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Tibial fractures

Nipun Sodhi, Anton Khlopas, Joseph O Ehiorobo, Caitlin Condrey, Kevin Marchand, Robert C Marchand, Matthew S Hepinstall, Michael A Mont
INTRODUCTION: Tibial or femoral extra-articular deformities complicate the goal achieving optimal mechanical axis alignment for successful total knee arthroplasty (TKA) outcomes. In the presence of these extra-articular deformities, standard operative techniques and instruments may not be reliable. Robotic-arm assisted technology was developed to help achieve a well-aligned and balanced knee in a variety of clinical scenarios. Although prior case series have reported on the use of robotic-arm assisted devices for cases with severe angular deformity, there is a lack of data concerning the use of the robotic device for patients with other potentially complex surgical factors...
March 18, 2019: Surgical Technology International
Peter J Ogrodnik, Peter Bm Thomas
There is a need for a quick, simple, repeatable, but quantifiable assessment tool to determine the fracture healing endpoint of tibial fractures that does not rely on the use of X-rays or on un-measured manipulation. This article presents an argument to support a 'maximum of 1° bending' criterion. The criterion was established from an examination of patient fracture stiffness profiles and following observations of stiffness measurements made in clinics. A proprietary mono-lateral external fixator was used to test the criterion...
March 19, 2019: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
M Krause, G Müller, K-H Frosch
OBJECTIVE: Complete visualization of the articular surface in comminuted uni- or bicondylar tibial plateau fractures as a prerequisite for anatomical reconstruction to reduce the risk of posttraumatic osteoarthritis. INDICATIONS: Unicondylar lateral or medial as well as bicondylar intra-articular tibial plateau fractures with central and/or dorsal fracture lines; comminuted destruction of the medial or lateral tibial plateau with dislocation of >2 mm. CONTRAINDICATIONS: Critical soft tissue in the approach area, femoral condylar fracture, intraligamentous ruptures of the medial or lateral ligaments or the posterolateral corner...
March 18, 2019: Operative Orthopädie und Traumatologie
V Filardi
In this paper, an innovative design of prosthesis, conceived to heal the comminuted fractures of long bones has been investigated. The proposed prosthesis consists of two shell valves hinged to each other by a central pin and bearing slits along the surface in such a way as to guarantee the exchange of body fluids and at the same time ensure the structural stability of the bone. Two screws then hold the two valves together. The operative technique for the introduction of this type of prosthesis for the decomposed fracture of long bones consists in the incision of the fracture site, introduction of the open shell prosthesis with reduction of the fracture and composition of the bone fragments, closure by means of fixing screws of the prosthesis shell, stitching open wound flaps...
March 2019: Journal of Orthopaedics
Özgür Çiçekli, Alauddin Kochai, Erhan Şükür, Ali Murat Başak, Alper Kurtoğlu, Mehmet Türker
OBJECTIVES: This study aims to evaluate proximal, shaft, and distal tibial fractures treated with suprapatellar (SP) tibial intramedullary nailing (IMN) in terms of alignment, healing, and patellofemoral (PF) pain. PATIENTS AND METHODS: The study included 58 patients (41 males, 17 females; mean age 42.9 years; range, 18 to 75 years) treated via the SP approach in semiextention. Suprapatellar IMN surgeries were performed by two surgeons. After a minimum of 12 months of follow-up, patients' genders, ages, limb sides, fracture types, and classifications were recorded...
April 2019: Joint Diseases & related Surgery
Jianzhao Wang, Xiaojuan Zhang, Sheng Li, Bing Yin, Guobin Liu, Xiaodong Cheng, Yingze Zhang
PURPOSE: Internal fixation device failure is rare but unavoidable. Fatigue-related mechanisms are responsible for most mechanical failures of orthopedic plates. Plate design needs to be optimized for both long fatigue life and bone healing. Only in this way can we reduce the occurrence of internal fixation failure. To address this issue, we aimed to provide a theoretical basis for improving the design of orthopedic plates. MATERIAL AND METHODS: The finite element method was used to conduct a computational investigation...
March 19, 2019: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
Matjaž Groznik, Matej Cimerman, Lara Lusa, Nina Ružić Gorenjec, Alojz Ihan
BACKGROUND: Early diagnosis of acute posttraumatic osteomyelitis (POM) is of vital importance for avoiding devastating complications. Diagnosing POM is difficult due to the lack of a highly specific and sensitive test, such as in myocardial infarct, stroke and intracranial bleeding. Serum inflammatory markers, C-reactive protein (CRP), procalcitonin (PCT), white blood cells (WBC) can support clinical findings but they are not able to differentiate between inflammatory response to infection and the host response to non-infection insult with high specificity and sensitivity...
March 5, 2019: Injury
Xun Chen, Wentao Zhang, Zirui Yu, Yufei Wang, Shihui Zhang, Tao Song
Objective: To summarize the effectiveness of bone transport with unilateral external fixator combined with locked plate internal fixation in treatment of infected tibial nonunion. Methods: Between January 2010 and December 2014, 23 patients with infected tibial nonunion were treated with bone transport with unilateral external fixator combined with locked plate internal fixation. There were 19 males and 4 females with an average age of 37.8 years (range, 19-54 years)...
March 1, 2019: Chinese Journal of Reparative and Reconstructive Surgery
Zhu Dai, Yunliang Lei, Ying Liao, Zhiwei Chen, Dehong Fu, Zhou Li
Objective: To explore the clinical effects of combined operation involving tibial tubercle distalization for the recurrent patellar dislocation with patella alta. Methods: Between April 2010 and May 2016, 14 cases of recurrent patellar dislocation with patella alta were treated with combined operation involving tibial tubercle distalization. There were 5 males and 9 females with an average age of 18.5 years (range, 13-26 years). The left knee was involved in 9 cases and the right knee in 5 cases...
March 1, 2019: Chinese Journal of Reparative and Reconstructive Surgery
Lingfei Guo, Yinqiao Du, Mingchao Zhang, Jingyang Sun, Zhigang Jin, Yawen Peng, Junmin Shen, Yonggang Zhou
Objective: To evaluate short-term effectiveness of revision total knee arthroplasty (TKA) with porous-coated metaphyseal Sleeve and MBT implant. Methods: A clinical data of 23 patients (24 knees) who underwent revision TKA by using porous-coated metaphyseal Sleeve combined with MBT implant between March 2015 and April 2017 was retrospectively analyzed. There were 8 males (8 knees) and 15 females (16 knees). The age ranged from 48 to 85 years (mean, 65.4 years). The cause of revision TKA included infection in 14 knees, aseptic loosening in 8 knees, instability in 1 knee, and stiff knee in 1 knee...
March 1, 2019: Chinese Journal of Reparative and Reconstructive Surgery
Mi Hyun Song, Tae-Jin Kim, Sung Hyun Kang, Hae-Ryong Song
BACKGROUND: Low-intensity pulsed ultrasound (LIPUS) has been widely accepted in promoting the fracture healing process. However, there have been limited clinical trials focused on the efficacy of LIPUS during distraction osteogenesis (DO) by the technique of lengthening over the nail procedure. The purpose of the current study was to evaluate the efficacy of LIPUS during DO. METHODS: We retrospectively evaluated 30 patients (60 segments) who underwent simultaneous bilateral tibial lengthening over the nail...
March 14, 2019: BMC Musculoskeletal Disorders
Martin Bäumlein, Alexander Hanke, Boyko Gueorguiev, Michael Nerlich, Emmanouil Liodakis, Thomas Perren, Paavo Rillmann, Christian Ryf, Markus Loibl
INTRODUCTION: Tibial plateau fractures occur frequently during downhill skiing. There is a lack of information about the outcome and development of posttraumatic osteoarthritis after internal fixation of such fractures at long-term follow-up in skiers. MATERIALS AND METHODS: A population of 83 skiers was followed up in a case series after internal fixation of intra-articular tibial plateau fractures AO-OTA 41 B1-B3 and C1-C3. Functional outcomes Visual Analog Scale, Tegner Activity Scale, Modified Lysholm Score, Hospital for Special Surgery (HSS) Knee Score and X-ray images of the affected knees (preoperative, postoperative and at time of follow-up) were obtained...
March 12, 2019: Archives of Orthopaedic and Trauma Surgery
O O'Malley, A J Trompeter, S Krishnanandan, M Vesely, P Holt, G Goh, N Papadakos, V Bhatia, C B Hing
BACKGROUND: Tibial fractures have an incidence of 15% of all adult fractures. They have been shown to have the highest incidence of non-union in long bone fractures and the highest incidence of vascular injury. Evidence from the literature suggests that a good vascular supply is important to ensure bone union. The aim of our study was to prospectively assess the incidence of vascular injuries in open tibial fractures and determine whether they were associated with an increased risk of non-union...
March 13, 2019: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
J H Li, Y B Lin, G S Yu, S X Zhang, Y Y Liu, H B Xu
Extra-articular distal tibial fractures as a result of high-energy damage are often comminuted or displaced, frequently accompanied by severe soft tissue injuries.Poor blood supply and various complications make the treatment more difficult,affecting life quality of the patients.The main goals of the treatment are to abtain a healed,well-aligned fracture,functional range of motion of the ankle joint and minimizing complications.It is generally recommended that surgical treatment be performed in the proper context of local conditions to facilitate early functional exercise...
March 1, 2019: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
S M Feng, S C Zhang, A G Wang, Z Y Zhang
Objective: To analyze the clinical effects of all-inside arthroscopic treatment for the patients of avulsion fracture of tibial origin withⅠdegree supination and external rotation injury according to the Lauge-Hansen classification. Methods: A retrospective analysis of 34 patients (34 feet) who had underwent all-inside arthroscopic for avulsion fracture of tibial origin with Ⅰ degree supination and external rotation injury from September 2015 to September 2017 in Department of Hand and Foot Microsurgery, Xuzhou Central Hospital...
March 1, 2019: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Andreas Ladurner, Yves P Acklin, Thomas S Mueller, Christoph Sommer
INTRODUCTION: Medial parapatellar or transpatellar ligament approaches are commonly used for nail osteosynthesis in tibia shaft fractures. The lower leg is normally in a hanging position to allow guide wire insertion and reaming of the tibia. However, this position complicates fracture reduction and retention, as well as image intensification throughout the procedure. A lateral parapatellar approach with the lower leg in a semi-extended, horizontal position has been previously described for proximal tibial fracture fixation...
March 7, 2019: Archives of Orthopaedic and Trauma Surgery
S Manegold, A Springer, S Märdia, S Tsitsilonis
PURPOSE OF THE STUDY The aim of the present study was to evaluate the postoperative outcome of patients with pilon tibial fractures with a minimum follow-up of 24 months, treated according to a staged treatment algorithm. MATERIAL AND METHODS In total, 27 patients (mean age 43.6 ± 13 years, range 18-69) with a pilon tibial fracture and a minimum follow-up of 24 months were included in the study. Medical recordings (discharge documents and surgical reports) and radiographic examinations were analyzed. All enrolled patients were invited for a clinical and radiological follow-up examination (ROM, AOFAS hindfoot score, Kellgren score)...
2019: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
Yue Liu, Yan Zhang, Xu Liang, Jin Shao, Zisheng Ai, Tieyi Yang
We aimed to investigate the incidence of proximal fibula fractures in patients with tibial plateau fractures and to identify risk factors for such combined injuries. From January 2011 to December 2015, 354 patients with tibial plateau fractures who had been admitted to a level 1 trauma center were retrospectively evaluated by an orthopaedic trauma surgeon and two skeletal radiologists. Anteroposterior plain radiography and computed tomography (CT) were used to characterize the injuries, and the incidence of associated proximal fibula fractures was determined...
March 1, 2019: Journal of Knee Surgery
Jeremy E Raducha, Ishaan Swarup, Jonathan M Schachne, Aristides I Cruz, Peter D Fabricant
No abstract text is available yet for this article.
February 2019: JBJS Reviews
Brian W Yang, Benjamin J Shore, Emily Rademacher, Collin May, Colyn J Watkins, Michael P Glotzbecker
BACKGROUND: There has been little investigation into the epidemiology of Cozen's phenomenon, genu valgum as a complication of proximal tibial metaphysis fractures. In this study, we present a large case series of proximal tibia fractures in children to describe the prevalence, epidemiology, and characteristics associated with Cozen's phenomenon following proximal tibial fracture in children. METHODS: We searched the orthopedic database at our institution for all patients aged 1 to 8 years old with proximal tibia fractures presenting for initial fracture management between January 1, 2014 and December 31, 2017...
February 25, 2019: Journal of Pediatric Orthopedics
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