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Distal tibial fractures

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https://www.readbyqxmd.com/read/28925312/what-is-the-best-treatment-for-displaced-salter-harris-ii-physeal-fractures-of-the-distal-tibia
#1
Hoon Park, Dong Hoon Lee, Seung Hwan Han, Sungmin Kim, Nam Kyu Eom, Hyun Woo Kim
Background and purpose - The optimal treatment of displaced Salter-Harris (SH) II fractures of the distal tibia is controversial. We compared the outcomes of operative and nonoperative treatment of SH II distal tibial fractures with residual gap of >3 mm. Factors that may be associated with the incidence of premature physeal closure (PPC) were analyzed. Patients and methods - We retrospectively reviewed 95 patients who were treated for SH II distal tibial fractures with residual gap of >3 mm after closed reduction...
September 19, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28913616/bone-phenotype-assessed-by-hrpqct-and-associations-with-fracture-risk-in-the-glow-study
#2
A E Litwic, L D Westbury, D E Robinson, K A Ward, C Cooper, E M Dennison
The epidemiology and pathogenesis of fractures in postmenopausal women has previously been investigated in the Global Longitudinal study of Osteoporosis in Women (GLOW). To date, however, relationships between bone imaging outcomes and fracture have not been studied in this cohort. We examined relationships between high-resolution peripheral quantitative computed tomography (HRpQCT) parameters and fracture in the UK arm of GLOW, performing a cluster analysis to assess if our findings were similar to observations reported from older participants of the Hertfordshire Cohort Study (HCS), and extended the analysis to include tibial measurements...
September 14, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/28890795/bilateral-patellar-fractures-and-increased-cortical-bone-thickness-associated-with-long-term-oral-alendronate-treatment-in-a-cat
#3
Nicola Council, Jon Dyce, Wm Tod Drost, Joao Felipe de Brito Galvao, Thomas J Rosol, Dennis J Chew
CASE SUMMARY: A 14-year-old cat presented with bilateral patellar fractures and radiographically thickened tibial cortices. This cat had been treated with alendronate for 8 years prior to presentation. To remove the subjectivity of the radiographic evaluation, tibial radiographs from 35 apparently healthy geriatric cats were used for comparison. Cortical and diaphyseal thickness were measured at the proximal and distal thirds of the tibia. Our cat had increased cortical bone thickness compared to that of the control cats...
July 2017: JFMS open reports
https://www.readbyqxmd.com/read/28888404/expert-tibial-nails-for-treating-distal-tibial-fractures-with%C3%A2-soft%C3%A2-tissue%C3%A2-damage-a-patient-series
#4
Zhenhai Wang, Yiheng Cheng, Dajiang Xin, Tong Liu, Wenqing Qu, Dan Wang, Yong Zhao, Jingjing Zhao
Distal tibial fractures with soft tissue damage are relatively difficult to treat. We assessed the outcomes of patients with these fractures treated with Expert Tibial Nails(®) (DePuy Synthes, Raynham, MA) from March 2012 to December 2014. At 6 months postoperatively, the general health quality of patients was assessed using operative time, interval to return to work, American Orthopaedic Foot and Ankle Society ankle scale score, pain measured using a visual analog scale, and short-form health outcomes 36-item survey physical functioning and mental health dimension scores...
September 7, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28878537/arthroscopically-assisted-surgical-fixation-of-a-juvenile-tillaux-fracture-and-implant-removal-a-case-report
#5
Takahisa Ogawa, Sadanori Shimizu
Juvenile Tillaux fractures are Salter-Hallis III fractures of the distal tibial epiphysis that occur only when the tibial epiphyses are closing. Theoretically, arthroscopically assisted reduction and fixation of a juvenile Tillaux fracture can facilitate the accurate reconstruction of the articular surface, using arthroscopic visualization. We treated a girl aged 14 years who had a juvenile Tillaux fracture by using arthroscopically assisted reduction and fixation. In order to obtain articular congruency, the screw was inserted under arthroscopic visualization...
August 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28834822/a-prospective-randomized-study-on-operative-treatment-for-simple-distal-tibial-fractures-minimally-invasive-plate-osteosynthesis-versus-minimal-open-reduction-and-internal-fixation
#6
Ji Wan Kim, Hyunuk Kim, Chang-Wug Oh, Joon-Woo Kim, Ki Chul Park
OBJECTIVES: To compare the radiological and clinical results of minimally invasive plate osteosynthesis (MIPO) and minimal open reduction and internal fixation (ORIF) for simple distal tibial fractures. DESIGN: Randomized prospective study. SETTING: Three level 1 trauma centers. PATIENTS: Fifty-eight patients with simple and distal tibial fractures were randomized into a MIPO group (treatment with MIPO; n=29) or a minimal group (treatment with minimal ORIF; n=29)...
August 22, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28834567/ethnic-differences-in-peripheral-skeletal-development-among-urban-south-african-adolescents-a-ten-year-longitudinal-pqct-study
#7
S M Schoenbuchner, J M Pettifor, S A Norris, L K Micklesfield, A Prentice, K A Ward
There are no longitudinal pQCT data of bone growth and development from sub-Saharan Africa, where rapid environmental, societal and economic transitions are occurring, and where fracture rates are predicted to rise. The aim of this study was to compare skeletal development in black and white South African adolescents using longitudinal data from the Birth to Twenty study. The Birth to Twenty Bone Health sub-cohort consisted of 543 adolescents (261[178 black] girls, 282[201 black] boys). Annual pQCT measurements of the radial and tibial metaphysis and diaphysis were obtained between ages 12 and 22 years (distal metaphysis: cross-sectional area [CSA] and trabecular bone mineral density [BMD]; diaphysis: total and cortical CSA, cortical BMD and polar stress-strain index [SSIp])...
August 23, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28821936/minimally-invasive-plate-augmentation-in-the-treatment-of-long-bone-non-unions
#8
Ki-Chul Park, Chang-Wug Oh, Joon-Woo Kim, Kyeong-Hyeon Park, Jong-Keon Oh, Il-Hyung Park, Hee-Soo Kyung, Jeong Heo
INTRODUCTION: Exchange nailing is most acceptable for treating hypertrophic non-union of the long bones, requiring the removal of previously fixed implant. However, its main effect of mechanical stabilization is controversial in non-isthmal area. We hypothesized that minimally invasive plate augmentation over the non-union site may have a better option, without the need of bone grafting or removing pre-existing implants. MATERIALS AND METHODS: Seventeen patients with hypertrophic non-union of the long bones between 2010 and 2014 on radiography who previously underwent intramedullary (IM) nailing or plate osteosynthesis for long-bone fractures were included...
August 18, 2017: Archives of Orthopaedic and Trauma Surgery
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
#9
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
#10
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
#11
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...
October 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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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