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Distal tibia fracture

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https://www.readbyqxmd.com/read/29785926/intramedullary-nail-fixation-versus-locking-plate-fixation-for-adults-with-a-fracture-of-the-distal-tibia-the-uk-fixdt-rct
#1
Matthew L Costa, Juul Achten, Susie Hennings, Nafisa Boota, James Griffin, Stavros Petrou, Mandy Maredza, Melina Dritsaki, Thomas Wood, James Masters, Ian Pallister, Sarah E Lamb, Nick R Parsons
BACKGROUND: The best treatment for fractures of the distal tibia remains controversial. Most of these fractures require surgical fixation, but the outcomes are unpredictable and complications are common. OBJECTIVES: To assess disability, quality of life, complications and resource use in patients treated with intramedullary (IM) nail fixation versus locking plate fixation in the 12 months following a fracture of the distal tibia. DESIGN: This was a multicentre randomised trial...
May 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29776736/trabecular-bone-score-at-the-distal-femur-and-proximal-tibia-in-individuals-with-spinal-cord-injury
#2
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/29758361/bone-accrual-in-oligo-amenorrheic-athletes-eumenorrheic-athletes-and-non-athletes
#3
Vibha Singhal, Karen Campoverde Reyes, Brooke Pfister, Kathryn Ackerman, Meghan Slattery, Katherine Cooper, Alexander Toth, Nupur Gupta, Mark Goldstein, Kamryn Eddy, Madhusmita Misra
BACKGROUND: Mechanical loading improves bone mineral density (BMD) and strength while decreasing fracture risk. Cross-sectional studies show that exercise advantage is lost in oligo-amenorrheic athletes (OA). Longitudinal studies examining the opposing effects of exercise and hypogonadism on bone are lacking in adolescents/young adults. OBJECTIVE: Evaluate differences in bone accrual over 12 months in OA, eumenorrheic athletes (EA) and non-athletes (NA). We hypothesized that bone accrual would be lower in OA than EA and NA, with differences most pronounced at non-weight bearing trabecular sites...
May 11, 2018: Bone
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/29750848/accelerated-bone-loss-in-older-men-effects-on-bone-microarchitecture-and-strength
#5
J A Cauley, A J Burghardt, S L Harrison, P M Cawthon, A V Schwartz, E Barrett Connor, Kristine E Ensrud, Lisa Langsetmo, S Majumdar, E Orwoll
Accelerated bone loss (ABL) shown on routine dual-energy X-ray absorptiometry (DXA) may be accompanied by microarchitectural changes, increased cortical porosity and lower bone strength. To test this hypothesis, we performed a cross-sectional study and used high resolution peripheral quantitative computed tomography (HR-pQCT) scans (SCANCO, Inc., Switzerland) to measure estimated bone strength and microarchitecture in the distal radius and distal and diaphyseal tibia. We studied 1628 men who attended the Year 14 exam of the Osteoporotic Fractures in Men (MrOS) study...
May 11, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29750829/robust-trabecular-microstructure-in-type-2-diabetes-revealed-by-individual-trabecula-segmentation-analysis-of-hr-pqct-images
#6
Jessica F Starr, Leonardo C Bandeira, Sanchita Agarwal, Ankit M Shah, Kyle K Nishiyama, Yizhong Hu, Donald J McMahon, X Edward Guo, Shonni J Silverberg, Mishaela R Rubin
Type 2 diabetes (T2D) patients have an increased fracture risk, which may be partly explained by compromised bone microarchitecture within the cortical bone compartment. Data on trabecular bone parameters in T2D are contradictory. By high resolution peripheral quantitative computed tomography (HR-pQCT) trabecular microarchitecture is preserved, yet larger trabecular holes are detected in T2D by MRI and DXA-based trabecular bone scores (TBS) are abnormal. To determine if there are differences in trabecular microstructure, connectivity and alignment in postmenopausal women with T2D as compared to controls, we performed individual trabecula segmentation (ITS) analysis on high-resolution peripheral quantitative computed tomography (HR-pQCT) scans of the distal radius and tibia in 92 women with (n = 42) and without (n = 50) T2D...
May 11, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29737558/risk-of-injury-to-the-sural-nerve-during-posterolateral-approach-to-the-distal-tibia-an-ultrasound-simulation-study
#7
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/29737002/lower-limb-reconstruction-with-chimeric-flaps-the-quad-flap
#8
Solomon M Azouz, Nikki A Castel, Aparna Vijayasekaran, Alanna M Rebecca, Salvatore C Lettieri
Early soft-tissue coverage is critical for treating traumatic open lower-extremity wounds. As free-flap reconstruction evolves, injuries once thought to be nonreconstructable are being salvaged. Free-tissue transfer is imperative when there is extensive dead space or exposure of vital structures such as bone, tendon, nerves, or blood vessels. We describe 2 cases of lower-extremity crush injuries salvaged with the quad flap. This novel flap consists of parascapular, scapular, serratus, and latissimus dorsi free flaps in combination on one pedicle...
May 7, 2018: Microsurgery
https://www.readbyqxmd.com/read/29735339/distal-medial-tibial-locking-plate-for-fixation-of-extraarticular-distal-humeral-fractures-an-alternative-choice-for-fixation
#9
Ali Cagdas Yorukoglu, Ahmet Fahir Demirkan, Nihal Buker
OBJECTIVE: The aim of this study was to describe an alternative fixation method for distal humeral extra-articular fractures through posterior approach using distal tibia anatomic locking plate; and to evaluate the patient's functional outcome and union condition. METHODS: Eighteen patients (11 men and 7 women; average age of 37.0 ± 17.3 years (range: 18-73 years)) with a distal humeral extra-articular fracture who were treated with distal tibial medial locking plate were included into the study...
May 4, 2018: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/29730704/normal-bone-microstructure-and-density-but-worse-physical-function-in-older-women-treated-with-selective-serotonin-reuptake-inhibitors-a-cross-sectional-population-based-study
#10
Berit Larsson, Dan Mellström, Lisa Johansson, Anna G Nilsson, Mattias Lorentzon, Daniel Sundh
Depression in the elderly is today often treated with selective serotonin reuptake inhibitors (SSRIs) because of their favorable adverse effect profile. However, treatment with SSRIs is associated with increased risk of fractures. Whether this increased risk depends on reduced bone strength or increased fall risk due to reduced physical function is not certain. The aim was therefore to investigate if treatment with SSRIs is associated with impaired bone microstructure, bone density, or physical function in older women...
May 5, 2018: Calcified Tissue International
https://www.readbyqxmd.com/read/29710663/effect-of-zuoguiwan-on-osteoporosis-in-ovariectomized-rats-through-rankl-opg-pathway-mediated-by-%C3%AE-2ar
#11
Feixiang Liu, Feng Tan, Weiwei Tong, Qiaoling Fan, Sumin Ye, Shengfeng Lu, Zhanli Teng, Miaomiao Han, Mingyue Zhang, Yi Chai
ETHNOPHARMACOLOGICAL RELEVANCE: The deficiency of kidney Yin is the main pathogenesis of postmenopausal osteoporosis (PMOP) according to traditional Chinese medicine (TCM). Zuoguiwan (ZGW) is among the classical prescriptions in TCM and has been applied to various diseases that are due to deficiency of kidney Yin, including osteoporosis, fractures, menopausal syndromes. However, the underlying mechanism of ZGW in treating PMOP remains poorly understood. AIM OF THE STUDY: ZGW, a traditional Chinese prescription, has been used to nourish Yin and reinforce the kidney since ancient times...
April 25, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
https://www.readbyqxmd.com/read/29701091/a-comparison-of-the-cost-effectiveness-of-intramedullary-nail-fixation-and-locking-plate-fixation-in-the-treatment-of-adult-patients-with-an-extra-articular-fracture-of-the-distal-tibia
#12
M Maredza, S Petrou, M Dritsaki, J Achten, J Griffin, S E Lamb, N R Parsons, M L Costa
Aim The aim of this study was to compare the cost-effectiveness of intramedullary nail fixation and 'locking' plate fixation in the treatment of extra-articular fractures of the distal tibia. Patients and Methods An economic evaluation was conducted from the perspective of the United Kingdom National Health Service (NHS) and personal social services (PSS), based on evidence from the Fixation of Distal Tibia Fractures (UK FixDT) multicentre parallel trial. Data from 321 patients were available for analysis. Costs were collected prospectively over the 12-month follow-up period using trial case report forms and participant-completed questionnaires...
May 1, 2018: Bone & Joint Journal
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
#13
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/29694676/prediction-of-fractures-in-men-using-bone-microarchitectural-parameters-assessed-by-high-resolution-peripheral-quantitative-computed-tomography-the-prospective-strambo-study
#14
Pawel Szulc, Stéphanie Boutroy, Roland Chapurlat
Areal bone mineral density (aBMD) poorly identifies men at high fracture risk. Our aim was to assess prediction of fractures in men by bone microarchitectural measures. At baseline, 825 men aged 60-87 had the assessment of bone microarchitecture at distal radius and distal tibia by high resolution peripheral QCT (HR-pQCT, XtremeCT-I SCANCO). Bone strength was estimated by micro-finite element analysis. During the prospective 8-year follow-up, 105 men sustained fractures (59 vertebral fractures in 49 men, 70 non-vertebral ones in 68 men)...
April 25, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29684510/the-rodent-tibia-fracture-model-a-critical-review-and-comparison-with-the-complex-regional-pain-syndrome-literature
#15
REVIEW
Frank Birklein, Alaa Ibrahim, Tanja Schlereth, Wade S Kingery
Distal limb fracture is the most common cause of complex regional pain syndrome (CRPS), thus the rodent tibia fracture model (TFM) was developed to study CRPS pathogenesis. This comprehensive review summarizes the published TFM research and compares these experimental results with the CRPS literature. The TFM generated spontaneous and evoked pain behaviors, inflammatory symptoms (edema, warmth) and trophic changes (skin thickening, osteoporosis) resembling symptoms in early CRPS. Neuropeptides, inflammatory cytokines, and nerve growth factor (NGF) have been linked to pain behaviors, inflammation, and trophic changes in the TFM model and proliferating keratinocytes were identified as the primary source of cutaneous cytokines and NGF...
April 20, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29679256/biomechanical-features-of-six-design-of-the-delta-external-fixator-for-treating-pilon-fracture-a-finite-element-study
#16
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/29673344/the-risk-of-violating-the-posterior-malleolar-fracture-when-nailing-the-ipsilateral-concomitant-spiral-distal-tibial-fracture
#17
Yu Zhang, Xiaodong Qin, Lijun Song, Xiang Li
BACKGROUND: For a distal tibial spiral fracture combined with a non-displaced posterior malleolar fragment (PMF), we proposed a hypothesis that the treating surgeon could assess the size of the PMF to determine the need for stabilizing that structure first before rodding the tibia. MATERIALS AND METHODS: Fifty 3-D models (22 females) of combined distal tibial and posterior malleolar fractures from one trauma center were reconstructed. In each case, a virtual tibial intramedullary nail (vIM nail) with three distal anteroposterior (AP) locking screws (S13 , S15 and S37 , the number indicating the distance from the screw to the nail tip) were inserted into the center of the tibial canal and ended on top of the distal tibial physeal scar...
April 19, 2018: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29666001/distal-tibial-triplane-fracture-with-ipsilateral-tibial-shaft-fracture-a-case-series
#18
Timothy S Holland, Christopher P Prior, Roger Dm Walton
BACKGROUND & PURPOSE: Distal tibial Triplane fracture with ipsilateral tibial shaft fracture is a rare but important problem. This rarely reported combination of injuries if not recognised may lead to deleterious consequences. METHODS/PATIENTS: The local database of all emergency admissions was scrutinised to identify subjects before interrogation of the clinical notes and relevant radiographic imaging. FINDINGS: This paper reports a series of five children who were found to have triplane fracture of the distal tibia with concomitant ipsilateral fracture of the tibial shaft...
April 14, 2018: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
https://www.readbyqxmd.com/read/29662767/reconstruction-of-the-lateral-tibia-plateau-fracture-with-a-third-triangular-support-screw-a-biomechanical-study
#19
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/29661687/impact-of-weight-loss-with-intragastric-balloon-on-bone-density-and-microstructure-in-obese-adults
#20
Eduardo Madeira, Miguel Madeira, Erika Paniago Guedes, Thiago Thomaz Mafort, Rodrigo Oliveira Moreira, Laura Maria Carvalho de Mendonça, Inayá Correa Barbosa Lima, Leonardo Vieira Neto, Paulo Roberto Alves de Pinho, Agnaldo José Lopes, Maria Lucia Fleiuss Farias
The historical concept that obesity protects against bone fractures has been questioned. Weight loss appears to reduce bone mineral density (BMD); however, the results in young adults are inconsistent, and data on the effects of weight loss on bone microstructure are limited. This study aimed to evaluate the impact of weight loss using an intragastric balloon (IGB) on bone density and microstructure. Forty obese patients with metabolic syndrome (mean age 35.1 ± 7.3 yr) used an IGB continuously for 6 mo...
March 21, 2018: Journal of Clinical Densitometry
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