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Distal tibial fractures

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https://www.readbyqxmd.com/read/29158651/soft-tissue-complications-in-distal-tibial-fractures-managed-with-medial-locking-plates-a-myth-or-reality
#1
Deepak Jain, Harpal Singh Selhi, Mohammad Yamin, Pankaj Mahindra
Background: Distal tibial fractures are common injuries that are prone to complications and require careful management. The use of medial periarticular locking plates is an established modality in the treatment if these fractures. These plates are inserted using the minimally invasive plate osteosynthesis (MIPO) or open technique. Our study looks at the soft tissue complications associated with the use of medial locking plates in the management of these fractures. Methods: This was a retrospective study carried out at a tertiary care university hospital in an urban setting...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29158645/evaluation-of-functional-outcome-of-pilon-fractures-managed-with-limited-internal-fixation-and-external-fixation-a-prospective-clinical-study
#2
Umesh Kumar Meena, Mahesh Chand Bansal, Prateek Behera, Rahul Upadhyay, Gyan Chand Gothwal
Introduction: The management of pilon fractures is controversial primarily due to the high rate of complications irrespective of the mode of treatment. Limited internal fixation with external fixation is associated with minimal soft tissue handling. This may reduce the chances of wound dehiscence and infection. This study was designed to evaluate the functional and clinical outcomes in patients treated with limited internal fixation combined with external fixation in pilon fractures. Material and methods: This study was conducted as a prospective clinical study on 56 skeletally mature patients with closed fractures with poor skin condition, and with open grade 1 and grade 2 distal tibial intra-articular fractures...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29158644/injury-mechanism-fracture-characteristics-and-clinical-treatment-of-pilon-fracture-with-intact-fibula-a-retrospective-study-of-23-pilon-fractures
#3
Jiang Liangjun, Zheng Qiang, Li Hang, Pan Zhijun
Objective: The effect of intact fibula on pilon fracture is not completely elucidated. We retrospectively analysed pilon fractures with intact fibula at our hospital over a 4 year period to understand the injury mechanism, fracture characteristics, treatment strategy and prognosis of this fracture. Methods: Pilon fracture patients with intact fibula treated in our hospital from January 2010 to December 2014 were observed. OA/ATO fracture type, Ruedi-Allgower classification and fracture characteristics were summarised...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29154969/adults-with-cystic-fibrosis-have-deficits-in-bone-structure-and-strength-at-the-distal-tibia-despite-similar-size-and-measuring-standard-and-relative-sites
#4
Kyle K Nishiyama, Sanchita Agarwal, Anna Kepley, Fernando Rosete, Yizhong Hu, X Edward Guo, Claire L Keating, Emily A DiMango, Elizabeth Shane
Individuals with cystic fibrosis (CF) have lower bone mineral density (BMD) by DXA and are at higher risk of fracture than healthy controls. However, the 2-dimensional measurement of areal BMD (aBMD) provided by DXA is influenced by bone size and the true extent of the bone deficit is unclear. Our objective was to use high-resolution peripheral quantitative computed tomography (HR-pQCT) and individual trabecula segmentation (ITS) analysis to compare volumetric BMD (vBMD), microarchitecture and estimated strength at the distal radius and tibia in 26 young adults with CF and 26 controls matched for age, gender, and race...
November 14, 2017: Bone
https://www.readbyqxmd.com/read/29153449/the-changing-epidemiology-of-open-fractures-in-vehicle-occupants-pedestrians-motorcyclists-and-cyclists
#5
Dennis Winkler, Stuart T Goudie, Charles M Court-Brown
AIMS: To investigate the changing epidemiology of open fractures in vehicle occupants, pedestrians, motorcyclists and cyclists. MATERIALS AND METHODS: Data on all non-spinal open fractures admitted to the Royal Infirmary of Edinburgh after a road traffic accident between 1988 and 2010 were collected and analysed to provide information about the changing epidemiology in different patient groups. Demographic information was collected on all patients with the severity of injury being analysed with the Injury Severity Score (ISS), Musculoskeletal Index (MSI) and the number of open fractures...
November 14, 2017: Injury
https://www.readbyqxmd.com/read/29145970/minimally-invasive-posteromedial-percutaneous-plate-osteosynthesis-for-diaphyseal-tibial-fractures-technique-description
#6
Andre Wajnsztejn, Robinson Esteves Santos Pires, Alexandre Leme Godoy Dos Santos, Pedro Jose Labronici, Helio Jorge Alvachian Fernandes, Mario Ferretti
PURPOSE: The aim of this study was to evaluate the feasibility of performing minimally-invasive plate osteosynthesis (MIPO) in tibial fractures using two posteromedial incisions, and to measure the distance between the plate and neurovascular structures. MATERIALS AND METHODS: We performed nine dissections of specimens that were submitted to tibial MIPO with two posteromedial incisions. One locking compression plate (LCP) of 14 to 16 holes was inserted into the submuscular tunnel in a retrograde manner...
October 2017: Injury
https://www.readbyqxmd.com/read/29141620/treatment-of-genu-valgum-in-children-by-means-of-temporary-hemiepiphysiodesis-using-eight-plates-short-term-findings
#7
Dirk Zajonz, Eckehard Schumann, Magdalena Wojan, Fabian B Kübler, Christoph Josten, Ulf Bühligen, Christoph E Heyde
BACKGROUND: Idiopathic genu valgum is a frequently diagnosed growth disorder in adolescence. Whenever the possibilities of conservative therapy have been exhausted, leg straightening by means of hemiepiphysiodesis has become the standard form of treatment. Because of their flexible screw-plate connection, eight-Plates have been reported in the literature to lead to lower complications regarding implant loosening and fracture compared to other implants. The aim of this retrospective survey was to analyse our own patient population who were treated for genu valgum by means of temporary hemiepiphysiodesis near the knee using eight-Plates to modulate growth...
November 15, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29136444/effect-of-locking-plate-fixation-vs-intramedullary-nail-fixation-on-6-month-disability-among-adults-with-displaced-fracture-of-the-distal-tibia-the-uk-fixdt-randomized-clinical-trial
#8
Matthew L Costa, Juul Achten, James Griffin, Stavros Petrou, Ian Pallister, Sarah E Lamb, Nick R Parsons
Importance: The best treatment for fractures of the distal tibia remains controversial. Most such fractures require surgical fixation but outcomes are unpredictable and complications are common. Objective: To assess disability, quality of life, and complications in patients with displaced tibial fracture treated with intramedullary nail fixation vs locking plate fixation. Design, Setting, and Participants: A multicenter randomized trial recruiting 321 patients 16 years or older with an acute, displaced, extra-articular fracture of the distal tibia from April 2013 through April 2016 with final follow-up in February 2017...
November 14, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29125812/is-talon-tibial-intramedullary-nailing-clinically-superior-compared-to-conventional-locked-nailing
#9
Yalkın Çamurcu, Hakan Sofu, Ahmet Issın, Nizamettin Koçkara, Erdinç Genç, Mehmet Çetinkaya
OBJECTIVES: This study aims to compare the results of talon tibial intramedullary (IM) nailing with the results of conventional distal locked tibial IM nailing. PATIENTS AND METHODS: The study included 60 patients (37 males, 23 females; mean age 42.2 years; range 18 to 92 years) who underwent tibial IM nailing with the diagnosis of unilateral, closed or open (Gustilo-Anderson type 1) tibial diaphyseal fracture (Orthopaedic Trauma Association 42) between January 2013 and January 2016...
December 2017: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/29122282/masquelet-technique-with-external-locking-plate-for-recalcitrant-distal-tibial-nonunion
#10
Ching-Hou Ma, Yen-Chun Chiu, Kun-Ling Tsai, Yuan-Kun Tu, Cheng-Yo Yen, Chin-Hsien Wu
OBJECTIVE: In the present retrospective study, we aimed to analyze the results of treatment for recalcitrant distal tibial nonunion using Masquelet technique with locking plate as a definitive external fixator. MATERIALS: We included 15 consecutive cases of distal tibial nonunion treated at our hospital between January 2012 and December 2015. The reconstructive procedure comprised debridement of the nonunion site, deformity correction, stabilization with an external locked plate, defect filling with cement spacer for inducing membrane formation, and bone reconstruction using a cancellous bone autograft (Masquelet technique)...
October 26, 2017: Injury
https://www.readbyqxmd.com/read/29103207/complex-tibial-fractures-are-associated-with-lower-social-classes-and-predict-early-exit-from-employment-and-worse-patient-reported-qol-a-prospective-observational-study-of-46-complex-tibial-fractures-treated-with-a-ring-fixator
#11
Rasmus Elsoe, Peter Larsen, Juozas Petruskevicius, Søren Kold
The long-term outcomes following complex fractures of the tibia are reported to carry a risk of knee pain, malalignment, articular injury and post-traumatic osteoarthritis. The main objective of this study was to account for the patient-reported quality of life (QOL) 12 months after ring fixator removal in patients with a complex tibial fracture. Secondary objectives included a review of the socio-economic characteristics of the patient group and the rate of return to work in the study period. A prospective follow-up study was conducted of 60 patients with complex fractures of the tibia treated with ring external fixation...
November 4, 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/29053502/the-community-orthopaedic-surgeon-taking-trauma-call-pediatric-ankle-fracture-pearls-and-pitfalls
#12
Shital N Parikh, Charles T Mehlman
Pediatric ankle fractures are common and have unique fracture characteristics because of the presence of distal tibial and fibular physes. When displaced (>3 mm widening of the physis or >2 mm intra-articular gap/step-off), these fractures are typically treated with anatomical reduction and internal fixation. Computed tomography is recommended for preoperative evaluation and surgical planning for intra-articular fractures. These fractures in younger children with substantial growth remaining should be followed closely to monitor for any growth disturbance...
November 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29051887/uncommon-floating-knee-in-a-teenager-a-case-report-of-ipsilateral-physeal-fractures-in-distal-femur-and-proximal-tibia
#13
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 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...
May 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29033156/component-fracture-in-the-kotz-modular-femoral-tibial-reconstruction-system-an-under-reported-complication
#14
Tyler M Hauer, Matthew T Houdek, Rej Bhumbra, Anthony M Griffin, Jay S Wunder, Peter C Ferguson
BACKGROUND: Primary bone tumors of the femur are commonly reconstructed using an endoprosthesis. Different modes of implant failure have been described, including structural failure; although uncommon, this may be an under-reported complication. The purpose of this study is to examine the rates and risk factors for implant fracture of the Kotz Modular Femoral Tibial Reconstruction system (KMFTR). METHODS: Two hundred twenty-one patients (95 women and 126 men) who underwent a KMFTR reconstruction were reviewed...
September 21, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29025614/outcome-of-distal-tibia-physeal-fractures-a-review-of-cases-as-related-to-risk-factors
#15
Fabio D'Angelo, Giuseppe Solarino, Davide Tanas, Alessia Zani, Paolo Cherubino, Biagio Moretti
INTRODUCTION: The physeal fractures represent the 20-30% of all fractures of the child. The distal tibial physis is the third most frequently injured. The most important complication is the premature physeal closure (PPC). Aim of this study is to evaluate risk factors that can influence the outcome like fracture pattern, fracture displacement, mechanism of injury and treatment method. MATERIAL AND METHODS: The records of 46 patients treated for distal tibia physeal fractures between 2003 and 2013 were reviewed...
October 2017: Injury
https://www.readbyqxmd.com/read/28986074/finite-element-analysis-of-the-stability-of-ao-ota-43-c1-type-distal-tibial-fractures-treated-with-distal-tibia-medial-anatomic-plate-versus-anterolateral-anatomic-plate
#16
O Fuad Oken, A Ozgur Yildirim, Mehmet Asilturk
BACKGROUND: The treatment of a pilon fracture type is possible from a medial, an anterolateral approach or both medial and lateral. The aim of study was compare the stability of two different plate fixation of a tibia pilon AO-43C1 type fractures. MATERIAL AND METHODS: In this study, three-dimensional finite element stress analysis was applied using isotropic materials and static linear analysis. Loading of 400 N force was applied to the model of a patient fixed in a standing position...
October 3, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28932487/intra-articular-fractures-of-the-distal-tibia-current-concepts-of-management
#17
REVIEW
Alexandre Sitnik, Aleksander Beletsky, Steven Schelkun
Results of the treatment of intra-articular fractures of the distal tibia have improved significantly during the last two decades.Recognition of the role of soft tissues has led to the development of a staged treatment strategy. At the first stage, joint-bridging external fixation and fibular fixation are performed. This leads to partial reduction of the distal tibial fracture and allows time for the healing of soft tissues and detailed surgical planning.Definitive open reduction and internal fixation of the tibial fracture is performed at a second stage, when the condition of the soft tissues is safe...
August 2017: EFORT open reviews
https://www.readbyqxmd.com/read/28925312/what-is-the-best-treatment-for-displaced-salter-harris-ii-physeal-fractures-of-the-distal-tibia
#18
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
#19
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
#20
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
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