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Tibial nailing

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https://www.readbyqxmd.com/read/28216752/management-of-gustilo-anderson-iii-b-open-tibial-fractures-by-primary-fascio-septo-cutaneous-local-flap-and-primary-fixation-the-fix-and-shift-technique
#1
P R Ramasamy
BACKGROUND: Open fractures of tibia have posed great difficulty in managing both the soft tissue and the skeletal components of the injured limb. Gustilo Anderson III B open tibial fractures are more difficult to manage than I, II, and III A fractures. Stable skeletal fixation with immediate soft tissue cover has been the key to the successful outcome in treating open tibial fractures, in particular, Gustilo Anderson III B types. If the length of the open wound is larger and if the exposed surface of tibial fracture and tibial shaft is greater, then the management becomes still more difficult...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28199292/management-of-open-tibial-shaft-fractures-does-the-timing-of-surgery-affect-outcomes
#2
Oscar A Duyos, David Beaton-Comulada, Ariel Davila-Parrilla, Jose Carlos Perez-Lopez, Krystal Ortiz, Christian Foy-Parrilla, Francisco Lopez-Gonzalez
BACKGROUND: Open tibial shaft fractures require emergent care. Treatment with intravenous antibiotics and fracture débridement within 6 to 24 hours is recommended. Few studies have examined outcomes when surgical treatment is performed >24 hours after occurrence of the fracture. METHODS: This retrospective study included 227 patients aged ≥18 years with isolated open tibial shaft fractures in whom the time to initial débridement was >24 hours. The statistical analysis was based on time from injury to surgical débridement, Gustilo-Anderson classification, method of fixation, union status, and infection status...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28198793/proximity-and-risks-of-the-anterior-neurovascular-and-tendinous-anatomy-of-the-distal-leg-relative-to-anteriorly-applied-distal-locking-screws-for-tibia-nailing-a-plea-for-open-insertion
#3
Phillip M Mitchell, Cory A Collinge, Eric Barcak, Edward Perez, Kostas Triantafillou
PURPOSE: To determine the proximity and potential risks to distal leg anatomy from anterior to posteriorly (A-P) applied distal tibia locking screws for tibial nailing. DESIGN: Retrospective. SETTING: ACS level I trauma center. PATIENTS/PARTICIPANTS: Twenty consecutive adult patients undergoing computed tomograms with intravenous contrast (CTAs) on uninjured legs. MAIN OUTCOME MEASUREMENTS: Simulated 5 mm distal interlocking screws placed in the A-P axis of an ideally placed tibial nail at 10 mm increments from the tibial plafond (10 to 40mm) were studied in relation to the distal leg's anterior anatomy...
February 14, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28194379/reliability-of-the-radiographic-union-scale-in-tibial-fractures-rust
#4
Fernando Antonio Silva de Azevedo Filho, Ricardo Britto Cotias, Matheus Lemos Azi, Armando Augusto de Almeida Teixeira
OBJECTIVE: This study aimed to evaluate the inter- and intra observer reproducibility of the radiographic score of consolidation of the tibia shaft fractures. METHODS: Fifty-one sets of radiographs in anteroposterior (AP) and profile (P) of the tibial shaft treated with intramedullary nail were obtained. The analysis of X-rays was performed in two stages, with a 21-day interval between assessments by a group of nine evaluators. To evaluate the reproducibility of RUST score between the evaluators, the intra-class correlation coefficient (ICC) with a 95% confidence interval was used...
January 2017: Revista Brasileira de Ortopedia
https://www.readbyqxmd.com/read/28193138/removal-of-interlocking-intramedullary-nail-for-relieve-of-knee-pain-after-tibial-fracture-repair
#5
Shaodong Zhang, Xiaotao Wu, Lei Liu, Chen Wang
OBJECTIVE: To investigate the effects of intramedullary nail removal after tibial fracture repair. METHODS: Sixty patients at our hospital were enrolled in a prospective study and divided into moderate/severe knee pain (visual analog scale (VAS) ≥ 4) and mild/no knee pain (VAS < 4) groups after interlocking intramedullary nailing. Variables studied included the distance from the tip of the nail to the tibial plateau and the front of the tibia on a normalized lateral X-ray, the VAS score of knee and ankle pain, the range of motion of the knee and ankle, and Johner-Wruhs criteria before, 6 weeks after operation, and at the last follow-up...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28184364/tibial-lengthening-using-a-fixator-assisted-lengthening-plate-a-new-technique
#6
Haci Bayram Tosun, Ismail Agir, Seyitali Gumustas, Sancar Serbest, Abuzer Uludag, Suat Celik
BACKGROUND: There are many techniques that are used for limb lengthening. Lengthening a limb over a plate is an alternative choice used in children or when using an intramedullary nail is difficult. OBJECTIVES: In this study, we presented a new technique for tibial lengthening using a monolateral external fixator over a lengthening plate. MATERIALS AND METHODS: For tibial lengthening, a monolateral external fixator was attached to the composite bone model medially...
November 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28176597/the-risk-of-iatrogenic-injury-to-anterior-tibial-artery-variations-during-tibial-nail-distal-interlocking
#7
Nathan J Fanter, Sandra E Inouye, Christopher W Beiser
INTRODUCTION: Tibial intramedullary nailing remains a common tibial fracture fixation method. Tibial nailing indications continue to expand. Neurovascular complications from tibial nailing have been described; however, the proximity of distal tibial locking bolts to the anterior tibial artery (ATA) variants has not. MATERIALS AND METHODS: 52 cadaveric legs were dissected identifying three common ATA variants. Each ATA variant received an intraluminal wire to facilitate fluoroscopic identification...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28169938/percutaneous-or-open-reduction-of-closed-tibial-shaft-fractures-during-intramedullary-nailing-does-not-increase-wound-complications-infection-or-nonunion-rates
#8
Darryl A Auston, Jordan Meiss, Rafael Serrano, Thomas Sellers, Gregory Carlson, Timothy Hoggard, Michael Beebe, Jonathan Quade, David Watson, R Bruce Simpson, Brian Kistler, Anjan Shah, Roy Sanders, Hassan Mir
OBJECTIVE: To compare the incidence of complications (wound, infection, nonunion) among those patients treated with closed, percutaneous, and open intramedullary nailing for closed tibial shaft fractures. DESIGN: Retrospective Review. SETTING: Multiple trauma centers. PATIENTS: Skeletally mature patients with closed tibia fractures amenable to treatment with an intramedullary device. INTERVENTION: Intramedullary fixation with closed, percutaneous, or open reduction...
December 26, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28144605/limb-lengthening-using-the-precice-tm-nail-system-complications-and-results
#9
Ulrich Wiebking, Emmanouil Liodakis, Mohamed Kenawey, Christian Krettek
BACKGROUND: Three types of telescopic nails are mainly used for intramedullary limb lengthening nowadays. Despite some important advantages of this new technology (e.g. controlled distraction rate, not restricted availability, possibility to perform accordion maneuvers), few articles exist on clinical results and complications after lengthening with the PRECICE(TM) nail (Ellipse, USA). OBJECTIVES: The aim of the current study was to describe and analyze the complications associated with lengthening with the PRECICE(TM) nail...
December 2016: Archives of Trauma Research
https://www.readbyqxmd.com/read/28135373/elution-profiles-of-two-methods-of-antibiotic-tibial-nail-preparations
#10
Matthew R Karek, Nancy M Jackson, Jeffrey C Flynn, Rahul Vaidya, David C Markel
Interlocking nails coated with antibiotic-supplemented cement provide effective treatment of infected long bone nonunion, but the thicker coating on guidewires may provide greater antibacterial activity. This study compared the properties of cement cured on each construct by evaluating 2-cm segments of 8-mm interlocking nails and 3.5-mm guidewires coated with antibiotic-supplemented cement. Each construct (n=7 for each group) was coated with polymethylmethacrylate cement (Simplex; Stryker Orthopaedics, Mahwah, New Jersey) containing either 1 g tobramycin or 1 g vancomycin powder plus 2...
January 30, 2017: Orthopedics
https://www.readbyqxmd.com/read/28131638/treatment-preferences-in-turkey-for-open-fracture-of-the-tibial-diaphysis
#11
Güzelali Özdemir, Barış Yılmaz, Baran Kömür, Evrim Şirin, Nazım Karahan, Erman Ceyhan
OBJECTIVE: The purpose of this study was to investigate different treatment methods employed by orthopedic surgeons for open tibial fracture in adults. METHODS: Survey of 12 questions regarding treatment of open tibial fracture was conducted with 285 orthopedics and traumatology specialists in Turkey in personal interviews and using web-based technique. RESULTS: Of all survey participants, 99.6% responded that tetanus prophylaxis is necessary emergency procedure in cases of adult open tibial diaphysis fracture...
January 25, 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28126324/does-weight-bearing-assignment-after-intramedullary-nail-placement-alter-healing-of-tibial-shaft-fractures
#12
D A Greenhill, M Poorman, C Pinkowski, F V Ramsey, C Haydel
INTRODUCTION: There is no consensus regarding postoperative weight-bearing (WB) assignment after treatment of tibial shaft fractures with an intramedullary nail. This study aims to determine if the postoperative WB assignment after tibia intramedullary nail placement alters healing. METHODS: Closed AO type 42A fractures treated with a reamed statically-locked intramedullary nail over a 10-year period were retrospectively reviewed from injury at 2, 3, 6, 9 and 12 month intervals until union or revision...
January 23, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28088942/a-distal-lock-electromagnetic-targeting-device-for-intramedullary-nailing-suggestions-and-clinical-experience
#13
Guido Antonini, Wilfried Stuflesser, Cornelio Crippa, Georgios Touloupakis
PURPOSE: To describe our clinical experience with a system named SureShot? Distal Targeting (Smith & Nephew, Memphis, USA) based on magnetic field presence and discuss our suggestions on this technique. METHODS: We analysed prospectively 47 patients affected by humeral, tibial or femoral fractures, treated in our institution during a 3-year period of time (August 2010 to September 2013). We considered the following parameters: the time to set up, the time to position a single screw, the effectiveness of the system (drilling ad screwing), the irradiation exposure time during distal locking procedure and surgical complications...
December 1, 2016: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
https://www.readbyqxmd.com/read/28072652/in-vivo-correlation-of-radiographic-scoring-radiographic-union-scale-for-tibia-fractures-and-biomechanical-data-in-a-sheep-osteotomy-model-can-we-define-union-radiographically
#14
Jody Litrenta, Paul Tornetta, William Ricci, Roy W Sanders, Robert V OʼToole, Jason W Nascone, Henry Faber, Darren Wilson
OBJECTIVE: To determine (1) the reliability of the standard and modified Radiographic Union Scale for Tibia fractures (RUST) score in a sheep osteotomy model, and (2) the standard and modified RUST scores that represent biomechanical union. DESIGN: The tibia cortices in a sheep osteotomy model treated by intramedullary nails were radiographically evaluated using standard and modified RUST scores. Scores that correlated with biomechanical union, based on the torsional stiffness of the contralateral tibia, were determined...
March 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28043310/electromagnetic-navigation-in-distal-locking-of-long-diaphyseal-interlocking-intramedullary-nailing
#15
Zhentao Zhou, Xiaozhong Zhou, Bingchen Shan, Haibin Zhou, Zhengfeng Lu, Qirong Dong
OBJECTIVE: To describe the applications and effects of electromagnetic navigation (EN) technology in distal locking for the treatment of long diaphyseal fracture (LDF) with interlocking intramedullary nailing (IIN). STUDY DESIGN: An interventional study. PLACE AND DURATION OF STUDY: The Second Affiliated Hospital of Soochow University, China, from March 2013 to July 2014. METHODOLOGY: Patients who underwent IIN-LDF were selected...
December 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28040086/monofocal-bone-transport-technique-for-bone-defects-greater-than-5-cm-in-tibia-our-experience-in-a-case-series-of-24-patients
#16
Kemal Aktuglu, Hüseyin Günay, Jabrayil Alakbarov
BACKGROUND: As the tibial bone defect increases in size, the problems in treatment also increase. The treatment may be problematic but different treatment approaches can be used. Among these approaches, distraction osteogenesis is a method an orthopedic surgeon with limited conditions can use although it has a longer treatment period. In our case series, we evaluated current treatment approaches. METHOD: Retrospective study based on patient records and radiographs...
December 2016: Injury
https://www.readbyqxmd.com/read/28040079/prevalence-and-risk-factors-for-re-interventions-following-reamed-intramedullary-tibia-nailing
#17
Petros Z Stavrou, Vincenzo Ciriello, Stylianos Theocharakis, Suribabu Gudipati, Theodoros H Tosounidis, Nikolaos K Kanakaris, Peter V Giannoudis
INTRODUCTION: This study aimed to identify the prevalence and the risk factors for re-interventions following reamed intramedullary nailing (IMN) of tibial shaft fractures. PATIENTS AND METHODS: We retrospectively analysed a prospectively populated data of adult patients that underwent reamed intramedullary nailing for stabilization of tibial shaft fractures over a period of three years. Exclusion criteria were immature patients, pathological and periarticular fractures...
December 2016: Injury
https://www.readbyqxmd.com/read/28034610/anterior-tibial-artery-pseudoaneurysm-due-to-interlocking-bolt-of-tibial-nail-a-case-report-and-review
#18
Nitesh Gahlot, Rajendra Kumar Kanojia
Vascular injuries associated with the tibial nailing have been reported in few case reports. We here report a unique case of anterior tibial artery (ATA) pseudoaneurysm caused by the second proximal coronal interlocking bolt. We found that the position of interlocking bolts on the nail brings them very close to the anatomical positions of arteries in leg. The reports of ATA injury by interlocking bolts highlight the need for reconsidering the nail design and screw hole positions.
January 2017: Acta Orthopaedica et Traumatologica Turcica
https://www.readbyqxmd.com/read/28031644/ineffective-treatment-of-low-molecular-weight-heparin-in-obese-subject-with-traumatic-fractures-of-the-leg
#19
Egidio Imbalzano, Michele Creazzo, Giovanni Trapani, Giuseppina Lizio, Antonino Saitta
American College of Chest Physicians Evidence-Based Clinical Practice Guidelines, 9th edition, 2012, suggest no prophylaxis rather than pharmacological thromboprophylaxis in management of venous thromboembolism (VTE) risk of isolated lower leg injuries distal to knee requiring leg immobilization. Low-molecular-weight heparin (LMWH) is a class of drugs commonly used as antithrombotics in surgery and in case of prolonged bed rest and hypomobility. A 35-year-old obese man with no history of health disease (height, 170 cm; weight, 95 kg; and body mass index, 32...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28031510/use-of-a-magnetic-bone-nail-for-lengthening-of-the-femur-and-tibia
#20
Ozgur Karakoyun, Sami Sokucu, Mehmet Fatih Erol, Metin Kucukkaya, Yavuz Selim Kabukçuoğlu
PURPOSE: To report our experience with the PRECICE nail for limb lengthening in 23 patients. METHODS: Records of 15 female and 8 male patients aged 14 to 38 (mean, 23.6) years who underwent lengthening of the tibia (n=6) or femur (n=21) using the PRECICE nail were reviewed. The reasons for lengthening included trauma (n=7), hemihypertrophy (n=2), focal femoral deficiency (n=2), Ellis-van Creveld syndrome (n=1), hip septic arthritis sequelae (n=1), hereditary multiple exostosis (n=1), club foot sequela (n=1), congenital tibial pseudoarthrosis (n=1), fibrous dysplasia (n=1), idiopathic limb length discrepancy (n=7), and cosmetic (n=1)...
December 2016: Journal of Orthopaedic Surgery
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