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Distal tibial fractures

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https://www.readbyqxmd.com/read/29313169/upright-activity-and-higher-motor-function-may-preserve-bone-mineral-density-within-6%C3%A2-months-of-stroke-a-longitudinal-study
#1
Karen Borschmann, Sandra Iuliano, Ali Ghasem-Zadeh, Leonid Churilov, Marco Y C Pang, Julie Bernhardt
PURPOSE: Bone fragility contributes to increased fracture risk, but little is known about the emergence of post-stroke bone loss. We investigated skeletal changes and relationships with physical activity, stroke severity, motor control and lean mass within 6 months of stroke. METHODS: This is a prospective observational study. Participants were non-diabetic but unable to walk within 2 weeks of first stroke. Distal tibial volumetric bone mineral density (vBMD, primary outcome), bone geometry and microstructure (high-resolution peripheral quantitative computed tomography) were assessed at baseline and 6 months, as were secondary outcomes total body bone mineral content and lean mass (dual energy X-ray absorptiometry), bone metabolism (serum osteocalcin, N-terminal propeptide of type 1 procollagen (P1NP), C-terminal telopeptide of type 1 collagen (CTX)), physical activity (PAL2 accelerometer) and motor control (Chedoke McMaster) which were also measured at 1 and 3 months...
January 8, 2018: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29305233/anterolateral-distal-tibia-locking-plate-osteosynthesis-and-their-ability-to-capture-otac3-pilon-fragments
#2
Arun Aneja, T David Luo, Boshen Liu, Molina Domingo, Kerry Danelson, Jason J Halvorson, Eben A Carroll
BACKGROUND: Intra-articular Pilon fractures remain therapeutically challenging due to osteochondral fracturing and comminution, marginal impaction, and insult to the soft tissue envelope. The purpose of this study was to compare the efficacy of anterolateral distal tibial locking plates in capturing main fracture fragments in tibial plafond fractures. METHODS: From May 2011 to Dec 2015, 169 OTA C-type pilon fractures met inclusion and exclusion criteria with computed tomographic (CT) scans performed prior to definitive fixation...
December 16, 2017: Injury
https://www.readbyqxmd.com/read/29276733/decisive-differences-in-the-bone-repair-processes-of-the-metaphysis-and-diaphysis-in-young-mice
#3
Satoshi Inoue, Hirotada Otsuka, Jiro Takito, Masanori Nakamura
Fractures are common traumatic injuries that mainly occur in the metaphyses of long bones such as the proximal humerus, distal radius, and proximal femur. However, most studies of fracture repair processes have focused on the diaphyseal region. In this study, we compared the bone repair processes of the metaphysis and the diaphysis of the mouse tibia. Bone apertures were formed in the tibial metaphysis and diaphysis. At indicated times after surgery, samples were collected, and the healing process was investigated using micro-computed tomography, as well as histological, immunohistochemical, and mRNA expression analyses...
June 2018: Bone Reports
https://www.readbyqxmd.com/read/29244680/irreducible-ankle-fracture-from-an-interposed-chaput-fragment-a-case-report
#4
Chihua Lee, Thomas J Douglas
CASE: A 23-year-old active-duty military service member sustained an unusual irreducible fracture-dislocation of the ankle joint. Preoperative computed tomography showed an anterolateral tibial (Chaput) fragment entrapped within the distal syndesmosis, preventing adequate reduction. An open reduction of the fragment was performed in the operating room, which allowed near-anatomic reduction and internal fixation of the tibiotalar joint. At the 21-month follow-up visit, the patient remained on active duty in the Navy without limitations...
April 2017: JBJS Case Connector
https://www.readbyqxmd.com/read/29230422/novel-semiquantitative-bone-marrow-oedema-score-and-fracture-score-for-the-magnetic-resonance-imaging-assessment-of-the-active-charcot-foot-in-diabetes
#5
L Meacock, N L Petrova, Ana Donaldson, A Isaac, A Briody, R Ramnarine, M E Edmonds, D A Elias
There are no accepted methods to grade bone marrow oedema (BMO) and fracture on magnetic resonance imaging (MRI) scans in Charcot osteoarthropathy. The aim was to devise semiquantitative BMO and fracture scores on foot and ankle MRI scans in diabetic patients with active osteoarthropathy and to assess the agreement in using these scores. Three radiologists assessed 45 scans (Siemens Avanto 1.5T, dedicated foot and ankle coil) and scored independently twenty-two bones (proximal phalanges, medial and lateral sesamoids, metatarsals, tarsals, distal tibial plafond, and medial and lateral malleoli) for BMO (0-no oedema, 1-oedema < 50% of bone volume, and 2-oedema > 50% of bone volume) and fracture (0-no fracture, 1-fracture, and 2-collapse/fragmentation)...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/29218771/menopause-related-appendicular-bone-loss-is-mainly-cortical-and-results-in-increased-cortical-porosity
#6
Åshild Bjørnerem, Xiaofang Wang, Minh Bui, Ali Ghasem-Zadeh, John L Hopper, Roger Zebaze, Ego Seeman
After menopause, remodeling becomes unbalanced and rapid. Each of the many remodeling transactions deposits less bone than it resorbed, producing microstructural deterioration. Trabecular bone is said to be lost more rapidly than cortical bone. However, because 80% of the skeleton is cortical, we hypothesized that most menopause-related bone loss and changes in bone microstructure are cortical, not trabecular in origin, and are the result of intracortical remodeling. Distal tibial and distal radial microstructure were quantified during 3...
December 8, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/29199087/primary-total-knee-arthroplasty-for-acute-fracture-around-the-knee
#7
REVIEW
S Parratte, M Ollivier, J-N Argenson
Relatively poor results have been reported with open reduction and internal fixation of complex fractures around the knee in elderly osteoporotic patients, and primary total knee arthroplasty (TKA) has been proposed as an alternative solution. While limiting the number of procedures, it meets two prerequisites: 1) to save the patient's life, thanks to early weight-bearing, to limit decubitus complications; and 2) to save knee function and patient autonomy, thanks to early knee mobilization. There are 3 main indications: complex articular fractures in elderly patients with symptomatic osteoarthritis prior to fracture; complex articular fractures of the tibial plateau in elderly patients whose bone quality makes internal fixation hazardous; and major destruction of the distal femur in younger patients...
November 30, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29183896/paediatric-salter-harris-type-iv-injury-of-distal-tibia-with-talus-fracture
#8
Swapnil Kothadia, Umesh Birole, Ashish Ranade
Fracture of talus with Salter-Harris injury of the distal end of tibia is a rare injury in paediatric age group. The authors report a case of a 13-year-old male child who sustained type IV Salter-Harris injury to the medial malleolus with coronal spilt along with spilt and depressed fracture of the neck of talus and fracture of the lateral process of talus with stable compression fracture of spine sustained due to fall from 6 meters height. CT scan delineated the morphology of fracture pattern and helped in preoperative planning...
November 27, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29182123/angular-deformity-development-after-the-distal-tibial-physeal-fractures
#9
B Özkul, M S Saygılı, E Çetinkaya, F Arslanoğlu, I A Bayhan, B Demir, A C Tekin
Several clinical and radiological factors can be prognostic in the development of angular deformity following physeal injuries of the distal tibia. One of the radiological parameters, premature physeal closure (PPC), can be detected during postoperative follow-ups. Aim of our study was to identify the prognostic factors in development of angular deformity and its relationship with PPC. One hundred and four patients treated due to physeal injuries of the distal tibia were included in our study. Patients were divided into three groups based on Salter-Harris (SH) classification...
December 2016: Acta Orthopaedica Belgica
https://www.readbyqxmd.com/read/29172015/tibial-impingement-secondary-to-distal-fibular-lag-screw-placement-a-case-report
#10
Lu Bai, Wen Zhou, Wen-Tao Zhang, Wei Huang, Hong-Lei Zhang
Impingement, tibial erosions, and "painful hardware" caused by a lag screw used for malleolar fracture stabilization are rare occurrences. We report a case of a symptomatic lag screw, used to fix a distal fibular fracture, that impinged on the distal tibial and causing symptoms. Awareness of the condition and early diagnosis based on thoughtful review of CT images are key to symptom alleviation. A review of the published data on the complication of "painful hardware" following ankle fracture fixation is also presented...
November 17, 2017: Technology and Health Care: Official Journal of the European Society for Engineering and Medicine
https://www.readbyqxmd.com/read/29171365/-distal-femur-fracture-in-a-woman-with-a-lower-limb-prosthesis
#11
E C T Baars, A K Mostert
BACKGROUND: People who use a lower limb prosthesis can fracture their distal femur after a trivial fall; however, this kind of fracture is uncommon. CASE DESCRIPTION: A 53-year-old woman with a trans-tibial prosthesis fell in her kitchen. She felt pain just above the socket of the prosthesis, was unable to get up and her knee and leg were swollen. Radiographic imaging showed a distal femur fracture, for which she received a non-operative treatment with a stump cast...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29158651/soft-tissue-complications-in-distal-tibial-fractures-managed-with-medial-locking-plates-a-myth-or-reality
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
RANDOMIZED CONTROLLED TRIAL
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
#20
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
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