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Limb fractures

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https://www.readbyqxmd.com/read/28816894/the-clavicle-trial-a-multicenter-randomized-controlled-trial-comparing-operative-with-nonoperative-treatment-of-displaced-midshaft-clavicle-fractures
#1
Philip M Ahrens, Nicholas I Garlick, Julie Barber, Emily M Tims
BACKGROUND: The treatment of displaced midshaft clavicle fractures remains controversial. METHODS: We undertook a multicenter randomized controlled trial to compare effectiveness and safety between nonoperative management and ORIF (open reduction and internal fixation) for displaced midshaft clavicle fractures in adults. Three hundred and one eligible adult patients were randomized to 1 of the 2 treatment groups and followed at 6 weeks, 3 months, and 9 months after recruitment...
August 16, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28809628/-the-effect-of-activation-of-the-shoulder-girdle-muscles-on-functional-outcomes-of-rehabilitation-in-patients-with-surgically-treated-distal-radius-fractures
#2
V Jančíková, J Opavský, P Dráč, A Krobot, I Čižmář
PURPOSE OF THE STUDY The aim of the study was to assess the functional outcomes of rehabilitation in patients with surgically treated distal radius fractures in the early postoperative period. We compared the functional outcomes of patients undergoing standard rehabilitation with the group of patients whose postoperative rehabilitation was extended with shoulder girdle exercises of the affected upper limb while the wrist was immobilized. Several indices and variables were used for the assessment of the functional therapeutic outcomes of the affected wrist...
2017: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/28807380/reconstruction-after-osteomyelitis-of-the-midfoot-from-high-pressure-washer-injury
#3
Matthew M Reiner, Wissam E Khoury, Audley Mackel, Duane J Ehredt, Mark C Razzante
Reports of ballistic injures to the extremities typically include those involving gunshot wounds. However, high-pressure washer injuries frequently lead to equally damaging injuries. These injuries should not be overlooked, because they can result in high morbidity and complication rates. Similar to the open fracture protocol, these injuries require prompt debridement and irrigation with administration of antibiotics to avoid limb loss. The present case report identified a delay in the treatment protocol that left limited options for the patient...
August 11, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28802425/outcomes-of-dynamic-hip-screw-augmented-with-trochanteric-wiring-for-treatment-of-unstable-type-a2-intertrochanteric-femur-fractures
#4
Chetan Puram, Chetan Pradhan, Atul Patil, Vivek Sodhai, Parag Sancheti, Ashok Shyam
BACKGROUND: Posteromedial and greater trochanteric fragments are a major cause of telescoping and medialization of the femoral shaft in an unstable intertrochanteric fracture. This leads to significant limb shortening, fracture collapse in varus position and implant failure, which can be prevented by trochanteric wiring in addition to dynamic hip screw (DHS) fixation. The purpose of our study is to assess the outcomes of DHS augmented with trochanteric wiring in unstable type A2 intertrochanteric fractures...
August 2017: Injury
https://www.readbyqxmd.com/read/28802423/effectiveness-of-exchange-k-nail-and-augmented-plating-in-aseptic-femoral-diaphyseal-non-union
#5
K H Sancheti, Chetan Pradhan, Atul Patil, Chetan Puram, Parkalp Bharti, Parag Sancheti, Ashok Shyam
BACKGROUND: Femoral diaphyseal non-unions present difficult scenario to manage. There are multiple options but most of them still report varying incidences of failure. We combined the principles of augmented plating and exchange nailing and aim to study the effectiveness of this technique. METHOD: A retrospective study at a tertiary trauma centre was conducted. Seventy patients (60 men, 10 women), average age 40.7±15.27 years (range 18-81 years) with diaphyseal femoral fracture non-unions treated between July 2010 and January 2015 were reviewed...
August 2017: Injury
https://www.readbyqxmd.com/read/28802421/symptomatic-medial-humeral-epicondylar-fracture-non-union-rare-presentation-of-a-relatively-common-injury
#6
Vidisha S Kulkarni, Nitish Arora, Harshit Gehlot, Sagar Saxena, Sunil G Kulkarni, Supreet Bajwa
BACKGROUND: Symptomatic non-union of medial humeral epicondylar fractures is a limited entity. Some studies recommend surgical excision of the fragment, but the results are controversial. The purpose of this study is to evaluate the outcome of open reduction and internal fixation of a medial epicondyle non-union fragment. MATERIALS AND METHODS: A retrospective study was conducted in all the patients, who were operated in our hospital between the year 2010 and 2015 for symptomatic medial humeral epicondyle non-union...
August 2017: Injury
https://www.readbyqxmd.com/read/28790464/the-history-of-biomechanics-in-total-hip-arthroplasty
#7
Jan Van Houcke, Vikas Khanduja, Christophe Pattyn, Emmanuel Audenaert
Biomechanics of the hip joint describes how the complex combination of osseous, ligamentous, and muscular structures transfers the weight of the body from the axial skeleton into the appendicular skeleton of the lower limbs. Throughout history, several biomechanical studies based on theoretical mathematics, in vitro, in vivo as well as in silico models have been successfully performed. The insights gained from these studies have improved our understanding of the development of mechanical hip pathologies such as osteoarthritis, hip fractures, and developmental dysplasia of the hip...
July 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28782836/histone-deacetylase-3-deletion-in-mesenchymal-progenitor-cells-hinders-long-bone-development
#8
Marina Feigenson, Lomeli Carpio Shull, Earnest L Taylor, Emily T Camilleri, Scott M Reister, Andre J van Wijnen, Elizabeth W Bradley, Jennifer J Westendorf
Long bone formation is a complex process that requires precise transcriptional control of gene expression programs in mesenchymal progenitor cells. Histone deacetylases (Hdacs) coordinate chromatin structure and gene expression by enzymatically removing acetyl groups from histones and other proteins. Hdac inhibitors are used clinically to manage mood disorders, cancers and other conditions, but are teratogenic to the developing skeleton and increase fracture risk in adults. In this study, the functions of Hdac3, one of the enzymes blocked by current Hdac inhibitor therapies, in skeletal mesenchymal progenitor cells were determined...
August 7, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28780771/low-molecular-weight-heparin-for-prevention-of-venous-thromboembolism-in-patients-with-lower-limb-immobilization
#9
REVIEW
Aniek Ag Zee, Kelly van Lieshout, Maaike van der Heide, Loes Janssen, Heinrich Mj Janzing
BACKGROUND: Immobilization of the lower limb is a risk factor for venous thromboembolism (VTE). Low molecular weight heparins (LMWHs) are anticoagulants, which might be used in adult patients with lower-limb immobilization to prevent deep venous thrombosis (DVT) and its complications. This is an update of the review first published in 2008. OBJECTIVES: To assess the effectiveness of low molecular weight heparin for the prevention of venous thromboembolism in patients with lower-limb immobilization in an ambulatory setting...
August 6, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28780003/outcomes-of-gartland-type-iii-supracondylar-fractures-treated-using-blount-s-method
#10
C Muccioli, S ElBatti, I Oborocianu, O Rosello, F Solla, E Chau, J L Clement, V Rampal
BACKGROUND: Supracondylar fractures of the elbow with major displacement are usually treated by surgical pinning and less often non-operatively as described by Blount.The objective of this study was to assess the clinical and radiological outcomes of Gartland type III supracondylar fractures treated at least 3 years earlier using Blount's method. HYPOTHESIS: Blount's method produces good outcomes after more than 3 years when used to treat Gartland type III supracondylar fractures of the humerus...
August 2, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28777416/ultrasound-guided-intravenous-catheter-insertion-in-a-prone-patient-using-a-t-probe-in-emergency-setting
#11
Antonio Lazzari, Roberto Bini, Roberto Bertucci, Antonio Coletti, Paolo Voghera
INTRODUCTION: Central venous catheterizations are common intraoperative procedures.Central venous catheter (CVC) placements are usually performed with patients lying in the supine position using real-time ultrasound (US) guidance. CASE DESCRIPTION: A 43-year-old man underwent open right popliteal artery reconstruction in the prone position for a limb-threatening injury. Excessive continuous intraoperative bleeding, increased by a coexisting pelvic fracture, was temporarily stabilized by a T POD device, but with the need of external fixation, required the placement of CVC, which was not feasible whilst in the prone position without US help...
July 26, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28772349/the-effects-of-multiple-anesthetic-episodes-on-equine-recovery-quality
#12
J P Platt, B T Simon, M Coleman, E A Martinez, M A Lepiz, A E Watts
BACKGROUND: Although rare, 70% of equine fatalities during recovery from general anaesthesia (GA) are due to catastrophic fractures from poor recovery quality. OBJECTIVE: To determine the effect of repeated GA recovery on GA recovery quality. STUDY DESIGN: Experimental blinded trial. METHODS: Eight adult horses underwent six GA events on sevoflurane for distal limb MRI examination over a 14-week period. Prior to GA recovery, xylazine was administered...
August 3, 2017: Equine Veterinary Journal
https://www.readbyqxmd.com/read/28761666/radial-and-ulnar-fracture-treatment-with-paraosseous-clamp-cerclage-stabilisation-technique-in-17-toy-breed-dogs
#13
George Manchi, Mathias M Brunnberg, Muhammad Shahid, Ahmad Al Aiyan, Eric Chow, Leo Brunnberg, Silke Stein
OBJECTIVE: Description of surgical technique, complications and outcome of radius/ulna fractures in toy and miniature breed dogs treated with the paraosseous clamp-cerclage stabilisation (PCCS) method. STUDY DESIGN: Retrospective study. METHODS: Clinical records of small breed dogs with fractures of the radius and ulna were reviewed between January 2011 and January 2016. Inclusion criteria were bodyweight of ≤3.5 kg, fracture of the radius and ulna of one or two limbs without previous repair attempts, available follow-up information, and the use of PCCS for repair of the fracture as the sole method of fixation...
2017: Veterinary Record Open
https://www.readbyqxmd.com/read/28758848/double-plating-fixation-of-comminuted-femoral-shaft-fractures-with-concomitant-thoracic-trauma
#14
Tao Cheng, Ronggang Xia, Xiaoyu Yan, Congfeng Luo
Objective This study was performed to evaluate the clinical outcomes in adult polytraumatized patients with thoracic injury and femoral shaft fractures treated with double-plating fixation. Methods From November 2010 to October 2014, 15 polytraumatized patients with femoral shaft fractures were enrolled in this retrospective study. Radiographic findings and functional outcomes were assessed at 1, 3, 6, and 12 months postoperatively. Results Fourteen (93%) of the 15 femoral shaft fractures achieved bony union, with a mean time to union of 9...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28756873/accordion-technique-combined-with-minimally-invasive-percutaneous-decortication-for-the-treatment-of-bone-non-union
#15
Qun Zhang, Wei Zhang, Zhuo Zhang, Peifu Tang, Lihai Zhang, Hua Chen
BACKGROUND: A variety of approaches have been used to treat oligotrophic or atrophic non-union. Conventional methods are often associated with great operative trauma, increased blood loss, a risk of re-infection, higher medical costs, and complications at the donor site. This study aimed to assess the clinical efficacy of the accordion technique combined with Minimally Invasive Percutaneous Decortication (MIPD) for these types of bone non-union. METHODS: From January 2010 to December 2015, 20 patients with long bone aseptic non-unions of the lower extremities without bone defects who were treated with the accordion technique combined with MIPD...
July 12, 2017: Injury
https://www.readbyqxmd.com/read/28750232/effects-of-chair-yoga-therapy-on-physical-fitness-in-patients-with-psychiatric-disorders-a-12-week-single-blind-randomized-controlled-trial
#16
Saeko Ikai, Hiroyuki Uchida, Yuya Mizuno, Hideaki Tani, Maki Nagaoka, Kenichi Tsunoda, Masaru Mimura, Takefumi Suzuki
INTRODUCTION: Since falls may lead to fractures and have serious, potentially fatal outcomes, prevention of falls is an urgent public health issue. We examined the effects of chair yoga therapy on physical fitness among psychiatric patients in order to reduce the risk of falls, which has not been previously reported in the literature. METHODS: In this 12-week single-blind randomized controlled trial with a 6-week follow-up, inpatients with mixed psychiatric diagnoses were randomly assigned to either chair yoga therapy in addition to ongoing treatment, or treatment-as-usual...
July 19, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28747511/autologous-minced-muscle-grafts-improve-endogenous-fracture-healing-and-muscle-strength-after-musculoskeletal-trauma
#17
Brady J Hurtgen, Catherine L Ward, Chrissy M Leopold Wager, Koyal Garg, Stephen M Goldman, Beth E P Henderson, Todd O McKinley, Sarah M Greising, Joseph C Wenke, Benjamin T Corona
The deleterious impact of concomitant muscle injury on fracture healing and limb function is commonly considered part of the natural sequela of orthopedic trauma. Recent reports suggest that heightened inflammation in the surrounding traumatized musculature is a primary determinant of fracture healing. Relatedly, there are emerging potential therapeutic approaches for severe muscle trauma (e.g., volumetric muscle loss [VML] injury), such as autologous minced muscle grafts (1 mm(3) pieces of muscle; GRAFT), that can partially prevent chronic functional deficits and appear to have an immunomodulatory effect within VML injured muscle...
July 2017: Physiological Reports
https://www.readbyqxmd.com/read/28741325/continuous-pain-and-swelling-after-humerus-fracture-in-an-86-years-old-woman
#18
M Herrera-Pérez, J Boluda-Mengod, R Muñoz-Ortus, M J Gutiérrez-Morales, J Pais-Brito
Metastases to bone are the most frequent cause of destructive lesions to the skeleton in adults . The tumours that are most likely to metastasize to bone are prostate (32%), breast (22%), kidney (16%), lung and thyroid. The typical distribution of metastatic lesions are to the spine, ribs, pelvis, and proximal limb girdles. The humerus is the second most common site for long bone metastases, behind only the femur in its frequency of involvement . It represents the 20% of all bony metastases. We present a clinical case of an 86 yo woman with a previous diagnosis of myofibroblastic sarcoma of the maxillaris who suffers a pathological fracture of the humeral shaft secondary to metastasis and was misdiagnosed and treated for a typical humeral fracture using and intramedullary pinning (Hackethal technique), producing the progression of the disease within the humeral shaft...
January 2017: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28737011/a-distinctive-patchy-osteomalacia-characterises-phospho1-deficient-mice
#19
Alan Boyde, Katherine A Staines, Behzad Javaheri, Jose Luis Millan, Andrew A Pitsillides, Colin Farquharson
The phosphatase PHOSPHO1 is involved in the initiation of biomineralisation. Bones in Phospho1 knockout (KO) mice show histological osteomalacia with frequent bowing of long bones and spontaneous fractures: they contain less mineral, with smaller mineral crystals. However, the consequences of Phospho1 ablation on the microscale structure of bone are not yet fully elucidated. Tibias and femurs obtained from wild-type and Phospho1 null (KO) mice (25-32 weeks old) were embedded in PMMA, cut and polished to produce near longitudinal sections...
August 2017: Journal of Anatomy
https://www.readbyqxmd.com/read/28736125/minimally-invasive-treatment-of-displaced-femoral-shaft-fractures-with-a-teleoperated-robot-assisted-surgical-system
#20
Qing Zhu, Bin Liang, Xingsong Wang, Xiaogang Sun, Liming Wang
BACKGROUND: Minimally invasive surgical operation of intramedullary (IM) nailing is a standard technique for treating diaphyseal fractures. However, in addition to its advantages, there are some drawbacks such as the frequent occurrence of malalignment, physical fatigue and high radiation exposure to medical staff. The use of robotic and navigation techniques is promising treatments for femoral fractures. MATERIALS AND METHODS: This paper presents a novel robot-assisted manipulator for femoral shaft fracture reduction with indirect contact with the femur...
July 12, 2017: Injury
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