-force-and-vibration-transmissibility-of-a-finger
#12
John Z Wu, Daniel E Welcome, Thomas W McDowell, Xueyan S Xu, Ren G Dong
It is known that the vibration characteristics of the fingers and hand and the level of grip action interacts when operating a power tool. In the current study, we developed a hybrid finger model to simulate the vibrations of the hand-finger system when gripping a vibrating handle covered with soft materials. The hybrid finger model combines the characteristics of conventional finite element (FE) models, multi-body musculoskeletal models, and lumped mass models. The distal, middle, and proximal finger segments were constructed using FE models, the finger segments were connected via three flexible joint linkages (i...
May 9, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28467335/fifth-metacarpal-neck-fractures-fixation-with-antegrade-locked-flexible-intramedullary-nailing
#13
Francesco Pogliacomi, Elisabetta Mijno, Alesssio Pedrazzini, Silvio Tocco, Massimo Tonani, Francesco Ceccarelli, Enrico Vaienti
BACKGROUND: Fifth metacarpal neck fractures (commonly named "boxer's fractures") are the most common metacarpal injuries and usually affect young active people. These lesions are mainly treated conservatively. Their surgical management, if indicated, is still a matter of debate. Different procedures have been described. The aim of this study was to evaluate the outcomes of 18 boxer's fractures which were synthesized with antegrade locked flexible intramedullary nailing. MATERIALS AND METHODS: All patients, at a mean follow-up of 45 months, were clinically evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score and the Patient Rated Wrist/Hand Evaluation (PRWHE)...
April 28, 2017: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/28415456/osteoinductive-composite-coatings-for-flexible-intramedullary-nails
#14
E N Bolbasov, A V Popkov, D A Popkov, E N Gorbach, I A Khlusov, A S Golovkin, A Sinev, V M Bouznik, S I Tverdokhlebov, Y G Anissimov
This work presents composite coatings based on a copolymer of vinylidene fluoride with tetrafluoroethylene (VDF-TeFE) and hydroxyapatite (HA) for flexible intramedullary nails (FIN). The effect of the proportion of VDF-TeFE (100-25% wt.) on physicochemical and biological properties of the composite coatings was investigated. It was shown that a decrease of VDF-TeFE in the coating hinders its crystallization in β and γ forms which have piezoelectric properties. The decrease also reduces an adhesive strength to 9...
June 1, 2017: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/28399048/pediatric-femoral-shaft-fractures-a-multicenter-review-of-the-aaos-clinical-practice-guidelines-before-and-after-2009
#15
John D Roaten, Derek M Kelly, Joseph L Yellin, John M Flynn, Micaela Cyr, Sumeet Garg, Alexander Broom, Lindsay M Andras, Jeffrey R Sawyer
BACKGROUND: To determine if the AAOS clinical practice guidelines (CPG) for the treatment of pediatric femoral shaft fractures (2009) changed treatment, we analyzed pediatric femoral shaft fractures at 4 high-volume, geographically separated, level-1 pediatric trauma centers over a 10-year period (2004 to 2013). METHODS: Consecutive series of pediatric femoral shaft fractures (ages, birth to 18 y) treated at the 4 centers were reviewed. Treatment methods were analyzed by age and treatment method for each center and in aggregate...
April 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28330797/flexible-intramedullary-nailing-for-treatment-of-proximal-humeral-and-humeral-shaft-fractures-in-children-a-retrospective-series-of-118-cases
#16
Z Pogorelić, S Kadić, K P Milunović, I Pintarić, M Jukić, D Furlan
BACKGROUND: The aim of this study was to analyze outcomes of treatment and complications in children treated with flexible intramedullary nailing (FIN) due to humeral fracture. HYPOTHESIS: The FIN for treatment of humeral fractures in children would allow an early functional and cast-free follow-up with a quick pain reduction and low complication rate. PATIENTS AND METHODS: From May 2002 until May 2016 case records of all children who underwent fixation with titanium intramedullary nails because of humeral fracture were retrospectively reviewed...
March 19, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28261435/flexible-intramedullary-nailing-of-forearm-fractures-at-the-distal-metadiaphyseal-junction-in-adolescents
#17
Byung Sung Kim, Yong Sung Lee, Sung Yong Park, Jae Hwi Nho, Sun Geun Lee, Young Hwan Kim
BACKGROUND: The purpose of this study was to analyze the radiographic and functional outcomes of flexible intramedullary (IM) nailing in adolescent patients with forearm fractures at the diaphysis or at the metadiaphyseal junction (MDJ). METHODS: We retrospectively reviewed the results of 40 patients who underwent IM nailing for pediatric forearm fractures. Thirty males and 10 females were followed for an average of 16 months (range, 12 to 20 months). Their average age was 11 years (range, 10 to 16 years)...
March 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28180118/spontaneous-hemarthrosis-of-the-knee-late-complication-of-flexible-femur-nailing-a-case-report
#18
Indranil V Kushare, Matthew E Oetgen, Suzanne J Walters
We present a case report of acute spontaneous knee hemarthosis due to erosion of the nail through the knee joint capsule in a boy, seven months following retrograde flexible nailing for fractured femur. Careful positioning of the location of the insertion site of flexible nails and proper nail tip management are important to avoid this rare late complication.
September 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28153480/radiographic-predictors-of-symptomatic-screw-removal-after-retrograde-femoral-nail-insertion
#19
Max Hamaker, Nathan N O'Hara, W Andrew Eglseder, Marcus F Sciadini, Jason W Nascone, Robert V O'Toole
INTRODUCTION: Removal of symptomatic implants is a common procedure performed by orthopaedic trauma surgeons. No guidance is available regarding which factors contribute to the likelihood of an implant becoming symptomatic. Our objective was to determine whether radiographic parameters associated with distal interlocks in retrograde femoral nails are associated with the rate of symptomatic screw removal. PATIENTS AND METHODS: We conducted a retrospective review at a Level I trauma center...
January 6, 2017: Injury
https://www.readbyqxmd.com/read/28150088/neurocognitive-findings-in-onychophagia-pathological-nail-biting
#20
Austin W Blum, Sarah A Redden, Jon E Grant
A notable number of people struggle to control the desire to bite their nails, resulting in impairment and distress. Understanding this behavior and the inability to control it has received little research attention. One possible mechanism to understand nail biting is through the use of neurocognitive assessments. Neurocognitive assessments of pathological nail biting, however, are lacking. This analysis assesses the clinical presentation and neurocognitive profile of adults with nail biting relative to participants without nail biting...
February 1, 2017: Psychiatric Quarterly
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