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Tibial nailing

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https://www.readbyqxmd.com/read/28408084/semiextended-approach-for-intramedullary-nailing-via-a-patellar-eversion-technique-for-tibial-shaft-fractures-evaluation-of-the-patellofemoral-joint
#1
Tomohiro Yasuda, Shu Obara, Junji Hayashi, Masayuki Arai, Kaoru Sato
Intramedullary nail fixation is a common treatment for tibial-shaft fractures, and it offers a better functional prognosis than other conservative treatments. Currently, the primary approach employed during intramedullary nail insertion is the semiextended position is the suprapatellar approach, which involves a vertical incision of the quadriceps tendon Damage to the patellofemoral joint cartilage has been highlighted as a drawback associated with this approach. To avoid this issue, we perform surgery using the patellar eversion technique and a soft sleeve...
March 25, 2017: Injury
https://www.readbyqxmd.com/read/28385946/the-management-of-open-tibial-fractures-in-children-a-retrospective-case-series-of-eight-years-experience-of-61-cases-at-a-paediatric-specialist-centre
#2
R S Nandra, F Wu, A Gaffey, C E Bache
AIMS: Following the introduction of national standards in 2009, most major paediatric trauma is now triaged to specialist units offering combined orthopaedic and plastic surgical expertise. We investigated the management of open tibia fractures at a paediatric trauma centre, primarily reporting the risk of infection and rate of union. PATIENTS AND METHODS: A retrospective review was performed on 61 children who between 2007 and 2015 presented with an open tibia fracture...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28368929/outcomes-after-arthroscopic-fixation-of-tibial-eminence-fractures-with-bioabsorbable-nails-in-skeletally-immature-patients
#3
Amit M Momaya, Connor Read, Megan Steirer, Reed Estes
The aim of this paper is to report the outcomes and any complications with arthroscopic bioabsorbable nail fixation of tibial eminence fractures in skeletally immature patients. We retrospectively reviewed all surgically treated tibial eminence fractures treated by a single surgeon and seven patients were identified with a minimum 2-year follow-up. Mean deficits of flexion and extension were minimal. Satisfactory Tegner levels, Lysholm knee scores, and International Knee Documentation Committee subjective scores were reported...
March 31, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28361218/intramedullary-nailing-of-tibial-shaft-fractures-in-the-semi-extended-position-using-a-suprapatellar-portal-technique
#4
REVIEW
Boris A Zelle
Intramedullary nail fixation remains the standard treatment for displaced tibial shaft fractures. Establishing an appropriate starting point remains a crucial step in the surgical procedure. Tibial nailing using an infrapatellar starting point with the knee flexed over a radiolucent triangle has been established as a widely-used standard technique. Tibial nail insertion with the knee in the semi-extended position was introduced with the goal to counteract post-operative procurvatum deformities that frequently have been reported as a common problem in proximal third tibial shaft fractures...
March 30, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28333575/is-clinical-measurement-of-anatomic-axis-of-the-femur-adequate
#5
Chi-Chuan Wu
Background and purpose - The accuracy of using clinical measurement from the anterior superior iliac spine (ASIS) to the center of the knee to determine an anatomic axis of the femur has rarely been studied. A radiographic technique with a full-length standing scanogram (FLSS) was used to assess the adequacy of the clinical measurement. Patients and methods - 100 consecutive young adult patients (mean age 34 (20-40) years) with chronic unilateral lower extremity injuries were studied. The pelvis and intact contralateral lower extremity images in the FLSS were selected for study...
March 23, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28328865/novel-management-of-distal-tibial-and-fibular-fractures-with-acumed-fibular-nail-and-minimally-invasive-plating-osteosynthesis-technique-a-case-report
#6
Tie-Jun Wang, Wei-Na Ju, Bao-Chang Qi
RATIONALE: Anatomical characteristics, such as subcutaneous position and minimal muscle cover, contribute to the complexity of fractures of the distal third of the tibia and fibula. Severe damage to soft tissue and instability ensure high risk of delayed bone union and wound complications such as nonunion, infection, and necrosis. PATIENT CONCERNS: This case report discusses management in a 54-year-old woman who sustained fractures of the distal third of the left tibia and fibula, with damage to overlying soft tissue (swelling and blisters)...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28293156/indications-of-implant-removal-a-study-of-83-cases
#7
Muhammad Haseeb, Muhammad Farooq Butt, Tariq Altaf, Khalid Muzaffar, Anil Gupta, Aleena Jallu
INTRODUCTION: Fracture fixation has become advanced with the advent of new and custom metal implants for each type of bone/fracture. After union though, the implant ceases to be important and may be removed. Routine removal is advocated by some and opposed by others. Nevertheless, some patients require removal of the hardware because of various implant-related problems. Our study was aimed at identifying the most common causes for implant removal. OBJECTIVE: To investigate the common indications of orthopedic implant removal surgeries...
January 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28244909/predictors-of-reoperation-for-adult-femoral-shaft-fractures-managed-operatively-in-a-sub-saharan-country
#8
Edmund N Eliezer, Billy T Haonga, Saam Morshed, David W Shearer
BACKGROUND: The optimal treatment for femoral shaft fractures in low-resource settings has yet to be established, in part, because of a lack of data supporting operative treatment modalities. We aimed to determine the reoperation rate among femoral fractures managed operatively and to identify risk factors for reoperation at a hospital in a Sub-Saharan country. METHODS: We conducted a prospective clinical study at a single tertiary care center in Tanzania, enrolling all skeletally mature patients with diaphyseal femoral fractures managed operatively from July 2012 to July 2013...
March 1, 2017: Journal of Bone and Joint Surgery. American Volume
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
Darryl A Auston, Jordan Meiss, Rafael Serrano, Thomas Sellers, Gregory Carlson, Timothy Hoggard, Michael Beebe, Jonathan Quade, David Watson, Robert Bruce Simpson, Brian Kistler, Anjan Shah, Roy Sanders, Hassan R Mir
OBJECTIVE: To compare the incidence of complications (wound, infection, and 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...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28144605/limb-lengthening-using-the-precice-tm-nail-system-complications-and-results
#17
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
#18
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
#19
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
#20
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
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