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Proximal tibia fracture

Galateia J Kazakia, Julio Carballido-Gamio, Andrew Lai, Lorenzo Nardo, Luca Facchetti, Courtney Pasco, Chiyuan A Zhang, Misung Han, Amanda Hutton Parrott, Phyllis Tien, Roland Krug
Background: There is evidence that human immunodeficiency virus (HIV) infection and antiretroviral therapy (ART) are independent risk factors for osteoporosis and fracture which is not solely explained by changes in bone mineral density. Thus, we hypothesized that the assessment of trabecular microstructure might play an important role for bone quality in this population and might explain the increased fracture risk. In this study, we have assessed bone microstructure in the proximal femur using high-resolution magnetic resonance imaging (MRI) as well as in the extremities using high resolution peripheral quantitative computed tomography (HR-pQCT) in HIV-infected men and healthy controls and compared these findings to those based on areal bone mineral density (aBMD) derived from dual X-ray absorptiometry (DXA) which is the standard clinical parameter for the diagnosis of osteoporosis...
February 2018: Quantitative Imaging in Medicine and Surgery
Kali Tileston, Steven Frick
Injuries about the proximal tibia are quite common in children. Understanding the mechanisms of injury and treatment strategies is imperative for practitioners caring for these patients. Similarly, appreciating the anatomy of the proximal tibia and the adjacent neurovascular structures can assist a practitioner in recognizing the potential associated risks following fracture. Patients with injuries about the proximal tibia require long-term follow-up, and knowledge of the natural history of these fractures is imperative...
March 7, 2018: Journal of Knee Surgery
Adeel Anwar, Zhen Zhang, Decheng Lv, Gang Lv, Zhi Zhao, Yanfeng Wang, Yue Cai, Wasim Qasim, Muhammad Umar Nazir, Ming Lu
BACKGROUND: Clinically there are different fixation methods used for fixation of the posterior malleolar fractures (PMF), but the best treatment modality is still not clear. Few studies have concentrated on this issue, least of all using a biomechanical comparison. The purpose of this study was to carry out a computational comparative biomechanics of three different commonly used fixation constructs for the fixation of PMF by finite element analysis (FEA). METHODS: Computed tomography (CT) images were used to reconstruct three dimensional (3D) model of the tibia...
March 6, 2018: BMC Musculoskeletal Disorders
Megan E Cain, Job N Doornberg, Robin Duit, Jock Clarnette, Ruurd Jaarsma, Bhavin Jadav
BACKGROUND: Intramedullary-nails (IMN) are the treatment of choice for most tibial shaft fractures due to their minimally-invasive nature and non-demanding surgical technique. However, a potential iatrogenic pitfall is intra-articular interlocking screw positioning within the proximal (PTFJ) and distal (DTFJ) tibiofibular joints that may go unrecognized. OBJECTIVE: To evaluate the incidence of intra-articular screw penetration of the PTFJ and DTFJs after interlocking of IMN for tibial fractures...
March 1, 2018: Injury
Enrico B Arkink, Annelies van der Plas, Ruth W Sneep, Monique Reijnierse
Trampoline fractures are transversely oriented impaction fractures of the proximal tibia sustained by young children jumping on a trampoline. Unaware of the mechanism of this specific nontraumatic fracture, physicians may fail to detect these fractures on plain radiographs, as radiological findings may be very subtle. In this case report, we present a rare case of bilateral trampoline fractures with an explanation of the trauma mechanism.
December 2017: Radiology Case Reports
Manoj Kumar, Ravisha Wadhwa, Priyanka Kothari, Ritu Trivedi, Divya Vohora
Evidence from several studies indicates that the long-term treatment of selective serotonin reuptake inhibitors (SSRIs) is associated with a decrease in bone mass and increase the risk of fractures. The present work evaluated and compared the effect of treatment with two SSRIs viz. fluoxetine and escitalopram on bone biomarkers (P1NP and βCTX) in male Wistar rats. In addition, the effect of these drugs on bone microarchitecture of lumbar and tibia bones was carried out. Fluoxetine (8.2mg/kg) treatment for 40 days significantly reduced (P< 0...
February 19, 2018: European Journal of Pharmacology
Isabel R Orriss, Stuart Lanham, Dawn Savery, Nicholas D E Greene, Philip Stanier, Richard Oreffo, Andrew J Copp, Gabriel L Galea
Fractures are a common comorbidity in children with the neural tube defect (NTD) spina bifida. Mutations in the Wnt/planar cell polarity (PCP) pathway contribute to NTDs in humans and mice, but whether this pathway independently determines bone mass is poorly understood. Here, we first confirmed that core Wnt/PCP components are expressed in osteoblasts and osteoclasts in vitro. In vivo, we performed detailed µCT comparisons of bone structure in tibiae from young male mice heterozygous for NTD-associated mutations versus WT littermates...
February 20, 2018: Scientific Reports
Bin Yuan, Bao-Jian Ge, Bai-Yi Meng
Dislocation of proximal tibiofibular joint(PTFJ) is relatively infrequent in clinic, it can be either isolated or associated with tibia fracture, fibular fracture and ankle injury and so on. Chronic symptomatic PTFJ instability are easily mixed with meniscal tears. It was easily neglected because of the mild clinical presentation and atypical change on radiography. Early diagnosis and treatment are crucial to prevent chronic knee pain and instability. The paper concluded the anatomy, classification, complication, diagnosis, treatment, clinical effect and insufficient of the dislocation of PTFJ, to direct the diagnosis and treatment of proximal tibiofibular joint dislocation in clinical work...
October 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Andre M Samuel, Pablo J Diaz-Collado, Lauren K Szolomayer, Daniel H Wiznia, Wayne W Chan, Adam M Lukasiewicz, Bryce A Basques, Daniel D Bohl, Jonathan N Grauer
Proximal tibia fractures are associated with concurrent collateral ligament injuries. Failure to recognize these injuries may lead to chronic knee instability. The purpose of this study was to identify risk factors for concurrent collateral ligament injuries with proximal tibia fractures and their association with inpatient outcomes. A total of 32,441 patients with proximal tibia fractures were identified in the 2011-2012 National Trauma Data Bank. A total of 1445 (4.5%) had collateral ligament injuries, 794 (2...
February 16, 2018: Orthopedics
Zile Singh Kundu, Milind Tanwar, Parveen Rana, Rajeev Sen
Background: Primary benign and malignant tumors of the proximal fibula are not very common. Upper fibula being an expendable bone; the majority of the primary bone tumors at this site are usually treated with en bloc proximal fibulectomy. There is scarce literature on functional results, difficulties faced during dissection when to preserve or sacrifice common peroneal nerve and importance of lateral collateral ligament repair after proximal fibulectomy. The present study attempts at assessing these variables...
January 2018: Indian Journal of Orthopaedics
Ton Tran, Bernard K Chen, Xinhua Wu, Chung Lun Pun
BACKGROUND: Repair of peri-prosthetic proximal tibia fractures is very challenging in patients with a total knee replacement or arthroplasty. The tibial component of the knee implant severely restricts the fixation points of the tibial implant to repair peri-prosthetic fractures. A novel implant has been designed with an extended flange over the anterior of tibial condyle to provide additional points of fixation, overcoming limitations of existing generic locking plates used for proximal tibia fractures...
February 2, 2018: Injury
Sajal Chirvi, Frank Pintar, Narayan Yoganandan, Anjishnu Banerjee, Mike Schlick, William Curry, Liming Voo
Under body blast (UBB) loading to military transport vehicles is known to cause foot-ankle fractures to occupants due to energy transfer from the vehicle floor to the feet of the soldier. The soldier posture, the proximity of the event with respect to the soldier, the personal protective equipment (PPE) and age/sex of the soldier are some variables that can influence injury severity and injury patterns. Recently conducted experiments to simulate the loading environment to the human foot/ankle in UBB events (~5ms rise time) with variables such as posture, age and PPE were used for the current study...
November 2017: Stapp Car Crash Journal
Berna Okudan, Nazım Coşkun, Pelin Arıcan
Stress fractures are injuries most commonly seen in the lower limbs and are usually caused by repetitive stress. While the distal and middle third of the tibia is the most frequent site for stress fractures (almost 50%), stress fractures of the proximal tibia is relatively rare and could be confused with other types of tibial fractures, thus altering management plans for the clinician. Early diagnosis of stress fractures is also important to avoid complications. Imaging plays an important role in the diagnosis of stress fractures, especially bone scan...
February 1, 2018: Molecular Imaging and Radionuclide Therapy
Conglin Ye, Qi Lai, Shengtao Zhang, Tian Gao, Jin Zeng, Min Dai
RATIONALE: Osteopoikilosis is a rare and asymptomatic disease of the bone, which is often discovered occasionally on radiography for irrelevant complaints. Characterized by multiple, small, circular, or oval-shaped radiodense lesions, it may be confused with bony metastatic tumors. PATIENT CONCERNS: The present study describes a case of a 17-year-old adolescent who suffered from pain and movement limitation of his left thigh following a fall from standing height...
November 2017: Medicine (Baltimore)
Mihail-Lazar Mioc, Radu Prejbeanu, Bogdan Deleanu, Bogdan Anglitoiu, Horia Haragus, Marius Niculescu
Distal tibia fractures are reported to have a high complication rate pre-operatively as well as post-operatively, which can include open fractures, soft tissue damage, infection, malalignment, pseudarthrosis and ankle arthrosis. The operative treatment for the extra-articular distal tibia fractures is a controversial topic in the orthopaedic literature. Some of these fractures are proximal enough to be treated with an intramedullary nail while others are too distal for that. The aim of our study was to compare the results we have had with intramedullary nail (IMN) and minimally invasive plate osteosynthesis (MIPO) in distal metaphyseal (extra-articular) tibia fractures...
January 22, 2018: International Orthopaedics
Elliot R Row, Stephen Kottmeier, David E Komatsu, John T Watson, Clifford Jones
PURPOSE: We present a surgical strategy to manage multicolumnar tibial plateau fracture variants by addressing the predominant posterior fragment employing a Lobenhoffer approach in the prone position followed by supine patient repositioning for anterolateral column access. DESIGN: Multicenter retrospective analysis. SETTING: Three academic Level 1 trauma centers. PATIENTS/METHODS: Twenty-eight cases (28 patients/28 knees) met inclusion criteria between 2003 and 2014...
January 5, 2018: Journal of Orthopaedic Trauma
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
Fancheng Chen, Xiaowei Huang, Yingsun Ya, Fenfen Ma, Zhi Qian, Jifei Shi, Shuolei Guo, Baoqing Yu
BACKGROUND: Proximal tibia fractures are one of the most familiar fractures. Surgical approaches are usually needed for anatomical reduction. However, no single treatment method has been widely established as the standard care. Our present study aims to compare the stress and stability of intramedullary nails (IMN) fixation and double locking plate (DLP) fixation in the treatment of extra-articular proximal tibial fractures. METHODS: A three-dimensional (3D) finite element model of the extra-articular proximal tibial fracture, whose 2-cm bone gap began 7 cm from the tibial plateau articular surface, was created fixed by different fixation implants...
January 16, 2018: Journal of Orthopaedic Surgery and Research
Ejaz Afzal, Fatima Sherin, Omair Khan, Noaman Hussain Siddiqui
BACKGROUND: osteogenesis needs circulation of blood in the bones. Bone growth, repair of fracture, maintenance of bone vitality and other injures also need blood circulation in proper way. Blood is allowed to flow via holes in the diaphysis, which are called as nutrient foramina. METHODS: The crosssectional study was done in the department of Anatomy, Ayub and Khyber Medical College (Osteology Sections). The aim was to observe diaphyseal nutrient foramina in the human long bones of the lower limb...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
Weiwen Chen, Judy M Simpson, Lyn M March, Fiona M Blyth, Dana Bliuc, Thach Tran, Tuan V Nguyen, John A Eisman, Jacqueline R Center
BACKGROUND: Non-hip non-vertebral fractures (NHNV) constitute the majority of osteoporotic fractures but few studies have examined the association between these fractures, co-morbidity and mortality. OBJECTIVE: To examine the relationship between individual non-hip non-vertebral fractures, co-morbidities and mortality. METHODS: Prospective population-based cohort of 267,043 subjects (45 and Up Study, Australia) had baseline questionnaires linked to hospital administrative and all-cause mortality data from 2006 - 2013...
January 4, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
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