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Tibial stress fracture managent

M M Reverte-Vinaixa, J H Nuñez, D Muñeton, N Joshi, E Castellet, J Minguell
PURPOSE: Tibial-side avulsion injuries of the posterior cruciate ligament are rare injuries. In displaced fracture, the reduction and fixation is the treatment of choice, although the optimal surgical management has not yet been determined. The aim of this study was to evaluate the clinical, functional, and radiological outcome after an open reduction and internal fixation with staples of a posterior cruciate ligament tibial avulsion. METHODS: A historical cohort of patients who underwent open reduction and internal fixation with staple due to a posterior cruciate ligament tibial avulsion were reviewed...
January 17, 2019: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
Mahmoud Jabalameli, Hossein A Hadi, Abolfazl Bagherifard, Mohammad Rahbar, Mohammadreza Minator Sajjadi
Background: Presentation of proximal tibia stress fracture is not infrequent among elderly patients due to their poor bone stock. Optimal management of patients with severe gonarthrosis of the knee and concurrent tibial stress fracture is not known yet. In this study we report the outcome of primary total knee arthroplasty (TKA) using stemmed components in elderly patients. Methods: Between 2009 and 2014, a total of 16 elderly patients with proximal tibial stress fractures and concurrent gonarthrosis were treated with TKA using long stemmed components...
September 2018: Archives of Bone and Joint Surgery
George A Tsakotos, Anastasios V Tokis, Christos G Paganias
BACKGROUND: Leg pain in athletes is a common condition and is often related to tibial stress fracture. When non-operative treatment fails, the optimal surgical treatment is controversial. The aim of this study was to report a case of tension band plating of an anterior tibial stress fracture nonunion, treated previously with intramedullary nailing. To the best of our knowledge, this is the first reported case in which tension band plating was placed without removing the preexisting intramedullary nail...
June 29, 2018: Journal of Medical Case Reports
Julia M Reilly, Eric Bluman, Adam S Tenforde
Extracorporeal shockwave therapy (ESWT) is a technology that was first introduced into clinical practice in 1982 for urologic conditions. Subsequent clinical applications in musculoskeletal conditions have been described in treatment of plantar fasciopathy, both upper and lower extremity tendinopathies, greater trochanteric pain syndrome, medial tibial stress syndrome, management of nonunion fractures, and joint disease including avascular necrosis. The aim of this review is to summarize the current understanding of treatment of musculoskeletal conditions with ESWT, accounting for differences in treatment protocol and energy levels...
December 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
O Lauthe, M Soubeyrand, A Babinet, V Dumaine, P Anract, D J Biau
Aims: The primary aim of this study was to determine the morbidity of a tibial strut autograft and characterize the rate of bony union following its use. Patients and Methods: We retrospectively assessed a series of 104 patients from a single centre who were treated with a tibial strut autograft of > 5 cm in length. A total of 30 had a segmental reconstruction with continuity of bone, 27 had a segmental reconstruction without continuity of bone, 29 had an arthrodesis and 18 had a nonunion...
May 1, 2018: Bone & Joint Journal
Michael J Arnold, Aaron L Moody
Running is a common form of exercise but predisposes athletes to several running-related injuries. Most running injuries are due to overuse and respond to conservative treatment. Tendinopathies in the patellar, Achilles, and hamstring tendons are common, and are primarily treated with eccentric exercise. Iliotibial band syndrome and patellofemoral pain syndrome are less common than patellar tendinopathy and are treated by strengthening exercises for the core and legs in addition to flexibility exercises. Acute hamstring strains and medial tibial stress syndrome require a period of relative rest, followed by stretching and graded return to activity...
April 15, 2018: American Family Physician
Zaira S Chaudhry, Steven M Raikin, Marc I Harwood, Meghan E Bishop, Michael G Ciccotti, Sommer Hammoud
BACKGROUND: Although most anterior tibial stress fractures heal with nonoperative treatment, some may require surgical management. To our knowledge, no systematic review has been conducted regarding surgical treatment strategies for the management of chronic anterior tibial stress fractures from which general conclusions can be drawn regarding optimal treatment in high-performance athletes. PURPOSE: This systematic review was conducted to evaluate the surgical outcomes of anterior tibial stress fractures in high-performance athletes...
January 2019: American Journal of Sports Medicine
Jo Anne Au Yong, Daniel D Lewis, Scott B Citino, Mark W Cunningham, Alan R Cross, James P Farese, Luisito S Pablo
The clinical outcomes of six free-ranging Florida panthers ( Puma concolor coryi) that underwent surgical stabilization of appendicular long-bone fractures (three femoral fractures, one tibial and one tibial and fibular fracture and two radial and ulnar fractures) were evaluated. These panthers presented to the University of Florida from 2000-2014. Estimated age of the panthers ranged from 0.5 to 4.5 yr, and weights ranged from 22 to 65 kg. Causes of injuries were vehicular collision ( n = 4) and capture related ( n = 2)...
March 2018: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
Berna Okudan, Nazım Coşkun, Pelin Arıcan
Stress fractures are injuries most commonly seen in the lower limbs and are usually caused by repetitive stress. While the distal and middle third of the tibia is the most frequent site for stress fractures (almost 50%), stress fractures of the proximal tibia is relatively rare and could be confused with other types of tibial fractures, thus altering management plans for the clinician. Early diagnosis of stress fractures is also important to avoid complications. Imaging plays an important role in the diagnosis of stress fractures, especially bone scan...
February 1, 2018: Molecular Imaging and Radionuclide Therapy
Priscilla Tu
The differential diagnosis of heel pain is extensive, but a mechanical etiology is the most common. The specific anatomic location of the pain can help guide diagnosis. The most common diagnosis is plantar fasciitis, which leads to medial plantar heel pain, especially with the first weight-bearing steps after rest. Other causes of plantar heel pain include calcaneal stress fractures (progressively worsening pain after an increase in activity or change to a harder walking surface), nerve entrapment or neuroma (pain accompanied by burning, tingling, or numbness), heel pad syndrome (deep, bruise-like pain in the middle of the heel), and plantar warts...
January 15, 2018: American Family Physician
Young Jun Kim, Jae Hoon Lee
We assessed the clinical and radiographic outcomes of posterior inferior tibiofibular ligament (PITFL) release to achieve anatomic reduction of posterior malleolar fractures (PMFs). Nineteen PMFs (>25% of tibial plafond) that could not be reduced after anatomic reduction of distal fibula fractures were managed by PITFL release. The syndesmosis was stressed intraoperatively and by 2 surgeons unaware of the postoperative measurements to increase reliability. The pre- and postoperative fracture gaps and articular step-offs were measured on lateral radiographs of all patients and computed tomography (CT) scans of 12...
January 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
Aniek Pm van Zantvoort, Paul Cuppen, Marc R Scheltinga
The differential diagnosis of exercise-induced lower leg pain in young individuals is extensive and includes entities such as chronic exertional compartment syndrome, popliteal arterial entrapment syndrome, cystic adventitial disease, medial tibial stress syndrome and tibial stress fractures. Peripheral nerve-related lower leg pain syndromes are unusual. We present a 41-year-old woman who was diagnosed with an ancient schwannoma of the right common peroneal nerve (CPN) as a rare cause of lower leg pain. This case report provides simple diagnostic bedside tools that may be used to diagnose CPN abnormalities...
October 4, 2017: BMJ Case Reports
Fahri Erdogan, Ilker Abdullah Sarikaya, Ata Can, Baris Gorgun
Total knee arthroplasty (TKA) is a surgical procedure which is widely used in the treatment of gonarthrosis secondary to rheumatoid arthritis (RA). The incidence of stress fractures in tibia in the patients with RA is higher compared to normal patients. In this study, we report two cases of TKA and intramedullary nailing in RA patients with severe knee arthritis and tibial nonunion. Both patients had a satisfactory clinical outcome with radiological healing of the tibial fracture.
January 2018: Acta Orthopaedica et Traumatologica Turcica
Greg A J Robertson, Alexander M Wood
Stress fractures in sport are becoming increasing more common, comprising up to 10% of all of sporting injuries. Around 90% of such injuries are located in the lower limb. This articles aims to define the optimal management of lower limb stress fractures in the athlete, with a view to maximise return rates and minimise return times to sport. Treatment planning of this condition is specific to the location of the injury. However, there remains a clear division of stress fractures by "high" and "low" risk...
March 18, 2017: World Journal of Orthopedics
Mark Wu, Ryan Fallon, Benton E Heyworth
Athletic overuse injuries are becoming an increasingly common entity in the active pediatric population. The prevalence of these injuries may be attributed to the combination of an underdeveloped musculoskeletal system, increased participation in competitive sport at a younger age, and increased duration and intensity of training. Many of these injuries may go unreported and/or undiagnosed, as they do not all result in time lost from sports, and are not always appreciated on imaging. Left unrecognized, untreated, or poorly managed, overuse injuries can have long-term health consequences for young athletes...
December 2016: Sports Medicine and Arthroscopy Review
R R Taube, L T Wadsworth, R J Johnson
In brief Tibial stress fractures often occur in Patients who participate in running and jumping sports. With rest, most stress fractures heal without incident, though midshaft fractures are more resistant to healing. Bone scans are usually required to confirm the diagnosis. Relative rest, strength training, proper footwear, and treating underlying risk factors are the mainstays of treatment. A new treatment option is a pneumatic brace that the patient can wear when he or she returns to play. Physicians should be prepared to counsel competitive athletes about the risks of returning to play too soon...
April 1993: Physician and Sportsmedicine
Miguel Montero-Baker, Gregory J Ziomek, Luis Leon, Aaron Gonzales, Robert S Dieter, Crystal L Gadd, John P Pacanowski
BACKGROUND: The structural limitations of currently available laser-cut nitinol stents in the highly diseased arterial system of the lower extremity are well described. These devices are frequently used in long-segment occlusions, at the adductor hiatus, and across the knee into the popliteal artery and tibial-peroneal trunk despite concerns related to the high mobility of the knee joint and the potential for external stent compression, fractures, and occlusion. The Supera stent (Abbott Vascular, Santa Clara, Calif) was developed to provide superior radial strength, fracture resistance, and flexibility compared with laser-cut nitinol stents...
October 2016: Journal of Vascular Surgery
D B McKeag, C Dolan, J G Garrick
In brief: Overuse injuries of the lower extremity represent a frequent, significant problem. This article discusses management of the most common overuse disorders: anterior tibialis strain, medial tibial stress syndrome, compartment syndrome, stress fractures, and Achilles tendinitis. These injuries often are the culmination of a process (repetitive stress) rather than the result of a single event. Grading injuries on a scale of 1 to 4 according to severity can help determine the correct treatment. The primary treatment goal is to reduce inflammation through icing, rest, and appropriate use of nonsteroidal anti-inflammatory agents...
July 1989: Physician and Sportsmedicine
Joseph L Petfield, Garry T Hayeck, David L Kopperdahl, Leon J Nesti, Tony M Keaveny, Joseph R Hsu
Virtual stress testing (VST) provides a non-invasive estimate of the strength of a healing bone through a biomechanical analysis of a patient's computed tomography (CT) scan. We asked whether VST could improve management of patients who had a tibia fracture treated with external fixation. In a retrospective case-control study of 65 soldier-patients who had tibia fractures treated with an external fixator, we performed VST utilizing CT scans acquired prior to fixator removal. The strength of the healing bone and the amount of tissue damage after application of an overload were computed for various virtual loading cases...
April 2017: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Steven K Dailey, Michael T Archdeacon
INTRODUCTION: Stress fractures are overuse injuries most commonly seen in athletes, military recruits, and individuals with endocrine abnormalities. It has been demonstrated that chronic cases of anterior tibial stress fractures refractory to conservative management respond well to intramedullary nailing. To our knowledge, only one report has been published concerning patients with bilateral tibial stress fractures treated with bilateral intramedullary nailing. All patients in the series were high-level athletes...
January 2014: Journal of Orthopaedic Case Reports
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