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tibia fractures

Devon S Callahan, Zane Ashman, Dennis Y Kim, David S Plurad
Long bone fractures are cited as an etiology for significant blood loss; however, there is scant supporting literature. We examined the relationship between long bone fractures, blood transfusions, and solid organ injuries. We hypothesize that transfusions are rare with long bone fractures in the absence of a liver or splenic injury. We performed a retrospective analysis of patients admitted with femur, tibia, and humerus fractures. Outcomes included transfusion requirements and mortality. A total of 1837 patients were included...
October 2016: American Surgeon
Hai-Ming Huang, Xiao-Lin Li, Shu-Qiang Tu, Xiao-Feng Chen, Chang-Chun Lu, Liang-Hua Jiang
BACKGROUND: Roughly focused extracorporeal shock waves therapy (ESWT) is characterized by a wide focal area, a large therapy zone, easy positioning, and less pain during treatment. The purpose of this study was to investigate the effects of roughly focused ESWT on the expression of osteoprotegerin (OPG) and bone morphogenetic protein-2 (BMP-2) in osteoporotic fractures in rats. METHODS: Seventy-two female Sprague-Dawley (SD) rats, 3 months old, were divided into sham-operated group (n = 6) and an ovariectomized (OVX) group (n = 66)...
2016: Chinese Medical Journal
Andrew S Wilmot, Alexander T Ruutiainen, Prashant T Bakhru, Mark E Schweitzer, Nogah Shabshin
OBJECTIVE: Primary: to describe the presence and pattern of soft tissue edema in subchondral insufficiency fractures of the knee (SIFK). Secondary: to investigate the gender distribution and identify factors associated with disease progression. METHODS: MR images of 74 SIFKs in 74 patients were retrospectively reviewed for soft tissue edema presence and location, meniscal tears and extrusion and synovitis. The clinical records were reviewed for age, gender, and BMI...
November 2016: European Journal of Radiology
Maral Tajerian, Victor Hung, Hamda Khan, Lauren J Lahey, Yuan Sun, Frank Birklein, Heidrun H Krämer, William H Robinson, Wade S Kingery, J David Clark
OBJECTIVE: Using a mouse model of complex regional pain syndrome (CRPS), our goal was to identify autoantigens in the skin of the affected limb. METHODS: A CRPS-like state was induced using the tibia fracture/cast immobilization model. Three weeks after fracture, hindpaw skin was homogenized, run on 2-d gels, and probed by sera from fracture and control mice. Spots of interest were analyzed by liquid chromatography-mass spectroscopy (LC-MS) and the list of targets validated by examining their abundance and subcellular localization...
October 20, 2016: Experimental Neurology
William T Obremskey, Norele Cutrera, Christopher M Kidd
BACKGROUND: The purpose of this study was to determine optimal treatment of stable tibial shaft fractures using intramedullary nailing (IMN) or casting. MATERIALS AND METHODS: We performed a multi-center prospective study cohort. Patients with stable tibia shaft fractures meeting Sarmiento's criteria (isolated closed fractures with less than 12 mm of shortening and 10° of angulation) were enrolled prospectively and treated with either a reamed IMN with static interlocking screws or closed reduction followed by long-leg casting...
October 21, 2016: Journal of Orthopaedics and Traumatology: Official Journal of the Italian Society of Orthopaedics and Traumatology
Stephen Matthew Quinnan
Obtaining optimal results in the treatment of extraarticular distal tibia fractures can be challenging. Plate and screw and intramedullary fixation have proven to be effective treatments, but are associated with significant complication rates when used for open fractures and patient with severe medical comorbidities. External fixation is a third alternative that is less often employed, but provides a very effective means of treatment. Circular external fixation offers great flexibility in obtaining anatomic alignment and stable fixation for even the most challenging distal tibia fractures...
November 2016: Journal of Orthopaedic Trauma
Daniel Torino, Samir Mehta
The role of fibular fixation in patients with distal tibia fractures is controversial. Although the stability of the fibula is critical in patients with syndesmotic instability or highly comminuted pilon fractures, fibular fixation in extraarticular distal tibia fractures or elementary intraarticular distal tibia fractures is more controversial. Biomechanical studies, as performed in sawbones or cadaveric models, denote advantages to fibular fixation with respect to specific uniplanar motion. However, the increased stability is susceptible to the fracture pattern of the tibia, fixation strategy for the tibia, fixation strategy for the fibula, and loading pattern of the entire construct...
November 2016: Journal of Orthopaedic Trauma
Richard S Yoon, Frank A Liporace
Intramedullary nail and plate combination techniques have been described mostly for use in the proximal tibia. However, the nail and plate combination technique can also be used in the distal tibia, to counteract the deforming forces that cause construct failure and nonunion. In this article, we review pertinent anatomy and biomechanics and offer case examples that highlight the indications and applications of the nail and plate combination technique for distal tibia fractures.
November 2016: Journal of Orthopaedic Trauma
John A Scolaro, Francis H Broghammer, Derek J Donegan
The optimal treatment strategy for distal tibia fractures, especially those with intraarticular extension, remains controversial. Although open reduction and internal fixation with a plate and screw device is commonly performed for these injuries, the risk of soft tissue complications using this approach is significant. Staged treatment protocols and alternative means of fixation have been proposed to address these undesired events. Although potentially more technically demanding than fixation of diaphyseal or extraarticular tibial fractures, intramedullary nail (IMN) fixation of simple intraarticular distal tibia fractures is a viable treatment alternative with unique advantages...
November 2016: Journal of Orthopaedic Trauma
Michael Talerico, Jaimo Ahn
The objective of this article is to highlight the salient points of preoperative planning, intraoperative considerations for fracture reduction methods, and implant fixation when treating distal diaphyseal or diametaphyseal tibia fractures with an intramedullary nail. Through review of the necessary preoperative considerations, techniques available to hold and maintain a reduction, and lastly how to maximize the selected implant of intramedullary nail, we hope to assist the treating surgeon in simplifying these sometimes complex fractures into manageable injuries that can be treated successfully with an intramedullary implant...
November 2016: Journal of Orthopaedic Trauma
Heather A Vallier
Displaced distal tibia shaft fractures are effectively treated with standard plates and intramedullary nails. Plate fixation performed with meticulous soft tissue handling results in minimal risks of infection and poor wound healing. Standard plates have high rates of primary union, whereas locking plates may delay union because of increased stiffness. Tibial healing may also be delayed after plating of the fibula, although fibula reduction and fixation may aid accuracy of reduction of the tibia. Malalignment occurs more often with infrapatellar intramedullary nailing versus plates, and early results of suprapatellar nailing appear promising in minimizing intraoperative malalignment...
November 2016: Journal of Orthopaedic Trauma
Phillip M Mitchell, Benjamin M Weisenthal, Cory A Collinge
OBJECTIVE: To evaluate the incidence of knee sepsis following suprapatellar nailing of open tibia fractures. DESIGN: Retrospective SETTING:: ACS Level 1 trauma centerPatients/Participants: We reviewed 139 open tibia fractures that underwent suprapatellar nailing as definitive treatment over a five-year period (January 1, 2011 to January 1, 2016). The majority of patients (90%, n=126) underwent intramedullary nailing at the time of their initial surgery. We defined knee sepsis as intra-articular infection requiring operative debridement, either open or arthroscopically, within one month's time...
October 1, 2016: Journal of Orthopaedic Trauma
Daniel S Chan, Paul M Balthrop, Brian White, David Glassman, Roy W Sanders
OBJECTIVE: To determine whether multiple approaches pose an increased risk to fracture healing when compared to a standard single approach in the treatment of pilon (OTA 43C) fractures. DESIGN: Retrospective review of a prospective database. SETTING: Level I academic trauma center and level II community trauma center. METHODS: From January 1, 2005 to December 31, 2011, all records of patients treated for OTA 43C fractures of the distal tibia were reviewed...
October 1, 2016: Journal of Orthopaedic Trauma
Nevzat Dabak, Hasan Göçer, Alper Çıraklı
BACKGROUND: Giant Cell Tumor is considered a benign, local and aggressive tumor. Although considered a benign bone tumor, it is still the subject of discussion and research because of the associated local bone destruction, as well as high rates of recurrence and distant metastases. Options are being developed for both surgical techniques and adjuvant therapies. AIMS: The present study evaluated the administration of cryotherapy via a pressurized-spray technique in giant cell tumors of the bone...
September 2016: Balkan Medical Journal
Yunzhu Meng, Wansoo Pak, Berkan Guleyupoglu, Bharath Koya, F Scott Gayzik, Costin D Untaroiu
Child pedestrian protection deserves more attention in vehicle safety design since they are the most vulnerable road users who face the highest mortality rate. Pediatric Finite Element (FE) models could be used to simulate and understand the pedestrian injury mechanisms during crashes in order to mitigate them. Thus, the objective of the study was to develop a computationally efficient (simplified) six-year-old (6YO-PS) pedestrian FE model and validate it based on the latest published pediatric data. The 6YO-PS FE model was developed by morphing the existing GHBMC adult pedestrian model...
October 16, 2016: Accident; Analysis and Prevention
Utku Kandemir, Safa Herfat, Mary Herzog, Paul Viscogliosi, Murat Pekmezci
OBJECTIVES: The goal of this study is to compare the fatigue strength of a locking intramedullary nail (LN) construct to a double locking plate (DLP) construct in comminuted proximal extra-articular tibia fractures. METHODS: Eight pairs of fresh frozen cadaveric tibias with low bone mineral density (Age: 80 ± 7 (SD) years, T-score: -2.3 ± 1.2) were used. One tibia from each pair was fixed with LN while the contralateral side was fixed with DLP for complex extra-articular multifragmentary, metaphyseal fractures (simulating OTA41-A3...
October 7, 2016: Journal of Orthopaedic Trauma
Brian R Waterman, Baris Gun, Julia O Bader, Justin D Orr, Philip J Belmont
PURPOSE: To comprehensively quantify established risk factors for the development of lower extremity stress fractures within a contemporary U.S. military cohort. METHODS: Using the Defense Medical Epidemiological Database, all U.S. service members diagnosed with tibia/fibula, metatarsal, other bone, femoral neck, and femoral shaft stress fractures were identified based on International Classification of Diseases, 9th Revision, Clinical Modification code from 2009 to 2012...
October 2016: Military Medicine
Kerrin C DePeter, Stephen M Blumberg, Sarah Dienstag Becker, James A Meltzer
BACKGROUND: Despite being an effective analgesic for children with fractures, some clinicians may avoid prescribing ibuprofen due to its potentially harmful effect on bone healing. OBJECTIVE: To determine if exposure to ibuprofen is associated with an increased risk of bone healing complications in children with fractures. METHODS: We performed a retrospective study of children aged 6 months to 17 years who presented to the pediatric emergency department (PED) with a fracture of the tibia, femur, humerus, scaphoid, or fifth metatarsus and who followed up with the orthopedic service...
October 14, 2016: Journal of Emergency Medicine
Chul Hyun Park, Oog Jin Shon, Gi Beom Kim
BACKGROUND: Traditionally, Gustilo Anderson grade IIIb open tibial fractures have been treated by initial wide wound debridement, stabilization of fracture with external fixation, and delayed wound closure. The purpose of this study is to evaluate the clinical and radiological results of staged treatment using negative pressure wound therapy (NPWT) for Gustilo Anderson grade IIIb open tibial fractures. MATERIALS AND METHODS: 15 patients with Gustilo Anderson grade IIIb open tibial fractures, treated using staged protocol by a single surgeon between January 2007 and December 2011 were reviewed in this retrospective study...
September 2016: Indian Journal of Orthopaedics
Rohan A Ramasubbu, Benjamin M Ramasubbu
BACKGROUND: Management of open tibial fractures is well documented in adults, with existing protocols outlining detailed treatment strategies. No clear guidelines exist for children. Surgical stabilization of tibial fractures in the pediatric population requires implants that do not disrupt the open epiphyses (growth plate). Both elastic stable intramedullary nails and external fixation can be used. The objective of this study was to identify the optimal method of surgical stabilization in the treatment of open tibial fractures in children...
September 2016: Indian Journal of Orthopaedics
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