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(Knee OR tibia OR pilon) AND fracture

Kwang-Bok Lee, Seong-Yup Jeong, Seung-Ho Kim, Dong-Gun Shim
The surgical management of distal intra-articular comminuted fracture of the tibia (pilon fracture) is difficult because complications frequently develop. The minimally invasive plate osteosynthesis technique is generally accepted for this type of fracture. In this study, complications developed after open reduction and internal fixation using multiple miniplates for accurate reduction of small fracture fragments. Therefore, when we use this technique, we need to pay attention to the development of complications such as nonunion, avascular necrosis, and osteomyelitis by the disruption of both endosteal blood supply by fracture and periosteal blood supply during approach or reduction...
May 2018: Journal of the American Podiatric Medical Association
Sebastian Lotzien, Clemens Hoberg, Martin F Hoffmann, Thomas A Schildhauer
PURPOSE: The number of total knee arthroplasties (TKA) increased rapidly. In conjunction with higher implantation rates, periprosthetic femur fractures following TKA are also gradually increasing. Purpose of this study was to evaluate polyaxial locking plate treatment of periprosthetic femoral fractures with retained total knee replacement using polyaxial locking plates in regard to quality of life, functional outcome and complications. METHODS: The Study design is a single-center retrospective cohort analysis...
June 22, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Tien Yeoh, Efthymios Iliopoulos, Alex Trompeter
The most commonly accepted system of classification for tibia plateau fractures is that of Schatzker. Increasingly, both high energy injuries and atypical osteoporotic fragility failures have led to more complex, unusual and previously undescribed fracture patterns being recognized. We present a case of a patient with a previously unreported pattern of tibia plateau fracture and knee dislocation. We highlight the challenges confronted and present the management and the outcomes of his injury. A 28-year old male motorcyclist was involved in a head on collision with a truck and was transferred by helicopter to our level 1 major trauma centre emergency department...
May 24, 2018: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
Marie Anneberg, Ole Brink
The aim for this review is to present general considerations in relation to malalignment after osteosynthesis with plate fixation and its consequences after fractures in adults in each of the following anatomical locations: humerus, forearm, femur, tibia. Recommendations for accepted malalignment in humerus diaphyseal fracture is varus <20 degrees, valgus <15 degrees, sagittal deformity <5 degrees and rotation <30 degrees. Recommendations when treating fractures of the forearm is anatomical reduction...
June 2018: Injury
Simone Wurm, Volker Bühren, Peter Augat
The standard treatment for patella fractures is tension band wiring. However, with tension band wiring anatomical reduction and rigid fixation can be challenging and the clinical outcome after patella fracture is often not satisfying. The purpose of this prospective clinical observation was to evaluate the clinical outcome in patients with patella fractures treated with an angular stable patella plate. Between 2011 and 2015 a total of 67 patients were treated with an angular stable patella plate. Outcome in these patients was evaluated by the Knee Outcome Survey Activities of Daily Living Scale (KOS-ADL) and range of motion of the knee joint was assessed...
June 2018: Injury
K N Manjunath, M S Venkatesh, Ashwini Shivaprasad
Background: Reconstruction of the popliteal region has limited option in terms of muscle flaps or myocutaneous flaps. Gastrocnemius muscle or the myocutaneous flaps are the option for majority of cases. However, reach of Gastrocnemius is limited if the wound is on the distal one-third thigh or the lateral aspect of knee region. Similarly, if the wound injures the muscle, then coverage becomes all the more difficult. Although inferiorly based fasciocutaneous flaps can cover the wound in case of bony injuries, muscle flaps are beneficial as they help in fracture healing...
January 2018: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
Claudia Beaudoin, Sonia Jean, Lynne Moore, Philippe Gamache, Louis Bessette, Louis-Georges Ste-Marie, Jacques P Brown
Prognostic tools are available to identify individuals at high risk of osteoporotic fracture and assist physicians in management decisions. Some authors have suggested improving the predictive ability of current tools by integrating characteristics of prior fractures (number, location and time since prior fracture). The objectives of this study were i) to evaluate the sex-age-specific association between characteristics of prior fractures and the occurrence of a future osteoporotic fracture and ii) to assess whether the characteristics of prior fractures could increase the discriminative ability of fracture risk prediction tools...
June 20, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Ying Chen, Jian Zhang, Zhe Chen, Quanguang Wang, Bing Li, Rujing Lai, Xuzhong Xu, Zhifang Cao, Lizhen Yu
BACKGROUND AND OBJECTIVES: Although intravenous lipid emulsion has been proved a powerful antidote for local anesthetic toxicity, there are few pharmacokinetic data on using lipid infusion as a pretreatment for other clinical applications. We assessed the influence of lipid pretreatment on the pharmacodynamics and pharmacokinetics of levobupivacaine. METHODS: Altogether, 12 patients undergoing below-knee surgery for a fracture were randomly assigned to 2 groups (6 patients per group): pretreatment with 1...
June 19, 2018: Regional Anesthesia and Pain Medicine
Syed Mannan, Mohammed Ali, Lukasz Mazur, Mei Chin, Ahmed Fadulelmola
Background: Incidence of infection following total elbow replacement (TER) is recognised to be higher compared to hip or knee arthroplasty. Extensive swelling following TER can complicate the wound healing which might lead to infection. Tranexamic Acid (TXA) is proven to reduce blood loss peri-operatively which might contribute to better healing outcomes. Our aim is to assess the effect of TXA in wound healing following TER. Methods: A retrospective review of a single surgeon case series. 10 patients had TER mainly for complicated elbow fractures, four of them were relatively immune-supressed...
2018: Journal of Bone and Joint Infection
S Campi, S J Mellon, D Ridley, B Foulke, C A F Dodd, H G Pandit, D W Murray
Objectives: The primary stability of the cementless Oxford Unicompartmental Knee Replacement (OUKR) relies on interference fit (or press fit). Insufficient interference may cause implant loosening, whilst excessive interference could cause bone damage and fracture.The aim of this study was to identify the optimal interference fit by measuring the force required to seat the tibial component of the cementless OUKR (push-in force) and the force required to remove the component (pull-out force)...
March 2018: Bone & Joint Research
Atsushi Kogure, Yu Mori, Hidetatsu Tanaka, Masayuki Kamimura, Naoya Masahashi, Shuji Hanada, Eiji Itoi
Intramedullary nailing is widely performed for internal fixation of fractures. The applicable elasticity of materials composing intramedullary nails remains unclear. The present study aimed to evaluate the effects of the elastic property of β-type titanium alloy nails on fracture healing compared with conventional Ti-6Al-4V alloy nails using a rabbit tibial osteotomy model. Two types of intramedullary nails composed of β-type Ti-Nb-Sn alloy (Young's modulus: 37 GPa) or Ti-6Al-4V alloy (Young's modulus: 110 GPa) were used for osteotomy fixation in the tibiae of rabbits...
June 19, 2018: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
Sander van Hoeve, Michael Houben, Jan P A M Verbruggen, Paul Willems, Kenneth Meijer, Martijn Poeze
Ankle fractures are among the most common lower limb fractures. Associations between postoperative radiographic results and clinical outcome have been found, but less is known about the relevant ankle biomechanics. This study analysed ankle kinematics, radiographic findings and patient-reported outcome measures (PROM) in patients treated for ankle fractures. The hypothesis was that patients after ankle fracture surgery had less flexion/extension in the ankle compared to healthy subjects and that fracture severity had significant influence on kinematics and patient satisfaction...
June 19, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Abdel-Salam A Ahmed, Mohammed S Singer, Hossam A El Bigawi
OBJECTIVES: To evaluate the outcomes of neglected pilon fractures treated by the Ilizarov fixator and to determine whether this technique was successful in avoiding an ankle arthrodesis. DESIGN: Retrospective case series. SETTING: Level I university trauma center. PATIENTS: Between January 2003 and March 2015, 18 patients (mean age of 42.17 years) with an untreated pilon fracture with late presentation (>1 month) were evaluated...
July 2018: Journal of Orthopaedic Trauma
Dylan L McCreary, Melissa White, Sandy Vang, Brad Plowman, Brian P Cunningham
OBJECTIVES: To use surgical treatment of isolated ankle fractures as a model to compare time-driven activity-based costing (TDABC) and our institution's traditional cost accounting (TCA) method to measure true cost expenditure around a specific episode of care. METHODS: Level I trauma center ankle fractures treated between 2012 and 2016 were identified through a registry. Inclusion criteria were age greater than 18 years and same-day ankle fracture operation. Exclusion criteria were pilon fractures, vascular injuries, soft-tissue coverage, and external fixation...
July 2018: Journal of Orthopaedic Trauma
Michael Nienhaus, Ivan Zderic, Dieter Wahl, Boyko Gueorguiev, Pol Maria Rommens
BACKGROUND: Displaced transverse patellar fractures require open reduction and internal fixation. State-of-the-art stabilization techniques are tension band wiring (TBW) using Kirschner wires or cannulated screws. These techniques are associated with high rates of secondary fracture displacement, implant migration, implant prominence, wound-healing disturbances, and the need for implant removal. Recently, a locked intraosseous patellar nail prototype was developed. The aim of the present study was to investigate the biomechanical performance of this nail compared with TBW using cannulated screws...
June 20, 2018: Journal of Bone and Joint Surgery. American Volume
Xueliang Cui, Hui Chen, Yunfeng Rui, Yang Niu, He Li
Objectives Two-stage open reduction and internal fixation (ORIF) and limited internal fixation combined with external fixation (LIFEF) are two widely used methods to treat Pilon injury. However, which method is superior to the other remains controversial. This meta-analysis was performed to quantitatively compare two-stage ORIF and LIFEF and clarify which method is better with respect to postoperative complications in the treatment of tibial Pilon fractures. Methods We conducted a meta-analysis to quantitatively compare the postoperative complications between two-stage ORIF and LIFEF...
January 1, 2018: Journal of International Medical Research
Gabriele Falzarano, Giuseppe Pica, Antonio Medici, Giuseppe Rollo, Michele Bisaccia, Raffaele Cioffi, Mario Pavone, Luigi Meccariello
The aim of our study was to investigate which technique among hybrid external fixation, plate and screws, and intramedullary nailing produces better outcomes in foot loading when treating type 43.A1, 43.A2, and 43.A3 fractures, according to the AO classification. From November 2011 to December 2014, 34 patients, including 25 (73.5%) males and 9 (26.5%) females with an average age of 32.3 (range 16 to 67) years, with a type A tibia fracture were treated with intramedullary nailing, plate and screws, or hybrid external fixation...
June 15, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Karen Mys, Filip Stockmans, Evie Vereecke, G Harry van Lenthe
Due to the rising life expectancy, bone diseases (e.g. osteoporosis, osteoarthritis) and trauma (e.g. fracture) have become an important socio-economic burden. Accurate visualization and quantification of the bone microstructure in vivo is seen as an important step to enhance diagnosis and treatment. Micro-computed tomography (microCT) has become the gold standard in three-dimensional (3D) imaging of trabecular bone structure. Yet, usage is limited to ex vivo analyses, hence, it cannot be used to evaluate bone and bone adaptive responses in a patient...
June 14, 2018: Bone
W Brent Edwards, Narina Simonian, Ifaz T Haider, Alan S Anschel, David Chen, Keith E Gordon, Elaine K Gregory, Ki H Kim, Ramadevi Parachuri, Karen L Troy, Thomas J Schnitzer
Spinal cord injury (SCI) is associated with marked bone loss and an increased risk of fracture. We randomized 61 individuals with chronic SCI and low bone mass to receive either: teriparatide 20 µg/day plus sham vibration 10 min/day (n = 20), placebo plus vibration 10 min/day (n = 20), or teriparatide 20 µg/day plus vibration 10 min/day (n = 21). Patients were evaluated for 12 months; those who completed were given the opportunity to participate in an open-label extension where all participants (n = 25) received teriparatide 20 µg/day for an additional 12 months and had the optional use of vibration (10 min/day)...
June 15, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Brian M Ilfeld, Rodney A Gabriel, Engy T Said, Amanda M Monahan, Jacklynn F Sztain, Wendy B Abramson, Bahareh Khatibi, John J Finneran, Pia T Jaeger, Alexandra K Schwartz, Sonya S Ahmed
BACKGROUND AND OBJECTIVES: Percutaneous peripheral nerve stimulation (PNS) is an analgesic modality involving the insertion of a lead through an introducing needle followed by the delivery of electric current. This modality has been reported to treat chronic pain as well as postoperative pain the day following knee surgery. However, it remains unknown if this analgesic technique may be used in ambulatory subjects following foot procedures beginning within the recovery room immediately following surgery, and with only short series of patients reported to date, the only available data are derived from strictly observational studies...
June 13, 2018: Regional Anesthesia and Pain Medicine
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