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Bone nonunion

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https://www.readbyqxmd.com/read/28938394/risk-factors-for-failure-of-bone-grafting-of-tibia-nonunions-and-segmental-bone-defects-a-new-preoperative-risk-assessment-score
#1
Michael A Maceroli, Mark J Gage, Brent T Wise, Daniel Connelly, Katherine Ordonio, Renan C Castillo, Molly P Jarman, Jason W Nascone, Robert V OʼToole, Marcus F Sciadini
OBJECTIVE: To develop a clinically useful prediction model of success at the time of surgery to promote bone healing for established tibial nonunion or traumatic bone defects. DESIGN: Retrospective case controlled. SETTING: Level 1 trauma center. PATIENTS: Adult patients treated with surgery for established tibia fracture nonunion or traumatic bone defects from 2007 to 2016. Two hundred three patients met the inclusion criteria and were available for final analysis...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938393/ilizarov-treatment-protocols-in-the-management-of-infected-nonunion-of-the-tibia
#2
Martin McNally, Jamie Ferguson, Raj Kugan, David Stubbs
OBJECTIVES: We present a treatment algorithm comprising 4 Ilizarov methods in managing infected tibial nonunion, using nonunion mobility and segmental defect size to govern treatment choice. DESIGN: Decision protocol analysis study. SETTING: A university-affiliated teaching hospital. PATIENTS/PARTICIPANTS: Seventy-nine patients were treated with 1 of 4 Ilizarov protocols. All patients had undergone at least one previous operation, 38 had associated limb deformity, and 49 had nonviable nonunions...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938389/shortening-and-angulation-strategies-to-address-composite-bone-and-soft-tissue-defects
#3
Sarah N Pierrie, Joseph R Hsu
Gustilo-Anderson IIIB tibial fractures and infected tibial nonunions represent particular challenges for the orthopaedic trauma surgeon. Debridement of dysvascular bone and soft tissues can create composite bone and soft tissue defects. Restoring the soft tissue envelope is a critical step in preventing or treating ongoing infection and in restoring local blood supply. Shortening and angulation techniques, including the gradual expansion muscle flap, rely on distraction histogenesis to address composite bone and soft tissue loss...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938384/-iatrogenic-segmental-defect-how-i-debride-high-energy-open-tibial-fractures
#4
Brendan R Southam, Michael T Archdeacon
High-energy, open tibial shaft fractures may result in significant comminution, bone loss, and soft tissue injuries. Early, thorough debridement of all nonviable tissue is of critical importance in treating these fractures as an inadequate initial debridement increases the risk of infection and nonunion. Large iatrogenic bone and soft tissue defects can result from debridement and will require subsequent reconstruction by both orthopaedic and plastic surgeons. Although a variety of approaches exist to address these reconstructions, successful management of bone defects remains a considerable challenge...
October 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28938362/muscle-versus-fasciocutaneous-free-flaps-in-lower-extremity-traumatic-reconstruction-a-multicenter-outcomes-analysis
#5
Eugenia H Cho, Ronnie L Shammas, Martin J Carney, Jason M Weissler, Andrew R Bauder, Adam D Glener, Stephen J Kovach, Scott T Hollenbeck, L Scott Levin
PURPOSE: Clinical indications are expanding for the use of fasciocutaneous free flaps in lower extremity traumatic reconstruction. We assessed the impact of muscle versus fasciocutaneous free flap coverage on reconstructive and functional outcomes. METHODS: A multicenter retrospective review was conducted on all lower extremity traumatic free flaps performed at Duke University (1997-2013) and the University of Pennsylvania (2002-2013). Muscle and fasciocutaneous flaps were compared in two subgroups (acute trauma and chronic traumatic sequelae), according to limb salvage, return to ambulation, flap outcomes, and secondary flap procedures...
September 15, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28935593/factors-affecting-peri-implant-fracture-following-locking-plate-for-osteoporotic-distal-femur-fractures
#6
Ki-Chul Park, Seung-Jae Lim, Young Sik Song, Kyu-Tae Hwang
INTRODUCTION: The purpose of this study is to evaluate the outcomes and to analyze the risk factors for the occurrence of peri-implant fracture after treatment of osteoporotic distal femoral fracturesusing a locking plate. HYPOTHESIS: Risk factors affecting peri-implant fracture exist after locking plate fixation in osteoporotic distal femur fracture. MATERIALS AND METHODS: Eighty nine(88 patients) with osteoporotic distal femoral fractures were evaluated between January2006 and January2014...
September 18, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28921041/stabilization-of-scaphoid-type-b2-fractures-with-one-or-two-headless-compression-screws
#7
S Quadlbauer, T Beer, Ch Pezzei, J Jurkowitsch, A Tichy, T Hausner, M Leixnering
INTRODUCTION: Fractures of the scaphoid account for the most commonly injured carpal bone. Minimally displaced fractures of the waist will heal in 85-90% when using a below elbow cast. However, fractures with displacement have a higher risk for nonunion. Therefore, open reduction and fixation with headless compression screws (HCS) have become the preferred method of treatment. The aim of this study was to compare the radiological and clinical outcome of unstable scaphoid B2 type fractures, stabilized using one or two headless compression screws...
September 18, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28906587/vascularized-thumb-metacarpal-periosteal-pedicled-flap-for-scaphoid-nonunion-an-anatomical-study-and-pediatric-case-report
#8
Sergi Barrera-Ochoa, Gerardo Mendez-Sanchez, Alfonso Rodriguez-Baeza, Jorge Knörr, Jayme Augusto Bertelli, Francisco Soldado
PURPOSE: Through an anatomical review, the primary aim of this study was to delineate the dorsal thumb metacarpal (TM) periosteal branches of the radial artery (RA). In addition, we report here the clinical utility of a vascularized TM periosteal pedicled flap (VTMPF), supplied by the first dorsal metacarpal artery (FDMA), in a complex case of scaphoid nonunion. METHODS: Ten latex-colored upper limbs from fresh human cadavers were used. Branches of the RA were dissected under 3x loupe magnification, noting the periosteal branches arising from the FDMA...
September 14, 2017: Microsurgery
https://www.readbyqxmd.com/read/28905221/comparison-between-percutaneous-and-open-reduction-for-treating-paediatric-talar-neck-fractures
#9
Xu Zhang, Xinzhong Shao, Yadong Yu, Yingzhe Zhang, Guizheng Zhang, Dehu Tian
BACKGROUND: The purpose of the study was to introduce percutaneous reduction and fixation of paediatric talar neck fractures. The study also included a comparison between the technique and the conventional open surgery. METHODS: From October 2003 to May 2013, 23 children (group A) with closed two-part talar neck fractures were treated with percutaneous reduction. For comparison, another group of 26 children (group B) were treated with the conventional open surgery...
September 13, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28900671/-wrist-arthrodesis-with-a%C3%A2-fixed-angle-low-profile-fusion-plate-without-carpometacarpal-joint-fixation
#10
REVIEW
S Köhler, K Koch, A Arsalan-Werner, I M Mehling, J Seegmüller, H Krimmer, Michael Sauerbier
OBJECTIVE: Total wrist arthrodesis to improve functional use of the hand by reducing pain and increasing grip strength. INDICATIONS: Painful destruction of the radio- and midcarpal joints. CONTRAINDICATIONS: Analgesia and satisfactory hand function after motion-preserving surgical or conservative treatment. Chronic joint infection. SURGICAL TECHNIQUE: Posterior approach to the wrist. Removal of articular surfaces destroyed all the way down to cancellous bone...
September 12, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28900294/timing-for-surgical-stabilization-with-k-wires-after-open-fractures-of-proximal-and-middle-phalangeal-shaft
#11
Yanchun Gao, Qiyang Wang, Hongyi Zhu, Zhengyu Xu
The optimal timing for surgical stabilization after open fractures of proximal and middle phalangeal shaft remained unclear. Total 147 patients with single open fracture in proximal or middle phalangeal shaft (arrived within 8 hours) who received K-wire fixation from June 2012 to June 2015 were included for analysis. The timing for surgical stabilization of fractures (immediate or delayed) was decided according to the surgeons' preferences. The Michigan hand outcomes questionnaire (MHQ) scores, grip strength and total active motion (TAM) one year after the initial surgery were similar between the two groups...
September 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28893145/non-vascularized-iliac-bone-grafting-for-scaphoid-nonunion-with-avascular-necrosis
#12
Jihyeung Kim, Jin Woo Park, Jeehyeok Chung, Kee Jeong Bae, Hyun Sik Gong, Goo Hyun Baek
We present the surgical outcomes of non-vascularized bone grafting taken from the iliac crest in 24 patients with scaphoid nonunion and avascular necrosis. The Fisk-Fernandez technique was used in 11 patients, and cancellous bone grafting was used in 13 patients. Bony union was achieved in 22 of the 24 patients. Non-vascularized iliac bone grafting can be used for the surgical management of scaphoid nonunion with avascular necrosis. Although revascularization of the proximal fragment after surgery was not evaluated, bony union was confirmed in nearly all patients...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28888525/clinical-and-radiological-outcomes-following-radioscapholunate-fusion
#13
David Montoya-Faivre, Germain Pomares, Valentin Calafat, François Dap, Gilles Dautel
INTRODUCTION: Radioscapholunate (RSL) fusion is typically performed following wrist trauma. It addresses the pain caused by radiocarpal osteoarthritis but reduces the wrist's mobility. The objective of this study was to determine the long-term clinical and radiological outcomes of this procedure. MATERIALS AND METHODS: This was a retrospective study of all wrists operated for RSL fusion in our surgery unit over a 12-year period. The clinical analysis consisted of joint amplitudes, grip strength, pain (VAS) and functional scores (PRWE, QuickDash, Mayo Wrist Score)...
September 6, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28868203/titanium-versus-polyetheretherketone-implants-for-vertebral-body-replacement-in-the-treatment-of-77-thoracolumbar-spinal-fractures
#14
Rafael Augusto Castro Santiago Brandão, Warley Carvalho da Silva Martins, Aluízio Augusto Arantes, Sebastião Nataniel Silva Gusmão, Gilles Perrin, Cédric Barrey
BACKGROUND: Titanium and polyetheretherketone (PEEK) implants have been used in spinal surgery with low rejection rates. Compared to titanium, PEEK has many advantages, including a density more similar to that of bone, radiolucency, and a lack of artifacts in computed tomography (CT) and magnetic resonance imaging (MRI). In this study, we evaluated the effectiveness of PEEK cages as an alternative to titanium for bone fusion after fractures of the thoracolumbar spine. We also propose a classification to the impaction index...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28865584/bone-block-arthrodesis-procedure-in-failures-of-first-metatarsophalangeal-joint-replacement
#15
Federico Giuseppe Usuelli, Jacopo Tamini, Camilla Maccario, Miriam Grassi, Eric W Tan
BACKGROUND: The treatment for the failure of a first metatarsophalangeal joint (MTP1) prosthesis can be complex. There is no consensus regarding the ideal treatment. One of the main issues is the available bone stock after prosthesis removal. The aim of the study was to report the clinical and radiographic results for MTP1 arthrodesis with autologous calcaneus bone graft (bone-block fusion) as a revision procedure of a previous MTP1 implant failure. METHODS: This study included 12 patients diagnosed with failure of a MTP1 prosthesis...
September 2017: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28860406/vascularised-fibular-grafts-for-reconstruction-of-extremity-bone-defects-after-resection-of-bone-and-soft-tissue-tumours-a-single-institutional-study-of-49-patients
#16
M Emori, M Kaya, H Irifune, N Takahashi, J Shimizu, E Mizushima, Y Murahashi, T Yamashita
AIMS: The aims of this study were to analyse the long-term outcome of vascularised fibular graft (VFG) reconstruction after tumour resection and to evaluate the usefulness of the method. PATIENTS AND METHODS: We retrospectively reviewed 49 patients who had undergone resection of a sarcoma and reconstruction using a VFG between 1988 and 2015. Their mean follow-up was 98 months (5 to 317). Reconstruction was with an osteochondral graft (n = 13), intercalary graft (n = 12), inlay graft (n = 4), or resection arthrodesis (n = 20)...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28860405/the-use-of-an-anterior-pelvic-internal-fixator-to-treat-disruptions-of-the-anterior-pelvic-ring-a-report-of-technique-indications-and-complications
#17
M Dahill, J McArthur, G L Roberts, M R Acharya, A J Ward, T J S Chesser
AIMS: The anterior pelvic internal fixator is increasingly used for the treatment of unstable, or displaced, injuries of the anterior pelvic ring. The evidence for its use, however, is limited. The aim of this paper is to describe the indications for its use, how it is applied and its complications. PATIENTS AND METHODS: We reviewed the case notes and radiographs of 50 patients treated with an anterior pelvic internal fixator between April 2010 and December 2015 at a major trauma centre in the United Kingdom...
September 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28856344/bone-stress-injuries-in-the-military-diagnosis-management-and-prevention
#18
Steven F DeFroda, Kenneth L Cameron, Matthew Posner, Peter K Kriz, Brett D Owens
Bone stress injuries occur when forces applied to a bone for an extended period exceed the ability of the bone to adequately remodel. These injuries, which range from stress reactions to nondisplaced and even displaced fractures, most often affect people who experience high levels of repetitive stress and loading in the lower extremity or changes in physical activity level. For example, stress fractures are common in endurance athletes, in athletes engaged in preseason and early-season conditioning, and in military recruits...
July 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28844421/adolescent-clavicle-nonunions-potential-risk-factors-and-surgical-management
#19
Andrew T Pennock, Eric W Edmonds, Donald S Bae, Mininder S Kocher, Ying Li, Frances A Farley, Henry B Ellis, Philip L Wilson, Jeffrey Nepple, J Eric Gordon, Samuel C Willimon, Michael T Busch, David D Spence, Derek M Kelly, Nirav K Pandya, Coleen S Sabatini, Kevin G Shea, Benton E Heyworth
BACKGROUND: Clavicle nonunions in adolescent patients are exceedingly rare. The purpose of this study was to evaluate a series of clavicle nonunions from a pediatric multicenter study group to assess potential risk factors and treatment outcomes. METHODS: A retrospective review of all clavicle nonunions in patients younger than 19 years was performed at 9 pediatric hospitals between 2006 and 2016. Demographic and surgical data were documented. Radiographs were evaluated for initial fracture classification, displacement, shortening, angulation, and nonunion type...
August 22, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28840305/subtypes-of-endothelial-progenitor-cells-affect-healing-of-segmental-bone-defects-differently
#20
Erica M Giles, Charles Godbout, Wendy Chi, Michael A Glick, Tony Lin, Ru Li, Emil H Schemitsch, Aaron Nauth
PURPOSE: Treating fracture nonunion with endothelial progenitor cells (EPCs) is a promising approach. Nevertheless, the effect of different EPC-related cell populations remains unclear. In this study, we compared the therapeutic potential of early (E-EPCs) and late EPCs (L-EPCs). METHODS: Male Fischer 344 rats were used for cell isolation and in vivo experiments. Bone marrow-derived E-EPCs and L-EPCs were kept in culture for seven to ten days and four weeks, respectively...
August 24, 2017: International Orthopaedics
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