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Tibial Fracture

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https://www.readbyqxmd.com/read/28742786/proper-distal-placement-of-tibial-nail-improves-rate-of-malalignment-for-distal-tibia-fractures
#1
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/28742679/delayed-treatment-of-a-posterior-cruciate-ligament-tibial-insertion-avulsion-fracture-in-a-child-with-open-physis-a-case-report-with-a-4-year-follow-up
#2
Tales M Guimarães, Paulo V P Helito, Fabio J Angelini, Marco K Demange, José R Pécora, Camilo P Helito
Posterior cruciate ligament avulsion fracture from its tibial insertion is a rare pathology in children. It is usually caused by high-energy traumas and its diagnosis is not always easy. Late diagnosis leads to late treatment, which can result in suboptimal results. We present a case of a 13-year-old boy hit by a car, who had a delay in diagnosis and treatment because of severe head trauma. The patient was treated 4 months after the trauma with open reduction and internal fixation of the avulsion fracture. After 4 years of follow-up, he has no complaints and has achieved good functional outcome...
September 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28737641/tibial-plateau-fracture
#3
(no author information available yet)
No abstract text is available yet for this article.
July 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28737640/tibial-plateau-fracture
#4
Patrick Graham
No abstract text is available yet for this article.
July 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28736122/treatment-of-tibial-nonunion-with-posterolateral-bone-grafting
#5
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/28735430/approaches-and-fixation-of-the-posterolateral-fracture-fragment-in-tibial-plateau-fractures-a-review-with-an-emphasis-on-rim-plating-via-modified-anterolateral-approach
#6
REVIEW
Jae-Woo Cho, Jinil Kim, Won-Tae Cho, Jin-Kak Kim, Puspak Samal, Pranay H Gujjar, William T Kent, Jong-Keon Oh
PURPOSE: To review available approaches and fixation methods for posterolateral fracture fragment (PLF) in tibial plateau fracture, and to propose an algorithm to treat various types of plateau fractures which all involve the PLF. METHODS: This article reviews multiple surgical approaches for PLF and suggests an algorithm for suitable approach and fixation method according to PLF with combined plateau fracture. RESULTS: The modified anterolateral approach is a suitable single approach for fractures with a PLF combined with an anterolateral plateau fracture and for isolated posterolateral fracture fragments...
July 22, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28734986/exogenous-hedgehog-antagonist-delays-but-does-not-prevent-fracture-healing-in-young-mice
#7
Xiaochen Liu, Jennifer A McKenzie, Clayton W Maschhoff, Michael J Gardner, Matthew J Silva
Fracture healing recapitulates many aspects of developmental osteogenesis. The hedgehog (Hh) signaling pathway, essential to skeletal development, is upregulated during fracture healing, although its importance is unclear. Our goal was to assess the functional importance of Hh signaling in endochondral fracture healing. We created closed, transverse diaphyseal femur fractures in mice, stabilized with an intramedullary pin, and administered a systemic Hh inhibitor or vehicle. Because Hh pathway activation is mediated by the receptor Smoothened (Smo), we used the Smo antagonist GDC-0449 (GDC, 50mg/kg, twice daily) to target the pathway...
July 19, 2017: Bone
https://www.readbyqxmd.com/read/28733042/complications-and-unplanned-outcomes-following-operative-treatment-of-tibial-plateau-fractures
#8
David Kugelman, Abdullah Qatu, Jack Haglin, Phillip Leucht, Sanjit Konda, Kenneth Egol
INTRODUCTION: The operative management of tibial plateau fractures is challenging and post-operative complications do occur. The purpose of this study was three-fold. 1). To report complications and unplanned outcomes in patients who had sustained tibial plateau fractures and were operatively managed 2). To report predictors of these post-operative events 3). To report if differences in clinical outcomes exist in patients who sustained a post-operative event. METHODS: Over 11 years, all tibial plateau fractures were prospectively followed...
July 12, 2017: Injury
https://www.readbyqxmd.com/read/28724382/activation-of-cannabinoid-receptor-type-2-attenuates-surgery-induced-cognitive-impairment-in-mice-through-anti-inflammatory-activity
#9
Lingling Sun, Rui Dong, Xin Xu, Xi Yang, Mian Peng
BACKGROUND: Neuroinflammation plays a major role in postoperative cognitive dysfunction (POCD). Accumulated evidence indicates that cannabinoid receptor type 2 (CB2R) can mediate anti-inflammatory and immunomodulatory effects in part by controlling microglial activity. However, the impact of CB2R on postoperative cognition has not been investigated. We hypothesized that CB2R is involved in surgery-induced cognitive impairment in adult mice. METHODS: Adult C57BL/6 mice were subjected to intramedullary fixation surgery for tibial fracture under isoflurane anesthesia and CB2R agonist (JWH133) or CB2R antagonist (AM630) treatment...
July 19, 2017: Journal of Neuroinflammation
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
#10
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/28721498/functional-outcome-of-intra-articular-tibial-plateau-fractures-the-impact-of-posterior-column-fractures
#11
Juriaan van den Berg, Maike Reul, Menno Nunes Cardozo, Anastasiya Starovoyt, Eric Geusens, Stefaan Nijs, Harm Hoekstra
ABASTRACT: INTRODUCTION: Although regularly ignored, there is growing evidence that posterior tibial plateau fractures affect the functional outcome. The goal of this study was to assess the incidence of posterior column fractures and its impact on functional outcome and general health status. We aimed to identify all clinical variables that influence the outcome and improve insights in the treatment strategies. METHODS: A retrospective cohort study including 218 intra-articular tibial plateau fractures was conducted...
July 18, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28721473/biomechanics-of-the-classic-metaphyseal-lesion-finite-element-analysis
#12
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/28720982/single-incision-pediatric-flexible-intramedullary-tibial-nailing
#13
John G Coury, Zachary C Lum, Nicholas P O'Neill, Joseph A Gerardi
BACKGROUND: There has been a trend towards flexible intramedullary nailing for unstable tibial shaft fractures in the pediatric population, traditionally, utilizing a 2-incision technique with passage of one nail medially and one nail laterally. Our study aims to compare a single incision approach for flexible nailing of unstable tibial shaft fractures in pediatric patients to the traditional 2-incision approach. METHODS: Patients were selected for operative fixation if they had a length unstable tibial shaft fracture confirmed by fluoroscopy...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28720305/ecto-5-nucleotidase-cd73-regulates-bone-formation-and-remodeling-during-intramembranous-bone-repair-in-aging-mice
#14
Vivian Bradaschia-Correa, Anne M Josephson, Alexander J Egol, Matthew M Mizrahi, Kevin Leclerc, Jason Huo, Bruce N Cronstein, Philipp Leucht
Ecto-5'-nucleotidase (CD73) generates adenosine, an osteoblast activator and key regulator of skeletal growth. It is unknown, however, if CD73 regulates osteogenic differentiation during fracture healing in adulthood, and in particular how CD73 activity regulates intramembranous bone repair in the elderly. Monocortical tibial defects were created in 46-52-week-old wild type (WT) and CD73 knock-out mice (CD73(-/-)) mice. Injury repair was analyzed at post-operative days 5, 7, 14 and 21 by micro-computed tomography (micro-CT), histomorphometry, proliferating cell nuclear antigen (PCNA) immunostaining, alkaline phosphatase (ALP) and tartrate-resistant acid phosphatase (TRAP) histochemistry...
July 4, 2017: Tissue & Cell
https://www.readbyqxmd.com/read/28720096/clinical-and-radiographic-predictors-of-acute-compartment-syndrome-in-the-treatment-of-tibial-plateau-fractures-a-retrospective-cohort-study
#15
Axel Gamulin, Anne Lübbeke, Patrick Belinga, Pierre Hoffmeyer, Thomas V Perneger, Matthieu Zingg, Gregory Cunningham
BACKGROUND: The aim of the study was to evaluate the relation between demographic, injury-related, clinical and radiological factors of patients with tibial plateau fractures and the development of acute compartment syndrome. METHODS: All consecutive adult patients with intra-articular tibial plateau fractures admitted in our urban academic medical centre between January 2005 and December 2009 were included in this retrospective cohort study. The main outcome measurement was the development of acute compartment syndrome...
July 18, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28719943/treatment-with-circular-external-fixation-of-bicondylar-tibial-fractures-potential-in-accurate-reduction-and-efficacy-on-functional-results
#16
Giovanni Lovisetti, Ettore Vulcano, Lorenzo Bettella, Rohoman Tasarib, Tania Tondolo, Francesco Sala
No abstract text is available yet for this article.
July 18, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28719546/fracture-table-application-for-pediatric-femur-fractures-incidence-and-risk-factors-associated-with-adverse-outcomes
#17
Brian A Kelly, Manahil Naqvi, Emily S Rademacher, Patricia E Miller, Daniel J Hedequist, Michael P Glotzbecker, Travis H Matheney, Benjamin J Shore
BACKGROUND: Flexible elastic nails, submuscular plating, and rigid locked intramedullary nails are common methods of fixation for pediatric femur fractures (PFF) in which the fracture table is used to aid reduction. Little is known about complications associated with fracture table application in PFF. The purpose of this study was to determine the incidence and risk factors associated with adverse outcomes related to fracture table application for the treatment of PFF. METHODS: A retrospective chart review of all children (younger than 18 y) treated for a femur fracture with the use of the fracture table between 2004 and 2015 at a single tertiary pediatric hospital was performed...
July 17, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28717066/a-heart-shaped-sleeve-simplifies-intramedullary-tibial-nail-insertion-when-using-the-suprapatellar-approach
#18
Kosuke Tajima, Chikako Shimizu, Soichiro Ohno, Yusho Nishida, Kazuhiko Udagawa, Junichi Sasaki
The suprapatellar approach for intramedullary tibial nailing has become widely accepted over the past decade. A round sleeve is passed beneath the patella to protect the surface of the patellofemoral joint (PFJ). However, the round sleeve cannot be easily stabilized in the PFJ because it does not conform to the shape of the patellar apex. Consequently, we produced a heart-shaped sleeve to simplify the insertion of the entry sleeve during the suprapatellar approach. Using the new sleeve, the following procedure is used: (1) make a longitudinal 4 cm skin incision proximal to the patella to reach the PFJ, (2) insert the guide pin manually to the ventral edge of the tibial plateau, (3) insert the cannulated trocar along the guide pin, (4) insert the heart-shaped sleeve along the cannulated trocar, (5) remove the cannulated trocar, (6) ream the entry point through the heart-shaped sleeve...
July 15, 2017: Keio Journal of Medicine
https://www.readbyqxmd.com/read/28715376/a-rat-tibial-growth-plate-injury-model-to-characterize-repair-mechanisms-and-evaluate-growth-plate-regeneration-strategies
#19
Christopher B Erickson, Nichole Shaw, Nancy Hadley-Miller, Michael S Riederer, Melissa D Krebs, Karin A Payne
A third of all pediatric fractures involve the growth plate and can result in impaired bone growth. The growth plate (or physis) is cartilage tissue found at the end of all long bones in children that is responsible for longitudinal bone growth. Once damaged, cartilage tissue within the growth plate can undergo premature ossification and lead to unwanted bony repair tissue, which forms a "bony bar." In some cases, this bony bar can result in bone growth deformities, such as angular deformities, or it can completely halt longitudinal bone growth...
July 4, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28712877/bone-mass-microarchitecture-and-strength-are-influenced-by-race-ethnicity-in-young-adult-men-and-women
#20
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
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