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Distal tibial fractures

Danka Grčević, Marina Sironi, Sonia Valentino, Livija Deban, Hrvoje Cvija, Antonio Inforzato, Nataša Kovačić, Vedran Katavić, Tomislav Kelava, Ivo Kalajzić, Alberto Mantovani, Barbara Bottazzi
Pentraxin 3 (PTX3) is an inflammatory mediator acting as a fluid-phase pattern recognition molecule and playing an essential role in innate immunity and matrix remodeling. Inflammatory mediators also contribute to skeletal homeostasis, operating at multiple levels in physiological and pathological conditions. This study was designed to investigate the role of PTX3 in physiological skeletal remodeling and bone healing. Micro-computed tomography (μCT) and bone histomorphometry of distal femur showed that PTX3 gene-targeted female and male mice ( ptx3-/- ) had lower trabecular bone volume than their wild-type ( ptx3+/+ ) littermates (BV/TV by μCT: 3...
2018: Frontiers in Immunology
Chaowei Guo, Jianxiong Ma, Xinlong Ma, Ying Wang, Lei Sun, Bin Lu, AiXian Tian, Yan Wang, BenChao Dong
BACKGROUND: Intramedullary nailing (IMN) and plate have been reported as two effective devices for treating distal extra-articular fractures. However, reports of complications after fractures with use of different tibial fixation techniques in literatures are controversial. Thus, we performed a meta-analysis of randomized controlled trials (RCTs) to compare IMN with plate for evaluating the safety and efficacy. METHODS: The studies were searched from PubMed, Embase, Web of science and the Cochrane Central Register of Controlled Trials by two reviewers up to August 2017...
March 16, 2018: International Journal of Surgery
Ayman Ebied, Ahmed Zayda, Sameh Marei, Hany Elsayed
INTRODUCTION: Successful treatment of knee comminuted periarticular fractures associated with osteoporosis and pre-existing arthritis is a challenging task. METHODS: This is a prospective study on 27 patients who had comminuted intra and periarticular knee fractures and pre-existing arthritis. Fractures were classified according to Muller's AO classification. Primary knee arthroplasty was performed ± internal fixation following 4 weeks of splinting. A stem was added to the tibial tray and Legacy Constrained Condylar Knee (LCCK) or Rotating Hinge (RH) prosthesis were used depending on the level of ligament damage and bone defects...
2018: SICOT-J
Andy Tsai, Patrick R Johnston, Jeannette M Perez-Rossello, Micheál A Breen, Paul K Kleinman
BACKGROUND: The distal tibia is a common location for the classic metaphyseal lesion (CML). Prior radiologic-pathologic studies have suggested a tendency for medial, as opposed to lateral, cortical injury with the CML, but there has been no formal study of the geographic distribution of this strong indicator of abuse. OBJECTIVE: This study compares medial versus lateral cortical involvement of distal tibial CMLs in a clinical cohort of infants with suspected abuse...
March 14, 2018: Pediatric Radiology
Ryan R Birks, Michael P Kowaleski
OBJECTIVES:  The purpose of this study is to compare the load at failure and mode of failure between (1) tibial plateau levelling osteotomy (TPLO) and combined TPLO and tibial tuberosity transposition (TPLO-TTT) (Phase I) and (2) TPLO-TTT and tibial tuberosity transposition (TTT) (Phase II). METHODS:  Seven pairs of cadaveric tibiae were tested in each of the Phase I (TPLO vs. TPLO-TTT) and Phase II (TPLO-TTT vs. TTT) experiments. One limb of each pair was randomly assigned to one of two groups for each experimental phase...
February 2018: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Luis A Aponte-Tinao, Jose I Albergo, Miguel A Ayerza, D Luis Muscolo, Federico Milano Ing, German L Farfalli
BACKGROUND: Preservation of limb function after resection of malignant bone tumors in skeletally immature children is challenging. Resection of bone sarcomas and reconstruction with an allograft in patients younger than 10 years old is one reconstructive alternative. However, long-term studies analyzing late complications and limb length discrepancy at skeletal maturity are scarce; this information would be important, because growth potential is altered in these patients owing to the loss of one physis during tumor resection...
March 2018: Clinical Orthopaedics and related Research
Lin Wang, Yingze Zhang, Zhaohui Song, Hengrui Chang, Ye Tian, Fei Zhang
PURPOSE: To describe and evaluate the novel method of using elastic bionic fixation device in treating the distal tibiofibular syndesmosis (DTS) injury. METHODS: From June 2013 to January 2014, 17 subjects with ankle fractures combined with DTS separation were treated by the elastic bionic fixation device. The syndesmotic parameters, healing, functional scores, and possible complications were recorded. RESULTS: All patients had a mean follow-up of 23...
March 9, 2018: International Orthopaedics
Yousef Marwan, Shubhang Kulkarni, Abdullah Addar, Nizar Algarni, Iskandar Tamimi, Mathieu Boily, Paul A Martineau
PURPOSE: The purpose of this study is to describe the prevalence and associated factors of anterolateral ligament (ALL) injury in knee dislocation (KD). METHODS: A retrospective review of charts and radiological images was done for patients who underwent multiligamentous knee reconstruction surgery for KD in the authors' institution from May 2008 to December 2016. The inclusion criteria were both genders, skeletally mature, and first dislocation. Previous anterior cruciate ligament injury or surgery were the exclusion criteria...
March 3, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
C S Florio
A computational model was used to compare the local bone strengthening effectiveness of various isometric exercises that may reduce the likelihood of distal tibial stress fractures. The developed model predicts local endosteal and periosteal cortical accretion and resorption based on relative local and global measures of the tibial stress state and its surface variation. Using a multisegment three-dimensional leg model, tibia shape adaptations due to thirty-three combinations of hip, knee, and ankle joint angles and the direction of a single or sequential series of generated isometric resultant forces were predicted...
March 5, 2018: International Journal for Numerical Methods in Biomedical Engineering
Megan E Cain, Job N Doornberg, Robin Duit, Jock Clarnette, Ruurd Jaarsma, Bhavin Jadav
BACKGROUND: Intramedullary-nails (IMN) are the treatment of choice for most tibial shaft fractures due to their minimally-invasive nature and non-demanding surgical technique. However, a potential iatrogenic pitfall is intra-articular interlocking screw positioning within the proximal (PTFJ) and distal (DTFJ) tibiofibular joints that may go unrecognized. OBJECTIVE: To evaluate the incidence of intra-articular screw penetration of the PTFJ and DTFJs after interlocking of IMN for tibial fractures...
March 1, 2018: Injury
Kristian Samuelsson, Eleonor Svantesson, Eric Hamrin Senorski, Bengt Östman
February is a busy month for the ambulance skiing patrol at the skiing resorts in Norway and on this day, a call regarding an 11-year-old boy on one of the hills reached the team. What no one knew at that moment was that this boy had suffered a unique injury and that his X-rays would reveal something that, prior to this, had never been described in the history of mankind. This patient had suffered a simultaneous avulsion fracture of both the femoral and tibial insertion sites of the anterior cruciate ligament without suffering any other injuries to the knee...
March 1, 2018: BMJ Case Reports
Iftikhar H Wani, Naseem Ul Gani, Mohammad Yaseen, Adil Bashir, Mohammad Shahid Bhat, Munir Farooq
BACKGROUND: The ideal treatment of distal tibial extra articular fractures remains controversial. Minimally invasive percutaneous plate osteosynthesis and intramedullary nailing are the two most commonly used methods. We did a prospective randomized controlled study to assess the functional outcome of distal tibial extra articular tibial fractures by comparing these treatment methods. MATERIALS AND METHODS: Sixty patients with distal tibial extra articular fractures were randomly assigned to an IMN (intramedullary nailing) group and a MIPPO (minimally invasive percutaneous plate osteosynthesis) group...
December 30, 2017: Ortopedia, Traumatologia, Rehabilitacja
Michele Bisaccia, Andrea Cappiello, Luigi Meccariello, Giuseppe Rinonapoli, Gabriele Falzarano, Antonio Medici, Cristina Ibáñez Vicente, Luigi Piscitelli, Verdiana Stano, Olga Bisaccia, Auro Caraffa
INTRODUCTION: Distal tibial fractures are the most common long bone fractures. Several studies focusing on the methods of treatment of displaced distal tibial fractures have been published. To date, locked plates, intramedullary nails and external fixation are the three most used techniques. The aim of our study was to compare intramedullary nail (IMN) and locked plate (LP) for treatment of this kind of fracture. MATERIALS AND METHODS: We collected data on 81 patients with distal tibial fractures (distance from the joint between 40 and 100 mm) and we divided into two groups: IMN and LP...
2018: SICOT-J
Isabel R Orriss, Stuart Lanham, Dawn Savery, Nicholas D E Greene, Philip Stanier, Richard Oreffo, Andrew J Copp, Gabriel L Galea
Fractures are a common comorbidity in children with the neural tube defect (NTD) spina bifida. Mutations in the Wnt/planar cell polarity (PCP) pathway contribute to NTDs in humans and mice, but whether this pathway independently determines bone mass is poorly understood. Here, we first confirmed that core Wnt/PCP components are expressed in osteoblasts and osteoclasts in vitro. In vivo, we performed detailed µCT comparisons of bone structure in tibiae from young male mice heterozygous for NTD-associated mutations versus WT littermates...
February 20, 2018: Scientific Reports
Melissa Corso, Christopher DeGraauw, William Hsu
Introduction: Osteochondral lesions of the tibial plafond account for approximately 2.6% of osteochondral lesions in the ankle. There are few cases describing this lesion in the literature, with little information on mechanism of injury, history/physical findings or recommendations for management. Case Presentation: A 17-year-old male competitive soccer player presented with a 6-7 month history of medial ankle pain after an inversion sprain. He presented with locking and giving way of the ankle with weight-bearing and pushing off the foot to the contralateral side...
December 2017: Journal of the Canadian Chiropractic Association
Hiroshi Sasai, Daisuke Fujita, Eiko Seto, Yuki Denda, Yutaro Imai, Kanako Okamoto, Kensaku Okamura, Masaru Furuya, Hiroyuki Tani, Kazumi Sasai
OBJECTIVE To evaluate outcome of limb fracture repair in rabbits. DESIGN Retrospective case series. ANIMALS 139 client-owned rabbits with limb fractures treated between 2007 and 2015. PROCEDURES Medical records were reviewed for information on fracture location, fracture treatment, and time to fracture healing. RESULTS 25 rabbits had fractures involving the distal aspects of the limbs (ie, metacarpal or metatarsal bones, phalanges, and calcaneus or talus). Fractures were treated in 23 of these 25 rabbits (external coaptation, n = 17; external skeletal fixation, 4; and intramedullary pinning, 2) and healed in all 23, with a median healing time of 28 days (range, 20 to 45 days)...
February 15, 2018: Journal of the American Veterinary Medical Association
Berna Okudan, Nazım Coşkun, Pelin Arıcan
Stress fractures are injuries most commonly seen in the lower limbs and are usually caused by repetitive stress. While the distal and middle third of the tibia is the most frequent site for stress fractures (almost 50%), stress fractures of the proximal tibia is relatively rare and could be confused with other types of tibial fractures, thus altering management plans for the clinician. Early diagnosis of stress fractures is also important to avoid complications. Imaging plays an important role in the diagnosis of stress fractures, especially bone scan...
February 1, 2018: Molecular Imaging and Radionuclide Therapy
M T Yin, A RoyChoudhury, K Nishiyama, T Lang, J Shah, S Olender, D C Ferris, C Zeana, A Sharma, B Zingman, M Bucovsky, I Colon, E Shane
We found that HIV+/HCV+ women had 7-8% lower areal bone mineral density (aBMD) by dual-energy x-ray absorptiometry (DXA) at the spine, hip, and radius (p < 0.01) and 5-7% lower volumetric BMD (vBMD) by central quantitative computed tomography (cQCT) at the spine and hip (p < 0.05). These data suggest that true deficits in vBMD may contribute to bone fragility and excess fractures reported in HIV+/HCV+ women. INTRODUCTION: aBMD by DXA is lower in persons coinfected with HIV and HCV (HIV+/HCV+) than with HIV monoinfection (HIV+)...
February 1, 2018: Osteoporosis International
Peter O'Farrell, Annette-Christi Barnard, Franz Birkholtz
Management of open lower limb fractures with soft tissue defects can be a technically challenging orthopaedic problem. Limited availability of orthoplastic services means that alternatives to the fix and flap concept are required in order to prevent infected non-unions from developing. The proposed 'bayonet apposition' allows the surgeon to temporarily shorten the limb without angulating the limb or creating a bone defect and removing viable bone. The viable bone edges are overlapped in a bayonet-like manner in order to appose the wound and skin edges...
January 24, 2018: Strategies in Trauma and Limb Reconstruction
Fancheng Chen, Xiaowei Huang, Yingsun Ya, Fenfen Ma, Zhi Qian, Jifei Shi, Shuolei Guo, Baoqing Yu
BACKGROUND: Proximal tibia fractures are one of the most familiar fractures. Surgical approaches are usually needed for anatomical reduction. However, no single treatment method has been widely established as the standard care. Our present study aims to compare the stress and stability of intramedullary nails (IMN) fixation and double locking plate (DLP) fixation in the treatment of extra-articular proximal tibial fractures. METHODS: A three-dimensional (3D) finite element model of the extra-articular proximal tibial fracture, whose 2-cm bone gap began 7 cm from the tibial plateau articular surface, was created fixed by different fixation implants...
January 16, 2018: Journal of Orthopaedic Surgery and Research
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