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Proximal tibia fracture

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https://www.readbyqxmd.com/read/28192826/the-management-of-bone-defects-in-periarticular-knee-injuries-a-review-article
#1
Brian Buck, Yvonne M Murtha
Traumatic bone defects of the distal femur and proximal tibia present treatment challenges for the orthopaedic traumatologist. In addition to bone loss, significant soft tissue compromise and cartilage defects leave the patient and surgeon with few reconstructive options for proper long-term joint function. These injuries are often complicated by delayed healing, nonunion, malunion, infection, and poor subjective patient outcomes. There are a variety of clinical problems associated with the treatment of periarticular fractures about the knee...
February 13, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28173978/the-effects-of-tibia-profile-distraction-angle-and-knee-load-on-wedge-instability-and-hinge-fracture-a-finite-element-study
#2
Pei-Wei Weng, Chia-Hsien Chen, Chu-An Luo, Jui-Sheng Sun, Yang-Hwei Tsuang, Cheng-Kung Cheng, Shang-Chih Lin
Several plate systems for high tibial osteotomy (HTO) have been developed to stabilize the opening wedge of an osteotomized tibia. Among them, the TomoFix system, having a quasi-straight and T-shaped design, has been widely adopted in the literature. However, this system is implemented by inserting a lag (i.e., cortical) screw through the proximal combi-hole, to deform the plate and pull the distal tibia toward the plate. This process potentially induces plate springback and creates an elastic preload on the osteotomized tibia, especially at the lateral hinge of the distracted wedge...
February 4, 2017: Medical Engineering & Physics
https://www.readbyqxmd.com/read/28167879/early-revision-surgery-for-tibial-plateau-non-union-and-mal-union
#3
Dominic L Van Nielen, Christopher S Smith, David L Helfet, Peter Kloen
BACKGROUND: Although relatively rare, non-unions and mal-unions of tibial plateau fractures present significant challenges for the orthopedic surgeon. With careful pre-operative planning, tibial plateau mal-union or non-union revision surgery with intra-articular and varus opening osteotomies can provides good functional results when performed early (within 1 year) after primary surgical procedure. QUESTIONS/PURPOSES: We present our treatment algorithm for approaching and treating non-union or mal-union of tibial plateau fractures...
February 2017: HSS Journal: the Musculoskeletal Journal of Hospital for Special Surgery
https://www.readbyqxmd.com/read/28129271/fatigue-failure-in-extra-articular-proximal-tibia-fractures-locking-intramedullary-nail-versus-double-locking-plates-a-biomechanical-study
#4
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 with 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, whereas the contralateral side was fixed with DLP for complex extra-articular multifragmentary metaphyseal fractures (simulating OTA 41-A3...
February 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28128005/isolated-metaphyseal-injury-influences-unrelated-bones
#5
Love Tätting, Olof Sandberg, Magnus Bernhardsson, Jan Ernerudh, Per Aspenberg
Background and purpose - Fracture healing involves different inflammatory cells, some of which are not part of the traditional bone field, such as B-cells and cytotoxic T-cells. We wanted to characterize bone healing by flow cytometry using 15 different inflammatory cell markers in a mouse model of metaphyseal injury, and incidentally discovered a previously unknown general skeletal reaction to trauma. Material and methods - A bent needle was inserted and twisted to traumatize the cancellous bone in the proximal tibia of C57/Bl6 female mice...
January 27, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28109138/adaptations-in-the-microarchitecture-and-load-distribution-of-maternal-cortical-and-trabecular-bone-in-response-to-multiple-reproductive-cycles-in-rats
#6
Chantal Mj de Bakker, Allison R Altman-Singles, Yihan Li, Wei-Ju Tseng, Connie Li, X Sherry Liu
Pregnancy, lactation, and weaning result in dramatic changes in maternal calcium metabolism. In particular, the increased calcium demand during lactation causes a substantial degree of maternal bone loss. This reproductive bone loss has been suggested to be largely reversible, as multiple clinical studies have found that parity and lactation history have no adverse effect on postmenopausal fracture risk. However, the precise effects of pregnancy, lactation, and post-weaning recovery on maternal bone structure are not well understood...
January 21, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28100198/mr-imaging-for-detection-of-trampoline-injuries-in-children
#7
E Hauth, H Jaeger, P Luckey, M Beer
BACKGROUND: The recreational use of trampolines is an increasingly popular activity among children and adolescents. Several studies reported about radiological findings in trampoline related injuries in children. The following publication presents our experience with MRI for detection of trampoline injuries in children. METHODS: 20 children (mean 9.2 years, range: 4-15 years) who had undergone an MRI study for detection of suspected trampoline injuries within one year were included...
January 18, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28057011/functional-and-radiological-outcomes-of-a-minimally-invasive-surgical-approach-to-monostotic-fibrous-dysplasia
#8
Mamer S Rosario, Katsuhiro Hayashi, Norio Yamamoto, Akihiko Takeuchi, Shinji Miwa, Yuta Taniguchi, Hiroyuki Tsuchiya
BACKGROUND: Reports showing high recurrence rates for intralesional curettage and bone grafting have made the current treatment principle for fibrous dysplasia controversial. This study aimed to report the postoperative clinical outcomes from three minimally invasive surgical strategies we use for monostotic fibrous dysplasia (MFD). PATIENTS AND METHODS: Twelve patients with MFD presenting with no pathologic fracture or deformity and treated with one of three surgical strategies-plain open biopsy, plain alpha-tricalcium phosphate (ATP) reconstruction, and prophylactic bridge plating-were included...
January 5, 2017: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28051829/apophyseal-and-epiphyseal-knee-injuries-in-the-adolescent-athlete
#9
P Persiani, F M Ranaldi, A Formica, M Mariani, O Mazza, M Crostelli, C Villani
OBJECTIVES: In the context of pediatric sports injuries, the epiphyseal and apophyseal knee fractures represent rather peculiar lesions. The most frequently involved anatomical area is the knee. The peculiar function of the physis and the need to preserve their integrity, makes choosing what treatment methods to employ very important. Objective of this study is to assess the kind and the effectiveness of the most suitable treatment in the apophyseal and epiphyseal knee lesions occurring in the adolescents...
November 2016: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28040091/reconstruction-of-patellar-tendon-following-implantation-of-proximal-tibia-megaprosthesis-for-the-treatment-of-post-traumatic-septic-bone-defects
#10
Giorgio M Calori, Emilio Luigi Mazza, Luca Vaienti, Simone Mazzola, Alessandra Colombo, Luca Gala, Massimiliano Colombo
INTRODUCTION: Latest advances made in joint replacement implants allows reconstruction of entire limbs. These special prostheses or megaprostheses were originally designed for the treatment of severe oncological bone loss. Nowadays, however, the indications and applications of these devices are expanding to other orthopaedic and trauma clinical conditions. Since 2008 we have implanted 152 megaprostheses in non-oncological conditions: 87 were implanted for post-traumatic failures aseptic/septic (represented by complex non-unions and critical size bone defects); 26 total femur, 52 distal femur and 9 proximal tibia...
December 2016: Injury
https://www.readbyqxmd.com/read/28032708/what-role-does-low-bone-mineral-density-play-in-the-killer-turn-effect-after-transtibial-posterior-cruciate-ligament-reconstruction
#11
Yue Li, Xing-Zuo Chen, Jin Zhang, Guan-Yang Song, Xu Li, Hua Feng
OBJECTIVE: To explore the mechanism of the "killer turn", which is reported to be a reason for postoperative residual laxity after transtibial posterior cruciate ligament (PCL) reconstruction, in a low bone mineral density (BMD) condition. METHODS: A total of 80 skeletally mature female New Zealand white rabbits were included for biomechanical evaluation after transtibial PCL reconstructions. The subjects were equally divided into low BMD (n = 40) and control groups (n = 40)...
November 2016: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28031518/arthroscopic-fixation-with-endobutton-for-tibial-eminence-fractures-visualised-through-a-proximal-superomedial-portal-a-surgical-technique
#12
Hitoshi Sekiya, Kenzo Takatoku, Akinori Kimura, Yuji Kanaya, Takashi Fukushima, Katsushi Takeshita
Most tibial eminence fractures are avulsion fractures of the anterior cruciate ligament (ACL) from its tibial insertion. This study describes a new arthroscopic technique using an additional proximal superomedial portal to visualise the tibial eminence fracture and to fix the fracture with the EndoButton to avoid the risk of fragment breakage. The proximal superomedial portal enables fracture reduction without damage to the intermeniscal ligament. Fixation with the EndoButton is strong enough to allow early rehabilitation with vigorous exercise...
December 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28029668/titanium-elastic-nailing-system-tens-for-tibia-fractures-in-children-functional-outcomes-and-complications
#13
K M Kc, P Acharya, A Sigdel
INTRODUCTION: Closed reduction and cast application is still regarded as first line treatment for pediatric tibial fractures. Over the past few decades, management of pediatric tibial fractures has shifted more towards operative intervention because of quicker recovery, shorter rehabilitation period, less immobilization, lack of stiffness of adjoining joints, and less psychological impact to the children. Flexible intramedullary nails not only fulfill the above advantage but also maintain alignment and rotation...
October 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/27989337/review-of-drop-hallux-assessment-and-surgical-repair
#14
Carl A Kihm, Craig A Camasta
Peroneal nerve palsy is common. The hallmark clinical manifestation of peroneal nerve palsy is drop foot. In the drop foot condition, the ankle cannot flex, and the foot does not clear the ground during the swing phase of gait. Spontaneous nerve repair can yield complete or incomplete resolution of drop foot. Some patients with incomplete resolution are left with a drop hallux condition, in which the ankle can dorsiflex, but the hallux remains unable to dorsiflex. This has not been thoroughly discussed in the past, regarding surgical repair...
January 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/27955656/means-of-enhancing-bone-fracture-healing-optimal-cell-source-isolation-methods-and-acoustic-stimulation
#15
Corina Adriana Ghebes, Maaike Vera Jasmijn Braham, Adelgunde Veronica Clemens Maria Zeegers, Auke Jan Sijbe Renard, Hugo Fernandes, Daniel B F Saris
BACKGROUND: The human body has an extensive capacity to regenerate bone tissue after trauma. However large defects such as long bone fractures of the lower limbs cannot be restored without intervention and often lead to nonunion. Therefore, the aim of the present study was to assess the pool and biological functions of human mesenchymal stromal cells (hMSCs) isolated from different bone marrow locations of the lower limbs and to identify novel strategies to prime the cells prior to their use in bone fracture healing...
December 12, 2016: BMC Biotechnology
https://www.readbyqxmd.com/read/27921146/bone-loss-at-the-distal-femur-and-proximal-tibia-in-persons-with-spinal-cord-injury-imaging-approaches-risk-of-fracture-and-potential-treatment-options
#16
REVIEW
C M Cirnigliaro, M J Myslinski, M F La Fountaine, S C Kirshblum, G F Forrest, W A Bauman
Persons with spinal cord injury (SCI) undergo immediate unloading of the skeleton and, as a result, have severe bone loss below the level of lesion associated with increased risk of long-bone fractures. The pattern of bone loss in individuals with SCI differs from other forms of secondary osteoporosis because the skeleton above the level of lesion remains unaffected, while marked bone loss occurs in the regions of neurological impairment. Striking demineralization of the trabecular epiphyses of the distal femur (supracondylar) and proximal tibia occurs, with the knee region being highly vulnerable to fracture because many accidents occur while sitting in a wheelchair, making the knee region the first point of contact to any applied force...
December 5, 2016: Osteoporosis International
https://www.readbyqxmd.com/read/27890690/successful-outcome-with-minimally-invasive-plate-osteosynthesis-for-periprosthetic-tibial-fracture-after-total-knee-arthroplasty
#17
H-J Kim, K-C Park, J-W Kim, C-W Oh, H-S Kyung, J-K Oh, K-H Park, S-D Yoon
INTRODUCTION: The incidence of periprosthetic fractures after total knee arthroplasty (TKA) is increasing, and treatment is becoming more necessary. In periprosthetic tibial fractures, the stem of the tibial component largely occupies the medullary canal of the proximal tibia, which limits the selection of implants. The purpose of this study was to evaluate the effectiveness of the minimally invasive plate osteosynthesis (MIPO) technique with locking plates for periprosthetic tibial fractures after TKA...
November 25, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27884644/evaluating-augmentation-with-calcium-phosphate-cement-chronos-inject-for-bone-defects-after-internal-fixation-of-proximal-tibial-fractures-a-prospective-multicenter-observational-study
#18
C W Oh, K C Park, Y H Jo
INTRODUCTION: Managing subchondral bone defects in proximal tibia fractures after plateau reduction is an important consideration. ChronOS Inject is a recently developed calcium phosphate bone substitute that shows relatively fast osteointegration. HYPOTHESIS: Using chronOS Inject during internal fixation of proximal tibial fractures provides a satisfactory treatment option that is both clinically and radiologically safe. PATIENTS AND METHODS: Patients enrolled in this study were treated with chronOS Inject bone void filler, during internal fixation of proximal tibial fractures...
November 21, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27882811/the-ao-pediatric-comprehensive-classification-of-long-bone-fractures-pccf-part-ii
#19
Alexander Joeris, Nicolas Lutz, Andrea Blumenthal, Theddy Slongo, Laurent Audigé
Background and purpose - To achieve a common understanding when dealing with long bone fractures in children, the AO Pediatric Comprehensive Classification of Long Bone Fractures (AO PCCF) was introduced in 2007. As part of its final validation, we present the most relevant fracture patterns in the lower extremities of a representative population of children classified according to the PCCF. Patients and methods - We included patients up to the age of 17 who were diagnosed with 1 or more long bone fractures between January 2009 and December 2011 at either of 2 tertiary care university hospitals in Switzerland...
November 24, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27870672/the-clinical-and-economic-impact-of-generic-locking-plate-utilization-at-a-level-ii-trauma-center
#20
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
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