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Tibial Fracture

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https://www.readbyqxmd.com/read/29162269/trans-articular-kirschner-wire-fixation-in-treating-complex-tibial-plateau-fractures-complicated-by-multiple-ligaments-injuries-a-case-report-and-literature-review
#1
Jianbin Wu, Yiyang Wang, Feiya Zhou, Lei Yang, Jun Tang
There is no guideline and consensus about when and how to treat accompanying multi-ligaments injuries, especially anterior and/or posterior cruciate ligaments, in tibial plateau fractures. We report one case of fracture and dislocation of tibial plateau, treated by open reduction and internal plates fixation, augmented by trans-articular Kirschner wire fixation to overcome instability and malrotation of the knee joints discovered intraoperatively. The Kirschner wire was removed about four weeks after the index operation, and the patient begun functional exercise from then on...
November 18, 2017: Injury
https://www.readbyqxmd.com/read/29162248/predicting-syndesmotic-injuries-in-ankle-fractures-a-new-system-based-on-the-medial-malleolar-focus
#2
Enrique Sánchez-Morata, José Carlos Martínez-Ávila, Elena Vacas Sánchez, Verónica Jiménez Díaz, Jaime Zorrilla Sánchez de Neyra, Jesús Vilá Y Rico
The early establishment of the diagnosis of a syndesmotic injury is essential for treatment selection. However, such injuries may not be apparent radiographically. Previous studies have attempted to describe correlations between medial malleolar fracture geometry and syndesmotic disruption. The main objective of this study was to create predictive models for assessing syndesmotic injuries based on an originally described angle, i.e., the medial crural-focal angle (MCFA). This study included 138 ankle fractures involving the medial malleolus...
November 2017: Injury
https://www.readbyqxmd.com/read/29162247/severe-tibial-plateau-fractures-schatzker-v-vi-open-reduction-and-internal-fixation-versus-hybrid-external-fixation
#3
Maria L Bertrand, F Javier Pascual-López, Enrique Guerado
Tibial plateau fractures (TPF) are highly prone to complications and adverse effects. Their treatment has long been a matter of controversy, as fracture patterns and possible damage to soft tissues can easily aggravate complications. On the one hand, open reduction and internal fixation (ORIF) techniques provide a good approach to joint shape restoration and biomechanics, but they may also provoke a higher rate of soft-tissue complications. On the other, hybrid external fixation (HEF), although allowing little facility for reduction, may, theoretically, produce much less damage to the soft tissues...
November 2017: Injury
https://www.readbyqxmd.com/read/29159851/comparison-of-three-fixation-methods-in-treatment-of-tibial-fracture-in-adolescents
#4
REVIEW
Lixiang Lin, Yang Liu, Chuanlu Lin, Yifei Zhou, Yongzeng Feng, Xiaolong Shui, Kehe Yu, Xiaolang Lu, Jianjun Hong, Yang Yu
BACKGROUND: Tibial fractures are the most common musculoskeletal injury in adolescents. The optimal management of tibial fractures in adolescents is controversial. In this study, we compared the outcomes including complications of three fixation methods in tibial fractures of adolescents and explored the factors associated with the complications. METHODS: A retrospective cohort study about 83 diaphyseal tibial fractures in 79 children and adolescents, who were treated with plate fixation (PF), elastic stable intramedullary nail fixation (ESINF), or external fixation (EF), was conducted...
November 21, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29159663/infrapatellar-vs-suprapatellar-approach-to-obtain-an-optimal-insertion-angle-for-intramedullary-nailing-of-tibial-fractures
#5
Joerg Franke, Annika Homeier, Lars Metz, Thilo Wedel, Volker Alt, Sven Spät, Bernd Hohendorff, Reinhard Schnettler
BACKGROUND: During intramedullary nailing of tibial fractures, the insertion angle of the nail is of great importance. When the nail impacts the posterior cortex due to a large insertion angle with a dorsal target course, higher insertion forces are needed, and the danger of iatrogenic fractures increases. Accordingly, the insertion direction should be as parallel as possible to the longitudinal axis of the tibia. We aimed to confirm the hypothesis that intramedullary nailing of tibial fractures can be performed with smaller insertion angles via a suprapatellar approach rather than infrapatellar approach...
November 20, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29158651/soft-tissue-complications-in-distal-tibial-fractures-managed-with-medial-locking-plates-a-myth-or-reality
#6
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/29158648/non-invasive-repair-of-an-iatrogenic-tibial-artery-branch-pseudoaneurysm-after-intramedullary-nailing
#7
Cameron G Hanson, Logan F Hanson
Tibial fractures are a commonly seen injury in orthopedic surgery. Intramedullary nailing is considered the standard of care, as complications are rare. Those of a vascular nature, including iatrogenically induced pseudoaneurysms of the tibial artery have been previously described in the literature, however each reported case has required surgical repair. In the current case, we describe a repair of a tibial artery branch pseudoaneurysm, after direct contact with an interlocking screw from tibial intramedullary nailing, via ultrasound-guided thrombin injection...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29158646/management-of-comminuted-tibial-end-bony-avulsion-of-posterior-cruciate-ligament-by-open-posterior-approach-using-suture-bridge-technique-a-case-series
#8
Vivek Pandey, Naveen Mathai, A Varshini, Kiran Acharya
Background: Comminuted tibial end bony avulsion of posterior cruciate ligament (PCL) is a challenging problem in terms of accurate reduction, fixation and union to provide a stable knee. Arthroscopic reduction or a screw fixation is good option for a large fragment but comminuted fragment reduction remains a challenge. Suture bridge technique using two anchors can provide an accurate reduction and stable fixation. Method: 10 patients of isolated comminuted PCL avulsion with a mean age of 30 years were fixed by standard posterior approach using suture bridge technique...
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
#9
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
#10
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/29157843/predictors-of-osteoarthritis-following-operative-treatment-of-medial-tibial-plateau-fractures
#11
Markus Parkkinen, Jan Lindahl, Tatu J Mäkinen, Seppo K Koskinen, Antti Mustonen, Rami Madanat
PURPOSE: To determine factors influencing the development of posttraumatic osteoarthritis (OA) following medial tibial plateau fractures and to evaluate concomitant injuries associated with these fractures. MATERIALS AND METHODS: A chart review of patients with operatively treated medial tibial plateau fractures admitted to our Level I trauma centre from 2002 to 2008 was performed. Of 63 patients, 41 participated in a clinical and radiographic examination. The mean age was 47 years (range 16-78) and the mean follow-up time was 7...
November 14, 2017: Injury
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
#12
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/29153450/is-external-fixation-needed-for-the-treatment-of-tibial-fractures-with-acute-compartment-syndrome
#13
Tae Hun Kim, Jun Young Chung, Keun Su Kim, Hyung Keun Song
Acute compartment syndrome (ACS) after tibial fracture carries a risk of various complications, including infection, delayed union, nonunion, nerve damage, and poor prognosis. For the treatment of fractures with ACS, fasciotomy is conducted, and the method to stabilise the fracture has to be considered. Thirty-five patients who underwent surgery for ACS with tibial shaft fractures were evaluated, and the results of initial internal fixation (Group I, 20 patients) and initial external fixation (Group II, 15 patients) were analysed...
November 16, 2017: Injury
https://www.readbyqxmd.com/read/29153449/the-changing-epidemiology-of-open-fractures-in-vehicle-occupants-pedestrians-motorcyclists-and-cyclists
#14
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/29149352/prognostic-potential-of-markers-of-bone-turnover-in-delayed-healing-tibial-diaphyseal-fractures
#15
Malhar Kumar, Dnyaneshwar Shelke, Saumil Shah
INTRODUCTION: Clinical and radiographic examinations detect delayed or nonunion only after the event has occurred. Biochemical markers of bone turnover (BTMs) are promising laboratory tools that offer an early insight into the likelihood of delayed union. We hypothesized that BTMs display temporal variations following fractures and the behavior of BTMs differ between normal and delayed union of fractures. METHODS: This was a prospective study of patients with closed fracture of tibia treated with intramedullary, interlocking nailing...
November 17, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29145970/minimally-invasive-posteromedial-percutaneous-plate-osteosynthesis-for-diaphyseal-tibial-fractures-technique-description
#16
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/29145966/outcome-evaluation-of-staged-treatment-for-bicondylar-tibial-plateau-fractures
#17
Vincenzo Giordano, Ney Pecegueiro do Amaral, Hilton A Koch, Rodrigo Pires E Albuquerque, Felipe Serrão de Souza, José Félix Dos Santos Neto
BACKGROUND: The universal accepted strategy for treating high-energy tibial plateau fractures remains a topic of ongoing debate. The challenge for the practicing orthopaedic trauma surgeon is to provide anatomical articular fracture reduction, with successfully managing the complex soft-tissue injury that is commonly present at patient admission. The primary aim of the actual study was to evaluate the results of a staged protocol for the treatment of high-energy bicondylar tibial plateau fractures...
October 2017: Injury
https://www.readbyqxmd.com/read/29145963/functional-results-and-isokinetic-muscle-strength-in-patients-with-fraser-type-i-floating-knee-treated-with-internal-fixation
#18
Fernando Brandao Andrade-Silva, Adriana Carvalho, Caio Mansano, Aline Giese, Marcos de Camargo Leonhardt, Dennis Barbosa, Kodi Edson Kojima, Jorge Santos Silva
INTRODUCTION: According to Fraser's description, ipsilateral femoral and tibial diaphyseal fractures are characterised as type I floating knee and have a better prognosis than fractures with joint involvement (type II). There are few reports of functional and muscle strength in these patients. The objective of this study was to evaluate the functional and isokinetic muscle strength of patients with type I floating knee undergoing femoral and tibial internal fixation. METHODS: Patients with type I floating knee undergoing concomitant femoral and tibial internal fixation were invited for clinical evaluation...
October 2017: Injury
https://www.readbyqxmd.com/read/29144538/control-of-hemorrhage-through-the-osteotomy-gap-during-tibial-plateau-leveling-osteotomy-9-cases
#19
Luis Matres-Lorenzo, Aidan McAlinden, Antoine Bernardé, Fabrice Bernard
OBJECTIVE: To describe a new technique to control intraoperative hemorrhage during tibial plateau leveling osteotomy (TPLO) and report subsequent short-term and long-term complications. STUDY DESIGN: Retrospective case series. ANIMALS: Nine dogs with arterial hemorrhage during TPLO. METHODS: Medical records of dogs with hemorrhage controlled through the osteotomy gap of a TPLO were reviewed at 2 institutions over 8 years...
November 16, 2017: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29141620/treatment-of-genu-valgum-in-children-by-means-of-temporary-hemiepiphysiodesis-using-eight-plates-short-term-findings
#20
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
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