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Proximal tibia fracture

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https://www.readbyqxmd.com/read/29786151/time-dependent-loss-of-trabecular-bone-in-human-tibial-plateau-fractures
#1
Lucian Bogdan Solomon, David Kitchen, Paul Hamill Anderson, Dongqing Yang, Yolandi Starczak, Masakazu Kogawa, Egon Perilli, Peter Jonathan Smitham, Mark Sean Rickman, Dominic Thewlis, Gerald James Atkins
We investigated if time between injury and surgery affects cancellous bone properties in patients suffering tibial plateau fractures (TPF), in terms of structural integrity and gene expression controlling bone loss. A cohort of 29 TPF, operated 1-17 days post-injury, had biopsies from the fracture and an equivalent contralateral limb site, at surgery. Samples were assessed using micro-computed tomography and real-time RT-PCR analysis for the expression of genes known to be involved in bone remodeling and fracture healing...
May 22, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29785447/posterior-cortical-breakage-leads-to-posterior-tibial-slope-change-in-lateral-hinge-fracture-following-opening-wedge-high-tibial-osteotomy
#2
Sung-Sahn Lee, Kyung-Wook Nha, Dae-Hee Lee
PURPOSE: This study was designed to analyze the relationship between changes in posterior tibial slope and the absence or presence of lateral hinge fracture, diagnosed in the sagittal and axial planes, as well as the coronal plane, by computed tomography (CT) following opening wedge high tibial osteotomy (HTO). METHODS: This study involved 55 patients (55 knees) undergoing opening wedge HTO for primary medial osteoarthritis. Lateral hinge fractures were evaluated on CT scans according to the Takeuchi classification and were also classified as subtypes A, B, and C, depending on anterior, posterior, and both anterior and posterior cortical disruptions, respectively, as determined by the sagittal and axial planes of CT scans which corresponded to the fracture line visible on coronal CT scans...
May 21, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/29776736/trabecular-bone-score-at-the-distal-femur-and-proximal-tibia-in-individuals-with-spinal-cord-injury
#3
Stacey Lobos, Anne Cooke, Gillian Simonett, Chester Ho, Steven K Boyd, W Brent Edwards
Rapid declines in bone mineral density (BMD) at the knee after spinal cord injury (SCI) are associated with an increased risk of fracture. Evaluation of bone quality using the trabecular bone score (TBS) may provide a complimentary measure to BMD assessment to examine bone health and fracture risk after SCI. The purpose of this study was to assess bone mineral density (BMD) and trabecular bone score (TBS) at the knee in individuals with and without SCI. Nine individuals with complete SCI (mean time since SCI 2...
April 24, 2018: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/29751130/association-of-high-resolution-peripheral-quantitative-computed-tomography-hr-pqct-bone-microarchitectural-parameters-with-previous-clinical-fracture-in-older-men-the-osteoporotic-fractures-in-men-mros-study
#4
Howard A Fink, Lisa Langsetmo, Tien N Vo, Eric S Orwoll, John T Schousboe, Kristine E Ensrud
High-resolution peripheral quantitative computed tomography (HR-pQCT) assesses both volumetric bone mineral density (vBMD) and trabecular and cortical microarchitecture. However, studies of the association of HR-pQCT parameters with fracture history have been small, predominantly limited to postmenopausal women, often performed limited adjustment for potential confounders including for BMD, and infrequently assessed strength or failure measures. We used data from the Osteoporotic Fractures in Men (MrOS) study, a prospective cohort study of community-dwelling men aged ≥65 years, to evaluate the association of distal radius, proximal (diaphyseal) tibia and distal tibia HR-pQCT parameters measured at the Year 14 (Y14) study visit with prior clinical fracture...
May 8, 2018: Bone
https://www.readbyqxmd.com/read/29748140/bone-microarchitecture-of-the-tibial-plateau-in-skeletal-health-and-osteoporosis
#5
Matthias Krause, Jan Hubert, Simon Deymann, Alexander Hapfelmeier, Birgit Wulff, Andreas Petersik, Klaus Püschel, Michael Amling, Thelonius Hawellek, Karl-Heinz Frosch
BACKGROUND: Impaired bone structure poses a challenge for the treatment of osteoporotic tibial plateau fractures. As knowledge of region-specific structural bone alterations is a prerequisite to achieving successful long-term fixation, the aim of the current study was to characterize tibial plateau bone structure in patients with osteoporosis and the elderly. METHODS: Histomorphometric parameters were assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT) in 21 proximal tibiae from females with postmenopausal osteoporosis (mean age: 84...
May 7, 2018: Knee
https://www.readbyqxmd.com/read/29737558/risk-of-injury-to-the-sural-nerve-during-posterolateral-approach-to-the-distal-tibia-an-ultrasound-simulation-study
#6
Ewa Mizia, Przemysław A Pękala, Piotr Chomicki-Bindas, Wojciech Marchewka, Marios Loukas, Alexander G Zayachkowski, Krzysztof A Tomaszewski
Introduction When surgeons operate on the foot and ankle, the most common complication that may arise is injury of the cutaneous nerves. The sural nerve (SN) is potentially at risk of being injured when treating fractures involving the distal tibia using the posterolateral approach. The aim of this study was to evaluate how differences in length and position of the surgical treatment of fractures involving the distal tibia can affect the risk of SN injury. Materials and Methods The study involved 40 healthy volunteers (n=80 lower limbs)...
May 8, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29721763/optimization-of-a-closed-rat-tibial-fracture-model
#7
Kareem Obayes Handool, Sahar Mohammed Ibrahim, Ubedullah Kaka, Muhammad Aarif Omar, Jalila Abu, Md Sabri Mohd Yusoff, Loqman Mohamad Yusof
BACKGROUND: The use of a closed fracture model has become the preferred model to study the fracture healing process, given that the periosteum and the soft tissue surrounding the fracture site play an important role in the fracture healing process. Some techniques like osteotomy, drilling the long bones and the use of the guillotine-like apparatus to induce fracture are characterized by some undesirable effects and complications. The aim of this study is to optimize and evaluate an in vivo fracture model using three-point bending pliers that can be used to study secondary bone fracture healing in rats...
May 2, 2018: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/29700856/defining-the-width-of-the-normal-tibial-plateau-relative-to-the-distal-femur-critical-normative-data-for-identifying-pathologic-widening-in-tibial-plateau-fractures
#8
Adam M Johannsen, Austin M Cook, Michael Gardner, Julius A Bishop
INTRODUCTION: Tibial plateau widening in the setting of fracture is an indication for surgical treatment, and restoring width is an important goal of surgery. In order to identify and correct pathological widening, the width of the normal tibial plateau must first be defined. The aim of this study was to establish normative data for the width of the tibial plateau relative to the distal femur to enable surgeons to identify and correct pathological widening in the setting of tibial plateau fracture...
April 26, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29679256/biomechanical-features-of-six-design-of-the-delta-external-fixator-for-treating-pilon-fracture-a-finite-element-study
#9
Muhammad Hanif Ramlee, Mohd Ayub Sulong, Evelyn Garcia-Nieto, Daniel Angure Penaranda, Antonio Ros Felip, Mohammed Rafiq Abdul Kadir
Pilon fractures can be caused by high-energy vertical forces which may result in long-term patient immobilization. Many experts in orthopedic surgery recommend the use of a Delta external fixator for type III Pilon fracture treatment. This device can promote immediate healing of fractured bone, minimizing the rate of complications as well as allowing early mobilization. The characteristics of different types of the Delta frame have not been demonstrated yet. By using the finite element method, this study was conducted to determine the biomechanical characteristics of six different configurations (Model 1 until Model 6)...
April 21, 2018: Medical & Biological Engineering & Computing
https://www.readbyqxmd.com/read/29667926/proximal-tibia-stress-fracture-with-osteoarthritis-of-knee-radiological-and-functional-analysis-of-one-stage-tka-with-long-stem
#10
Dhanasekaran Soundarrajan, Natesan Rajkumar, Palanisamy Dhanasekararaja, Shanmuganathan Rajasekaran
INTRODUCTION: Proximal tibia stress fractures with knee osteoarthritis pose a challenging situation. We evaluated the radiological and functional outcome of one-stage total knee arthroplasty (TKA) and long stem for patients with varied grades of knee arthritis and proximal tibia stress fractures.  Methods: We analysed 20 patients from April 2012 to March 2017 with proximal tibia stress fractures associated with knee osteoarthritis of varied grades. Out of 20 patients, five were acute fresh fractures...
2018: SICOT-J
https://www.readbyqxmd.com/read/29662767/reconstruction-of-the-lateral-tibia-plateau-fracture-with-a-third-triangular-support-screw-a-biomechanical-study
#11
Eduardo Moran, Ivan Zderic, Kajetan Klos, Paul Simons, Miguel Triana, R Geoff Richards, Boyko Gueorguiev, Mark Lenz
Background: Split fractures of the lateral tibia plateau in young patients with good bone quality are commonly treated using two minimally invasive percutaneous lag screws, followed by unloading of the knee joint. Improved stability could be achieved with the use of a third screw inserted either in the jail-technique fashion or with a triangular support screw configuration. The aim of this study was to investigate under cyclic loading the compliance and endurance of the triangular support fixation in comparison with the standard two lag-screw fixation and the jail technique...
October 2017: Journal of Orthopaedic Translation
https://www.readbyqxmd.com/read/29625505/proximal-versus-distal-recipient-vessels-in-lower-extremity-reconstruction-a-retrospective-series-and-systematic-review
#12
John T Stranix, Zachary M Borab, William J Rifkin, Adam Jacoby, Z-Hye Lee, Lavinia Anzai, Daniel J Ceradini, Vishal Thanik, Pierre B Saadeh, Jamie P Levine
BACKGROUND:  Recipient vessels proximal to the zone of injury have traditionally been preferred for lower extremity reconstruction. However, more recent data have shown mixed outcomes when performing anastomoses distal to the zone of injury. We investigated the impact of recipient vessel location on free flap outcomes. METHODS:  Retrospective review (1979-2016); 312 soft tissue free flaps for open tibia fractures met inclusion criteria. Flap characteristics and perioperative outcomes were examined...
April 6, 2018: Journal of Reconstructive Microsurgery
https://www.readbyqxmd.com/read/29604557/headless-compression-screw-for-horizontal-medial-malleolus-fractures
#13
Robin Z Cheng, Adam M Wegner, Anthony W Behn, Derek F Amanatullah
BACKGROUND: Horizontal medial malleolus fractures are caused by the application of rotational force through the ankle joint in several orientations. Multiple techniques are available for the fixation of medial malleolar fractures. METHODS: Horizontal medial malleolus osteotomies were performed in eighteen synthetic distal tibiae and randomized into two fixation groups: 1) two parallel unicortical cancellous screws or 2) two Acutrak 2 headless compression screws...
March 27, 2018: Clinical Biomechanics
https://www.readbyqxmd.com/read/29564297/treatment-of-proximal-femur-osteomyelitis-occurred-after-proximal-femoral-nail-antirotation-fixation-with-antibiotic-cement-coated-tibia-intramedullary-nail-a-case-report
#14
Jong Ho Noh, Sung Jun Koh, Kee Haeng Lee
Antibiotic cement-coated intramedullary nails maintain a locally high antibiotic concentration while contributing to bone stability. We present a case of femoral subtrochanteric fracture in a patient with an infected nonunion who was successfully treated for an infection and nonunion using an antibiotic cement-coated tibial intramedullary nail. A 79-year-old woman with a right femoral subtrochanteric fracture underwent internal fixation using proximal femoral nail antirotation (PFNA). She developed osteomyelitis with nonunion at the surgical site 10 months postoperatively...
March 2018: Hip & Pelvis
https://www.readbyqxmd.com/read/29549568/cozen-s-deformity-resolved-by-guided-growth
#15
Matthew Morin, Joshua Klatt, Peter M Stevens
Proximal tibial metaphyseal fractures in children can lead to progressive and symptomatic tibial valgus. Corrective osteotomy has been abandoned, due to frequent complications, including recurrent valgus deformity. While spontaneous remodelling has been reported, this is not predictable. For children with persistent deformities, we have resorted to guided growth of the tibia. We present 19 patients who were successfully treated with guided growth, tethering the proximal medial physis. There were ten boys and nine girls, ranging in age from two to 13...
March 16, 2018: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/29541618/trabecular-bone-microstructure-is-impaired-in-the-proximal-femur-of-human-immunodeficiency-virus-infected-men-with-normal-bone-mineral-density
#16
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
https://www.readbyqxmd.com/read/29514377/proximal-tibial-fractures-in-the-pediatric-population
#17
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
https://www.readbyqxmd.com/read/29510693/biomechanical-efficacy-of-ap-pa-lag-screws-and-posterior-plating-for-fixation-of-posterior-malleolar-fractures-a-three-dimensional-finite-element-study
#18
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
https://www.readbyqxmd.com/read/29503014/high-incidence-of-screw-penetration-in-the-proximal-and-distal-tibiofibular-joints-after-intramedullary-nailing-of-tibial-fractures-a-prospective-cohort-and-mapping-study
#19
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...
April 2018: Injury
https://www.readbyqxmd.com/read/29484074/bilateral-trampoline-fracture-of-the-proximal-tibia-in-a-child
#20
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
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