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Bone nonunion

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https://www.readbyqxmd.com/read/28448706/-prognostic-factors-for-post-surgical-complications-in-bone-infection-and-pseudarthrosis
#1
A Cicero-Álvarez, S R León-Hernández, K Gutiérrez-Enríquez, S Zapata-Rivera
Bone infection and nonunion are the main orthopedic and traumatic complications whose treatment remains a challenge because multiple factors are involved in the rate of failures when you try to correct them. Knowing these factors were the problem that caused the research through a prospective longitudinal study of 83 patients of 43.3 ± 16.1 years old. They were treated for aseptic and septic nonunion, osteomyelitis, osteitis, malunion or infected joint replacement. The cases were classified with or without postoperative complications and outcome related to systemic and local factors taken prognostic model Cierny-Mader as factors affecting immune surveillance, metabolism and local vascularization...
September 2016: Acta Ortopédica Mexicana
https://www.readbyqxmd.com/read/28445273/staged-management-of-open-lisfranc-injury-experience-from-14-patients
#2
Wenqi Gu, Zhongmin Shi
There are still controversies on the management and outcome of open Lisfranc injury in available studies. This study evaluates the staged management of Lisfranc injury and its complications.Patients who received a staged strategy for open Lisfranc injury were reviewed.One patient with degloving injury suffered from partial skin and hallux necrosis which was treated by debridement, hallux amputation, definitive internal fixation, and local flap transfer on the 12th day after first stage management. A definitive internal fixation and simultaneous skin graft or flap coverage were performed in another 3 patients with soft tissue defects...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28438404/quantitative-ultrasound-and-tibial-dysplasia-in-neurofibromatosis-type-1
#3
David A Stevenson, Heather Hanson, Austin Stevens, John Carey, David Viskochil, Xiaoming Sheng, Karen Wheeler, Hillarie Slater
Neurofibromatosis type 1 (NF1) is a common autosomal dominant disorder associated with unilateral anterolateral bowing with subsequent fracture and nonunion. In infancy, physiologic bowing of the lower leg can be confused with pathologic tibial dysplasia in NF1. Little is known about the bone physiology of the tibiae prior to fracture or predictors of fracture. The aim of this study was to characterize bone quality of bowed tibiae prior to fracture in NF1 using quantitative ultrasound (QUS). Bone quality was assessed on both tibiae (the non-bowed and bowed tibiae) using QUS to measure speed of sound (SOS) at the mid-shaft in 23 individuals with NF1...
April 21, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28435567/role-of-antibiotic-cement-coated-nailing-in-infected-nonunion-of-tibia
#4
C Bhatia, A K Tiwari, S B Sharma, S Thalanki, A Rai
INTRODUCTION: Infected nonunion of long bones is a chronic and debilitating disorder. It is more difficult to deal with when the implant used for internal fixation itself becomes a potential media for infection because of bacterial adhesion and biofilm formation. Traditionally, it is managed by two-stage procedure for controlling the infection first and then treating the nonunion. This study has been undertaken to explore antibiotic cement coated nailing as single stage treatment modality for treating infection and achieving stability at the same time...
March 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28435558/nonunion-of-fractures-of-the-ulna-and-radius-diaphyses-clinical-and-radiological-results-of-surgical-treatment
#5
H Boussakri, A Elibrahimi, M Bachiri, M Elidrissi, M Shimi, A Elmrini
Aseptic nonunion of the radius and ulna is a major complication of forearm fractures, accounting for 2% to 10% of all forearm fractures. The aim of our study is to evaluate the functional and radiological results of surgical treatment of diaphyseal aseptic nonunion of the radius and ulna, with autologous bone grafting, decortication and internal plate fixation. A series of 21 patients (26 nonunions) was retrospectively reviewed, the average age was 35 years with a mean of 31,58 years (range 12-44 years). The fractures included isolated radius (n=6) and ulna (n=10), and both radius and ulna (n=5)...
July 2016: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/28431400/local-delivery-of-hmgb1-in-gelatin-sponge-scaffolds-combined-with-mesenchymal-stem-cell-sheets-to-accelerate-fracture-healing
#6
Deting Xue, Wei Zhang, Erman Chen, Xiang Gao, Ling Liu, Chenyi Ye, Yanbin Tan, Zhijun Pan, Hang Li
Fracture nonunion and delayed union continue to pose challenges for orthopedic surgeons. In the present study, we combined HMGB1 gelatin sponges with MSC sheets to promote bone healing after surgical treatment of rat tibial fractures. The HMGB1 gelatin sponge scaffolds supported the expansion of mesenchymal stem cells (MSCs) and promoted the osteogenic differentiation of MSCs and MSC sheets. Lentiviral vectors were then used to overexpress HMGB1 in MSCs. The results indicated that HMGB1 promotes the osteogenic differentiation of MSCs through the STAT3 pathway...
April 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/28425054/can-a-three-component-prosthesis-be-used-for-conversion-of-painful-ankle-arthrodesis-to-total-ankle-replacement
#7
Markus Preis, Travis Bailey, Lucas S Marchand, Alexej Barg
BACKGROUND: In patients with painful ankle arthrodesis, the surgical treatment is challenging, and may include takedown of ankle arthrodesis and conversion to a total ankle replacement (TAR). This procedure is technically demanding given the altered anatomy after arthrodesis. Few studies have evaluated TAR in the setting of prior arthrodesis. QUESTIONS/PURPOSES: (1) What intraoperative and perioperative complications were observed in patients who underwent conversion of an ankle arthrodesis to a TAR? (2) Was durable fixation achieved at short term, and what was the alignment of the components? (3) What subsequent surgical procedures were performed, including revisions? (4) What improvements were observed in pain, tibiotalar range of motion (ROM), and quality of life? METHODS: Between January 2007 and December 2014, 18 patients with a painful ankle arthrodesis underwent conversion to TAR at our tertiary referral center...
April 19, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28422876/low-complication-rate-of-elastic-stable-intramedullary-nailing-esin-of-pediatric-forearm-fractures-a-retrospective-study-of-202-cases
#8
Christiane Kruppa, Pamela Bunge, Thomas A Schildhauer, Marcel Dudda
Elastic stable intramedullary nailing (ESIN) has been established as state of the art treatment for forearm fractures in children, if operative stabilization is required. Their use has been expanded to single bone shaft fractures, and also more complex injuries such as Monteggia fractures or Monteggia-like lesions. A wide range of complications has been reported in the literature, up to 70% in certain investigations. The purpose of this study was to assess the complication rate after ESIN treatment of forearm fractures in children and adolescents in a representative cohort of patients from a level 1 trauma center in Germany...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28422848/teriparatide-as-a-nonoperative-treatment-for-tibial-and-femoral-fracture-nonunion-a-case-report
#9
Li Xiaofeng, Xu Daxia, Chen Yunzhen
RATIONALE: Fracture nonunion is a great challenge for orthopedic surgeons. Many surgical interventions are associated with significant pain and heavy economic burden. Therefore, our aim was to evaluate the outcomes of a new nonoperative treatment for fracture nonunion. PATIENT CONCERNS: A 44-year-old man suffered closed fractures of the right tibia and left femur. Eleven months after surgery, there was no radiographic healing between fracture fragments. DIAGNOSES: Fracture nonunion of the right tibia and left femur...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28419031/prognostic-factors-affecting-union-after-ulnar-shortening-osteotomy-in-ulnar-impaction-syndrome-a-retrospective-case-control-study
#10
Soo Min Cha, Hyun Dae Shin, Ki Jun Ahn
BACKGROUND: Ulnar shortening osteotomy (USO) is a widely adopted procedure with excellent outcomes. However, delayed union or nonunion has occasionally been observed. The purpose of this retrospective case-control study was to identify variables affecting osseous consolidation after USO in patients with ulnar impaction syndrome. METHODS: The study included 325 patients who had undergone USO between March 2008 and March 2014. We evaluated the association between union and basic demographic factors as well as preoperative pain (assessed on a visual analog scale [VAS]), range of wrist motion, grip strength, and modified Mayo wrist score...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28416462/clinical-assessment-of-115-cases-of-hindfoot-fusion-with-two-different-types-of-graft-allograft-dbm-bone-marrow-aspirate-versus-autograft-dbm
#11
Mathias Tricot, Paul-André Deleu, Christine Detrembleur, Thibaut Leemrijse
INTRODUCTION: Nonunion is a common complication (15%) of hindfoot and ankle arthrodesis. Autograft can improve the fusion rate because of its osteoconductive, osteoinductive and osteogenic properties. However, autograft harvesting is a source of morbidity. One alternative is to combine allograft with demineralized bone matrix (DBM) and iliac bone marrow aspirate (BMA). This combination graft has similar biological properties to healthy bone. When used alone, allograft has osteoconductive and sometimes structural properties...
April 14, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/28408376/a-comparative-study-of-tissue-engineered-constructs-from-acropora-and-porites-coral-in-a-large-animal-bone-defect-model
#12
A Decambron, M Manassero, M Bensidhoum, B Lecuelle, D Logeart-Avramoglou, H Petite, V Viateau
OBJECTIVES: To compare the therapeutic potential of tissue-engineered constructs (TECs) combining mesenchymal stem cells (MSCs) and coral granules from either Acropora or Porites to repair large bone defects. MATERIALS AND METHODS: Bone marrow-derived, autologous MSCs were seeded on Acropora or Porites coral granules in a perfusion bioreactor. Acropora-TECs (n = 7), Porites-TECs (n = 6) and bone autografts (n = 2) were then implanted into 25 mm long metatarsal diaphyseal defects in sheep...
April 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28394845/im-nail-fixation-of-atypical-femur-fractures-with-bone-marrow-aspirate-concentrate-leads-to-faster-union-a-case-control-study
#13
Andrew J Lovy, Jun S Kim, John Di Capua, Sulaiman Somani, Stephanie Shim, Aakash Keswani, Rohit Hasija, Yangguan Wu, David Joseph, Richard Ghillani
OBJECTIVES: High rates of implant failure and nonunion in atypical femur fractures (AFF) have been reported. The aim of this study was to evaluate bone marrow aspirate concentrate (BMAC) use in the treatment of AFF. DESIGN: Retrospective Case Control SETTING:: Level 1 Trauma Center PATIENTS:: Complete AFF, defined according to American Society of Bone and Mineral Research (ASBMR) criteria, from September 2009 to April 2015 with minimum 1 year follow up. INTERVENTION: Operative treatment with anterograde intramedullary (IM) nails...
April 7, 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28393309/free-non-vascularized-fibular-graft-for-treatment-of-large-bone-defect-around-the-elbow-in-pediatric-patients
#14
Kamolporn Kaewpornsawan, Perajit Eamsobhana
BACKGROUND: Large bone defect is a challenging problem in orthopedics practice. Several methods are available for bridging of these bone defects, including cancellous bone graft, free vascularized fibula graft, and bone transport with external ring fixator. The aim of this study was to describe our experience in nine pediatric cases of free non-vascularized autogenous fibular strut bone graft in which large bone defect and bone loss of >7 cm was caused by open fracture and infective nonunion around the elbow joint...
April 9, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28391429/femoral-neck-fracture-osteosynthesis-by-the-biplane-double-supported-screw-fixation-method-bdsf-reduces-the-risk-of-fixation-failure-clinical-outcomes-in-207-patients
#15
Orlin Filipov, Karl Stoffel, Boyko Gueorguiev, Christoph Sommer
INTRODUCTION: Osteosynthesis of femoral neck fractures is related up to 46% rate of complications. The novel method of biplane double-supported screw fixation (BDSF; Filipov's method) offers better stability using three medially diverging cannulated screws with two of them buttressed on the calcar. Biomechanically, the most effective component is the distal screw placed at steeper angle and supported on a large area along the distal and posterior cortex of the femoral neck following its spiral anterior curve...
April 8, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28391380/low-intensity-pulsed-ultrasound-is-effective-for-progressive-stage-lumbar-spondylolysis-with-mri-high-signal-change
#16
Hideyuki Arima, Yoshiji Suzuki, Daisuke Togawa, Yuki Mihara, Hideyuki Murata, Yukihiro Matsuyama
PURPOSE: This study aimed to investigate the treatment effects of low-intensity pulsed ultrasound (LIPUS) on progressive-stage spondylolysis. Spondylolysis is a stress fracture of the pars interarticularis. Based on the results of computed tomography, spondylolysis was classified into three categories: early, progressive, and terminal. Bone healing was prolonged or not obtained in progressive-stage spondylolysis. The progression of spondylolysis to nonunion has been associated with an increased incidence of spondylolisthesis...
April 8, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28389837/use-of-internal-lengthening-nails-in-post-traumatic-sequelae
#17
REVIEW
Hamza M Alrabai, Martin G Gesheff, Janet D Conway
External fixators are a well-established modality for treating fractures with bone defects, leg-length discrepancy, malunion, nonunion and other post-traumatic consequences. However, use of internal lengthening rods has remarkably increased recently for post-traumatic conditions. The main advantage of internal lengthening rods is eliminating pin-site complications. Internal lengthening rods are also associated with less pain. Motorised internal lengthening rods show promising performance in post-traumatic cases...
April 7, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28387196/bone-grafting-via-reamer-irrigator-aspirator-for-nonunion-of-open-gustilo-anderson-type-iii-tibial-fractures-treated-with-multiplanar-external-fixator
#18
Nicholas Kusnezov, Gautham Prabhakar, Matthew Dallo, Ahmed M Thabet, Amr A Abdelgawad
INTRODUCTION: The purpose of this investigation was to evaluate the outcomes following reamer-irrigator-aspirator (RIA) autogenous bone grafting (ABG) of high-grade open tibia fracture nonunions stabilized via multiplanar external fixation. METHODS: We retrospectively reviewed all patients with Gustilo-Anderson type III open tibia fractures treated with multiplanar external fixation and who underwent RIA ABG for nonunion at our institutional Level 1 Trauma Center between 2008 and 2015...
2017: SICOT-J
https://www.readbyqxmd.com/read/28385008/use-of-stem-cell-sheets-expressing-bone-morphogenetic-protein-7-in-the-management-of-a-nonunion-radial-fracture-in-a-toy-poodle
#19
Jaeyong Song, Yongsun Kim, Oh-Kyeong Kweon, Byung-Jae Kang
A 12-year-old castrated Toy Poodle was referred to Kangwon National University Animal Hospital with an oligotrophic nonunion fracture in the left distal 1/3 of the radius and an intact ulna. After fixation using a locking plate and screws, adipose-derived mesenchymal stem cell sheets expressing bone morphogenetic protein 7 (BMP-7) were transplanted to the fracture site to enhance the healing activity. The fracture healed at 9 weeks after surgery. In the present case, the mesenchymal stem cell sheets expressing BMP-7 promoted bone regeneration and healing in a nonunion fracture...
April 6, 2017: Journal of Veterinary Science
https://www.readbyqxmd.com/read/28383765/new-opportunities-for-fracture-healing-detection-impedance-spectroscopy-measurements-correlate-to-tissue-composition-in-fractures
#20
Monica C Lin, Frank Yang, Safa T Herfat, Chelsea S Bahney, Meir Marmor, Michel M Maharbiz
Accurate evaluation of fracture healing is important for clinical decisions on when to begin weight-bearing and when early intervention is necessary in cases of fracture nonunion. While the stages of healing involving hematoma, cartilage, trabecular bone, and cortical bone have been well characterized histologically, physicians typically track fracture healing by using subjective physical examinations and radiographic techniques that are only able to detect mineralized stages of bone healing. This exposes the need for a quantitative, reliable technique to monitor fracture healing, and particularly to track healing progression during the early stages of repair...
April 6, 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
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