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open distal femur fracture

Maria Silvia Spinelli, Eleonora Marini, Primo Andrea Daolio, Andrea Piccioli
In the last two decades bisphosphonates (BP) has become the mainstream therapy for osteoporosis and the benefit in reducing the incidence of fractures has been well demonstrated in several studies, together with the drug long term (5-10 years) efficacy and safety. A complication of the long-term use of bisphosphonates is a low-energy stress fractures located in the sub-trochanteric region and the femoral shaft called atypical femur fracture (AFF). These stress fractures can be seen on plain radiographs as simple transverse patterns, with unicortical beaking and hypertrophy of the diaphyseal lateral cortex...
February 2, 2019: Injury
Yanbin Bai, Xiong Zhang, Ye Tian, Dehu Tian, Bing Zhang
Surgical-site infection (SSI) is a common complication in orthopedic surgery; however, SSI after surgically managed distal femur fractures was not well studied. The aim of this study was to investigate the incidence of SSI and identify some modifiable and nonmodifiable risk factors.The patients' electronic medical records (EMRs) were reviewed to identify those who sustained a distal femur fracture and treated by open reduction and internal fixation (ORIF) between March 2014 and February 2018. SSI was defined based on the Centers for Disease Control criteria and confirmed according to the descriptions in EMR...
February 2019: Medicine (Baltimore)
Qi-Fang He, Han-Xu Wang, Hui Sun, Yu Zhan, Bin-Bin Zhang, Xue-Tao Xie, Cong-Feng Luo
OBJECTIVE: To present our clinical experience of treating varus malunion of the distal femur through a medial open-wedge osteotomy with double-plate fixation. METHODS: A prospective cohort study was performed. From January 2005 to February 2015, 15 consecutive patients with varus malunion following distal femur fractures were surgically treated at a single level I trauma center. The coronal and sagittal deformity were corrected by a medial open-wedge osteotomy of the distal femur...
February 5, 2019: Orthopaedic Surgery
Kaosheng Lu, Jixin Zhang, Jiaxiang Cheng, Haibo Liu, Chunyan Yang, Lichuan Yin, Hongbing Wang, Xiaojun You, Qiaoge Qu
There remains a lack of data on the epidemiological characteristics of surgical site infection (SSI) following the open reduction and internal fixation (ORIF) of intra-articular fractures of distal femur, and the aim of this study was to solve this key clinical issue. The electronic medical records (EMRs) of patients who underwent ORIF for distal femoral fracture from January 2013 to December 2017 were reviewed to identify those who developed a SSI. Then, we conducted univariate Chi-square analyses and used a multivariate logistic regression analysis model to determine the adjusted risk factors associated with SSI...
December 26, 2018: International Wound Journal
Neelam Ramana Reddy, Abhishek Bhalotia, Rajesh Podili
Introduction: Incidence of periprosthetic fractures is increasing with the rising number of total knee arthroplasties performed every year. The management of such fractures is challenging due to multiple factors. We reported a rare case with simultaneous bilateral distal femur and tibia periprosthetic fractures managed with open reduction and internal fixation (ORIF) and healed uneventfully. Case Report: A 64-year-old female came with simultaneous bilateral distal femur (Bilateral Type IIB Rorabeck) and tibia (Bilateral Type IIIB Felix) periprosthetic fractures following road traffic accident...
May 2018: Journal of Orthopaedic Case Reports
Martin Pietsch, Markus Hochegger, Martin Winkler, Sabrina Sandriesser, Thomas Freude, Peter Augat
PURPOSE: Valgus malalignment of the distal femur may be treated with corrective osteotomy. The purpose of this study was to compare the primary stability of a lateral opening-wedge osteotomy (LOWO) using a uniplanar compared to a biplanar technique. A study was carried out to test both surgeries, with both an intact medial cortex and with a deliberate attached cut of the medial cortex simulating a fracture. The primary hypothesis was that the biplanar technique provides higher axial and torsional stiffness...
December 13, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Tomasz Nizegorodcew, Giuseppe Palmieri, Marco Peruzzi, Marco Galli
BACKGROUND: Open articular fractures are an important issue due to their increasing incidence, along with the rise in motorcycle accidents. Oncology experience with allograft in orthopedics may be extended to cases of traumatic bone loss. CLINICAL CASE: A 37-year-old man with an open fracture of the distal femur and proximal tibia presented a massive bone loss of the lateral femoral condyle after a motorcycle accident. Following Damage Control Surgery, a considerable lateral femoral condyle allograft was used to restore the joint anatomy...
December 2018: Injury
Charles M Court-Brown, Andrew D Duckworth, Nicholas D Clement, Margaret M McQueen
INTRODUCTION: It is accepted that the incidence of fractures in patients aged ≥ 65 years is increasing but little is known about which fractures are becoming more common in this group of patients. Virtually all research has concentrated on the classic fragility fractures of the proximal femur, proximal humerus, pelvis, spine and distal radius but it is likely that other fractures are becoming more common. METHODS: We have examined two prospectively collected databases 10 years apart to see which fractures are becoming more common in ≥ 65 year old patients...
December 2018: Injury
M S Islam, M T Hossain, M N Uddin, M R Chowdhury, M S Hasan
We conducted a study to evaluate the reliability of the medial hemi-soleus muscle flap for wound coverage of infected open fracture of distal third of tibia. Wound coverage of exposed lower third tibia and ankle region remains a difficult task. Muscle flaps are preferred for infected wounds especially where there are exposed bone, joint and/or tendons. Soleus muscle is a good option for local reconstruction. Soleus being the prime ankle plantar flexor and stabilizer of the ankle in ambulation cannot be sacrificed without significant morbidity...
October 2018: Mymensingh Medical Journal: MMJ
Hazem A Farouk, Mostafa Saladin, Wessam Abu Senna, Walid Ebeid
PURPOSE: Assessment of the functional and oncologic outcomes regarding endoscopic curettage of different benign bone tumor types within variable anatomic locations. PATIENTS AND METHODS: During the period between February 2012 and December 2016, 26 patients with symptomatic intra-osseous benign bony lesions were included. The age ranged from 3 up to 49 years (mean 20), of 14 females and 12 males. The follow-up duration ranged from 26 up to 58 months (mean 41). Functional scoring was done according to the Revised Musculoskeletal Tumour Society Rating Scale...
2018: SICOT-J
Hosam E Matar, Paula Stritch, Nicholas Emms
Interprosthetic femur fractures between total hip and total knee replacements are challenging injuries with rising incidence. Stability of the either implants, quality, and quantity of remaining bone as well as patients' comorbidities play an important role in operative management. Open reduction and internal fixation, advanced revision arthroplasty techniques, and megaprostheses are available options. In more complex cases, custom-made implants maybe necessary to achieve immediate weight-bearing and restore function...
2018: Journal of Long-term Effects of Medical Implants
Khang H Dang, Connor A Armstrong, Ravi A Karia, Boris A Zelle
PURPOSE: Given the recent controversy in the literature and the alarming reports of early mechanical failure associated with the use of the Synthes 4.5 mm VA-LCP Curved Condylar Plate in acute distal femur fractures, the goal of our study was to examine the outcomes and mechanical failure rates of this implant in a larger patient population. METHODS: Patients 18 years of age and older who underwent plate fixation of their acute distal femoral fracture using the Synthes 4...
September 29, 2018: International Orthopaedics
Alexander B Christ, Harshvardhan Chawla, Elizabeth B Gausden, Jordan C Villa, David S Wellman, Dean G Lorich, David L Helfet
OBJECTIVES: To report outcomes and complications of periprosthetic distal femur fractures (PPDFF) treated with open reduction internal fixation (ORIF) using a plate construct, with or without endosteal augmentation. DESIGN: Retrospective Case Series. SETTING: One Level I trauma center and one tertiary care hospital. PATIENTS/PARTICIPANTS: Forty patients with PPDFFs, treated by 3 surgeons, were identified using an institutional trauma registry...
October 2018: Journal of Orthopaedic Trauma
Bi O Jeong, Duke Whan Chung, Jong Hun Baek
RATIONALE: Calcific myonecrosis is a very rare late sequela that occurs in patients who have had trauma accompanied by vascular compromise, in which a single muscle or entire muscles in a compartment undergoes necrosis and form a calcified mass. It is mostly a benign entity, but some cases cause bone destruction and form non-healing chronic sinuses. In such cases, wound management becomes difficult and there is a potential risk of secondary infection. PATIENT CONCERNS: A 60-year-old male was referred for evaluation of a pain, erythematous changes, and draining sinus of the anterolateral aspect of his left leg...
September 2018: Medicine (Baltimore)
Derrick M Knapik, Lewis G Zirkle, Raymond W Liu
BACKGROUND: Retrograde femoral nailing in skeletal immature patients would broaden the surgical options for fracture care and reconstructive procedures but involves violation of the open, active distal femoral physis with the potential for growth disturbance. The tolerance for putting a large diameter metal implant across the physis is largely unknown. The purpose of this pilot investigation was to define the upper limit of cross-sectional violation with a metal implant before causing premature growth arrest or inhibition using a sheep model...
November 2018: Journal of Pediatric Orthopedics
Seth R Yarboro
In this case, a lateral locking plate is used for fixation of a periprosthetic distal femur fracture in a 68-year-old woman. Modern implants with locking screw options and soft-tissue-sparing surgical techniques have improved the care of periprosthetic distal femur fractures. Although much debate about the working length and technical variables of plating exists, it is generally accepted that longer (>10 hole) plates with adequate working length and careful soft-tissue handling are preferred. This case outlines a stepwise approach to distal femur fractures to achieve appropriate plate position and restoration of alignment while avoiding excessive surgical exposure or soft-tissue dissection...
August 2018: Journal of Orthopaedic Trauma
Dax Varkey, Robert F Ostrum
Fractures of the distal femur with intercondylar extension and comminution are challenging cases and demand a thorough preoperative evaluation and execution of proper surgical technique. Identification of the intra-articular fractures, including coronal fractures of the lateral condyle, is important in planning surgery and emphasizes the need for computerized tomography scans. Recent advances with anatomic, locking plates have made minimally invasive surgery easier, but joint reduction needs to be performed meticulously in an open manner, and restoration of the mechanical alignment through plate fixation is essential for a good clinical outcome...
August 2018: Journal of Orthopaedic Trauma
Mattia Loppini, Guido Grappiolo
Over the last two decades, several conservative femoral prostheses have been designed. The goals of conservative stems include: the spearing of the trochanteric bone stock; a more physiological loading in the proximal femur reducing the risk of stress shielding; and to avoid a long stem into the diaphysis preventing impingement with the femoral cortex and thigh pain.All stems designed to be less invasive than conventional uncemented stems are commonly named 'short stems'. However, this term is misleading because it refers to a heterogeneous group of stems deeply different in terms of design, biomechanics and bearing...
May 2018: EFORT Open Reviews
Victoria Schlanser, Andrew Dennis, Katarina Ivkovic, Kimberly Joseph, Matthew Kaminsky, Thomas Messer, Stathis Poulakidas, Frederic Starr, Faran Bokhari
Reconstruction of skin and soft tissue wounds can pose a unique surgical challenge. This is especially true for cases of exposed bone and tendon where soft tissue loss is extensive and opportunities for tissue advancement or rotation are limited. A clinical case is presented describing an experience with dehydrated human amnion/chorion membrane (dHACM, EpiFix®/AmnioFix®, MiMedx Group, Marietta, GA) graft to obtain granulation over an open fracture with desiccated bone. The 22-year-old female trauma patient presented with high-grade bilateral lower extremity soft tissue loss after being run over and dragged by a semitruck...
October 23, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Tao Ji, Wei Guo, Rongli Yang, Xiaodong Tang, Dasen Li, Yi Yang
Objective: To investigate the surgical characteristics and preliminary effectiveness of Orthofix unilateral external fixator in the treatment of musculoskeletal tumors. Methods: Twenty-two patients received Orthofix unilateral external fixator treatment for bone defect after tumor excision or complications after limb salvage surgery between June 2011 and March 2016. There were 11 males and 11 females with a median age of 23.5 years (range, 4-57 years). The bone defect or limb length discrepancy after tumor resection was at proximal femur in 6 cases, distal femur in 8 cases, diaphysis of femur in 3 cases, proximal tibia in 2 cases, and diaphysis of tibia in 3 cases...
October 1, 2017: Chinese Journal of Reparative and Reconstructive Surgery
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