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Mal union

Gautam J K Tawari, Rajan Maheshwari, Sanjeev S Madan
A good long-term outcome following a total knee arthroplasty relies on restoration of the mechanical axis and effective soft tissue balancing of the prosthetic knee. Arthroplasty surgery in patients with secondary osteoarthritis of the knee with an extra-articular tibial deformity is a complex and challenging procedure. The correction of mal-alignment of the mechanical axis is associated with unpredictable result and with higher revision rates. Single-staged deformity correction and replacement surgery often result in the use of constraint implants...
March 20, 2018: Strategies in Trauma and Limb Reconstruction
Ahmad Oryan, Mohamadreza Baghaban Eslaminejad, Amir Kamali, Samaneh Hosseini, Forough Azam Sayahpour, Hossein Baharvand
Critical-sized bone defects constitute a major health issue in orthopedics and usually cause mal-unions due to an inadequate number of migrated progenitor cells into the defect site or their incomplete differentiation into osteogenic precursor cells. The current study aimed to develop an optimized osteoinductive and angiogenic scaffold by incorporation of strontium (Sr) and bioglass (BG) into gelatin/nano-hydroxyapatite (G/nHAp) seeded with bone marrow mesenchymal stem cells to enhance bone regeneration. The scaffolds were fabricated by a freeze-drying technique and characterized in terms of morphology, structure, porosity and degradation rate...
February 21, 2018: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
Chunlin Zhang, Bingfang Zeng, Kunpeng Zhu, Lei Zhang, Jianping Hu
BACKGROUND: The treatment of malignant tumours of the distal tibia is a challenging surgical problem due to the scarce soft tissue coverage and the instability of the ankle joint that often occurs after resection. However, there is no consensus on the ideal treatment for malignant tumours of the distal tibia. METHODS: We report a new reconstruction for five patients with high-grade osteosarcoma of distal tibia, using dual ipsilateral vascularized autogenous fibular graft in a trapezoid-shaped array and external fixator, with ankle arthrodesis and preserving subtalar joints...
December 20, 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
M Zahid, E H Rashid, H Inam, A J Zubairi, N Baloch, P M Hashmi
Scapular fractures are rare injuries and usually occur due to high energy trauma. Displaced Intra articular fractures usually require operative treatment and yields better outcomes as compared to conservative management. To assess the functional and radiological outcomes of displaced intra-articular scapular fractures managed with open reduction and internal fixation. 12 patients were retrospectively reviewed and included in the study. Post-operative functional outcomes were assessed using mean quick DASH (Disability of arm, hand and shoulder) score while radiological outcomes were analyzed as percentage of implant cut-through, mal-union, non-union or infection...
March 2017: Acta Orthopaedica Belgica
Roberto Berebichez-Fridman, Pablo Montero-Olvera, Ricardo Gómez-García, Enrique Berebichez-Fastlicht
Among various infections, chronic osteomyelitis is one of the most challenging in terms of treatment. This infection is more common among patients with open fractures and those who have undergone elective orthopedic procedures. The treatment of osteomyelitis requires high antibiotic doses and an aggressive and multifaceted surgical approach. The use of parenteral antibiotics alone, without debridement, is not sufficiently effective, due to the formation of sequestra and the low vascularity of the affected area...
August 2017: Medical Hypotheses
(no author information available yet)
OBJECTIVE: To evaluate the clinical result of atlantoaxial reduction and fixation guided by the intraoperative CT. METHODS: Sixteen cases were retrospectively studied, including seven males and nine females, with the mean age of 49.9 years. Twelve cases were diagnosed as chronic atlantoaxial instability or dislocation, while four cases as acute odontoid fracture and dislocation. Among the sixteen cases, fourteen underwent atlantoaxial fusion, while two underwent temporary atlantoaxial fixation without fusion...
June 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
Hiroaki Inui, Katsuya Nobuhara
BACKGROUND: Nail protrusion is suspected as a reason for the restriction of arm elevation after antegrade nailing of proximal humeral fractures, although assessment of the restriction of the glenohumeral joint during arm elevation has been insufficient. METHODS: In this retrospective study, 30 shoulders with proximal humeral fractures in 29 cases were treated with Polarus short nails (Acumed, Beaverton, OR, USA). At a mean final follow-up of 14 months, clinical outcomes, bony union, alignment including retroversion of the head and entry points of the nails were evaluated...
April 2017: Shoulder & Elbow
Theodoros H Tosounidis, Hassaan Qaiser Sheikh, Nikolaos K Kanakaris, Peter V Giannoudis
OBJECTIVES: To analyse the complications and outcomes (functional/radiographic) of Pelvic External Fixators applied as part of the definitive fixation in polytrauma patients. DESIGN: A single center retrospective chart review. SETTING: A level-1 trauma center. PATIENTS AND METHODS: We reviewed all the polytrauma patients (ISS>16) between 2007 and 2012 that had a PEF applied more than 30days. Complications including infection, aseptic loosening, neurological injury, loss of reduction, non-union and mal-union were recorded...
March 24, 2017: Injury
Jose Luis Ramirez-GarciaLuna, Daniel Chan, Robert Samberg, Mira Abou-Rjeili, Timothy H Wong, Ailian Li, Thorsten B Feyerabend, Hans-Reimer Rodewald, Janet E Henderson, Paul A Martineau
In the adult skeleton, cells of the immune system interact with those of the skeleton during all phases of bone repair to influence the outcome. Mast cells are immune cells best known for their pathologic role in allergy, and may be involved in chronic inflammatory and fibrotic disorders. Potential roles for mast cells in tissue homeostasis, vascularization and repair remain enigmatic. Previous studies in combined mast cell- and Kit-deficient KitW-sh/W-sh mice (KitW-sh) implicated mast cells in bone repair but KitW-sh mice suffer from additional Kit-dependent hematopoietic and non- hematopoietic deficiencies that could have confounded the outcome...
2017: PloS One
Sanath Kumar Shetty, Ragesh Chandran, Arjun Ballal, Lawrence John Mathias, Anoop Hegde, Ashwin Shetty
INTRODUCTION: Fractures of the clavicle are some of the most common fractures which are seen in the adult population. Mid-shaft fractures of the clavicle are considered the most common form of clavicle fractures and about half of them are displaced fractures. They have been managed non-operatively over the years. However, severe displacement and comminution of these fractures have warranted the requirement of operative intervention, due to increased incidence of mal-union, worsening of shoulder functions etc...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
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
Nisarg Mehta, Veenesh Selvaratnam, Nikolaos Giotakis, Badri Narayan
INTRODUCTION: Traditional methods of nailing distal tibial fractures have an unacceptable risk of mal-alignment due to difficulty in obtaining and maintaining reduction intra-operatively. Methods to obtain and maintain reduction when nailing these fractures, and therefore reducing the risk of Mal-alignment include modified external fixators, distractors and commercial reduction tools. Semi-extended intramedullary nailing of distal tibial fractures via a supra-patellar approach is now being used more commonly...
February 2017: Injury
S Dunlop, C L Ekegren, E R Edwards, R de Steiger, R Page, B J Gabbe
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Zahir Ur Rehman, Sardar Khan, Mark L Brusseau, Mohammad Tahir Shah
Rapid urbanization and industrialization result in serious contamination of soil with toxic metals such as lead (Pb) and cadmium (Cd), which can lead to deleterious health impacts in the exposed population. This study aimed to investigate Pb and Cd contamination in agricultural soils and vegetables in five different agricultural sites in Pakistan. The metal transfer from soil-to-plant, average daily intake of metals, and health risk index (HRI) were also characterized. The Pb concentrations for all soils were below the maximum allowable limits (MAL 350 mg kg(-1)) set by State Environmental Protection Administration of China (SEPA), for soils in China, while Cd concentrations in the soils were exceeded the MAL (61...
February 2017: Chemosphere
Jagandeep Singh Virk, Sudhir Kumar Garg, Parmanand Gupta, Vivek Jangira, Jagdeep Singh, Sudhir Rana
INTRODUCTION: Good results have been published by researchers with distal femur nail, dynamic condylar screw and even addition of a medial plate to a distal femur locking plate for treating distal femur fractures. By this study, we explore the capability of a distal femur locking plate to counter distal femur fractures of extra- articular, partial or intra- articular nature. Positive results have been published by various groups from all over the world. AIM: To study the functional and radiological outcome of distal femoral fractures in skeletally mature patients treated by open reduction and internal fixation with distal femur locking plate...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
Sridhar Reddy Kanubaddy, Sathya Kumar Devireddy, Kishore Kumar Rayadurgam, Rajsekhar Gali, Mallikarjun Rao Dasari, Sivaganesh Pampana
PURPOSE: This prospective study was conducted to evaluate the efficacy of stainless steel single linear miniplate with rectangular grid plate in the treatment of mandibular angle fractures. METHODS: This study included 30 patients who were allocated randomly into two groups of each. Group 1 patients were treated with single 2 mm × 4 hole linear stainless steel miniplate and group 2 patients with 2 mm × 4 hole rectangular grid plate. Patients were evaluated for fracture stability, occlusion, mouth opening, and complications at 1st week, 1 and 3 months post operatively...
December 2016: Journal of Maxillofacial and Oral Surgery
A Bhattacharyya, S Kumar
Deformity of wrist is very common after mal union of extra articular fractures over distal end of Radius. It causes limitation of movements too in different directions with or without pain. Deformity may be treated by different types of corrective osteotomy. We treated cases of this type of malunion with Fernandez osteotomy. This study is to observe the amount of correction and recovery of functional status in patients with malunited distal radius fractures treated with Fernandez osteotomy. This is a prospective study...
July 2016: Mymensingh Medical Journal: MMJ
Ian P Mayne, Simon N Bell, Warwick Wright, Jennifer A Coghlan
Acromial and scapular spine fractures after reverse total shoulder arthroplasty occur predominantly as a result of bony insufficiency secondary to patient and intra-operative technical factors. The spectrum of the pathology can range from a stress reaction to an undisplaced or displaced fracture. Prompt diagnosis of these fractures requires a high suspicion in the postoperative patient with a clinical presentation of acute onset of pain along the acromion or scapular spine and/or deterioration of shoulder function...
April 2016: Shoulder & Elbow
Akira Iwata, Masahiro Kanayama, Fumihiro Oha, Tomoyuki Hashimoto, Norimasa Iwasaki
PURPOSE: In the healing of osteoporotic vertebral fracture, global spinal mal-alignment might increase the load sharing at the fracture site and deteriorate the fracture healing. This study aimed to evaluate the effect of spinopelvic alignment on the union status of thoracolumbar osteoporosis-related vertebral compression fracture (OVCF). METHODS: Consecutive 48 patients with a single-level thoracolumbar fresh OVCF were treated non-operatively. Union was judged by three independent observers at 6 months, and patients were divided into union group and non-union group...
January 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Fariborz Ghaffarpasand, Mostafa Shahrezaei, Maryam Dehghankhalili
OBJECTIVE: To determine the effects of platelet rich plasma PRP on healing rates of long bone non-union fracture. METHOD: This was a randomized double-blind placebo controlled clinical trial being performed in a 12-month period. We included 75 adult (>18 years) patients suffering from long bone (Femur, Tibia, Humerus and Ulna) non-union fracture who were randomly assigned to receive 5mL PRP (n=37) or 5mL normal saline as placebo (n=38) in the site of fracture after intramedullary nailing or open reduction and internal fixation (ORIF) along with autologous bone graft...
July 2016: Bulletin of Emergency and Trauma
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