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Tibial nailing

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https://www.readbyqxmd.com/read/28720982/single-incision-pediatric-flexible-intramedullary-tibial-nailing
#1
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/28719546/fracture-table-application-for-pediatric-femur-fractures-incidence-and-risk-factors-associated-with-adverse-outcomes
#2
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
#3
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/28666045/lower-leg-fracture-irreducibility-resulting-from-entrapment-of-the-fibula-within-the-tibial-shaft
#4
Travis M Hughes, Flynn A Rowan, Lisa M Truchan
The tibia is the most commonly fractured long bone. Tibia fractures are simple, and most are amenable to immediate closed reduction. Reported cases of irreducibility resulting from entrapment of soft-tissue structures are rare. We report the case of a 23-year-old man who, in a high-speed motor vehicle crash, sustained a closed lower leg fracture that was later found to have a unique pattern in which the fibula was entrapped in the medullary cavity of the tibia. Limited open reduction was performed, and the entrapped distal fibula was removed with use of a bone hook...
May 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28664769/raised-compartment-pressures-are-frequently-observed-with-tibial-shaft-fractures-despite-the-absence-of-compartment-syndrome-a-prospective-cohort-study
#5
Kelvin Lor Kah Ho, Nicholas Yeoh Ching Sing, Khai Phang Wong, Andy Wee Teck Huat
PURPOSE: To measure the intracompartmental pressures surrounding tibial fractures not exhibiting any clinical evidence of compartment syndrome. Our hypothesis was that pressures often exceed the recommended threshold of fasciotomy despite the absence of compartment syndrome, and hence diagnosis based on pressure measurements alone is unreliable. METHODS: Thirteen consecutive patients with closed tibial shaft fractures without clinical suspicion of compartment syndrome, and who were planned for intramedullary nailing, were prospectively enrolled...
May 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28645704/reconstruction-of-large-diaphyseal-bone-defect-by-simplified-bone-transport-over-nail-technique-a-7-case-series
#6
F Ferchaud, L Rony, F Ducellier, P Cronier, V Steiger, L Hubert
INTRODUCTION: Reconstruction of large diaphyseal bone defect is complex and the complications rate is high. This study aimed to assess a simplified technique of segmental bone transport by monorail external fixator over an intramedullary nail. MATERIAL AND METHOD: A prospective study included 7 patients:2 femoral and 5 tibial defects.Mean age was 31 years (range, 16-61 years). Mean follow-up was 62 months (range, 46-84 months). Defects were post-traumatic, with a mean length of 7...
June 20, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28644119/damage-control-plating-in-open-tibial-shaft-fractures-a-cheaper-and-equally-effective-alternative-to-spanning-external-fixation
#7
Paul S Whiting, Phillip M Mitchell, Aaron M Perdue, Arnold J Silverberg, Sarah E Greenberg, Rachel V Thakore, Vasanth Sathiyakumar, Hassan R Mir, William T Obremskey, Manish K Sethi
The purpose of this study was to evaluate damage control plating (DCP) as an alternative to external fixation (EF) in the provisional stabilization of open tibial shaft fractures. Through retrospective analysis, the study found 445 patients who underwent operative fixation for tibial shaft fractures from 2008 to 2012. Twenty patients received DCP or EF before intramedullary nailing with a minimum follow-up of 3 months. Charts and radiographs were reviewed for postoperative complications. Hospital charges were reviewed for implant costs...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28620592/the-role-of-fibular-fixation-in-the-treatment-of-combined-distal-tibia-and-fibula-fracture-a-randomized-control-trial
#8
Mohammad Javdan, Mohammad Ali Tahririan, Morteza Nouri
BACKGROUND: This randomized, parallel-group, non-blinded study was designed to determine the role of fibular fixation in the treatment outcomes of combined distal tibia and fibula fractures. MATERIALS AND METHODS: Sixty patients with distal tibial and fibular fractures were randomly divided in two groups of case and controls. In the case group, fibula was fixed prior to the fixation of tibia. In the control group, tibia was fixed without fibular fixation. Primary outcomes were varus-valgus angulation, anterior-posterior angulation, union and side effects...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/28604652/comparison-of-tibial-intramedullary-nailing-guided-by-digital-technology-versus-conventional-method-a-prospective-study
#9
Lin Liu, Xian Xu, Xu Li, Wei Wu, Junfeng Cai, Qingyou Lu
BACKGROUND This prospective study aimed to compare clinical effects of intramedullary nailing guided by digital and conventional technologies in treatment of tibial fractures. MATERIAL AND METHODS Thirty-two patients (mean age 43 years, 18 males and 14 females) who were treated for tibial fractures from October 2010 to October 2012 were enrolled. They were sequentially randomized to receive intramedullary nailing guided by either digital technology (digital group, n=16) or conventional technology (conventional group, n=16)...
June 12, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28586586/comparative-analysis-of-anterior-knee-pain-in-transpatellar-and-medial-parapatellar-tendon-approaches-in-tibial-interlocking-nailing
#10
Saeed Ahmad, Ashfaq Ahmed, Latif Khan, Shahzad Javed, Naeem Ahmed, Amer Aziz
BACKGROUND: Anterior knee pain is the most common complaint after intramedullary nail of the tibia. The incidence of anterior knee pain ranges from 10-86% and the exact ethology is unclear. Transpatellar tendon approach is commonly used for tibial intramedullary interlocking nailing but it can also be done through medial parapatellar tendon approach. The objective of the study was to compare post-operative anterior knee pain after intramedullary nailing technique by transpatellar approach compared to medial parapatellar approach...
October 2016: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28585994/new-technique-for-removal-of-screws-with-damaged-heads
#11
Takahiro Iwata, Satoshi Nozawa, Masato Maeda, Haruhiko Akiyama
Removal of orthopedic implants may sometimes be difficult because of ongrowth of new bone. Titanium screws can become encased or stripped during the process of initial open reduction and internal fixation or at the time of hardware removal. Difficulty in removing screws from a locking plate is particularly well-known. Two patients with tibial and femoral diaphyseal fractures were treated using a locking plate or an intramedullary nail. However, after fracture healing, it was difficult to remove the locking screw or reconstruction screws because of damage to the heads...
June 6, 2017: Orthopedics
https://www.readbyqxmd.com/read/28584887/intramedullary-tibial-nailing-of-distal-tibiofibular-fractures-additional-fibular-fixation-or-not
#12
M Van Maele, B Molenaers, E Geusens, S Nijs, H Hoekstra
INTRODUCTION: The anatomy of the distal tibia accounts for reduced biomechanical stability and higher complication rates when treating distal tibiofibular fractures with an intramedullary tibia nail (IMTN). The goal of this study was to identify variables that affect the stability of IMTN. We assessed the value of additional fibular fixation, angular stable interlocking screws (ASLS) and multiplanar screw configuration in IMTN. PATIENTS AND METHODS: A retrospective cohort study was performed including 184 distal tibial fractures and associated fibula fracture treated with IMTN...
June 5, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/28583752/management-of-knee-rheumatoid-arthritis-and-tibia-nonunion-with-one-stage-total-knee-arthroplasty-and-intramedullary-nailing-a-report-of-two-cases
#13
Fahri Erdogan, Ilker Abdullah Sarikaya, Ata Can, Baris Gorgun
Total knee arthroplasty (TKA) is a surgical procedure which is widely used in the treatment of gonarthrosis secondary to rheumatoid arthritis (RA). The incidence of stress fractures in tibia in the patients with RA is higher compared to normal patients. In this study, we report two cases of TKA and intramedullary nailing in RA patients with severe knee arthritis and tibial nonunion. Both patients had a satisfactory clinical outcome with radiological healing of the tibial fracture.
June 2, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28571220/interlocking-nailing-versus-plating-in-tibial-shaft-fractures-in-adults-a-comparative-study
#14
Sagnik Mukherjee, Mahendra Singh Arambam, Sanjib Waikhom, Santosha, Pranav Vitthal Masatwar, Rohan Gautam Maske
INTRODUCTION: Tibial diaphyseal fractures are the commonest long bone fractures in adults, most commonly managed by intramedullary interlocking nailing. However, several meta-analysis show that locking plate osteosynthesis is equally effective in managing tibial diaphyseal fractures and are associated with less number of complications. AIM: To compare the results of fixation of tibial fractures following plating and nailing in terms of union, patient satisfaction and complications...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28567341/technical-note-anterior-cruciate-ligament-reconstruction-in-the-presence-of-an-intramedullary-femoral-nail-using-anteromedial-drilling
#15
Matthew Lacey, Joseph Lamplot, Kempland C Walley, Joseph P DeAngelis, Arun J Ramappa
AIM: To describe an approach to anterior cruciate ligament (ACL) reconstruction using autologous hamstring by drilling via the anteromedial portal in the presence of an intramedullary (IM) femoral nail. METHODS: Once preoperative imagining has characterized the proposed location of the femoral tunnel preparations are made to remove all of the hardware (locking bolts and IM nail). A diagnostic arthroscopy is performed in the usual fashion addressing all intra-articular pathology...
May 18, 2017: World Journal of Orthopedics
https://www.readbyqxmd.com/read/28566781/a-comparative-study-of-intramedullary-interlocking-nailing-and-minimally-invasive-plate-osteosynthesis-in-extra-articular-distal-tibial-fractures
#16
Arup K Daolagupu, Ashwani Mudgal, Vikash Agarwala, Kaushik K Dutta
BACKGROUND: Extraarticular distal tibial fractures are among the most challenging fractures encountered by an orthopedician for treatment because of its subcutaneous location, poor blood supply and decreased muscular cover anteriorly, complications such as delayed union, nonunion, wound infection, and wound dehiscence are often seen as a great challenge to the surgeon. Minimally invasive plate osteosynthesis (MIPO) and intramedullary interlocking nail (IMLN) are two well-accepted and effective methods, but each has been historically related to complications...
May 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28559143/rectus-femoris-muscle-atrophy-and-recovery-caused-by-preoperative-pretibial-traction-in-femoral-shaft-fractures-comparison-between-traction-period
#17
D-G Shim, T-Y Kwon, K-B Lee
BACKGROUND: Skeletal traction is performed to temporarily stabilize fracture sites before surgery in patients with femoral fracture. To date, however, there is no study evaluating the difference in the degree of the recovery, of the muscle strength, as well as muscle atrophy following skeletal traction. The purpose of this study was to compare the degree of recovery of rectus femoris muscle strength after surgery in association with muscle atrophy by analyzing the duration of preoperative tibial traction, age and sex in patients with femoral fracture...
May 27, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28545726/closed-tibial-shaft-fractures-treated-with-the-ilizarov-method-a-ten-year-case-series
#18
Jonathan David May, Thumri Paavana, Jonathan McGregor-Riley, Simon Royston
OBJECTIVES: To review the outcomes of patients treated with the Ilizarov method for an isolated, closed, simple diaphyseal, Tibial fracture at our institution over the last decade. METHODS: The Ilizarov frame database was used to identify 76 skeletally mature patients who sustained an isolated, closed, extra-articular, simple, diaphyseal Tibial fracture; the injury also known as a "nail-able Tibial fracture." RESULTS: The average age of the patient was 38 (17-70)...
May 15, 2017: Injury
https://www.readbyqxmd.com/read/28543367/successful-treatment-of-methicillin-susceptible-staphylococcus-aureus-osteomyelitis-with-oritavancin
#19
Dino J Delaportas, Sandy J Estrada, Matthew Darmelio
Staphylococcus aureus remains the most common causative pathogen in osteomyelitis. New or alternate therapies are often needed to adequately treat S. aureus infections in patients with drug allergies, treatment failures, or drug interactions. Oritavancin is a novel long-acting lipoglycopeptide approved by the Food and Drug Administration (FDA) in 2014 for the treatment of Acute Bacterial Skin and Skin Structure Infections (ABSSSI). With a terminal half-life of 8 to 10 days, oritavancin dosing regimens with infrequent parenteral administration now exist to treat infectious diseases such as osteomyelitis that would otherwise require daily dosing of intravenous antimicrobials for weeks; however clinical experience is lacking...
May 23, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28538453/does-concurrent-tibial-intramedullary-nailing-and-fibular-fixation-increase-rates-of-tibial-nonunion-a-matched-cohort-study
#20
Michael Githens, Justin Haller, Julie Agel, Reza Firoozabadi
OBJECTIVES: To determine if there is a difference in rates of tibial nonunion in patients undergoing tibial intramedullary (IM) nailing and fibular fixation as compared to a matched cohort undergoing tibial IM nailing alone. DESIGN: Retrospective matched cohort study. SETTING: Single Level 1 academic trauma center. PATIENTS: Consecutive patients 18 years and older with a tibia and fibula fracture treated with tibial IM nailing and fibular fixation who were determined radiographically and clinically healed or had a minimum 1-year follow-up were included...
June 2017: Journal of Orthopaedic Trauma
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