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Proximal tibia fracture

Richard S Yoon, Frank A Liporace
Intramedullary nail and plate combination techniques have been described mostly for use in the proximal tibia. However, the nail and plate combination technique can also be used in the distal tibia, to counteract the deforming forces that cause construct failure and nonunion. In this article, we review pertinent anatomy and biomechanics and offer case examples that highlight the indications and applications of the nail and plate combination technique for distal tibia fractures.
November 2016: Journal of Orthopaedic Trauma
Utku Kandemir, Safa Herfat, Mary Herzog, Paul Viscogliosi, Murat Pekmezci
OBJECTIVES: The goal of this study is to compare the fatigue strength of a locking intramedullary nail (LN) construct to a double locking plate (DLP) construct in comminuted proximal extra-articular tibia fractures. METHODS: Eight pairs of fresh frozen cadaveric tibias with low bone mineral density (Age: 80 ± 7 (SD) years, T-score: -2.3 ± 1.2) were used. One tibia from each pair was fixed with LN while the contralateral side was fixed with DLP for complex extra-articular multifragmentary, metaphyseal fractures (simulating OTA41-A3...
October 7, 2016: Journal of Orthopaedic Trauma
Ahmed Hamed Kassem Abdelaal, Norio Yamamoto, Katsuhiro Hayashi, Akihiko Takeuchii, Hiroyuki Tsuchiyai
INTRODUCTION: Leiomyoma is benign smooth-muscle tumor most commonly arising in the uterus, the gastrointestinal tract, and the skin. Leiomyomata are infrequently seen in the extremities and rarely seen in the bone. It is usually presented by a gradually increasing pain with nonspecific radiological findings, and could be a differential diagnosis for wide range of bone tumors. CASE PRESENTATION: We report a case of a 73-year-old Japanese female patient with a painful intraosseous leiomyoma involving the proximal tibia...
April 2016: Journal of Orthopaedic Case Reports
Matthew R Moralle, Nicholas D Stekas, Mark C Reilly, Michael S Sirkin, Mark R Adams
INTRODUCTION: Chronic osteomyelitis is a disease that requires fastidious treatment to eliminate. However, when eradication is unable to be achieved through exhaustive modalities of antibiotic therapy and multiple debridements, significant resection of the infected bone and soft tissue must be considered, including amputation. Here we report of a salvage procedure for chronic osteomyelitis of the left tibia by employing a rotationplasty to avoid an above knee amputation and instead provide the patient with a below knee amputation...
April 2016: Journal of Orthopaedic Case Reports
Vincenzo Giordano, Joseph Schatzker, Mauricio Kfuri
High-energy fractures of the proximal tibia with extensive fragmentation of the posterior rim of the tibial plateau are challenging. This technique aims to describe a method on how to embrace the posterior rim of the tibial plateau by placing a horizontal precontoured one-third tubular plate wrapped around its corners. This method, which we named "hoop plating," is mainly indicated for cases of crushed juxta-articular rim fractures, aiming to restore cortical containment of the tibial plateau. Through a lateral approach with a fibular head osteotomy (Lobenhoffer approach), both anterolateral and posterolateral fragments are directly reduced and supported by a one-third tubular plate of adequate length...
September 29, 2016: Journal of Knee Surgery
Salvi Prat, Santiago Gallardo-Villares, Marian Vives, Ana Carreño, Marta Caminal, Irene Oliver-Vila, Daniel Chaverri, Margarita Blanco, Margarita Codinach, Pere Huguet, José Ramírez, Javier A Pinto, Màrius Aguirre, Ruth Coll, Joan Garcia-López, Fernando Granell-Escobar, Joaquim Vives
Pseudoarhtrosis is a relatively frequent complication of fractures, in which the lack of mechanical stability and biological stimuli results in the failure of bone union, most frequently in humerus and tibia. Treatment of recalcitrant pseudoarthrosis relies on the achievement of satisfactory mechanical stability combined with adequate local biology. Herein we present two cases of atrophic pseudoarthrosis that received a Tissue Engineering Product (TEP) composed of autologous Bone Marrow-derived Mesenchymal Stromal Cells (BM-MSC) combined with deantigenised trabecular bone particles from tissue bank...
September 29, 2016: Journal of Tissue Engineering and Regenerative Medicine
W Z Meng, Y J Guo, Z K Liu, Y F Li, G Z Wang
Objective: To investigate the influencing factors for trauma-induced tibial infection in underground coal mine. Methods: A retrospective analysis was performed for the clinical data of 1 090 patients with tibial fracture complicated by bone infection who were injured in underground coal mine and admitted to our hospital from January 1995 to August 2015, including the type of trauma, injured parts, severity, and treatment outcome. The association between risk factors and infection was analyzed. Results: Among the 1 090 patients, 357 had the clinical manifestations of acute and chronic bone infection, 219 had red and swollen legs with heat pain, and 138 experienced skin necrosis, rupture, and discharge of pus...
July 20, 2016: Chinese Journal of Industrial Hygiene and Occupational Diseases
Hesham Saleh, Stephen Yu, Jonathan Vigdorchik, Ran Schwarzkopf
AIM: To review and report functional outcomes, complications, and survivorship associated with total knee arthroplasty (TKA) in the treatment of post-traumatic arthritis (PTA). METHODS: We conducted a systematic review according to the PRISMA guidelines. We searched PubMed, Cochrane Library, and SCOPUS in December 2015 for English-language clinical research studies, both prospective and retrospective, examining the use of TKA for the treatment of PTA. All relevant articles were accessed in full...
September 18, 2016: World Journal of Orthopedics
C J Tan, K A Johnson
OBJECTIVE: To report the clinical outcomes and complications of small animals that had articular or periarticular fractures or osteotomies stabilised with a notched head locking T-plate. METHODS: Medical records were searched retrospectively to identify animals that had a notched head locking T-plate used to stabilise a small articular or periarticular bone fragment. RESULTS: Nine dogs and two cats had an articular or periarticular bone fragment stabilised with a 2...
October 2016: Australian Veterinary Journal
Paul J Switaj, Daniel Fuchs, Mohammed Alshouli, Avinash G Patwardhan, Leonard I Voronov, Muturi Muriuki, Robert M Havey, Anish R Kadakia
BACKGROUND: A lateral approach with open reduction and internal fixation with a plate is a very effective technique for the majority of distal fibular fractures. However, this open approach for ankle fixation may be complicated by wound dehiscence and infection, especially in high-risk patients. An alternative to plating is an intramedullary implant, which allows maintenance of length, alignment, and rotation and which allows for decreased soft tissue dissection. While there has been clinical data suggesting favorable short-term outcomes with these implants, there is no current biomechanical literature investigating this technology in this particular fracture pattern...
2016: Journal of Orthopaedic Surgery and Research
Axel Somersalo, Juha Paloneva, Hannu Kautiainen, Eija LÖNnroos, Mikko HEinÄNen, Ilkka Kiviranta
Background and purpose - The association between mortality and lower extremity fractures (other than hip fractures in older individuals) is unclear. We therefore investigated mortality in adults of all ages after lower extremity fractures that required inpatient care. Patients and methods - Diagnosis code (ICD10), procedure code (NOMESCO), and 7 additional characteristics of patients admitted to the trauma ward at Central Finland Hospital were collected between 2002 and 2008 (n = 3,567). Patients were followed up until the end of 2012...
September 12, 2016: Acta Orthopaedica
Shafagh Monazzam, Parker B Goodell, Edgardo S Salcedo, Sandahl H Nelson, Philip R Wolinsky
BACKGROUND: Computed tomography Angiogram (CTA) is frequently utilized to detect vascular injuries even without exam findings indicating a vascular injury. We had the following hypotheses: 1) a CTA for lower extremity fractures with no clinical signs of a vascular injury is not indicated. 2) fracture location and pattern would correlate with the risk of a vascular injury. METHODS: A retrospective review was conducted on patients who had an acute lower extremity fracture(s) and a CTA...
September 16, 2016: Journal of Trauma and Acute Care Surgery
Donlaporn Kittivanichhkul, Narattaphol Charoenphandhu, Phisit Khemawoot, Suchinda Malaivijitnond
Since the in vitro and in vivo anti-osteoporotic effects of Pueraria mirifica (PM) in rodents have been verified, its activity in menopausal monkeys was evaluated as required before it can be applicable for human use. In this study, postmenopausal osteoporotic monkeys were divided into two groups (five per group), and fed daily with standard diet alone (PMP0 group) or diet mixed with 1,000 mg/kg BW of PM powder (PMP1000 group) for 16 months. Every two months, the bone mineral density (BMD), bone mineral content (BMC) and bone geometry parameters (cortical area and thickness, and periosteal and endosteal circumference) at the distal radius and proximal tibia were determined using peripheral quantitative computed tomography together with plasma and urinary bone markers...
September 6, 2016: Journal of Endocrinology
Justin Brantley, Aditi Majumdar, J Taylor Jobe, Antony Kallur, Christina Salas
BACKGROUND: Percutaneous pin fixation is often used in conjunction with closed-reduction and cast immobilization to treat pediatric distal tibia fractures. The goal of this procedure is to maintain reduction and provide improved stabilization, in effort to facilitate a more anatomic union. We conducted a biomechanical study of the torsional and bending stability of three commonly used pin configurations in distal tibia fracture fixation. METHODS: A transverse fracture was simulated at the metaphyseal/diaphyseal junction in 15 synthetic tibias...
2016: Iowa Orthopaedic Journal
Mohammad Gharedaghi, Mohammad Taghi Peivandi, Mehdi Mazloomi, Hasan Rahimi Shoorin, Mohammad Hasani, Parham Seyf, Fatemeh Khazaee
BACKGROUND: Massive bone allograft is an option in cases of limb preservation and reconstruction after massive benign and malignant bone tumor resection. The purpose of this study was to analyze the outcome of these procedures at Imam Reza Hospital, Mashhad University of Medical Sciences. METHODS: In this study, 113 cases have been presented. Eleven cases were excluded (patients has a traumatic defect or they passed away before the completion of the study's two-year follow up period)...
June 2016: Archives of Bone and Joint Surgery
J T Schousboe, O Riekkinen, J Karjalainen
: Pulse-echo ultrasonometry can be used as a pre-screen for hip osteoporosis before dual-energy x-ray absorptiometry (DXA), potentially allowing DXA to be avoided for the majority of post-menopausal women. Pulse-echo ultrasound measures of tibia cortical thickness are also associated with radiographically confirmed prior fractures, independent of femoral neck bone mineral density. INTRODUCTION: To estimate how well a pulse-echo ultrasound device discriminates those who have from those who do not have hip osteoporosis (femoral neck bone mineral density [BMD] or total hip BMD T-score ≤ -2...
August 4, 2016: Osteoporosis International
Gaetano Caruso, Emanuele Gerace, Vincenzo Lorusso, Rosario Cultrera, Loredana Moretti, Leo Massari
BACKGROUND: Chronic osteomyelitis is a challenging problem, and malignant transformation is a rare occurrence. We report a case of a patient with squamous cell carcinoma arising from an osteomyelitic hotbed and discuss through a literature review the etiopathogenesis, diagnosis, and treatment of this lesion. CASE PRESENTATION: A 69-year-old Italian man had sustained an exposed tibial fracture 40 years ago during a road accident, for which he had undergone various surgical osteosynthesis treatments with multiple antibiotic therapies...
2016: Journal of Medical Case Reports
Rodolfo Zamora, Craig Wright, Adam Short, David Seligson
: Intramedullary nailing is one viable option for treating fractures of the tibia with a short, proximal segment. For a procedure being carried out with the knee in a semi-extended position, either a suprapatellar or parapatellar approach may be used. The objective of this study is to demonstrate whether the entry point for tibia nails is obtainable through suprapatellar or parapatellar approaches and to evaluate the most frequent injuries of the knee with these two approaches. MATERIALS AND METHODS: Paired legs from 10 fresh frozen cadavers were used...
October 2016: Injury
Robert Probe
Over recent years, orthopaedic traumatologists have been gaining experience with tibial nailing in the extended position. Originally developed to address the complexities of alignment in proximal tibial fractures, this technique has also proven valuable in the treatment of tibial shaft fractures combined with ankle injuries. Depicted in this video presentation is the surgical techniques used to simultaneously address a spiral fracture of the distal tibia associated with a large coronal plane fracture of the tibial articular surface...
August 2016: Journal of Orthopaedic Trauma
Mark E Hake, James A Goulet
Posteromedial fractures of the tibial plateau are often encountered after high-energy injuries. They can be seen in isolation or in combination with lateral column fractures. These fractures must be recognized and stabilized independently of any lateral sided fracture to ensure the stability of the final construct. First described in 1997, the Lobenhoffer approach provides access to the posteromedial and posterior aspects of the proximal tibia, allowing for reduction and stabilization of fractures in this location with a posteromedial plate...
August 2016: Journal of Orthopaedic Trauma
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