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pilon tibial fractures

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https://www.readbyqxmd.com/read/28540568/-tibial-pilon-fractures-advoidance-and-therapy-of-complications
#1
REVIEW
Ralph Gaulke, Christian Krettek
Because of the complex fracture morphology and vulnerable soft tissue coverage, fractures of the tibial pilon are difficult to treat. Complications are more common than in bi- or trimalleolar fractures. The surgeon has to know about the special risks of these injuries to avoid complications. Early complications are soft tissue necrosis, persisting fragment dislocations after surgery, loss of reposition and deep wound infection. The surgeon has to be aware of early signs of compartment-syndrome and chronic regional pain syndrome (CRPS)...
May 24, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28458472/plating-of-pilon-fractures-based-on-the-orientation-of-the-fibular-shaft-component-a-biomechanical-study-evaluating-plate-stiffness-in-a-cadaveric-fracture-model
#2
Gennadiy A Busel, J Tracy Watson
OBJECTIVES: To evaluate mechanically superior method of pilon fracture fixation by comparing axial stiffness between anterolateral and medial tibial locking plates in a cadaveric fracture model. METHODS: Eight matched pairs of fresh frozen cadaver specimens (lower limb after through-knee disarticulation) were used to eliminate confounder of bone quality. Simulated pilon fractures were created so that each pair represented either varus or valgus fracture pattern (AO 43-A2) with associated fibular fractures (transverse or comminuted)...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28365069/quality-of-life-and-prognostic-factors-after-intra-articular-tibial-pilon-fracture
#3
Jorge De-Las-Heras-Romero, Ana M Lledo-Alvarez, Alejandro Lizaur-Utrilla, Fernando A Lopez-Prats
BACKGROUND: Intra-articular tibial plafond fractures are a challenge for the surgeon with generally poor functional outcomes. The purpose was to assess the impact of this injury on patient quality of life (QOL), as well as analyzed the predictor factors. METHODS: Retrospective study of 47 patients with mean age of 44.4 (range 18-79) years. Patients were also invited for new clinical and radiological assessments. QOL was evaluated by the Short Form-36 questionnaire and compared to the standard in the age-matched general population...
March 22, 2017: Injury
https://www.readbyqxmd.com/read/28337901/cardiopathy-and-osteoporosis-the-epidemiology-in-a-region-of-italy
#4
A Notarnicola, G Maccagnano, L Moretti, S Tafuri, B Moretti
Cardiopathies and osteoporosis are inter-related due to pathogenetic, hormonal, genetic features as well as an increased risk of fragility. An important feature is attributed to the process of atherosclerosis, which is responsible for an osteopenia effect and degeneration of vascular walls. To date the study populations have been limited. To verify the incidence of cardio-vascular disease in a larger osteoporotic population, we designed a retrospective clinical study analyzing the “Hospital Discharge Data” (HDD) in Apulia between 2006 and 2010...
January 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28323798/supplemental-perioperative-oxygen-to-reduce-surgical-site-infection-after-high-energy-fracture-surgery-oxygen-study
#5
Robert V OʼToole, Manjari Joshi, Anthony R Carlini, Robert A Sikorski, Armagan Dagal, Clinton K Murray, Michael J Weaver, Ebrahim Paryavi, Alec C Stall, Daniel O Scharfstein, Julie Agel, Mary Zadnik, Michael J Bosse, Renan C Castillo
Supplemental perioperative oxygen (SPO) therapy has been proposed as one approach for reducing the risk of surgical site infection (SSI). Current data are mixed regarding efficacy in decreasing SSI rates and hospital inpatient stays in general and few data exist for orthopaedic trauma patients. This study is a phase III, double-blind, prospective randomized clinical trial with a primary goal of assessing the efficacy of 2 different concentrations of perioperative oxygen in the prevention of SSIs in adults with tibial plateau, pilon (tibial plafond), or calcaneus fractures at higher risk of infection and definitively treated with plate and screw fixation...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323797/local-antibiotic-therapy-to-reduce-infection-after-operative-treatment-of-fractures-at-high-risk-of-infection-a-multicenter-randomized-controlled-trial-vanco-study
#6
Robert V OʼToole, Manjari Joshi, Anthony R Carlini, Clinton K Murray, Lauren E Allen, Daniel O Scharfstein, Joshua L Gary, Michael J Bosse, Renan C Castillo
A number of clinical studies in the spine literature suggest that the use of local vancomycin powder may substantially reduce surgical site infections (SSIs). These studies are primarily retrospective and observational and few focus on orthopaedic trauma patients. This study is a phase III, prospective, randomized, clinical trial to assess the efficacy of locally administered vancomycin powder in the prevention of SSI after fracture surgery. The primary goal of the VANCO Study is to compare the proportion of deep SSI 6 months after fracture fixation surgery...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28323767/how-to-get-to-the-distal-posterior-tibial-malleolus-a-cadaveric-anatomic-study-defining-the-access-corridors-through-3-different-approaches
#7
Mathieu Assal, Miki Dalmau-Pastor, Adrien Ray, Richard Stern
OBJECTIVE: Our objective is to review the anatomy and exposure of the posterior column and posterior tibial malleolus (the posterior tibial plafond) by defining the access corridors through 3 different approaches-posteromedial, posterolateral, and modified posteromedial. METHODS: Cadaveric dissection with percentage of posterior tibial malleolus exposed, and strain gauge measurements to evaluate traction on the neurovascular bundle. RESULTS: The 3 different approaches are applicable for exposure of different portions of the distal posterior tibial malleolus...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28288519/evaluation-of-fibular-fracture-type-vs-location-of-tibial-fixation-of-pilon-fractures
#8
Gennadiy A Busel, J Tracy Watson, Heidi Israel
BACKGROUND: Comminuted fibular fractures can occur with pilon fractures as a result of valgus stress. Transverse fibular fractures can occur with varus deformation. No definitive guide for determining the proper location of tibial fixation exists. The purpose of this study was to identify optimal plate location for fixation of pilon fractures based on the orientation of the fibular fracture. METHODS: One hundred two patients with 103 pilon fractures were identified who were definitively treated at our institution from 2004 to 2013...
March 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28167059/primary-arthrodesis-for-tibial-pilon-fractures
#9
REVIEW
Bryant Ho, John Ketz
Staged primary ankle arthrodesis is a viable option for high-energy pilon fractures that are nonreconstructible, in patients with delay in treatment or multiple medical comorbidities, or in patients with peripheral neuropathy. Small retrospective series demonstrate high union and low wound complication rates, although further studies are needed to determine the long-term results. Ankle arthrodesis offers decreased complication rates while eliminating the potential of posttraumatic ankle arthritis pain.
March 2017: Foot and Ankle Clinics
https://www.readbyqxmd.com/read/28159051/an-uncommon-case-of-irreducible-ankle-fracture-dislocation-the-bosworth-like-tibio-fibular-fracture
#10
Michele Cappuccio, Danilo Leonetti, Berardo Di Matteo, Domenico Tigani
An irreducible ankle-fracture dislocation characterized by the dislocation of the proximal fragment of the fibula posteriorly to the tibial tubercle is defined as "Bosworth injury". In the present report it is described, for the first time in literature, a complex case where the Bosworth injury was associated to a tibial plafond fracture: the proximal fibular fragment was entrapped between the tibial pilon and the fractured posterior tibial tubercle, which acted as a clamp, thus avoiding ankle reduction. Due to the presence of the tibial fracture, it was not possible to observe the typical radiological signs of Bosworth injury and therefore two unsuccessful reductions were attempted before performing a CT scan that revealed the complexity of the case, that required an immediate ORIF procedure to prevent the onset of complications...
March 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28090442/can-mri-accurately-detect-pilon-articular-malreduction-a-quantitative-comparison-between-ct-and-3t-mri-bone-models
#11
Shairah Radzi, Constantin Edmond Dlaska, Gary Cowin, Mark Robinson, Jit Pratap, Michael Andreas Schuetz, Sanjay Mishra, Beat Schmutz
BACKGROUND: Pilon fracture reduction is a challenging surgery. Radiographs are commonly used to assess the quality of reduction, but are limited in revealing the remaining bone incongruities. The study aimed to develop a method in quantifying articular malreductions using 3D computed tomography (CT) and magnetic resonance imaging (MRI) models. METHODS: CT and MRI data were acquired using three pairs of human cadaveric ankle specimens. Common tibial pilon fractures were simulated by performing osteotomies to the ankle specimens...
December 2016: Quantitative Imaging in Medicine and Surgery
https://www.readbyqxmd.com/read/27942740/primary-ankle-arthrodesis-for-severely-comminuted-tibial-pilon-fractures
#12
Mohamed E Al-Ashhab
Management of severely comminuted, complete articular tibial pilon fractures (Rüedi and Allgöwer type III) remains a challenge, with few treatment options providing good clinical outcomes. Twenty patients with severely comminuted tibial pilon fractures underwent primary ankle arthrodesis with a retrograde calcaneal nail and autogenous fibular bone graft. The fusion rate was 100% and the varus malunion rate was 10%. Fracture union occurred at a mean of 16 weeks (range, 13-18 weeks) postoperatively. Primary ankle arthrodesis is a successful method for treating highly comminuted tibial pilon fractures, having a low complication rate and a high satisfaction score...
March 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/27917329/minimally-invasive-treatment-of-tibial-pilon-fractures-through-arthroscopy-and-external-fixator-assisted-reduction
#13
Huasong Luo, Liaobin Chen, Kebin Liu, Songming Peng, Jien Zhang, Yang Yi
OBJECTIVE: The aim of this study was to evaluate the clinical outcome of tibial pilon fractures treated with arthroscopy and assisted reduction with an external fixator. METHODS: Thirteen patients with tibial pilon fractures underwent assisted reduction for limited lower internal fixation with an external fixator under arthroscopic guidance. The weight-bearing time was decided on the basis of repeat radiography of the tibia 3 months after surgery. Postoperative ankle function was evaluated according to the Mazur scoring system...
2016: SpringerPlus
https://www.readbyqxmd.com/read/27891412/revisited-a-prospective-study-on-functional-outcome-of-internal-fixation-of-tibial-pilon-fractures-with-locking-plate-using-mipo
#14
Rashid Anjum, Vikas Choudhary, Vivek Sharma
No abstract text is available yet for this article.
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27872380/management-of-distal-tibial-metaphyseal-bone-defects-with-an-intramedullary-nitinol-scaffold-a-novel-technique
#15
Samuel E Ford, J Kent Ellington
Difficult problems that are faced when reconstructing severe pilon fractures include filling metaphyseal defects and supporting an impacted, multifragmented articular surface. Supplements to plate fixation currently available in a surgeon's armamentarium include cancellous bone autograft, structural bone allograft, demineralized bone matrix, and calcium-based cements. Cancellous autograft possesses limited inherent mechanical stability and is associated with graft site morbidity. Structural allografts incorporate inconsistently and are plagued by late resorption...
November 20, 2016: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27870672/the-clinical-and-economic-impact-of-generic-locking-plate-utilization-at-a-level-ii-trauma-center
#16
Austin Mcphillamy, Taylor P Gurnea, Alastair E Moody, Christopher G Kurnik, Minggen Lu
OBJECTIVES: In today's climate of cost containment and fiscal responsibility, generic implant alternatives represent an interesting area of untapped resources. As patents have expired on many commonly used trauma implants, generic alternatives have recently become available from a variety of sources. The purpose of this study was to examine the clinical and economic impact of a cost containment program using high quality, generic orthopaedic locking plates. The implants available for study were anatomically precontoured plates for the clavicle, proximal humerus, distal radius, proximal tibia, distal tibia, and distal fibula...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27797787/re-evaluation-of-low-intensity-pulsed-ultrasound-in-treatment-of-tibial-fractures-trust-randomized-clinical-trial
#17
RANDOMIZED CONTROLLED TRIAL
Jason W Busse, Mohit Bhandari, Thomas A Einhorn, Emil Schemitsch, James D Heckman, Paul Tornetta, Kwok-Sui Leung, Diane Heels-Ansdell, Sun Makosso-Kallyth, Gregory J Della Rocca, Clifford B Jones, Gordon H Guyatt
OBJECTIVE:  To determine whether low intensity pulsed ultrasound (LIPUS), compared with sham treatment, accelerates functional recovery and radiographic healing in patients with operatively managed tibial fractures. DESIGN:  A concealed, randomized, blinded, sham controlled clinical trial with a parallel group design of 501 patients, enrolled between October 2008 and September 2012, and followed for one year. SETTING:  43 North American academic trauma centers...
October 25, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27780508/external-fixation-versus-open-reduction-and-internal-fixation-for-tibial-pilon-fractures-a-meta-analysis-based-on-observational-studies
#18
COMPARATIVE STUDY
Yi-Chen Meng, Xu-Hui Zhou
PURPOSE: Tibial pilon fractures remain challenging for an orthopaedic surgeon to repair. External fixation (ExFix) and open reduction and internal fixation (ORIF) are two widely used methods for repairing tibial pilon fractures. However, conclusions of comparative studies regarding which method is superior are controversial. Our aim is to compare ORIF and ExFix and clarify which method is better in terms of reduction and union results and major complications. METHODS: A computerized research of MEDLINE, EMBASE, Springer, and Cochrane Library (before December 2014) for studies of any design comparing ORIF and ExFix was conducted...
October 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/27768658/the-military-orthopedic-trauma-registry-the-potential-of-a-specialty-specific-process-improvement-tool
#19
Jessica C Rivera, Renee M Greer, Mary Ann Spott, Anthony E Johnson
BACKGROUND: The Military Orthopaedic Trauma Registry (MOTR) was designed to replicate the Department of Defense Trauma Registry's (DoDTR's) role as pillar for data-driven management of extremity war wounds. The MOTR continuously undergoes quality assurance checks to optimize the registry data for future quality improvement efforts. We conducted a quality assurance survey of MOTR entrants to determine if a simple MOTR data pull could provide robust orthopedic-specific information toward the question of causes for late amputation...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27763960/does-a-staged-posterior-approach-have-a-negative-effect-on-ota-43c-fracture-outcomes
#20
Daniel S Chan, Paul M Balthrop, Brian White, David Glassman, Roy W Sanders
OBJECTIVE: To determine whether multiple approaches pose an increased risk to fracture healing when compared with a standard single approach in the treatment of pilon (OTA 43C) fractures. DESIGN: Retrospective review of a prospective database. SETTING: Level I academic trauma center and level II community trauma center. METHODS: From January 1, 2005 to December 31, 2011, all records of patients treated for OTA 43C fractures of the distal tibia were reviewed...
February 2017: Journal of Orthopaedic Trauma
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