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https://www.readbyqxmd.com/read/29342496/-adverse-events-in-the-treatment-of-periprosthetic-fractures-around-the-knee-a-clinical-and-radiological-outcome-analysis
#1
Anna Janine Schreiner, Christoph Gonser, Christoph Ihle, Max Konstantin Zauleck, Tim Klopfer, Fabian Stuby, Ulrich Stöckle, Björn Gunnar Ochs
BACKGROUND: The incidence of periprosthetic fractures associated with total knee arthroplasty (PpFxK) has been reported to be 0.3 - 5.5%. 40% of all cases are related to revision TKA. The most common localisation is the distal femur. Classification is performed according to Rorabeck (RB). RB I - II fractures are usually treated with locked plating and retrograde intramedullary nailing, whereas RB III fractures are an indication for revision arthroplasty using a hinged endoprosthesis...
January 17, 2018: Zeitschrift Für Orthopädie und Unfallchirurgie
https://www.readbyqxmd.com/read/29341846/primary-intra-medullary-nailing-of-open-tibia-fractures-caused-by-low-velocity-gunshots-does-operative-debridement-increase-infection-rates
#2
Chester J Donnally, Charles M Lawrie, Jonathan I Sheu, Meredith A Gunder, Stephen M Quinnan
BACKGROUND: Although gunshot-induced extremity fractures are typically not considered open fractures, there is controversy regarding wound management in the setting of operative fixation to limit infection complications. Previous studies have evaluated the need for a formal irrigation and debridement (I&D) prior to intra-medullary nailing (IMN) of gunshot-induced femur fractures but none have specifically evaluated tibias. By comparing primary IMN for tibial shaft fractures caused by low-velocity firearms additionally treated with a formal operative I&D (group 1) with those without an I&D (group 2), we sought to identify whether there are: differences in treatment group infection rates; particular fracture patterns more prone to infection; and patient characteristics more prone to infections...
January 17, 2018: Surgical Infections
https://www.readbyqxmd.com/read/29331010/implants-for-extracapsular-neck-of-femur-fracture-dynamic-hip-screw-versus-intramedullary-nailing
#3
Faisal Farooq Butt, Adnan Shabbair Hussain, Ahmed Mushtaq Khan, Maria Sultan
Neck of femur fractures are the most prevalent type of injury in elderly trauma patients. Both intra and extra capsular type of fractures are equally distributed in the given population. Traditionally, Extra capsular fractures are fixed with Dynamic Hip screw or Intra medullary nailing based on the type of fracture. NICE (National Institute of Clinical Excellence) recommends fixing 31-A1 and 31-A2 fractures with DHS (Dynamic Hip Screw) whereas AO recommends fixing 31-A1 with DHS and 31-A2.1 subtype with DHS and 31-A2...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29329171/nonhuman-primate-rhesus-macaque-models-of-severe-pressure-targeted-hemorrhagic-and-polytraumatic-hemorrhagic-shock
#4
Forest R Sheppard, Antoni R Macko, Jacob J Glaser, Philip J Vernon, Alexander J Burdette, Ruth Madelaine Paredes, Craig A Koeller, Anthony E Pusateri, Douglas K Tadaki, Sylvain Cardin
BACKGROUND: We endeavored to develop clinically translatable nonhuman primate (NHP) models of severe polytraumatic hemorrhagic shock. METHODS: NHPs were randomized into five severe pressure-targeted hemorrhagic shock (PTHS) ± additional injuries scenarios: 30-min PTHS (PTHS-30), 60-min PTHS (PTHS-60), PTHS-60 + soft tissue injury (PTHS-60+ST), PTHS-60+ST + femur fracture (PTHS-60+ST+FF), and decompensated PTHS+ST+FF (PTHS-D). Physiologic parameters were recorded and blood samples collected at five time points with animal observation through T = 24 h...
February 2018: Shock
https://www.readbyqxmd.com/read/29324632/chair-lift-falls-and-injuries-in-children
#5
Eric W Glissmeyer, Ryan R Metzger, Robert Bolte
OBJECTIVE: The objective of this study was to compare demographic injury and treatment characteristics of hospitalized pediatric cases of falls from chair lifts to cases of other ski and snowboarding injuries and identify potential interventions for preventing falls from chair lifts. METHODS: Retrospective query of the trauma registry of Utah's only pediatric trauma center for children younger than 18 years requiring hospitalization for a ski or snowboarding injury from November 2004 to February 2014...
January 11, 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29324528/titanium-elastic-nailing-has-superior-value-to-plate-fixation-of-midshaft-femur-fractures-in-children-5-to-11-years
#6
Jerad D Allen, Kevin Murr, Ferras Albitar, Cale Jacobs, Eric S Moghadamian, Ryan Muchow
BACKGROUND: American Academy of Orthopaedic Surgeons (AAOS) Clinical Practice Guidelines for pediatric femoral shaft fractures indicate titanium elastic nails (TENs) for children 5 to 11 years old. Growing evidence suggests these fractures may also be treated with open or submuscular plating. The purpose of this study was to compare estimated blood loss (EBL), operative time, fluoroscopy time, cost, and subjective and objective pain scores between TENs and plating techniques used in 5- to 11-year-old children with midshaft femur fractures based on length stability...
January 10, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29320924/a-model-to-evaluate-pauwels-type-iii-femoral-neck-fractures
#7
Kevin M Magone, Jonas K Owen, Bernard P Kemker, Oliver Bloom, Sidney Martin, Patrick Atkinson
While many femoral neck fractures can be reliably treated with surgical intervention, Pauwels III femoral neck fractures in the young adult population continue to be a challenging injury, and there is no consensus on optimal treatment. As such, there are past and ongoing biomechanical studies to evaluate the fixation provided by different constructs for this inherently unstable fracture. While many investigations rely on cadavers to evaluate the biomechanical performance of a construct, significant inter-subject variability can confound the analysis...
January 1, 2018: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/29318088/hoffa-fragments-in-the-geriatric-distal-femur-fracture-myth-or-reality
#8
Brian W Hill, Lisa K Cannada
Background: Previous research reported the frequency of coronal plane (Hoffa) fractures in high-energy supracondylar femur fractures in a relatively young population. It is the purpose of this study to identify the frequency of coronal plane fractures seen in elderly patients. Methods: All patients over the age of 18 years treated for supracondylar femur fractures at 2 level I trauma centers were reviewed over a 4-year period. The patients were stratified (≥60 years and <60 years) and compared to determine differences in injury characteristics and fracture patterns with special attention to the prevalence of coronal plane fractures...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29318081/-hidden-preoperative-blood-loss-with-extracapsular-versus-intracapsular-hip-fractures-what-is-the-difference
#9
Katharine D Harper, Paul Navo, Frederick Ramsey, Sainabou Jallow, Saqib Rehman
Purpose: Excessive blood loss with hip fracture management has been shown to result in increased rates of complications. Our goal is to compare blood loss and transfusion rates between patients with intracapsular and extracapsular (both intertrochanteric (IT) and subtrochanteric (ST)) hip fractures. Methods: 472 patients were evaluated over a five-year period. Those who presented to the hospital with a proximal femur fracture (femoral neck, IT or ST) were considered for the study...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29276733/decisive-differences-in-the-bone-repair-processes-of-the-metaphysis-and-diaphysis-in-young-mice
#10
Satoshi Inoue, Hirotada Otsuka, Jiro Takito, Masanori Nakamura
Fractures are common traumatic injuries that mainly occur in the metaphyses of long bones such as the proximal humerus, distal radius, and proximal femur. However, most studies of fracture repair processes have focused on the diaphyseal region. In this study, we compared the bone repair processes of the metaphysis and the diaphysis of the mouse tibia. Bone apertures were formed in the tibial metaphysis and diaphysis. At indicated times after surgery, samples were collected, and the healing process was investigated using micro-computed tomography, as well as histological, immunohistochemical, and mRNA expression analyses...
June 2018: Bone Reports
https://www.readbyqxmd.com/read/29261592/whole-blood-and-hextend-bookends-of-modern-tactical-combat-casualty-care-field-resuscitation-and-starting-point-for-multi-functional-resuscitation-fluid-development
#11
Forest R Sheppard, Thomas A Mitchell, Antoni R Macko, Darren M Fryer, Leasha J Schaub, Kassandra M Ozuna, Jacob J Glaser
BACKGROUND: Hemorrhage is the leading cause of preventable death in traumatically injured civilian and military populations. Pre-hospital resuscitation largely relies on crystalloid and colloid intra-vascular expansion, as whole blood and component blood therapy are logistically arduous. In this experiment, we evaluated the bookends of Tactical Combat Casualty Care Guidelines recommendations of pre-hospital resuscitation with Hextend and whole blood in a controlled hemorrhagic shock model within non-human primates, as means of a multi-functional resuscitative fluid development...
December 20, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29259232/cardiac-depression-in-pigs-after-multiple-trauma-characterization-of-posttraumatic-structural-and-functional-alterations
#12
M Kalbitz, S Schwarz, B Weber, B Bosch, J Pressmar, F M Hoenes, C K Braun, K Horst, T P Simon, R Pfeifer, P Störmann, H Hummler, F Gebhard, H C Pape, M Huber-Lang, F Hildebrand
The purpose of this study was to define the relationship between cardiac depression and morphological and immunological alterations in cardiac tissue after multiple trauma. However, the mechanistic basis of depressed cardiac function after trauma is still elusive. In a porcine polytrauma model including blunt chest trauma, liver laceration, femur fracture and haemorrhage serial trans-thoracic echocardiography was performed and correlated with cellular cardiac injury as well as with the occurrence of extracellular histones in serum...
December 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29250502/outcomes-of-cephalomedullary-nailing-in-basicervical-fracture
#13
Seok Hyun Kweon, Sung Hyun Lee, Seng Hwan Kook, Young Chae Choi
Purpose: A basicervical femoral fracture is defined as a fracture of base of neck of femur that occurs medially from intertrochanteric line above lesser trochanter. In this study, we intended to evaluate radiological and clinical results of basicervical femoral fractures treated by intramedullary nailing. Materials and Methods: Fifteen patients, who underwent intramedullary nailing among 50 patients, out of 50 who were diagnosed with basicervical femoral fractures from July 2012 to May 2015 were studied...
December 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/29247259/effect-of-sarcopenia-on-clinical-and-surgical-outcome-in-elderly-patients-with-proximal-femur-fractures
#14
Ching-Di Chang, Jim S Wu, Jennifer Ni Mhuircheartaigh, Marry G Hochman, Edward K Rodriguez, Paul T Appleton, Colm J Mcmahon
PURPOSE: To investigate the relationship between sarcopenia with short-term surgical outcome in elderly patients with proximal femur fractures. METHODS AND MATERIALS: Following Institutional Review Board approval, a database of patients receiving a pelvis CT scan for acute trauma between January 2000-August 2016 was screened for an isolated proximal femur fracture. Patients were excluded if they were: < 50 years old, had conditions predisposing to sarcopenia (renal failure, congestive heart failure, muscular dystrophies), had undergone no surgical treatment, had other major traumatic injuries, or had a pathologic femur fracture...
December 15, 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/29246715/comparable-cumulative-incidence-of-late-periprosthetic-femoral-fracture-and-aseptic-stem-loosening-in-uncemented-total-hip-arthroplasty-a-concise-follow-up-report-at-a-minimum-of-20-years
#15
Moritz M Innmann, Marcus R Streit, Thomas Bruckner, Christian Merle, Tobias Gotterbarm
BACKGROUND: There is a lack of long-term studies into the third decade reporting on the incidence of periprosthetic femoral fracture (PPFF) and aseptic stem loosening (ASL) after cementless total hip arthroplasty (THA). The aim of the present retrospective, longitudinal cohort study was to compare the cumulative incidence of PPFF and ASL in a consecutive cohort of 326 patients with 354 primary uncemented THAs after 20-25 years and to identify risk factors being associated with PPFFs. METHODS: Postoperative femoral fractures were investigated for timing, mechanism of injury, Vancouver classification, and subsequent treatment...
November 16, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29242788/obturator-dislocation-of-hip-with-ipsilateral-fracture-neck-femur-a-case-report
#16
Sumit Kumar Jain, Parit Aggarwal, Arun Yadav
Introduction: Traumatic dislocation of the hip with ipsilateral fracture neck femur is a rare injury because of the different mechanism of both these injuries. The management of such injuries is a challenge as the chances of nonunion and avascular necrosis of femoral head are very high with fixation methods. We report a case of obturator dislocation of the hip with ipsilateral fracture neck of the femur which was treated with uncemented total hip replacement. Case Report: A 32-year-old male sustained obturator dislocation with ipsilateral fracture neck femur following road traffic accident...
September 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29240544/expected-time-to-return-to-athletic-participation-after-stress-fracture-in-division-i-collegiate-athletes
#17
Timothy L Miller, Marissa Jamieson, Sonsecharae Everson, Courtney Siegel
BACKGROUND: Few studies have documented expected time to return to athletic participation after stress fractures in elite athletes. HYPOTHESIS: Time to return to athletic participation after stress fractures would vary by site and severity of stress fracture. STUDY DESIGN: Retrospective cohort study. LEVEL OF EVIDENCE: Level 3. METHODS: All stress fractures diagnosed in a single Division I collegiate men's and women's track and field/cross-country team were recorded over a 3-year period...
December 1, 2017: Sports Health
https://www.readbyqxmd.com/read/29229219/computer-assisted-navigation-for-intramedullary-nail-fixation-of-intertrochanteric-femur-fractures-a-randomized-controlled-trial
#18
Ryan J Lilly, Denise M Koueiter, Kelly C Graner, Gregory P Nowinski, Jason Sadowski, Kevin D Grant
INTRODUCTION: Lag screw cutout is one of the most commonly reported complications following intramedullary nail fixation of intertrochanteric femur fractures. However, its occurrence can be minimized by a well-positioned implant, with a short Tip-to-Apex Distance (TAD). Computer-assisted navigation systems provide surgeons with the ability to track screw placement in real-time. This could allow for improved lag screw placement and potentially reduce radiation exposure to the patient and surgeon...
December 7, 2017: Injury
https://www.readbyqxmd.com/read/29211870/osteonecrosis-of-the-jaw-and-rebound-hypercalcaemia-in-young-people-treated-with-denosumab-for-giant-cell-tumour-of-bone
#19
Suma Uday, Louie Gaston, Luke Rogers, Michael Parry, Johnathan Joffe, John Pearson, David Sutton, Robert Grimer, Wolfgang Högler
Context: Denosumab, an inhibitor of receptor activator of nuclear factor kappa-B ligand, is an approved treatment for giant cell tumour of bone (GCTB) in adults and 'skeletally mature' adolescents. Safety concerns include oversuppression of bone remodelling, with risk of osteonecrosis of the jaw [ONJ] and atypical femur fractures during treatment in adults, and rebound hypercalcaemia after treatment cessation in children. To date, ONJ has never been reported in children or adolescents...
December 1, 2017: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29208310/equivalent-mortality-and-complication-rates-following-periprosthetic-distal-femur-fractures-managed-with-either-lateral-locked-plating-or-a-distal-femoral-replacement
#20
Jason S Hoellwarth, Mitchell S Fourman, Lawrence Crossett, Mark Goodman, Peter Siska, Gele B Moloney, Ivan S Tarkin
INTRODUCTION: Management of distal femur fractures above total knee arthroplasty (TKA) remains challenging. Two common surgical options are locked lateral plating (LLP) and distal femoral arthroplasty (DFR). Unfortunately, approximately 30-50% of patients may die within one year of injury, require further surgery, or not regain prior mobility performance. We compared 87 LLP to 53 DFR patients - to our knowledge the largest comparative study - focusing on 90- and 365-day mortality, mobility maintenance, and further surgery...
December 1, 2017: Injury
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