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Limb fractures

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https://www.readbyqxmd.com/read/29786151/time-dependent-loss-of-trabecular-bone-in-human-tibial-plateau-fractures
#1
Lucian Bogdan Solomon, David Kitchen, Paul Hamill Anderson, Dongqing Yang, Yolandi Starczak, Masakazu Kogawa, Egon Perilli, Peter Jonathan Smitham, Mark Sean Rickman, Dominic Thewlis, Gerald James Atkins
We investigated if time between injury and surgery affects cancellous bone properties in patients suffering tibial plateau fractures (TPF), in terms of structural integrity and gene expression controlling bone loss. A cohort of 29 TPF, operated 1-17 days post-injury, had biopsies from the fracture and an equivalent contralateral limb site, at surgery. Samples were assessed using micro-computed tomography and real-time RT-PCR analysis for the expression of genes known to be involved in bone remodeling and fracture healing...
May 22, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29785926/intramedullary-nail-fixation-versus-locking-plate-fixation-for-adults-with-a-fracture-of-the-distal-tibia-the-uk-fixdt-rct
#2
Matthew L Costa, Juul Achten, Susie Hennings, Nafisa Boota, James Griffin, Stavros Petrou, Mandy Maredza, Melina Dritsaki, Thomas Wood, James Masters, Ian Pallister, Sarah E Lamb, Nick R Parsons
BACKGROUND: The best treatment for fractures of the distal tibia remains controversial. Most of these fractures require surgical fixation, but the outcomes are unpredictable and complications are common. OBJECTIVES: To assess disability, quality of life, complications and resource use in patients treated with intramedullary (IM) nail fixation versus locking plate fixation in the 12 months following a fracture of the distal tibia. DESIGN: This was a multicentre randomised trial...
May 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29785116/myopathy-due-to-hmgcr-antibodies-in-adult-mimicking-muscular-dystrophy-associated-with-cancer-and-statin-exposure-narrative-review-of-the-literature-case-report
#3
Alzira Alves de Siqueira Carvalho, Vinicius Gomes da Silva, Edmar Zanoteli, David Feder
Necrotizing autoimmune myopathy is characterized by predominant muscle fiber necrosis and regeneration with little or no inflammation. We describe a 58-year-old woman with previous breast cancer and statin use who complained of rapidly progressive weakness of lower limbs without pain, making walking, running and climbing stairs difficult. The creatine kinase level was 2,843 U/L, and muscle biopsy showed a dystrophic pattern. The genetic test for muscular dystrophies was negative and for anti-3-hydroxy-3-methylglutaryl coenzyme A reductase was positive...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29776938/bilateral-lower-limb-ischaemia-following-acetabular-reconstruction-and-arthroplasty
#4
Nadim Tarazi, Alastair Thomas, Majid Chowdhry, Andrew Carrothers
The incidence of acetabular fractures has increased markedly in patients over 60 in the last quarter of a century, with open reduction and internal fixation being regarded to be the treatment of choice in most patients with displaced acetabular fractures. Lower limb ischaemia following acetabular fixation or arthroplasty is rare. However, such complications can be limb or life threatening, and therefore, it is important to recognise them as early as possible. We present the case of a 70-year-old man with no significant medical history who underwent acetabular fixation with simultaneous arthroplasty complicated with bilateral lower limb ischaemia...
May 18, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29776439/concurrence-of-symmetrical-peripheral-gangrene-and-venous-limb-gangrene-following-polytrauma-a-case-report
#5
Jih Huei Tan, Yuzaidi Mohamad, Chor Lip Henry Tan, Mahazir Kassim, Theodore E Warkentin
BACKGROUND: Symmetrical peripheral gangrene is characterized as acral (distal extremity) ischemic limb injury affecting two or more extremities, without large vessel obstruction, typically in a symmetrical fashion. Risk factors include hypotension, disseminated intravascular coagulation, and acute ischemic hepatitis ("shock liver"). In contrast, venous limb gangrene is characterized by acral ischemic injury occurring in a limb with deep vein thrombosis. Both symmetrical peripheral gangrene and venous limb gangrene present as acral limb ischemic necrosis despite presence of arterial pulses...
May 19, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29774199/malignant-metastasis-misdiagnosed-as-osteoporotic-compression-fracture-a-case-report
#6
Seul Gi Kim, Chang Il Ju, Hui Sun Wang, Seok Won Kim
In cases of vertebral collapse after a trivial injury in elderly patients with severe osteoporosis, it can be a diagnostic challenge to determine whether the cause is a benign compression fracture or malignant metastasis. A 78-year-old male patient was referred to the emergency department for the evaluation of weakness of the left lower limb. He had undergone percutaneous vertebroplasty four months earlier after being diagnosed with L3 osteoporotic compression fracture. He was treated with foraminotomy at the L3-4 level after being diagnosed with foraminal stenosis two months earlier at a spine clinic...
April 2018: Korean Journal of Neurotrauma
https://www.readbyqxmd.com/read/29771483/managing-shoulder-injuries-in-the-emergency-department-fracture-dislocation-and-overuse
#7
Richard Pescatore, Andrew Nyce
The complex structures of the shoulder can be injured by fracture, dislocation, and overuse, and correctly identifying and classifying injury is essential to avoiding pain, disability, and life- and limb-threatening complications. This issue presents a systematic approach to classifying shoulder injuries based on the mechanism of injury and clinical presentation, choosing appropriate imaging, and determining the best strategies for treatment, including reduction, surgical consultation, or outpatient referral...
June 2018: Emergency Medicine Practice
https://www.readbyqxmd.com/read/29758110/can-quantitative-computed-tomography-detect-bone-morphological-changes-associated-with-catastrophic-proximal-sesamoid-bone-fracture-in-thoroughbred-racehorses
#8
E N Cresswell, S P McDonough, S E Palmer, C J Hernandez, H L Reesink
BACKGROUND: Fracture of the proximal sesamoid bones continues to be the most common fatal musculoskeletal injury in US racehorses. Identifying factors that influence fracture risk could lead to screening techniques to reduce catastrophic injury rates and improve animal welfare. OBJECTIVES: To identify morphological differences between proximal sesamoid bones of the contralateral limb of fracture and control horses and assess the feasibility of computed tomography (CT) to detect traits associated with proximal sesamoid bone fracture...
May 14, 2018: Equine Veterinary Journal
https://www.readbyqxmd.com/read/29753451/single-stage-reconstruction-of-post-traumatic-and-post-excisional-composite-perigenual-defects-using-chimeric-pedicled-propelled-osteomyocutaneous-fibula-flap
#9
T M Balakrishnan, Sruthi Sridhar, J Jaganmohan, Hemantha Kumar Govinda Rajan, Singaravadivelu Vaidyanathan
INTRODUCTION: Composite perigenual defects (CPGDs) are exacting the expertise of the reconstructive surgeons. Segmental skeletal defects continue to be a challenge for both orthopedic and plastic surgeons. There are many techniques available for the reconstruction of segmental skeletal defects in the perigenual region. This study explores the outcomes of pedicled chimeric propelled osteomyocutaneous fibula flap reconstruction of post traumatic and post excisional composite perigenual defects (CPGDs) MATERIALS AND METHODS: It was a retrospective study conducted from 2011 to 2016 including 16 patients (5 post excisional defects and 11 post traumatic defects)...
April 27, 2018: Injury
https://www.readbyqxmd.com/read/29752819/post-polio-syndrome-and-the-late-effects-of-poliomyelitis-part-1-pathogenesis-biomechanical-considerations-diagnosis-and-investigations
#10
REVIEW
Julian K Lo, Lawrence R Robinson
Post-Polio Syndrome (PPS) is characterized by new muscle weakness and/or muscle fatigability that occurs many years following the initial poliomyelitis illness. There are many theories that exist on the pathogenesis of PPS, which remains incompletely understood. In contrast, the Late Effects of Poliomyelitis are often a consequence of biomechanical alterations that occur as a result of polio-related surgeries, musculoskeletal deformities or weakness. Osteoporosis and fractures of the polio-involved limbs are common...
May 12, 2018: Muscle & Nerve
https://www.readbyqxmd.com/read/29748878/clinical-and-radiological-outcome-of-gustilo-type-iii-open-distal-tibial-and-tibial-shaft-fractures-after-staged-treatment-with-posterolateral-minimally-invasive-plate-osteosynthesis-mipo-technique
#11
Xiaojian He, Chuanzhen Hu, Kaihua Zhou, Qilin Zhai, Weifeng Wen, Fugen Pan
OBJECTIVES: To evaluate the methods and the outcomes of Gustilo type III open distal tibial and tibial shaft fractures with severe anterior and medial soft-tissue injuries, treated with posterolateral minimally invasive plate osteosynthesis (MIPO) technique. METHODS: From May 2015 to May 2016, 10 patients with Gustilo type III open distal tibial and tibial shaft fractures with severe anterior and medial soft-tissue injuries (Gustilo-Anderson classification IIIA, 6; IIIB, 4) were treated with staged protocol using posterolateral minimally invasive plate osteosynthesis (MIPO) technique...
May 10, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29738404/validity-of-visual-assessment-of-sit-to-stand-after-hip-fracture
#12
Cynthia Zablotny, Tiffany Hilton, Linda Riek, Janet Kneiss, Joshua Tome, Jeff Houck
BACKGROUND AND PURPOSE: When treating older adults post-hip fracture, physical therapists routinely assess the sit-to-stand (STS) task using observational analysis. Studies have demonstrated that significant movement asymmetries in ground reaction force production of the fractured lower limb persist during STS, even though individuals may rise independently. To date, the validity of therapist judgments of lower limb force during STS has not been addressed. The purpose of this observational cohort study was to determine the accuracy of physical therapists' observational assessments of STS for detecting the involved limb and its ground reaction force contribution in older adults post-hip fracture...
May 5, 2018: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/29737558/risk-of-injury-to-the-sural-nerve-during-posterolateral-approach-to-the-distal-tibia-an-ultrasound-simulation-study
#13
Ewa Mizia, Przemysław A Pękala, Piotr Chomicki-Bindas, Wojciech Marchewka, Marios Loukas, Alexander G Zayachkowski, Krzysztof A Tomaszewski
Introduction When surgeons operate on the foot and ankle, the most common complication that may arise is injury of the cutaneous nerves. The sural nerve (SN) is potentially at risk of being injured when treating fractures involving the distal tibia using the posterolateral approach. The aim of this study was to evaluate how differences in length and position of the surgical treatment of fractures involving the distal tibia can affect the risk of SN injury. Materials and Methods The study involved 40 healthy volunteers (n=80 lower limbs)...
May 8, 2018: Clinical Anatomy
https://www.readbyqxmd.com/read/29737002/lower-limb-reconstruction-with-chimeric-flaps-the-quad-flap
#14
Solomon M Azouz, Nikki A Castel, Aparna Vijayasekaran, Alanna M Rebecca, Salvatore C Lettieri
Early soft-tissue coverage is critical for treating traumatic open lower-extremity wounds. As free-flap reconstruction evolves, injuries once thought to be nonreconstructable are being salvaged. Free-tissue transfer is imperative when there is extensive dead space or exposure of vital structures such as bone, tendon, nerves, or blood vessels. We describe 2 cases of lower-extremity crush injuries salvaged with the quad flap. This novel flap consists of parascapular, scapular, serratus, and latissimus dorsi free flaps in combination on one pedicle...
May 7, 2018: Microsurgery
https://www.readbyqxmd.com/read/29736917/use-of-cancellous-bone-grafting-to-promote-granulation-tissue-in-a-distal-limb-wound-in-a-dog
#15
K Barnes, O Lanz, S Barry, K Aulakh
A 5-year-old female spayed Shetland sheepdog presented for evaluation of bandage sores on the left pelvic limb after a splint was placed to stabilise a digit fracture incurred approximately 2 weeks previously. Multiple areas of necrosis were identified upon bandage removal. After debridement of devitalised tissue, a 4 cm wound on the plantar surface of the metatarsal bones (with exposed bone and tendons) remained. The Papineau technique (which involves removal of infected or necrotic tissue, placement of autogenous cancellous bone graft within a wound, and delayed skin closure) was used to treat this wound...
May 7, 2018: Journal of Small Animal Practice
https://www.readbyqxmd.com/read/29733036/a-systematic-review-of-lost-time-injuries-in-the-global-mining-industry
#16
Behdin Nowrouzi-Kia, Basem Gohar, Jennifer Casole, Carla Chidu, Jennifer Dumond, Alicia McDougall, Behnam Nowrouzi-Kia
BACKGROUND: Mining is a hazardous occupation with elevated rates of lost-time injury and disability. OBJECTIVE: The purpose of this study is twofold: 1) To identify the type of lost-time injuries in the mining workforce, regardless of the kind of mining and 2) To examine the antecedent factors to the occupational injury (lost-time injuries). METHODS: We identified and extracted primary papers related to lost-time injuries in the mining sector by conducting a systematic search of the electronic literature in the eight health and related databases...
May 1, 2018: Work: a Journal of Prevention, Assessment, and Rehabilitation
https://www.readbyqxmd.com/read/29728757/recurrent-meningitis-in-children-etiologies-outcome-and-lessons-to-learn
#17
Amira Masri, Abeer Alassaf, Najwa Khuri-Bulos, Imad Zaq, Azmy Hadidy, Faris G Bakri
PURPOSE: Recurrent meningitis in children is a rare condition. However, its early recognition is important in order to prevent serious complications. This study aims to review cases of recurrent meningitis in children. METHODS: This is a retrospective study that included children diagnosed with recurrent meningitis and who were followed at child neurology clinic at the Jordan University Hospital from January 2001 to June 2017. RESULTS: Thirteen patients were included (nine males and four females)...
May 4, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29726449/proof-of-concept-of-a-partial-weight-bearing-supporting-real-time-feedback-system
#18
Andrés I Tkachenko-Bril, Harald Jagoš, Veronika David, Katharina Pils, Jakob Gaudernak, Dietmar Rafolt
BACKGROUND: Patient compliance with lower limb partial weight bearing (PWB) instructions during post-surgical early mobilization is often low and many are unable to adhere to the prescribed limits without the implementation of concurrent biofeedback. OBJECTIVES: A real-time feedback system based on eSHOE instrumented insoles was tested in order to preliminarily quantify its efficiency at improving geriatric patients' compliance. METHODS: In order to gain a proof of concept, measurements with one patient after a hip fracture were carried out...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29725516/surgical-fixation-of-a-comminuted-inter-trochanteric-fracture-in-a-patient-with-bilateral-below-knee-amputation
#19
B H Lee, S W Ho, C Y Kau
Surgical fixation of hip fractures in patients with below knee amputation is challenging due to the difficulty in obtaining optimal traction for reduction of the fracture. Surgeons may face difficulty in positioning such patients on the traction table due to the absence of the foot and distal lower limb. There are several techniques described to overcome this technical difficulty. In this case report, we present a case of a 64-year old gentleman with bilateral below knee amputation presenting with a comminuted right intertrochanteric fracture...
March 2018: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29725515/a-limb-threatening-long-arterial-dissection-caused-by-humerus-neck-fracture-a-case-report
#20
R Kurnaz, M Ikizler, M Ozbayburtlu, T Gunes
Proximal humerus fracture is a common arm trauma and rarely occurs with vascular injury which however is a serious complication. In this case report, we present a long segment dissection of the axillary and brachial arteries as a rare complication due to fragmented proximal humerus fracture and shoulder dislocation. An 80-year old female patient was seen at the emergency department. Radiograph examination has revealed a fragmented proximal humerus fracture besides dislocation of the head of humerus towards the axillary area...
March 2018: Malaysian Orthopaedic Journal
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