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Distal Tibial Fracture

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
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 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
Kadir Bahadır Alemdaroğlu, Serkan İltar, Alper Ozturk, Emre Gültaç, Mehmet Yücens, Nevres Hürriyet Aydoğan
Background: To compare the union times of the uncomplicated tibial shaft fractures, which were distally locked by two coronal and one sagittal screws and by only two coronal screws. Methods: 45 patients with tibial shaft treated with intramedullary nailing included in this study. 23 of 45 fractures were treated with uniplanar two distal interlocking (Group 1) and 22 fractures were treated with biplanar three distal interlocking (Group 2). Patients with closed fractures treated by closed nailing and having a full set of radiographs on PACS system was included...
January 2019: Archives of Bone and Joint Surgery
İbrahim Alper Yavuz, Ahmet Ozgur Yildirim, Ozdamar Fuad Oken, Erman Ceyhan, Fatih İnci, Ozlem Ozkale Yavuz, Deniz Sozmen Cılız
Long-term studies have shown that 10% to 20% of patients continue to experience ankle pain years after tibial fracture, which causes poor functional results and dissatisfaction. The aim of this study was to show that there could be a talus injury in patients with a tibial shaft fracture and to reveal occult talus lesions with magnetic resonance imaging (MRI) examination. Fifty-two patients with a tibial shaft fracture, with closed epiphyses, not extending to the joint and with no problems in the application of MRI examination were included...
February 22, 2019: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Vaskar Das, Jeffrey S Kroin, Mario Moric, Robert J McCarthy, Asokumar Buvanendran
BACKGROUND: Metformin, an adenosine monophosphate (AMP)-activated protein kinase activator, as well as a common drug for type 2 diabetes, has previously been shown to decrease mechanical allodynia in mice with neuropathic pain. The objective of this study is to determine if treatment with metformin during the first 3 weeks after fracture would produce a long-term decrease in mechanical allodynia and improve a complex behavioral task (burrowing) in a mouse tibia fracture model with signs of complex regional pain syndrome...
February 18, 2019: Anesthesia and Analgesia
Takashi Suzuki, Yuhei Nakayama, Kentaro Matsui, Keisuke Ishii, Taketo Kurozumi, Masateru Shindo
PURPOSE: The prevalence and distribution of air present in the leg in closed and low-grade open tibial shaft fractures are unknown on multidetector high-resolution computed tomography (CT). The purpose of this study was to determine the rate of surgical site infection (SSI) in cases where debridement was not performed in the area of air infiltration. METHODS: Eighty-one closed and low-grade open tibial shaft fractures that underwent multidetector high-resolution CT on admission and were treated with an intramedullary nail were examined retrospectively...
January 2019: Journal of Orthopaedic Surgery
Albert C Lynch, John A Davies
OBJECTIVE:  The main aim of this study was to evaluate a percutaneous method of bone alignment using a diaphyseal tibial fracture model. MATERIALS AND METHODS:  Mid-shaft diaphyseal fractures were created in 12 large-breed canine tibiae. Interaction pins were inserted into the proximal and distal bone segments. Computed tomography scans of the fractured tibiae and pins were imported into three-dimensional (3D) modelling software and the fractures were virtually reduced...
February 13, 2019: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
Xuan Ye, Dawei Huang, Diana M Perriman, Paul N Smith
BACKGROUND: Tibial-plateau fractures with depressed osteochondral fragments have a high incidence of articular subsidence post reduction. Locking plates aim to prevent this via 'raft' screws below the subchondral bone. However, differences in plate design and patient anatomy result in variability of screw position in relation to the fragments they are designed to support. We evaluate the effect of screw placement and articular subsidence with this fracture pattern. METHODS: A retrospective cohort study of operatively treated tibial-plateau fractures with free osteochondral fragments was performed to determine if screw placement was correlated with articular subsidence...
February 12, 2019: ANZ Journal of Surgery
Juan M Guerra, Martha A Hanes, Cordelia Rasa, Nagarajan Loganathan, Wendy Innis-Whitehouse, Ednia Gutierrez, Saraswathy Nair, Jameela Banu
In women, age-related bone loss is associated with increased risk of bone fracture. Existing therapies are associated with severe side effects; thus, there is a need to find alternative medicines with less or optimal side effects. Cissus quadrangularis (CQ), an Ayurvedic medicine used to enhance fracture healing, was tested for its bone protective properties and studied to discern the mechanism by which it is beneficial to bone. Female Sprague Dawley rats were either sham operated or ovariectomized and were fed CQ for 3 months...
February 12, 2019: Journal of Bone and Mineral Metabolism
J L Erichsen, P I Andersen, B Viberg, C Jensen, F Damborg, L Froberg
PURPOSE: To conduct a systematic review and meta-analysis comparing physical function and complications following DIATF surgery with external fixation (EF) or open reduction internal fixation (ORIF). METHOD: A search was conducted using PubMed, Embase, Cochrane CENTRAL, Open Grey and Orthopaedic Proceedings. Studies with a level of evidence of I-III on patients (≥ 18 years) with DIATFs operated on with either EF or ORIF were included. A total of 3814 studies were identified...
February 9, 2019: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
V Rausch, M Hackl, J Oppermann, T Leschinger, M Scaal, L P Müller, K Wegmann
INTRODUCTION: Injuries to the peroneal nerve are a common complication in operative treatment of proximal tibial or fibular fractures. To minimize the risk of iatrogenic injury to the nerve, detailed knowledge of the anatomy of the peroneal nerve is essential. Aim of this study was to present a detailed description of the position and branching of the peroneal nerve based on 3D-images to assist preparation for surgical approaches to the fibular head and the tibial plateau. METHODS: The common peroneal nerve, the deep and the superficial peroneal nerve were marked with a radiopaque thread in 18 formalin-embalmed specimens...
February 8, 2019: Archives of Orthopaedic and Trauma Surgery
Seung-Beom Han, Jae-Hyuk Choi, Atul Mahajan, Young-Soo Shin
BACKGROUND: This study compared the rates of plain radiographs and computed tomography (CT) for detecting lateral hinge fractures and to evaluate factors affecting lateral hinge fractures in patients following medial opening-wedge high tibial osteotomy (MOWHTO). METHODS: This prospective study included 59 patients (65 knees) undergoing MOWHTO for primary medial compartment osteoarthritis with a 2-year follow-up between 2013 and 2016. Clinical and radiographic evaluations were performed using Knee Society Score and Western Ontario and McMaster Universities Arthritis Index, and we calculated the hip-knee-ankle angle, weight-bearing line ratio, lateral distal femoral angle, medial proximal tibial angle, posterior tibial slope, osteotomy gap height, and osteotomy gap filling rate...
January 17, 2019: Journal of Arthroplasty
Valeria F Caparbo, Pedro Furlam, Carla G S Saad, Jackeline C Alvarenga, Berengère Aubry-Rozier, Didier Hans, Artur J de Brum-Fernandes, Rosa M R Pereira
OBJECTIVES: To compare bone quality using the trabecular bone score (TBS) and bone microarchitecture in the distal tibia using high-resolution peripheral quantitative computed tomography (HR-pQCT) in ankylosing spondylitis (AS) patients and healthy controls (HC). METHODS: Areal bone mineral density (aBMD) and TBS (TBS iNsight software) were evaluated using DXA (Hologic, QDR 4500); while volumetric bone mineral density (vBMD) and bone microarchitecture were analyzed in the distal tibia using HR-pQCT (Scanco) in 73 male patients with AS and 52 age-matched HC...
January 29, 2019: Bone
Paul S Whiting, Daniel D Galat, Lewis G Zirkle, Michael K Shaw, Jeremiah D Galat
OBJECTIVES: 1) To determine the infection rate following fixation of open tibial shaft fractures using the Surgical Implant Generation Network (SIGN) intramedullary nail in low- and middle-income countries; and 2) to identify risk factors for infection. DESIGN: Prospective cohort study using an international online database. SETTING: Multiple hospitals in low- and middle-income countries worldwide. PATIENTS/PARTICIPANTS: 1061 open tibia fractures treated with the SIGN nail in low- and middle-income countries between March 2000 and February 2013...
January 24, 2019: Journal of Orthopaedic Trauma
V Schütte, A Schmidt-Hebbel, A B Imhoff, A Achtnich
OBJECTIVE: To report a surgical technique for the treatment of patellar tendon ruptures augmented with an internal brace suture tape. INDICATIONS: Acute patellar tendon ruptures, fractures of the distal patellar pole, chronic insufficiency of the patellar tendon or revision surgery for failed repairs. CONTRAINDICATIONS: Severe damage to the surrounding soft tissue. Local infection. Life-threatening conditions. SURGICAL TECHNIQUE: Direct longitudinal anterior approach to the patellar tendon...
January 25, 2019: Operative Orthopädie und Traumatologie
Liangcong Hu, Yuan Xiong, Bobin Mi, Adriana C Panayi, Wu Zhou, Yi Liu, Jing Liu, Hang Xue, Chengcheng Yan, Abudula Abududilibaier, Lang Chen, Guohui Liu
BACKGROUND: Distal metadiaphyseal tibial fractures are commonly seen lower limb fractures. Intramedullary nail fixation (IMN) and plate internal fixation (PL) are the two mainstay treatments for tibial fractures, but agreement on the best internal fixation for distal tibial fractures is still controversial. This meta-analysis was designed to compare the success of IMN and PL fixations in the treatment of distal metadiaphyseal tibial fractures, in terms of complications and functional recovery...
January 25, 2019: Journal of Orthopaedic Surgery and Research
Juan Du, Katherine Brooke-Wavell, Margaret A Paggiosi, Chris Hartley, Jennifer S Walsh, Vadim V Silberschmidt, Simin Li
OBJECTIVE: Quantifying spatial distribution of trabecular bone mechanical competence and microstructure is important for early diagnosis of skeletal disorders and potential risk of fracture. The objective of this study was to determine a spatial distribution of trabecular mechanical and morphological properties in human distal tibia and examine the contribution of regional variability of trabecular microarchitecture to mechanical competence. METHODS: A total of 340 representative volume elements at five anatomic regions of trabecular bone - anterior, posterior, lateral, medial and centre - from ten white European-origin postmenopausal women were studied...
January 15, 2019: Bone
Kaushik Bhowmick, P R J V C Boopalan, Chandrasekaran Gunasekeran, Abel Livingston, Thilak Samuel Jepegnanam
Infected nonunion and malunion of tibial plateau are rare injuries with no standardized protocols for treatment. This study assessed the outcome of chronic infected intra-articular proximal tibial fractures with and without metaphyseal bone loss managed with the Ilizarov ring fixator. A series of six patients of intra-articular infected nonunion of the tibial plateau and two patients with malunited plateau with metaphyseal nonunion were treated in a tertiary care hospital. Three of these eight patients had a metaphyseal bone loss or bone gap after debridement and underwent internal transport with distal corticotomy to obtain the bone length...
January 16, 2019: Journal of Knee Surgery
Jinhee Park, Yunsik Cha, Michael Seungcheol Kang, Soo-Sung Park
OBJECTIVES: to investigate the fracture pattern and periosteal entrapment in adolescent distal tibial physeal fractures. DESIGN: Retrospective case series SETTING:: Level I academic trauma centerPatients/Participants: Fifty patients (age 10-16 years) with displaced Salter-Harris type II, III, or IV distal tibial physeal fractures were retrospectively reviewed. INTERVENTION: periosteal involvement, fracture pattern MAIN OUTCOME MEASUREMENTS:: We investigated the incidence and location of periosteal entrapment in those fractures and the angle of the fracture plane of metaphyseal fragments on axial plane by using MRI...
January 8, 2019: Journal of Orthopaedic Trauma
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