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Distal tibial fractures

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https://www.readbyqxmd.com/read/28819612/uncommon-floating-knee-in-a-teenager-a-case-report-of-ipsilateral-physeal-fractures-in-distal-femur-and-proximal-tibia
#1
Youssef Othman, Lassaad Hassini, Aymen Fekih, Issam Aloui, Abderrazek Abid
INTRODUCTION: The concomitance of ipsilateral physeal fractures of the distal femur and the proximal tibia is an extremely scarce entity. It is conceptually similar to floating knee in the pediatric population. CASE REPORT: One case with this injury is reported in a 16-year-old teenager. He was treated surgically by close reduction and internal fixation. The diagnosis of the tibial fracture was initially missed, and the fracture was seen on the post-operative radiographs...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28819607/a-gustilo-type-3b-open-tibial-fracture-treated-with-a-proximal-flexor-hallucis-longus-flap-a-case-report
#2
Tomohiro Yasuda, Masayuki Arai, Kaoru Sato, Koji Kanzaki
INTRODUCTION: In the treatment of Gustilo Type 3B open tibial fractures, it is important to perform soft tissue reconstruction and bone reconstruction simultaneously. Gastrocnemius muscle and soleus muscle flaps are generally used as rotational flaps for the tibia. The distal third of the tibia can often not be covered with the gastrocnemius muscle and soleus muscle flaps. Treatment distal to the distal third of the tibia is difficult because fewer flap options are available. In the present report, we describe our experience with a Gustilo Type 3B open tibial fracture treated by gastrocnemius muscle and soleus muscle flaps, along with an additional proximally based flexor hallucis longus flap, which is a rare procedure...
March 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28777278/elastic-intramedullary-nailing-versus-open-reduction-internal-fixation-of-pediatric-tibial-shaft-fractures
#3
Andrew T Pennock, Tracey P Bastrom, Vidyadhar V Upasani
BACKGROUND: The optimal fixation strategy for unstable pediatric tibia fractures is unclear with some favoring elastic intramedullary nails (EIN) and others favoring plate and screws [open reduction internal fixation (ORIF)]. The purpose of this study was to compare outcomes and complications of skeletally immature patients undergoing surgical stabilization of the tibia with either EIN or ORIF. METHODS: A retrospective review was performed on all patients undergoing EIN or ORIF of a diaphyseal fracture at a single pediatric level I trauma center between 2010 and 2016...
August 2, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28742786/proper-distal-placement-of-tibial-nail-improves-rate-of-malalignment-for-distal-tibia-fractures
#4
Konstantinos Triantafillou, Eric Barcak, Arturo Villarreal, Cory Collinge, Edward Perez
OBJECTIVES: We hypothesize that the anatomic center of the distal tibia is just lateral and anterior to the center of the distal tibia articular surface in the coronal and sagittal planes respectively, and that placement of the nail along this axis results in improved rates of malalignment when treating distal tibia fractures. DESIGN: Retrospective study SETTING:: One level I and one level II trauma center PATIENTS/PARTICIPANTS:: 203 distal tibia fractures treated with IMN (primary cohort) whose main fracture line extended within 5 cm of the plafond to evaluate the rate of malalignment with distal nail placement...
July 24, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28736122/treatment-of-tibial-nonunion-with-posterolateral-bone-grafting
#5
Michael J Foster, Robert V O'Toole, Theodore T Manson
OBJECTIVES: Posterolateral bone grafting to treat nonunions of the distal two-thirds of the tibia avoids the often traumatized and more tenuous anterior soft-tissue envelope. Few modern reports of its effectiveness are available. We assessed whether posterolateral bone grafting leads to high union and low complication rates. METHODS: We conducted a retrospective review at a Level I trauma center. Our study group was 59 patients with distal two-thirds tibial fractures treated with posterolateral bone grafting...
May 3, 2017: Injury
https://www.readbyqxmd.com/read/28722129/bone-strength-estimated-by-micro-finite-element-analysis-%C3%A2%C2%B5fea-is-heritable-and-shares-genetic-predisposition-with-areal-bmd-the-framingham-study
#6
David Karasik, Serkalem Demissie, Darlene Lu, Kerry E Broe, Steven K Boyd, Ching-Ti Liu, Yi-Hsiang Hsu, Mary L Bouxsein, Douglas P Kiel
Genetic factors contribute to the risk of bone fractures, partly because of effects on bone strength. High-resolution peripheral quantitative computed tomography (HR-pQCT) estimates bone strength using micro-finite element analysis (µFEA). The goal of this study was to investigate if the bone failure load estimated by HR-pQCT-based µFEA is heritable and to what extent it shares genetic regulation with areal bone mineral density (aBMD). Bone microarchitecture was measured by HR-pQCT at the ultradistal tibia and ultradistal radius in adults from the Framingham Heart Study (n = 1087, mean age 72 years; 57% women)...
July 19, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28721473/biomechanics-of-the-classic-metaphyseal-lesion-finite-element-analysis
#7
Andy Tsai, Brittany Coats, Paul K Kleinman
BACKGROUND: The classic metaphyseal lesion (CML) is strongly associated with infant abuse, but the biomechanics responsible for this injury have not been rigorously studied. Radiologic and CT-pathological correlates show that the distal tibial CML always involves the cortex near the subperiosteal bone collar, with variable extension of the fracture into the medullary cavity. Therefore, it is reasonable to assume that the primary site of bone failure is cortical, rather than intramedullary...
July 18, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28712877/bone-mass-microarchitecture-and-strength-are-influenced-by-race-ethnicity-in-young-adult-men-and-women
#8
Kristin L Popp, Julie M Hughes, Adriana Martinez-Betancourt, Matthew Scott, Victoria Turkington, Signe Caksa, Katelyn I Guerriere, Kathryn E Ackerman, Chun Xu, Ginu Unnikrishnan, Jaques Reifman, Mary L Bouxsein
Lower rates of fracture in both Blacks compared to Whites, and men compared to women are not completely explained by differences in bone mineral density (BMD). Prior evidence suggests that more favorable cortical bone microarchitecture may contribute to reduced fracture rates in older Black compared to White women, however it is not known whether these differences are established in young adulthood or develop during aging. Moreover, prior studies using high-resolution pQCT (HR-pQCT) have reported outcomes from a fixed-scan location, which may confound sex- and race/ethnicity-related differences in bone structure...
July 13, 2017: Bone
https://www.readbyqxmd.com/read/28708778/radiographic-investigation-of-the-distal-extension-of-fractures-into-the-articular-surface-of-the-tibia-the-ridefast-study
#9
Lucas S Marchand, Ajinkya A Rane, Zachary M Working, Lance G Jacobson, Erik N Kubiak, Thomas F Higgins, David L Rothberg
OBJECTIVE: To determine whether radiographic measurements are predictive of involvement of the distal tibia articular surface in tibial shaft fractures. DESIGN: Retrospective review. SETTING: Academic level-I trauma hospital. PATIENTS: Two-hundred seventeen patients with tibial shaft fractures distal to the isthmus (AO/OTA: 42-A1-3;42-B1-3;42-C1-3;43-A1-3). INTERVENTION: Analysis of AP and lateral radiographs...
June 22, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28697075/posterolateral-bone-grafting-for-distal-tibia-nonunion
#10
Sanjit Konda, Hesham Saleh, Nina Fisher, Kenneth A Egol
INTRODUCTION: This video demonstrates the technique of posterolateral bone grafting with iliac crest bone graft for a distal tibial nonunion. METHODS: The patient is a 42-year-old man who is 6 months status post an open distal tibia-fibula fracture treated surgically, and presents complaints of persistent right ankle pain. The fracture site was tender to palpation, and 3 consecutive plain radiographs spaced 6 weeks apart demonstrated no evidence of callus formation...
August 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28683418/tibial-impact-accelerations-in-gait-of-primary-school-children-the-effect-of-age-and-speed
#11
Oren Tirosh, Guy Orland, Alon Eliakim, Dan Nemet, Nili Steinberg
Tibial stress fractures are associated with increased lower extremity loading at initial foot-ground contact, reflected in high peak positive acceleration (>8g) of the tibia in adults. There is no reported data on peak positive acceleration of the tibia in children during walking and running. The aim of this study was to establish tibial peak positive acceleration responses in children across a range of age and gait speeds. Twenty-four children aged 8.5±1.4years with no known gait pathology comprised two age groups; Young (7-9year, n=12) and Older (10-12 years, n=12)...
June 27, 2017: Gait & Posture
https://www.readbyqxmd.com/read/28674752/-operative-access-for-treatment-of-pilon-fractures
#12
REVIEW
K Klaue
BACKGROUND: Under optimal conditions, fractures of the tibial pilon can be definitively managed operatively within 6 h after the trauma. Under suboptimal conditions, preoperative antiphlogistic treatment, possibly after approximate correction and external fixation of the alignment, is a reasonable option. Osteosynthesis implies reconstruction of good joint congruency in anatomical orientation. The soft tissue coverage of the distal lower leg is relatively poorly constructed and there is a high risk of devascularization, necrosis and ensuing infection...
July 3, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28666045/lower-leg-fracture-irreducibility-resulting-from-entrapment-of-the-fibula-within-the-tibial-shaft
#13
Travis M Hughes, Flynn A Rowan, Lisa M Truchan
The tibia is the most commonly fractured long bone. Tibia fractures are simple, and most are amenable to immediate closed reduction. Reported cases of irreducibility resulting from entrapment of soft-tissue structures are rare. We report the case of a 23-year-old man who, in a high-speed motor vehicle crash, sustained a closed lower leg fracture that was later found to have a unique pattern in which the fibula was entrapped in the medullary cavity of the tibia. Limited open reduction was performed, and the entrapped distal fibula was removed with use of a bone hook...
May 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28646430/mechanical-strength-assessment-of-a-drilled-hole-in-the-contralateral-cortex-at-the-end-of-the-open-wedge-for-high-tibial-osteotomy
#14
Arnaud Diffo Kaze, Stefan Maas, Alexander Hoffmann, Dietrich Pape
BACKGROUND: This study aimed to investigate, by means of finite element analysis, the effect of a drill hole at the end of a horizontal osteotomy to reduce the risk of lateral cortex fracture while performing an opening wedge high tibial osteotomy (OWHTO). The question was whether drilling a hole relieves stress and increases the maximum correction angle without fracture of the lateral cortex depending on the ductility of the cortical bone. METHODS: Two different types of osteotomy cuts were considered; one with a drill hole (diameter 5 mm) and the other without the hole...
December 2017: Journal of Experimental Orthopaedics
https://www.readbyqxmd.com/read/28636058/percutaneous-tibial-physeal-fracture-repair-in-small-animals-technique-and-17-cases
#15
Dirsko J F von Pfeil, Mathieu Glassman, Meaghan Ropski
OBJECTIVES: To retrospectively describe cases treated via percutaneous tibial physeal fracture repair (PTPFR), using intra-operative fluoroscopy (IFL) or digital radiography (DR). To describe a technique ("spiking"), used to treat tibial tuberosity avulsion fractures. METHODS: Clinical data of 14 dogs and three cats were included. The "spiking" technique was described. RESULTS: Intra-operative fluoroscopy (n = 11) and DR (n = 6) were successfully used in 11 tibial tuberosity avulsion fractures, one combined proximal physeal and tibial tuberosity avulsion fracture, and five distal tibial/fibular physeal fractures...
June 21, 2017: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/28633789/displaced-salter-harris-type-i-distal-fibula-fractures-two-case-reports-and-a-review-of-the-literature
#16
Jeremy Korsh, Stephen Adolfsen
Salter-Harris type I (SH-I) fractures of the distal fibula are commonly encountered in pediatric orthopedics. We describe 2 unique cases of adolescents with completely displaced SH-I distal fibula fractures that were treated operatively. In the first case, a closed reduction attempt failed and the patient required open reduction and internal fixation of the distal fibula and syndesmosis. The syndesmotic ligaments were avulsed from the distal fibular metaphysis. In the second case, closed reduction of the distal fibula fracture was partially successful, but anatomic reduction could not be achieved without open reduction...
July 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28620592/the-role-of-fibular-fixation-in-the-treatment-of-combined-distal-tibia-and-fibula-fracture-a-randomized-control-trial
#17
Mohammad Javdan, Mohammad Ali Tahririan, Morteza Nouri
BACKGROUND: This randomized, parallel-group, non-blinded study was designed to determine the role of fibular fixation in the treatment outcomes of combined distal tibia and fibula fractures. MATERIALS AND METHODS: Sixty patients with distal tibial and fibular fractures were randomly divided in two groups of case and controls. In the case group, fibula was fixed prior to the fixation of tibia. In the control group, tibia was fixed without fibular fixation. Primary outcomes were varus-valgus angulation, anterior-posterior angulation, union and side effects...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28588330/supracutaneous-plating-using-a-locking-plate-for-the-treatment-of-a-tibial-fracture-in-a-cat
#18
Tommaso Nicetto, Federico Longo
Radiographs revealed a slightly displaced long oblique diaphyseal tibial fracture with bone fissures running distally in a 2-year-old, 4.5 kg cat that had been hit by a car. An angle stable implant was applied in a supracutaneous fashion. The patient tolerated the external implant and had a satisfactory functional recovery. Radiographic follow-up after 60 days revealed sign of osseous union; therefore, the plate was removed.
June 2017: Canadian Veterinary Journal. la Revue Vétérinaire Canadienne
https://www.readbyqxmd.com/read/28584887/intramedullary-tibial-nailing-of-distal-tibiofibular-fractures-additional-fibular-fixation-or-not
#19
M Van Maele, B Molenaers, E Geusens, S Nijs, H Hoekstra
INTRODUCTION: The anatomy of the distal tibia accounts for reduced biomechanical stability and higher complication rates when treating distal tibiofibular fractures with an intramedullary tibia nail (IMTN). The goal of this study was to identify variables that affect the stability of IMTN. We assessed the value of additional fibular fixation, angular stable interlocking screws (ASLS) and multiplanar screw configuration in IMTN. PATIENTS AND METHODS: A retrospective cohort study was performed including 184 distal tibial fractures and associated fibula fracture treated with IMTN...
June 5, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28580249/endoscopic-adhesiolysis-of-flexor-hallucis-longus-muscle
#20
Tun Hing Lui
Adhesion of the flexor hallucis longus (FHL) muscle to the distal tibia can occur after distal tibial fracture, distal fibular fracture, low tibial osteotomy, soft-tissue injury at the posterior ankle, subclinical compartment syndrome of the distal deep posterior compartment of the leg, or Volkmann contracture after deep posterior compartment syndrome of the leg. The purpose of this Technical Note is to report the endoscopic approach of FHL muscle adhesiolysis. It is indicated in patients with symptomatic adhesion of the FHL muscle and contraindicated if there is entrapment of the FHL muscle or tendon in the fracture callus or if there is extensive fibrosis and contracture of the FHL muscle as a result of Volkmann contracture after deep posterior compartment syndrome of the leg...
April 2017: Arthroscopy Techniques
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