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Bone nonunion

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https://www.readbyqxmd.com/read/28229033/an-innovative-use-of-cortoss-bone-cement-to-stabilize-a-nonunion-after-interbody-fusion
#1
Michelle Granville, Robert E Jacobson
A 65-year-old male originally had surgery for spondylolisthesis at L5-S1 in 2008 and then went on to have an L4-5 transforaminal lumbar interbody fusion (TLIF) with pedicle screw fixation from L4 to S1 and interbody graft in 2010. Despite having two surgical procedures, he continued with intractable back pain and was told he had a failed lumbar fusion. When he was evaluated with a computerized tomography (CT) scan from April 2015, it demonstrated an erosive nonunion of the L4-5 interbody fusion without incorporation of the polyetheretherketone (PEEK) cage...
January 20, 2017: Curēus
https://www.readbyqxmd.com/read/28220260/three-stage-treatment-protocol-for-recalcitrant-distal-femoral-nonunion
#2
Ching-Hou Ma, Yen-Chun Chiu, Yuan-Kun Tu, Cheng-Yo Yen, Chin-Hsien Wu
INTRODUCTION: In this study, we proposed a three-stage treatment protocol for recalcitrant distal femoral nonunion and aimed to analyze the clinical results. MATERIALS AND METHODS: We retrospective reviewed 12 consecutive patients with recalcitrant distal femoral nonunion undergoing our three-stage treatment protocol from January 2010 to December 2014 in our institute. The three-stage treatment protocol comprised debridement of the nonunion site, lengthening to eliminate leg length discrepancy, deformity correction, stabilization with a locked plate, filling of the defect with cement spacer for inducing membrane formation, and bone reconstruction using a cancellous bone autograft (Masquelet technique) or free vascularized fibular bone graft...
February 20, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28216760/vanishing-bone-disease-of-chest-wall-and-spine-with-kyphoscoliosis-and-neurological-deficit-a-case-report-and-review-of-literature
#3
Sudhir Kumar Srivastava, Rishi Anil Aggarwal, Pradip Sharad Nemade, Sunil Krishna Bhoale
Vanishing bone disease is an extremely rare disorder of unknown etiology characterized by idiopathic osteolysis of bone. We describe a case of vanishing bone disease of chest wall and spine with kyphoscoliosis and neurological deficit. A 17-year-old male presented with gradually progressive deformity of back and dorsal compressive myelopathy with nonambulatory power in lower limbs. Radiographs revealed absent 4(th)-7(th) ribs on the right side with dorsal kyphoscoliosis and severe canal narrowing at the apex...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28216756/outcome-of-anatomic-locking-plate-in-extraarticular-distal-humeral-shaft-fractures
#4
Deepak Jain, Gurpreet S Goyal, Rajnish Garg, Pankaj Mahindra, Mohammad Yamin, Harpal S Selhi
BACKGROUND: Extraarticular fractures of distal humerus are challenging injuries to treat because of complex anatomy and fracture patterns. Functional bracing may not provide adequate stability in these injuries and operative treatment with intramedullary nails or conventional plates also has the limitation of inadequate fixation in the short distal fragment. The 3.5 mm precontoured single column locking plate (extraarticular distal humerus plate [EADHP]) has been introduced to overcome this problem...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28216747/complex-ao-type-c3-distal-femur-fractures-results-after-fixation-with-a-lateral-locked-plate-using-modified-swashbuckler-approach
#5
Anuj Agrawal, Vivek Kiyawat
BACKGROUND: Complex AO type C3 fractures of the distal femur are challenging injuries, fraught with complications such as malunion and stiffness. We prospectively evaluated a consecutive series of patients with complex AO type C3 distal femur fractures to determine the clinicoradiological outcome after fixation with a single locked plate using modified swashbuckler approach. MATERIALS AND METHODS: 12 patients with C3 type distal femur fractures treated with a lateral locked plate, using a modified swashbuckler approach, were included in the study...
January 2017: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/28215222/nf-%C3%AE%C2%BAb-as-a-therapeutic-target-in-inflammatory-associated-bone-diseases
#6
T-H Lin, J Pajarinen, L Lu, A Nabeshima, L A Cordova, Z Yao, S B Goodman
Inflammation is a defensive mechanism for pathogen clearance and maintaining tissue homeostasis. In the skeletal system, inflammation is closely associated with many bone disorders including fractures, nonunions, periprosthetic osteolysis (bone loss around orthopedic implants), and osteoporosis. Acute inflammation is a critical step for proper bone-healing and bone-remodeling processes. On the other hand, chronic inflammation with excessive proinflammatory cytokines disrupts the balance of skeletal homeostasis involving osteoblastic (bone formation) and osteoclastic (bone resorption) activities...
2017: Advances in Protein Chemistry and Structural Biology
https://www.readbyqxmd.com/read/28213747/bone-morphogenetic-protein-2-for-the-treatment-of-congenital-pseudarthrosis-of-the-tibia-or-persistent-tibial-nonunion-in-children-and-adolescents-a-retrospective-study-with-a-minimum-2-year-follow-up
#7
Tim N Hissnauer, Norbert Stiel, Kornelia Babin, Martin Rupprecht, Michael Hoffmann, Johannes M Rueger, Ralf Stuecker, Alexander S Spiro
There is a lack of studies reporting on rhBMP-2 application in pediatric orthopaedics, although few reports demonstrated promising results of the use of rhBMP-2 in children, especially for spine fusion and for the treatment of congenital pseudarthrosis of the tibia. The objectives of this study were (1) to examine clinical and radiographic healing after rhBMP-2 application for the treatment of congenital pseudarthrosis of the tibia (CPT) or persistent tibial nonunion in children and adolescents, and (2) to investigate the safety of rhBMP-2 use in these cases...
April 2017: Journal of Materials Science. Materials in Medicine
https://www.readbyqxmd.com/read/28211679/site-directed-immobilization-of-bmp-2-two-approaches-for-the-production-of-innovative-osteoinductive-scaffolds
#8
Barbara Tabisz, Werner Schmitz, Michael Schmitz, Tessa Luehmann, Eva Heusler, Jens-Christoph Rybak, Lorenz Meinel, Juliane E Fiebig, Thomas D Mueller, Joachim Nickel
The regenerative potential of bone is strongly impaired in pathological conditions, such as nonunion fractures. To support bone regeneration various scaffolds have been developed in the past, which have been functionalized with osteogenic growth factors such as bone morphogenetic proteins (BMPs). However, most of them required supra-physiological levels of these proteins leading to burst releases, thereby causing severe side effects. Site-specific, covalent coupling of BMP2 to implant materials might be an optimal strategy in order to overcome these problems...
February 17, 2017: Biomacromolecules
https://www.readbyqxmd.com/read/28210649/predictive-surgical-reasons-for-failure-after-coracoid-process-transfers
#9
Gregory Gasbarro, Juan Marcelo Giugale, Gilles Walch, Albert Lin
BACKGROUND: Recurrent anterior shoulder instability after coracoid process transfers may be caused by trauma, sports injury, or technical failure of the index procedure. Surgical techniques vary with regard to graft orientation and positioning and number of screws utilized for fixation. PURPOSE: To identify surgical and patient-related factors associated with failure, defined as the need for revision surgery. We hypothesized that failures will occur more commonly with single-screw fixation and graft malposition...
December 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/28205469/valgus-instability-of-the-elbow-due-to-medial-epicondyle-nonunion-treatment-by-fragment-excision-and-medial-collateral-ligament-reconstruction
#10
Yasunori Kaneshiro, Noriaki Hidaka, Koichi Yano, Makoto Fukuda, Hideki Sakanaka
BACKGROUND: The medial epicondyle nonunion becomes symptomatic valgus instability with medial elbow pain and joint instability due to dysfunction of the medial collateral ligament (MCL), thus requiring surgical treatment. The purpose of the present study is to report the clinical result of the fragment excision and ligament reconstruction by free tendon graft in the treatment of symptomatic medial epicondyle nonunion. METHODS: A retrospective study of five consecutive patients was performed...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28205468/vascularized-medial-femoral-condyle-bone-graft-for-resistant-nonunion-of-the-distal-radius
#11
Mark Henry
BACKGROUND: Nonunion involving the metaphyseal region of the distal radius is exceedingly rare, usually involving co-morbidity. Patients that have failed multiple prior conventional surgical interventions represent an even more difficult subset to treat; this investigation examined the utility of a specially designed free vascularized medial femoral condyle flap consisting of a central structural block graft with an extended corticoperiosteal sleeve to wrap around the junctions. METHODS: Six patients (5 males, 1 female) with a mean age of 52 years had failed to achieve union involving the distal radius metaphysis after a mean of 3...
March 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28198795/presence-of-failed-fracture-implants-in-association-with-lower-extremity-long-bone-nonunion-does-not-portend-worse-outcome-following-nonunion-repair
#12
Deirdre K Regan, Roy I Davidovitch, Sanjit Konda, Arthur Manoli, Philipp Leucht, Kenneth A Egol
OBJECTIVE: The purpose of this study was to determine whether the finding of failed fracture implants in association with lower extremity long bone fracture nonunion portends worse clinical or functional outcome following surgical nonunion repair. DESIGN: Retrospective analysis of prospectively collected data. SETTING: Academic Medical Center. PATIENTS: One hundred eighty-one patients who presented to our institution over a 10-year period and underwent surgical repair of a lower extremity fracture nonunion...
February 11, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28194348/analysis-of-bone-fixation-methods-in-digital-replantation
#13
Seung Woo Lee, Dong Chul Lee, Jin Soo Kim, Si Young Roh, Kyung Jin Lee
BACKGROUND: Adequate fixation of replanted digits is essential not only for short-term healing but for long-term function. Various bony fixation methods using Kirschner (K-) and intraosseous wire are available in replantation. We examined clinical and radiographic outcomes of fixation methods on bone union after digital replantation. METHODS: A single institutional retrospective review identified 992 patients who had undergone 1,247 successful replantations between July 2009 and September 2015...
January 2017: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/28192826/the-management-of-bone-defects-in-periarticular-knee-injuries-a-review-article
#14
Brian Buck, Yvonne M Murtha
Traumatic bone defects of the distal femur and proximal tibia present treatment challenges for the orthopaedic traumatologist. In addition to bone loss, significant soft tissue compromise and cartilage defects leave the patient and surgeon with few reconstructive options for proper long-term joint function. These injuries are often complicated by delayed healing, nonunion, malunion, infection, and poor subjective patient outcomes. There are a variety of clinical problems associated with the treatment of periarticular fractures about the knee...
February 13, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28169937/outcomes-of-distal-femur-nonunions-treated-with-a-combined-nail-plate-construct-and-autogenous-bone-grafting
#15
Basem Attum, Diana Douleh, Paul S Whiting, Gabrielle A White-Dzuro, Ashley C Dodd, Michelle S Shen, William T Obremskey, Manish K Sethi
SummaryIn this study, we sought to retrospectively evaluate union and infection rates after treatment of distal femur nonunions using a combined nail/plate construct with autogenous bone grafting. 10 patients treated at a Level I Trauma Center for nonunion of a femoral fracture using a combined nail/plate construct from 2004 to 2014 were included in the study. Union rate and postoperative infection rate were recorded.10 patients underwent treatment for nonunion of the distal femur. Mean interval from index surgery to nonunion repair was 12 months (range 4-36 months)...
December 26, 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28164051/modified-boyd-s-dual-onlay-bone-graft-technique-for-15-years-old-neglected-nonunion-fracture-both-bone-forearm-with-severe-angular-deformity-case-report
#16
Dhurvas Ramlal Ramprasath, Vasudevan Thirunarayanan, Duraisamy Ezhilmaran
INTRODUCTION: Neglected case of nonunion of fracture both bones forearm with deformity is very difficult to manage. Treatment options are minimal. Identifying such a case in literature is also very rare. One such rare case is discussed here. CASE REPORT: Here, we present a case of a 65-year-old male patient, who was operated 15 years back for fracture both bones forearm, with 3.5 mm dynamic compression plate. Fracture went into nonunion and plate was broken. The patient presented to us 15 years later in August 2013 with nonunion, broken, and loosened implants and varus deformity of 90°...
September 2016: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28155140/teriparatide-treatment-of-femoral-fracture-nonunion-that-autogenous-bone-grafting-failed-to-heal-a-case-report
#17
Wei Yu, Xiaodong Guo
PURPOSE: Management of fracture nonunion is challenging as another surgical intervention for the patient is often a necessity, which has a huge impact on both quality of life and economic burden of the patient. Thus, a less aggressive and better accepted treatment for nonunion is required. METHODS: We gave teriparatide to a 45-year-old man with femoral fracture nonunion 1 year after he underwent surgery with autogenous bone grafting that failed to heal his initial nonunion...
December 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28149724/endoscopic-accessory-navicular-synchondrosis-fusion
#18
Tun Hing Lui
The accessory navicular bone is one of the most common accessory ossicles of the foot. Fewer than 1% of accessory navicular bones are symptomatic, and most of these are type II accessory navicular bones. A separation of the synchondrosis is considered one of the main causes of pain. After an injury to the synchondrosis has resulted in a chondro-osseous disruption, the combined forces of tension and shear from the posterior tibial tendon and the foot aggravate the injury and prevent it from healing. Fusion of the synchondrosis is a logical surgical treatment option if the pain is recalcitrant to conservative measures...
December 2016: Arthroscopy Techniques
https://www.readbyqxmd.com/read/28148674/computer-hexapod-assisted-orthopaedic-surgery-provides-a-predictable-and-safe-method-of-femoral-deformity-correction
#19
A Hughes, N Heidari, S Mitchell, J Livingstone, M Jackson, R Atkins, F Monsell
AIMS: Computer hexapod assisted orthopaedic surgery (CHAOS), is a method to achieve the intra-operative correction of long bone deformities using a hexapod external fixator before definitive internal fixation with minimally invasive stabilisation techniques. The aims of this study were to determine the reliability of this method in a consecutive case series of patients undergoing femoral deformity correction, with a minimum six-month follow-up, to assess the complications and to define the ideal group of patients for whom this treatment is appropriate...
February 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28144608/the-current-perspectives-of-stem-cell-therapy-in-orthopedic-surgery
#20
REVIEW
Serkan Akpancar, Oner Tatar, Hasan Turgut, Faruk Akyildiz, Safak Ekinci
CONTEXT: Musculoskeletal injuries may be painful, troublesome, life limiting and also one of the global health problems. There has been considerable amount of interest during the past two decades to stem cells and tissue engineering techniques in orthopedic surgery, especially to manage special and compulsive injuries within the musculoskeletal system. EVIDENCE ACQUISITION: The aim of this study was to present a literature review regarding the most recent progress in stem cell procedures and current indications in orthopedics clinical care practice...
December 2016: Archives of Trauma Research
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