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Sample records for calcaneal fractures treated

  1. A STUDY OF FUNCTIONAL OUT COME OF INTRA - ARTICULAR CALCANEAL FRACTURES TREATED SURGICALLY

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    Prashanth

    2015-10-01

    Full Text Available The calcaneus (O scalcis is the largest and most often fractured tarsal bone. The treatment of calcaneal fractures continues to pose a challenge for the trauma surgeons despite advancement in surgical technique and implant devices. The prognosis for an extra - articular fra cture is uniformly good, but that for an intra - articular fracture is varied. The management of every aspect of intra - articular calcaneal fractures is controversial. Although some studies have demonstrated good results after open reduction and internal fixa tion of intra - articular calcaneal fractures, a few other studies say otherwise. The method of internal fixation is also a point of debate, with various proponents advocating fixation with pins, screws or plate fixation with screws. Even there is no consens us regarding the surgical approach, with many having been described, including medial, lateral, combined medial and lateral, extended lateral and sinus tarsi approaches. So it is the need of the hour, to identify treatment techniques, which use lesser hard ware, to provide better functional outcomes in terms of shorter duration of treatment, better stability and early weight bearing and so also the role of non - operative treatment in the calcaneal fracture management. In this study, we have attempted to evalu ate the results of calcaneal fracture management by open reduction and internal fixation. Ours is a prospective study centered in the Gandhi hospital from Nov 2012 to April 2014 in which 30 patients with intra - articular calcaneal fractures were treated by open reduction and internal fixation and the results were evaluated with AOFAS scoring system. In our analysis, we observed that an anatomical reduction to restore Bohler’s and Gissanes angles associated with rigid internal fixation is essential for better fu n ctional results.

  2. Operative treatment for calcaneal fracture with plate

    International Nuclear Information System (INIS)

    We treated calcaneal fractures by means of lateral approach using a calcaneal plate, and evaluated the clinical results. The mean age at the time of surgery was 60.1 (range: 36 to 78). The mean duration of follow-up was 3.4 years. Eleven feet were treated with the ACE calcaneal plate, and two feet were treated with the Rabbit plate. The clinical result evaluation according to the Maxfield criteria was as follows: excellent in nine feet; very good in two feet; poor in one foot. Pre-and postoperative changes in radiographic findings were studied. The improvement of the Boehler angle, width index, and intra-articular displacement was reflected in the clinical result. This method is considered to be an effective treatment for intra-articular calcaneal fractures. (author)

  3. BOHLER'S ANGLE: CORRELATION WITH OUTCOME IN DISPLACED INTRA-ARTICULAR CALCANEAL FRACTURES TREATED WITH LOCKING COMPRESSION PLATE FIXATION WITH AND WITHOUT BONE GRAFTING

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    Deepak P; Eknath D; Vijayanand; Satish

    2014-01-01

    BOHLER'S ANGLE: correlation with outcome in displaced intra-articular calcaneal fractures Treated with locking compression Plate Fixation with and without bone grafting. AIMS: The aim is an accurate reduction of the fracture with reconstruction of Bohler’s angle, length and axis and sub talar joint surface. To determine whether autologous bone graft supplementation is beneficial in achieving and maintaining restoration of Calcaneal height and anatomic reduction. SETTINGS AND ...

  4. Joint-Preserving Osteotomies for Malaligned Intraarticular Calcaneal Fractures.

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    Benirschke, Stephen K; Kramer, Patricia A

    2016-03-01

    Intraarticular calcaneal fracture treatments that result in malalignment often require reconstructive surgery. Seven cases are used to demonstrate the intricacies of reconstructive case management. Reestablishment of calcaneal height, length, orientation, and position relative to the other tarsals is necessary to reestablish appropriate foot function. Inherent or acquired gastrocnemius equinus should be treated with recession to reduce destructive forces on the reconstruction. PMID:26915782

  5. Distal posterior tibial artery pseudoaneurysm after fracture calcaneous

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    Dey, Subhajeet; Das, Anjan K.; Dey, Rubi

    2008-01-01

    Here we report a case of pseudoaneurysm of distal posterior tibial artery following closed fracture of calcaneous. Association of pseudoaneurysm of posterior tibial artery with fracture of calcaneous is extremely uncommon. It is always suggested that pseudoaneurysm be treated by reconstruction, but here we present the case treated by ligation, obliteration and excision as it was situated distally and the plantar arch circulation was maintained. The purpose of this case report is to bring atte...

  6. Early Weight-bearing Using Percutaneous External Fixator for Calcaneal Fracture

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    Sengodan, Vetrivel Chezian; Sengodan, Mugundhan Moongilpatti

    2012-01-01

    Calcaneal fracture, the most common tarsal bone fracture, occurs predominantly in manual labors and subsequently has got considerable socioeconomic implications. Treatment modality which can offer early weight bearing and early return to work is therefore needed for those patients. We have used a biplanar percutaneous external fixator for treating calcaneal fractures without operative and per operative visualization of the fractures. We have treated 17 calcaneal fractures in 16 patients, 12 i...

  7. A Prospective Study on Radiological and Functional Outcome of Displaced Tongue Type Intra-Articular Calcaneal Fractures Treated by Percutaneous Screw Fixation

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    Hegde, Anoop; Mathias, Lawrence John; Shetty, Vikram; Shetty, Ashwin

    2016-01-01

    Introduction Calcaneal fractures have posed a challenge to orthopaedic surgeon for many years. The major problem is to reconstruct the fracture and improve healing of the fracture and also the surrounding tissues. Anatomic restoration of the three-dimensional anatomy of the calcaneum is the goal of surgical management of calcaneal fractures. Over the years, various techniques have been developed to accomplish this goal. Aim To determine the functional outcome in displaced tongue-type calcaneal fracture treated by percutaneous screw fixation. Materials and Methods A prospective study was conducted from October 2012 and September 2014. A total of 23 patients with intra-articular ‘tongue type’ calcaneal fractures were included in the study. Complete clinical and radiological evaluation was done. The surgical procedure encompassed closed reduction and fixation with two criss-cross 6.5 mm cannulated cancellous across the fracture site under fluoroscopic guidance. Postoperatively, on day three ankle and toe mobilization was begun. Non-weight bearing crutch mobilization was begun on postoperative day three. Reviews were done at 6 weeks, 12 weeks and 24 weeks postoperatively. At 6 weeks partial weight bearing mobilization was started. Full weight bearing was begun at 12 weeks. The patient was finally reviewed at 24 weeks and assessment of ankle function was done as per the Maryland foot scoring system. Radiographs were compared and preoperative and postoperative Gissane’s and Bohler’s angles were also compared. The results were analysed as per descriptive statistics (frequency, percentage). The complications noted were documented. Results Of the 23 patients under the study, three had excellent results with mean score of 90, 17 had good results with mean score of 82.94 and three had fair results with mean score of 74. Only one patient had subtalar arthritis as a complication. No other complications were seen. Conclusion Percutaneous screw fixation of tongue type

  8. BOHLER'S ANGLE: CORRELATION WITH OUTCOME IN DISPLACED INTRA-ARTICULAR CALCANEAL FRACTURES TREATED WITH LOCKING COMPRESSION PLATE FIXATION WITH AND WITHOUT BONE GRAFTING

    Directory of Open Access Journals (Sweden)

    Deepak P

    2014-09-01

    Full Text Available BOHLER'S ANGLE: correlation with outcome in displaced intra-articular calcaneal fractures Treated with locking compression Plate Fixation with and without bone grafting. AIMS: The aim is an accurate reduction of the fracture with reconstruction of Bohler’s angle, length and axis and sub talar joint surface. To determine whether autologous bone graft supplementation is beneficial in achieving and maintaining restoration of Calcaneal height and anatomic reduction. SETTINGS AND DESIGN: Level 1 trauma center, Prospective, randomized. METHODS AND MATERIAL: Consecutive 46 patients who had fracture calcaneum were treated by open reduction and internal fixation by locking plate with and without bone graft during the period from November 2009 to April 2012. STATISTICAL ANALYSIS USED: AOFAS-Ankle-Hind foot Scale, t Test. RESULTS: Fewer complications and statistically significant better results related to treatment with locking plates with bone grafting confirmed in comparison to without bone grafting ones were noted for intra-articular calcaneal fractures. In Group A the mean time for union was 10.39wks. The results were good and excellent in 86.95%, 8.69 % had fair result and 4.34% had poor results. In Group B the mean time for union was 11.95 wks. The overall results were good and excellent in 73.91%, 13.04 % had fair result and 13.04 % had poor results. CONCLUSIONS: The operative treatment of intra-articular calcaneal fractures could restore Böhler's angle better and the patient could return to full weight bearing earlier. We confirmed that autologous bone graft supplementation is beneficial in achieving and maintaining restoration of calcaneal height and anatomic reduction.

  9. Calcaneal insufficiency avulsion fractures in diabetic patients

    International Nuclear Information System (INIS)

    This paper presents a calcaneal fracture pattern that appears to be unique to diabetic patients. Radiographs and clinical records of 58 patients with calcaneal fractures were evaluated, 18 were diabetic and 40 nondiabetic. All 18 diabetic patients were insulin dependent and had clinically evident peripheral neuropathy. Thirteen had juvenile-onset diabetes. The average time from the diagnosis of diabetes mellitus to insufficiency fracture was 21 years. Sixteen of the diabetic patients had no history of significant trauma, and 13 of them had insufficiency avulsion fractures limited to the posterior third of the calcaneus

  10. Outcome of open reduction and internal fixation of intraarticular calcaneal fracture fixed with locking calcaneal plate

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    Jain Saurabh; Jain Anil Kumar; Kumar Ish

    2013-01-01

    【Abstract】Objective: Debate continues regarding the management of calcaneal fractures, between open re- duction and internal fixation and closed treatment. Hence we aim at evaluating the radiological and functional out- comes of open reduction and internal fixation in displaced joint depression type of calcaneal fractures fixed with lock- ing calcaneal plate. Methods: In this series, 28 patients (26 unilateral and 2 bilateral) with joint depression type of calcaneal fr...

  11. Radiographic imaging of calcaneal fractures - the surgeons view point

    International Nuclear Information System (INIS)

    This paper presents a detailed description of calcaneal fractures, which are underestimated and neglected despite their relatively high frequency. In association with significant anatomic destruction of the calcaneus they lead to unsatisfactory results of fracture treatment. Radiographic features of a healthy calcaneal bone together with pathomechanism and radiographic attributes of most common fracture types are presented. The prognostic role of the posterior talo-calcaneal joint and extraarticular anatomy of the calcaneus are emphasized. Special attention is directed to the methods of calcaneal imaging, especially the most valuable in the authors opinion - lateral radiographic view and computed tomography. Other commonly used views: axial, antero-posterior or Broden, are also described, with explanation why they are rarely recommended. The widely used standard classification system for calcaneal fractures introduced by Sanders, based on computed tomography is presented. Correct x-ray imaging is the basis for further diagnostic workup and treatment, giving also valuable prognostic information. The orthopedic surgeon, who undertakes the difficult task of treating the broken calcaneus receives thorough information about bone damage, which helps to realize the consequences of injury and of possible negligence. According to the authors experience, problems discussed in this paper are rarely fully appreciated by radiologists and orthopedic surgeons resulting in, often, catastrophic consequences. (author)

  12. Sanders II–III calcaneal fractures fixed with locking plate in elderly patients

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    Long, Cheng; Fang, Yue; HUANG Fu-guo; Zhang, Hui; Wang, Guang-Lin; YANG Tian-fu; Liu, Lei

    2016-01-01

    Purpose To evaluate the clinical outcomes of locking calcaneal plate in treating calcaneal fracture (Sanders II–III) in elderly patients. Methods From October 2012 to December 2013, 23 elderly patients suffering from calcaneal fracture (Sanders II–III) were treated and followed up. There were 15 males and 8 females with the mean age of 68.5 years (range: 65–79 years). According to Sander's classification, 16 cases (16 feet) were type II fractures and 7 cases (7 feet) were type III fractures. ...

  13. Closed Reduction and Percutaneous Fixation of Calcaneal Fractures in Children.

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    Feng, Yongzeng; Yu, Yang; Shui, Xiaolong; Ying, Xiaozhou; Cai, Leyi; Hong, Jianjun

    2016-07-01

    Open reduction and internal fixation has been widely used to treat displaced intra-articular calcaneus fractures in children. However, the complications of surgical trauma and the wound created through the extended lateral approach cannot be ignored. This study analyzed the outcomes of displaced intra-articular calcaneal fractures in children treated with closed reduction and percutaneous fixation. Medical records of pediatric patients who had displaced intra-articular calcaneus fractures and underwent closed reduction and percutaneous fixation at the study institution between January 2008 and January 2013 were reviewed. Preoperative radiographs and computed tomography scans were used to evaluate and classify the fractures. Clinical outcomes and radiographic findings were assessed at postoperative follow-up. The study included 14 displaced intra-articular calcaneal fractures in 11 patients (7 boys and 4 girls). Mean patient age was 11.18 years (range, 6-16 years), and average follow-up time was 42.8 months postoperatively (range, 12-72 months). There were 6 tongue-type fractures and 8 joint depression-type fractures, based on the Essex-Lopresti classification, and there were 11 type II and 3 type III fractures, based on the Sanders classification. Average Böhler angle was 8.00° (range, -5° to 18°) preoperatively and 30.79° (range, 26° to 40°) postoperatively (P<.001). Average subjective American Orthopaedic Foot and Ankle Society hindfoot score was 65.7 (range, 52-68). No patients had wound breakdown or infection. In the treatment of displaced intra-articular calcaneal fractures in pediatric patients, closed reduction and percutaneous fixation achieved good outcomes, with few complications. [Orthopedics. 2016; 39(4):e744-e748.]. PMID:27111072

  14. Operative treatment of intra-articular calcaneal fractures with calcaneal plates and its complications

    Directory of Open Access Journals (Sweden)

    Rak Vaclav

    2009-01-01

    Full Text Available Background: In a retrospective study we analysed intra-articular calcaneal fracture treatment by comparing results and complications related to fracture stabilization with nonlocking calcaneal plates and locking compression plates. Materials and Methods: We performed 76 osteosynthesis (67 patients of intra-articular calcaneal fractures using the standard extended lateral approach from February 2004 to October 2007. Forty-two operations using nonlocking calcaneal plates (group A were performed during the first three years, and 34 calcaneal fractures were stabilized using locking compression plates (group B in 2007. In the Sanders type IV fractures, reconstruction of the calcaneal shape was attempted. Depending on the type of late complication, we performed subtalar arthroscopy in six cases, arthroscopically assisted subtalar distraction bone block arthrodesis in six cases, and plate removal with lateral-wall decompression in five cases. The patients were evaluated by the AOFAS Ankle-Hindfoot Scale. Results: Wound healing complications were 7/42 (17% in group A and 1/34 (3% in group B. No patient had deep osseous infection or foot rebound compartment syndrome. Preoperative size of Bφhler´s angle correlated with postoperative clinical results in both groups. There were no late complications necessitating corrective procedure or arthroscopy until December 2008 in Group B. All late complications ccurred in Group A. The overall results according to the AOFAS Ankle Hindfoot Scale were good or excellent in 23/42 (55% in group A and in 30/34 (85% in group B. Conclusion: Open reduction and internal fixation of intra-articular calcaneal fractures has become a standard surgical method. Fewer complications and better results related to treatment with locking compression plates confirmed in comparison to nonlocking ones were noted for all Sanders types of intra-articular calcaneal fractures. Age and Sanders type IV fractures are not considered to be the

  15. Diagnosis and classification of calcaneal fractures in computed tomography

    International Nuclear Information System (INIS)

    Purpose: To compare image quality of single-slice spiral CT (SSCT) and multislice spiral CT (MSCT) in the diagnosis and classification of calcaneal fractures and to present a rapid and precise algorithm for the classification system of Stuermer. Materials and Methods: In 102 patients with 124 calcaneal fractures, spiral CT was performed, in 82 cases as SSCT with a slice thickness (SD) of 3 mm, a table speed (TS) of 3-4 mm/rot and an increment of 1.5 mm. In 42 cases, patients were scanned using MSCT (SD of 1.25 mm, increment 0.8 mm). For these examinations, 2 different scan protocols were used, with a TS of 3.75 mm/rot in one group(n=21) and a TS of 7.5 mm/rot in the other group (n=21). The image quality of axial sections and reconstructed images was assessed on a scale from 1 to 5 (1=very good; 5=insufficient). The fractures were evaluated using a classification system according to Stuermer, which assigns three main groups (A/B/C) and three subtypes (1/2/3). Results: MSCT had substantial advantages over SSCT with respect to scan time and image quality, especially for multiplanar reformatting (median 1.5 versus 4.0). TS showed no significant influence on the image quality. The standardized evaluation of the images enabled a classification of fractures within 5 minutes. All fractures could be assigned to the different types and subtypes. This classification system takes into account the severity of the fracture and the therapeutic approach. The most common type (90 of 124 fractures) were 'joint depression' fractures (type C), which were treated by surgery in 92%. Type A fractures were treated conservatively in 72%. (orig.)

  16. LATERAL APPROACH UNDER FLUROSCOPIC GUIDANCE WITH NONLOCKING CALCANEAL PLATE IS AN EFFECTIVE TECHNIQUE FOR CLOSED CALCANEAL FRACTURE

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    Alok Sobhan; De, Soumya; Rana

    2014-01-01

    Intra-articular calcaneal fractures which accounts for about 75% of calcaneal fractures is usually associated with poor functional outcome. The present was under taken to evaluate the efficacy of open reduction and internal fixation of displaced articular fractures of calcaneum in adults through lateral approach under fluroscopic guidance with non-locking calcaneal plate and ipsilateral iliac crest bone graft. 30 adult patients (25 males and 5 females) with closed displaced in...

  17. Radiologic aspects of calcaneal fractures in childhood and adolescence

    International Nuclear Information System (INIS)

    One hundred and forty-three calcaneal fractures in 140 patients under the age of19 years were reviewed. Of the total number, 75% were in males. Eighty fractures were seen in females under 13 years of age and in males under 16 years of age. Fifteen (19%) of these fractures were initially not recognized. Four projections were available in the majority of the cases, and were reviewed: lateral, axial, straight dorsoplantar and oblique dorsoplantar views. The various types of fractures had different courses and localizations. The optimum demonstration of a fracture in a certain projection will therefore be dependent on the type of fracture present. It is clinically difficult to foresee a specific type of calcaneal fracture, and consequently it is recommended that all four views should be obtained routinely following trauma to the calcaneal region in patients of the pertinent age groups. (orig.)

  18. Outcome of open reduction and internal fixation of intraarticular calcaneal fracture fixed with locking calcaneal plate

    Directory of Open Access Journals (Sweden)

    Jain Saurabh

    2013-12-01

    Full Text Available 【Abstract】Objective: Debate continues regarding the management of calcaneal fractures, between open re- duction and internal fixation and closed treatment. Hence we aim at evaluating the radiological and functional out- comes of open reduction and internal fixation in displaced joint depression type of calcaneal fractures fixed with lock- ing calcaneal plate. Methods: In this series, 28 patients (26 unilateral and 2 bilateral with joint depression type of calcaneal fractures as per Essex-Lopresti classification system were operated on with locking calcaneal plate within 3 weeks of injury. Patients were evaluated in terms of associated injuries and X-rays of anteroposterior, lateral and axial views of the calcaneum. CT scan was done to assess the amount of com- minution and articular depression. Patients were followed up clinically and radiologically at least for 1 year. Radiologi- cal assessment was done by Bohler’s angle and Gissane’s angle along with measurement of calcaneal height and width. Functional outcome was assessed using the American Or- thopaedics Foot and Ankle Society (AOFAS scale. Results: At average follow-up of 14.5 months, average AOFAS score was 86.3 (range 66 to 97, with 86% having excellent to good results and 2 (7.7% and 1 (3.7% having fair and poor results respectively. All patients had stable ankle joint with all having dorsiflexion and plantar flexion more than 30°. Average subtalar range of motion was 17°. The mean Bohler’s angle, mean Gissane’s angle, calcaneal height and width were 25.47°, 121.3°, 4.32 cm and 3.81cm respectively at final follow-up. Three patients had flap ne- crosis at incision site and one had superficial and deep infection. Subtalar arthritis was seen in 5 patients, whereas sural nerve hypoaesthesia in 1 patient. None of the patients had compartment syndrome, heel pad problems, peroneal tendinitis, reflex sympathetic dystropy or implant failure. Conclusion: Open reduction and

  19. Biomechanical comparison of conventional and anatomical calcaneal plates for the treatment of intraarticular calcaneal fractures - a finite element study.

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    Yu, Bin; Chen, Wen-Chuan; Lee, Pei-Yuan; Lin, Kang-Ping; Lin, Kun-Jhih; Tsai, Cheng-Lun; Wei, Hung-Wen

    2016-10-01

    Initial stability is essential for open reduction internal fixation of intraarticular calcaneal fractures. Geometrical feature of a calcaneal plate is influential to its endurance under physiological load. It is unclear if conventional and pre-contoured anatomical calcaneal plates may exhibit differently in biomechanical perspective. A Sanders' Type II-B intraarticular calcaneal fracture model was reconstructed to evaluate the effectiveness of calcaneal plates using finite element methods. Incremental vertical joint loads up to 450 N were exerted on the subtalar joint to evaluate the stability and safety of the calcaneal plates and bony structure. Results revealed that the anatomical calcaneal plate model had greater average structural stiffness (585.7 N/mm) and lower von Mises stress on the plate (774.5 MPa) compared to those observed in the conventional calcaneal plate model (stiffness: 430.9 N/mm; stress on plate: 867.1 MPa). Although both maximal compressive and maximal tensile stress and strain were lower in the anatomical calcaneal plate group, greater loads on fixation screws were found (average 172.7 MPa compared to 82.18 MPa in the conventional calcaneal plate). It was noted that high magnitude stress concentrations would occur where the bone plate bridges the fracture line on the lateral side of the calcaneus bone. Sufficient fixation strength at the posterolateral calcaneus bone is important for maintaining subtalar joint load after reduction and fixation of a Sanders' Type II-B calcaneal fracture. In addition, geometrical design of a calcaneal plate should worth considering for the mechanical safety in practical usage. PMID:26813403

  20. Outcome of open reduction and internal fixation of intraarticular calcaneal fracture fixed with locking calcaneal plate

    Institute of Scientific and Technical Information of China (English)

    Saurabh Jain; Anil Kumar Jain; Ish Kumar

    2013-01-01

    Objective:Debate continues regarding the management of calcaneal fractures,between open reduction and internal fixation and closed treatment.Hence we aim at evaluating the radiological and functional outcomes of open reduction and internal fixation in displaced joint depression type of calcaneal fractures fixed with locking calcaneal plate.Methods:In this series,28 patients (26 unilateral and 2 bilateral) with joint depression type of calcaneal fractures as per Essex-Lopresti classification system were operated on with locking calcaneal plate within 3 weeks of injury.Patients were evaluated in terms of associated injuries and X-rays of anteroposterior,lateral and axial views of the calcaneum.CT scan was done to assess the amount ofcomminution and articular depression.Patients were followed up clinically and radiologically at least for 1 year.Radiological assessment was done by Bohler's angle and Gissane's angle along with measurement ofcalcaneal height and width.Functional outcome was assessed using the American Orthopaedics Foot and Ankle Society (AOFAS) scale.Results:At average follow-up of 14.5 months,average AOFAS score was 86.3 (range 66 to 97),with 86% having excellent to good results and 2 (7.7%) and 1 (3.7%) having fair and poor results respectively.All patients had stable ankle joint with all having dorsiflexion and plantar flexion more than 30°.Average subtalar range of motion was 17°.The mean Bohler's angle,mean Gissane's angle,calcaneal height and width were 25.47°,121.3°,4.32 cm and 3.81cm respectively at final follow-up.Three patients had flap necrosis at incision site and one had superficial and deep infection.Subtalar arthritis was seen in 5 patients,whereas sural nerve hypoaesthesia in 1 patient.None of the patients had compartment syndrome,heel pad problems,peroneal tendinitis,reflex sympathetic dystropy or implant failure.Conclusion:Open reduction and internal fixation with locking calcaneal plate gives sound functional outcome

  1. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    International Nuclear Information System (INIS)

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  2. Anterior process calcaneal fractures: a systematic evaluation of associated conditions

    Energy Technology Data Exchange (ETDEWEB)

    Petrover, David [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Hopital Beaujon, Service de Radiologie, Paris (France); Schweitzer, Mark E. [NYU Hospital for Joint Disease, Radiology Department, New York, NY (United States); Laredo, J.D. [Hopital Lariboisiere, Service de Radiologie, Paris (France)

    2007-07-15

    The objective was to evaluate the association, by MRI, of anterior calcaneal process fractures with tarsal coalitions, ankle sprains, and bifurcate ligament abnormalities. A retrospective review of 1,479 foot and ankle MR images was performed, over a period of 5 years, for isolated anterior process fractures of the calcaneus. Fifteen 1.5-T MR examinations were systematically evaluated by two radiologists in consensus. Marrow edema patterns, presence of a calcaneonavicular coalition, as well as bifurcate and anterior talofibular ligaments, were evaluated. There were 15 fractures of the anterior calcaneal process with an incidence of 1%. The average patient age was 51 years (range 25-82). Twelve patients were women and 3 were men. The majority of the fractures (14 out of 15) presented as an edema pattern on T2-weighted images, either diffuse (9 out of 15), or vertical (5 out of 15). One case did not show marrow edema, but rather a hypointense line. Nine patients (60%) demonstrated calcaneonavicular coalition and anterior calcaneal process fracture. In 6 patients (50%) the anterior talofibular ligament (ATFL) was thickened. Three patients did not have axial images, and were classified as non-conclusive for the ATFL evaluation. The bifurcate ligament was thickened with hyperintense signal demonstrating a sprain in 9 out of 13 (69%). Only 2 patients (16.5%) had an anterior calcaneal process fracture without any associated abnormality. We believe that there is a probable association of anterior process fractures and calcaneonavicular coalitions. We also feel, based on our results and the prior literature that there is likely also an association with both ATFL injuries and bifurcate ligament injuries. (orig.)

  3. Spontaneous calcaneal fracture in patients with diabetic foot ulcer: Four cases report and review of literature.

    Science.gov (United States)

    Evran, Mehtap; Sert, Murat; Tetiker, Tamer; Akkuş, Gamze; Biçer, Ömer Sunkar

    2016-07-16

    Spontaneous calcaneal fractures in diabetic patients without obvious trauma may occur, sometimes accompanying diabetic foot ulcers. In the current study we report four cases who were hospitalized for diabetic foot ulcer with concomitant calcaneal fractures. There were four diabetic patients (one type 1 and three type 2) who registered with diabetic foot ulcers with coexisting calcaneal fractures, all of which were classified as Type A according to Essex Lopresti Calcaneal Fracture Classification. Two of the patients with renal failure were in a routine dialysis program, as well as vascular compromise and osteomyelitis in all of the patients. The diabetic foot ulcer of the 61 years old osteoporotic female patient healed with local debridement, vacuum assisted closure and then epidermal growth factor while the calcaneal fracture was then followed by elastic bandage. In two patients could not prevent progression of diabetic foot ulcers and calcaneal fractures to consequent below-knee amputation. The only patient with type 1 diabetes mellitus improved with antibiotic therapy and split thickness skin grafting, while the calcaneal fracture did not heal. In the current study we aimed to emphasize the spontaneous calcaneal fractures as possible co-existing pathologies in patients with diabetic foot ulcers. After all the medical treatment, amputation below knee had to be performed in 2 patients. It should be noted that other accompanying conditions such as impaired peripheral circulation, osteomyelitis, chronic renal failure, and maybe osteoporosis is a challenge of the recovery of calcaneal fractures and accelerate the progress to amputation in diabetic patients. PMID:27458594

  4. Spontaneous calcaneal fracture in patients with diabetic foot ulcer: Four cases report and review of literature

    Science.gov (United States)

    Evran, Mehtap; Sert, Murat; Tetiker, Tamer; Akkuş, Gamze; Biçer, Ömer Sunkar

    2016-01-01

    Spontaneous calcaneal fractures in diabetic patients without obvious trauma may occur, sometimes accompanying diabetic foot ulcers. In the current study we report four cases who were hospitalized for diabetic foot ulcer with concomitant calcaneal fractures. There were four diabetic patients (one type 1 and three type 2) who registered with diabetic foot ulcers with coexisting calcaneal fractures, all of which were classified as Type A according to Essex Lopresti Calcaneal Fracture Classification. Two of the patients with renal failure were in a routine dialysis program, as well as vascular compromise and osteomyelitis in all of the patients. The diabetic foot ulcer of the 61 years old osteoporotic female patient healed with local debridement, vacuum assisted closure and then epidermal growth factor while the calcaneal fracture was then followed by elastic bandage. In two patients could not prevent progression of diabetic foot ulcers and calcaneal fractures to consequent below-knee amputation. The only patient with type 1 diabetes mellitus improved with antibiotic therapy and split thickness skin grafting, while the calcaneal fracture did not heal. In the current study we aimed to emphasize the spontaneous calcaneal fractures as possible co-existing pathologies in patients with diabetic foot ulcers. After all the medical treatment, amputation below knee had to be performed in 2 patients. It should be noted that other accompanying conditions such as impaired peripheral circulation, osteomyelitis, chronic renal failure, and maybe osteoporosis is a challenge of the recovery of calcaneal fractures and accelerate the progress to amputation in diabetic patients.

  5. Percutaneous reduction combined with bone graft in treatment of displaced intra-articular calcaneal fractures

    Institute of Scientific and Technical Information of China (English)

    Wang Xianhui; Mei Jiong; Li Shanzhu; Ni Ming; Shang Hongjing

    2009-01-01

    Objective: To introduce the experience and key points of percutaneous reduction combined with bone graft to treat calcaneal fractures. Methods: Percutaneous reduction and internal fixation combined with bone graft was performed from April 2004 to April 2006 on 15 cases (16 sides) with intra-articular calcaneal fractures including 13 males (14 feet) and 2 females (2 feet) ,with average age of 36. 6 years (24-61 years). All patients underwent radiography including lateral and axial views for calcaneus, oblique view for foot and three-dimensional CT imaging reconstruction. According to Sanders classification, there were 12 feet of type Ⅱ (3 type Ⅱ a, 3 type Ⅱ b and 8 type Ⅱ c)and 2 feet of type lilac. The length of calcaneus was recovered through traction by Steinmann pin which passed through calcaneal tubercle perpendicularly and the posterior facet was elevated until reduction by a curve scissors through an 0.5 cm incision along the primary fracture line of lateral calcaneus. The calcaneus was fixed with different cannulated cancellous screws according to the type of fractures. Then bone graft was injected to fill the defect of calcaneus through lateral incision. Results: All patients were followed up for an average of 18.4 months (ranged, 12 to 34 months). No complication such as wound infection, screw breakage and calcaneum varus was found postoperatively. The average time for bone healing was 10 weeks. The results were excellent in 12 cases, good in 4 cases according to the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score. The rate of excellent and good clinical results was 100%. The mean AOFAS hindfoot score in tongue type group (86.5+4.4) was better than in joint depression type group (81.2±1.7, P<0.05). Radiography showed basic restoration of Bohler's angle, Gissane's angle and calcaneal shape. Conclusion: The combination of percutaneous reduction and injectable bone graft is suitable for surgical treatment of Sanders 11 and III type

  6. Optimized preoperative planning of calcaneal fractures using spiral computed tomography

    International Nuclear Information System (INIS)

    The aim of this study was the evaluation of spiral-CT examinations in preoperative planning of calcaneal fractures supported by 3D reconstructions after electronic disarticulation. We examined 45 patients with 47 calcaneal fractures with diagnostic spiral-CT examinations in a prospective study. In addition to the conventional axial slices and sagittal reconstructions, 3D reconstructions prior to and after electronic disarticulation were performed and rated by orthopaedic surgeons and radiologists. The following diagnostic criteria were rated: involvement of articular facets, number of fragments and hindfoot deformities. Axial slices were considered to be the gold standard, because not all patients underwent surgical treatment. Axial slices showed involvement of 90 articular facets (100 %). Three-dimensional reformations after electronic disarticulation depicted 82 fractures (82 of 90, 91 %), sagittal reconstructions 63 fractures (63 of 90, 70 %). Three-dimensional reconstructions without electronic disarticulation showed five fractures (5 of 90, 5.5 %). The number of fragments was demonstrated best on sagittal reconstructions (two, three or four fragments); five fragments were diagnosed best on axial slices, and 3D reconstruction without electronic disarticulation showed only a very small number of fragments, due to overlaying bones. Hindfoot deformities (lateralisation, varus deformation, shortening) were demonstrated best on axial slices, except in terms of showing height reduction, which was demonstrated better on sagittal and 3D reconstructions. Three-dimensional reconstructions after electronic disarticulation support a clear understanding of the 3D position of the fragments and of their displacement in comparison with 3D reconstruction without electronic disarticulation, which is essential for an effective surgical reduction. Due to the potential manipulation of surface-oriented 3D reconstructions, regardless of whether electronic disarticulation is used

  7. Optimized preoperative planning of calcaneal fractures using spiral computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Freund, M.; Hohendorf, B.; Heller, M. [Department of Radiology, Medical School, University of Kiel (Germany); Thomsen, M. [Department of Orthopedic Surgery, Medical School, University of Heidelberg (Germany); Zenker, W. [Department of Traumatology, Medical School, University of Kiel (Germany)

    1999-06-01

    The aim of this study was the evaluation of spiral-CT examinations in preoperative planning of calcaneal fractures supported by 3D reconstructions after electronic disarticulation. We examined 45 patients with 47 calcaneal fractures with diagnostic spiral-CT examinations in a prospective study. In addition to the conventional axial slices and sagittal reconstructions, 3D reconstructions prior to and after electronic disarticulation were performed and rated by orthopaedic surgeons and radiologists. The following diagnostic criteria were rated: involvement of articular facets, number of fragments and hindfoot deformities. Axial slices were considered to be the gold standard, because not all patients underwent surgical treatment. Axial slices showed involvement of 90 articular facets (100 %). Three-dimensional reformations after electronic disarticulation depicted 82 fractures (82 of 90, 91 %), sagittal reconstructions 63 fractures (63 of 90, 70 %). Three-dimensional reconstructions without electronic disarticulation showed five fractures (5 of 90, 5.5 %). The number of fragments was demonstrated best on sagittal reconstructions (two, three or four fragments); five fragments were diagnosed best on axial slices, and 3D reconstruction without electronic disarticulation showed only a very small number of fragments, due to overlaying bones. Hindfoot deformities (lateralisation, varus deformation, shortening) were demonstrated best on axial slices, except in terms of showing height reduction, which was demonstrated better on sagittal and 3D reconstructions. Three-dimensional reconstructions after electronic disarticulation support a clear understanding of the 3D position of the fragments and of their displacement in comparison with 3D reconstruction without electronic disarticulation, which is essential for an effective surgical reduction. Due to the potential manipulation of surface-oriented 3D reconstructions, regardless of whether electronic disarticulation is used

  8. An outcomes assessment of intra-articular calcaneal fractures, using patient and physician's assessment profiles.

    LENUS (Irish Health Repository)

    Kennedy, J G

    2012-02-03

    Thirty-six patients with intra-articular displaced calcaneal fractures were examined to determine both physician- and patient-based outcomes. Three groups were selected. Group A was treated with open reduction and internal fixation, group B was treated with open reduction internal fixation and supplemental bone graft augmentation and the patients in group C were treated with plaster cast immobilisation and no formal operative treatment. All cohorts were well matched for age, sex and severity of injury. Patients were evaluated using both the American Foot and Ankle Society Scoring System (AFASS) and the short form 36 (SF-36). Minimum time to follow up was 4 years. No significant difference was observed between the three groups with regards to pain and functional outcomes using the AFASS score (P>0.05). No difference was observed between the three groups using the SF-36 score (P>0.1). A statistically significant difference was observed, using radiological criteria, between both groups A and B when compared to the non-operative group C. The rate of wound infection in groups A and B was 31.5%. No correlation was found between the SF-36 score and the AFASS score. No correlation was found between the radiological score and either the SF-36 or the AFASS score. This study has found that the conservative treatment of calcaneal fractures can produce satisfactory outcomes with lower morbidity than surgically treated fractures.

  9. The effect of fracture type and angular deterioration on the functional outcome of calcaneal fractures

    Directory of Open Access Journals (Sweden)

    Atilla Polat

    2011-03-01

    Full Text Available The aim of this study was to determine the effect of fracture type and angular deterioration on the outcome of calcaneal fractures.Materials and methods: Thirty-two patients (23 males, 9 females; mean age 45 years with calcaneus fractures retrospectively reviewed. Twenty-four fractures were closed, and eight fractures were open. Böhler and Gissane angles were measured using patient’s before, and after reduction X-ray films. According to the Essex-Lopresti classification there were three type I, 14 type II, and 15 type III fractures. Five patients were treated with casting (Group I, 19 patients with closed reduction K-wire application (Group II, and 8 patients with plate fixation. Final clinical outcome were assessed by Maryland Foot Score. Mean follow-up period was 109 weeks.Results: Mean Böhler and Gissane angles were 7°, 85° before reduction, and 20°, 100° after reduction, respectively. The mean Maryland Foot Score was 62 (range 55-72 in Group I, 68 (range 40-90, and 66 (range 58-79 in group II.The Maryland Foot score in Type I fracture was higher than Type III (p=0.025, and Typ II (p=0.094, respectively. In terms of last radiologic examination, the Maryland Foot Score was higher in those angle’s were in normal border than whose angle’s were abnormal (p=0.027 and p=0.02, respectively. Mean correction of angles in Group III were more than Group I, and Gruop II (p<0.05.Conclusion: Severe calcaneus fracture was related to poor functional outcome. Böhler and Gissane angle can be more corrected with plate fixation method, but has similar functional outcome.

  10. Risk of injury to vascular-nerve bundle after calcaneal fracture: comparison among three techniques

    Directory of Open Access Journals (Sweden)

    Pedro José Labronici

    2016-04-01

    Full Text Available OBJECTIVE: To ascertain whether the number of screws or pins placed in the calcaneus might increase the risk of injury when three different techniques for treating calcaneal fractures. METHOD: 126 radiographs of patients who suffered displaced calcaneal fractures were retrospectively analyzed. Three surgical techniques were analyzed on an interobserver basis: 31 radiographs of patients treated using plates that were not specific for the calcaneus, 48 using specific plates and 47 using an external fixator. The risk of injury to the anatomical structures in relation to each Kirschner wire or screw was determined using a graded system in accordance with the Licht classification. The total risk of injury to the anatomical structures through placement of more than one wire/screw was quantified using the additive law of probabilities for the product, for independent events. RESULTS: All of the models presented high explanatory power for the risk evaluated, since the coefficient of determination values (R2 were greater than 98.6 for all the models. Therefore, the set of variables studied explained more than 98.6% of the variations in the risks of injury to arteries, veins or nerves and can be classified as excellent models for prevention of injuries. CONCLUSION: The risk of injury to arteries, veins or nerves is not defined by the total number of pins/screws. The region and the number of pins/screws in each region define and determine the best distribution of the risk.

  11. Risk of injury to vascular-nerve bundle after calcaneal fracture: comparison among three techniques

    Science.gov (United States)

    Labronici, Pedro José; Reder, Vitor Rodrigues; de Araujo Marins Filho, Guilherme Ferreira; Pires, Robinson Esteves Santos; Fernandes, Hélio Jorge Alvachian; Mercadante, Marcelo Tomanik

    2016-01-01

    Objective To ascertain whether the number of screws or pins placed in the calcaneus might increase the risk of injury when three different techniques for treating calcaneal fractures. Method 126 radiographs of patients who suffered displaced calcaneal fractures were retrospectively analyzed. Three surgical techniques were analyzed on an interobserver basis: 31 radiographs of patients treated using plates that were not specific for the calcaneus, 48 using specific plates and 47 using an external fixator. The risk of injury to the anatomical structures in relation to each Kirschner wire or screw was determined using a graded system in accordance with the Licht classification. The total risk of injury to the anatomical structures through placement of more than one wire/screw was quantified using the additive law of probabilities for the product, for independent events. Results All of the models presented high explanatory power for the risk evaluated, since the coefficient of determination values (R2) were greater than 98.6 for all the models. Therefore, the set of variables studied explained more than 98.6% of the variations in the risks of injury to arteries, veins or nerves and can be classified as excellent models for prevention of injuries. Conclusion The risk of injury to arteries, veins or nerves is not defined by the total number of pins/screws. The region and the number of pins/screws in each region define and determine the best distribution of the risk. PMID:27069891

  12. LATERAL APPROACH UNDER FLUROSCOPIC GUIDANCE WITH NONLOCKING CALCANEAL PLATE IS AN EFFECTIVE TECHNIQUE FOR CLOSED CALCANEAL FRACTURE

    Directory of Open Access Journals (Sweden)

    Alok Sobhan

    2014-06-01

    Full Text Available Intra-articular calcaneal fractures which accounts for about 75% of calcaneal fractures is usually associated with poor functional outcome. The present was under taken to evaluate the efficacy of open reduction and internal fixation of displaced articular fractures of calcaneum in adults through lateral approach under fluroscopic guidance with non-locking calcaneal plate and ipsilateral iliac crest bone graft. 30 adult patients (25 males and 5 females with closed displaced intra articular fractures of calcaneum of less than 15 days constituted the study group. All cases were operated by lateral approach as described by Seligson, a modification of Gould’s technique under spinal anaesthesia. All machers Arthrosis Rating Scale were used for the evaluation of posttraumatic posterior facet degenerative changes. Primarily27 of all 35 wounds (77% healed without any form of wound complications. Excellent to good results noted in 3 (100% patients with preoperative Bohler´s angle larger or equal to 20° (n = 3 whereas patients with preoperative Bohler´s angle smaller than 20° (n=32 achieved excellent to good results in 16 cases (50% Clinically significant subtalararthrosis (Allmacher grade 2-4 noted in 7 cases (20% cases with Bohler´s angle smaller than 20° (n=32. In 5 cases, clinically significant complaints (Allmachers Arthrosis Rating Scale grades II to V noted. Therapeutic success of such fracture depends on timely open reduction and internal fixation with proper fracture reduction and early rehabilitation. Thus management of these injuries as well as complications should be performed in a specialized orthopaedics or traumatology center.

  13. An Atypical Calcaneal Fracture in a Child: A Literature Review Concerning the Treatment

    OpenAIRE

    Guterres, Leonardo Waihrich; Ribeiro, Deryck Aguiar; Ribeiro, Tiango Aguiar

    2014-01-01

    Calcaneal fractures are considered uncommon accounting for 0.005-0.41% of all children fractures. Few reports concerning treatment are available. Most of these fractures are non-displaced/minimally displaced and are associated with a fall of less than 1 m. The aim of this case report was to discuss the diagnosis and treatment of a child calcaneal fracture, an atypical presentation despite the high energy mechanism of trauma. A 7-year-old child fell from a 5-m ladder with all his weight on his...

  14. Effect of Intraoperative Three-Dimensional Imaging During the Reduction and Fixation of Displaced Calcaneal Fractures on Articular Congruence and Implant Fixation

    DEFF Research Database (Denmark)

    Eckardt, Henrik; Lind, Marianne

    2015-01-01

    BACKGROUND: Operative treatment of displaced calcaneal fractures should restore joint congruence, but conventional fluoroscopy is unable to fully visualize the subtalar joint. We questioned whether intraoperative 3-dimensional (3D) imaging would aid in the reduction of calcaneal fractures...

  15. The surgical dilemma of the malunited calcaneal joint depression fracture: the VAMC Miami experience.

    Science.gov (United States)

    Cohen, M

    1996-01-01

    During the period of October 1985 through March 1995, 25 patients presented to the Veterans Affairs Medical Center, Miami with a chief complaint of chronic pain status post calcaneal joint depression fracture. Their acute injury was treated conservatively at this and various other institutions. Nine patients were managed conservatively with orthotics, University of California Biomechanics Laboratory braces (UCBLs), shoe modification, or prosthetics. Sixteen patients underwent hindfoot fusions. Good to excellent results were obtained in 15 of the 16 fusions. The remaining patient, having an isolated subtalar fusion, was later diagnosed with multiple sclerosis. Proper evaluation of the chronic pain patient is critical when mapping out an appropriate treatment plan. Hindfoot arthrodesis with soft tissue decompression is a successful tool in eliminating chronic pain due to malunited depression fractures. PMID:8722881

  16. Ligamentotaxis for complex calcaneal fractures using Joshi′s external stabilization system

    Directory of Open Access Journals (Sweden)

    Singh Ajai

    2008-01-01

    Full Text Available Background: Controversies exist in the literature regarding the management of complex fractures of the calcaneum. We evaluated a series of complex fractures of the calcaneum managed by ligamentotaxis using Joshi′s external stabilization system (JESS for its efficacy. Materials and Methods: Forty-five patients having complex (comminuted, intra-articular fracture with compromised soft tissue condition fractures of the calcaneum, who were treated by external fixator (JESS based on the principle of ligamentotaxis. The gradual distraction was done to bring the articular margins together to maintain both alpha and beta angles to near normal range. Thirteen (28.9% patients underwent additional corticocancellous bone grafting with elevation of posterior facet. All patients were evaluated for their functional outcomes by American Orthopedic Foot and Ankle society (AOFAS Score for the ankle and hind foot. Mean duration of follow-up was 20.5 months. Results: Forty-two (93.4% of our patients did well with the ligamentotaxis. On evaluating final outcomes by AOFAS, approximately 71% of cases showed good results. Eleven patients (24.4% complained of persistent heel pain in the long-term follow-up. Out of these, eight (17.8% patients were those who had severe comminution with almost total loss of calcaneal height. The origin of heel pain was not the subtalar joint in all of these patients. On long-term follow-up none of these patients suffered from such severe pain so as to compel them to change the nature of their activity. Conclusion: We conclude that ligamentotaxis by JESS provides a viable and user-friendly alternative method of management of these complex calcaneal fractures.

  17. Ligamentotaxis for complex calcaneal fractures using Joshi's external stabilization system

    OpenAIRE

    Singh, Ajai; Srivastava, RN; Jah, M; Kumar, Ashish

    2008-01-01

    Background: Controversies exist in the literature regarding the management of complex fractures of the calcaneum. We evaluated a series of complex fractures of the calcaneum managed by ligamentotaxis using Joshi's external stabilization system (JESS) for its efficacy. Materials and Methods: Forty-five patients having complex (comminuted, intra-articular fracture with compromised soft tissue condition) fractures of the calcaneum, who were treated by external fixator (JESS) based on the princip...

  18. Percutaneous reduction and fixation of intraarticular calcaneal fractures

    OpenAIRE

    Schepers, Tim; Vogels, Lucas; Schipper, Inger; Patka, Peter

    2008-01-01

    textabstractObjective: Percutaneous reduction by distraction and subsequent percutaneous screw fixation to restore calcaneal and posterior talocalcaneal facet anatomy. The aim of this technique is to improve functional outcome and to diminish the rate of secondary posttraumatic arthrosis compared to conservative treatment and, secondly, to reduce infectious complications compared to open reduction and internal fixation (ORIF). Indications: Sanders type II-IV displaced intraarticular calcaneal...

  19. A Novel Technique for Closed Reduction and Fixation of Paediatric Calcaneal Fracture Dislocation Injuries

    Science.gov (United States)

    Faroug, Radwane; Stirling, Paul; Ali, Farhan

    2013-01-01

    Paediatric calcaneal fractures are rare injuries usually managed conservatively or with open reduction and internal fixation (ORIF). Closed reduction was previously thought to be impossible, and very few cases are reported in the literature. We report a new technique for closed reduction using Ilizarov half-rings. We report successful closed reduction and screwless fixation of an extra-articular calcaneal fracture dislocation in a 7-year-old boy. Reduction was achieved using two Ilizarov half-ring frames arranged perpendicular to each other, enabling simultaneous application of longitudinal and rotational traction. Anatomical reduction was achieved with restored angles of Bohler and Gissane. Two K-wires were the definitive fixation. Bony union with good functional outcome and minimal pain was achieved at eight-weeks follow up. ORIF of calcaneal fractures provides good functional outcome but is associated with high rates of malunion and postoperative pain. Preservation of the unique soft tissue envelope surrounding the calcaneus reduces the risk of infection. Closed reduction prevents distortion of these tissues and may lead to faster healing and mobilisation. Closed reduction and screwless fixation of paediatric calcaneal fractures is an achievable management option. Our technique has preserved the soft tissue envelope surrounding the calcaneus, has avoided retained metalwork related complications, and has resulted in a good functional outcome. PMID:23819090

  20. A Novel Technique for Closed Reduction and Fixation of Paediatric Calcaneal Fracture Dislocation Injuries

    Directory of Open Access Journals (Sweden)

    Radwane Faroug

    2013-01-01

    Full Text Available Paediatric calcaneal fractures are rare injuries usually managed conservatively or with open reduction and internal fixation (ORIF. Closed reduction was previously thought to be impossible, and very few cases are reported in the literature. We report a new technique for closed reduction using Ilizarov half-rings. We report successful closed reduction and screwless fixation of an extra-articular calcaneal fracture dislocation in a 7-year-old boy. Reduction was achieved using two Ilizarov half-ring frames arranged perpendicular to each other, enabling simultaneous application of longitudinal and rotational traction. Anatomical reduction was achieved with restored angles of Bohler and Gissane. Two K-wires were the definitive fixation. Bony union with good functional outcome and minimal pain was achieved at eight-weeks follow up. ORIF of calcaneal fractures provides good functional outcome but is associated with high rates of malunion and postoperative pain. Preservation of the unique soft tissue envelope surrounding the calcaneus reduces the risk of infection. Closed reduction prevents distortion of these tissues and may lead to faster healing and mobilisation. Closed reduction and screwless fixation of paediatric calcaneal fractures is an achievable management option. Our technique has preserved the soft tissue envelope surrounding the calcaneus, has avoided retained metalwork related complications, and has resulted in a good functional outcome.

  1. Extended lateral approach for intra-articular calcaneal fractures: an inverse relationship between surgeon experience and wound complications.

    Science.gov (United States)

    Schepers, Tim; Den Hartog, Dennis; Vogels, Lucas M M; Van Lieshout, Esther M M

    2013-01-01

    The current reference standard for the treatment of displaced intra-articular calcaneal fractures is open reduction and internal fixation using an extended lateral approach. In the present retrospective study, we evaluated the results of a consecutive series of patients treated in the same fashion from June 2005 to September 2011 using a subcuticular single-layer closure technique. We also determined the risk factors for the development of wound complications and the rate of wound complications. Also, we assessed which patient, fracture, and surgical characteristics affected these complications. During the 75-month study period, we operated on 53 displaced intra-articular calcaneal fractures in 50 patients using the extended lateral approach. The incision was closed using the subcuticular technique in 49 cases (92.45%). In the subcuticular closure group 2 (4.1%) deep infections and 2 (4.1%) superficial wound complications (1 dehiscence and 1 infection) occurred. Wound edge or flap necrosis was not encountered. The use of bone-void filler and the experience of the surgical team were significantly (p rate combined with the extended lateral approach. The effect of bone void fillers on the incidence of complications should receive more attention in future research. The association between wound complications and the experience level of the surgical team supports the need for centralization of this complex injury. PMID:23318101

  2. Traitement chirurgical des fractures articulaires du calcanéum par plaque vissée

    OpenAIRE

    Hammou, Nassreddine; Abid, Hatim; Shimi, Mohammed; El Ibrahimi, Abdelhalim; El Mrini, Abdelmajid

    2015-01-01

    Les fractures du calcanéum sont peu fréquentes mais le plus souvent graves. Le traitement chirurgical par plaque vissée est ardemment défendu. L'objectif de notre travail rétrospectif est d’évaluer les résultats du traitement chirurgical des fractures articulaires du calcanéum à travers une série de 12 patients opérée aux service d'orthopédie du CHU Hassan II de Fès sur une durée de 3 ans, et les comparer aux données de la littérature. L’âge moyen dans notre série était de 34 ans, le geste op...

  3. Modification of the sinus tarsi approach for open reduction and plate fixation of intra-articular calcaneus fractures: the limits of proximal extension based upon the vascular anatomy of the lateral calcaneal artery.

    Science.gov (United States)

    Femino, John E; Vaseenon, Tanawat; Levin, David A; Yian, Edward H

    2010-01-01

    The treatment of displaced calcaneal fractures remains controversial. Early surgical management to restore articular congruence and the structural function of the calcaneus is widely accepted as the best way to avoid the negative consequences of malunion. Concerns remain however regarding the best approach for reducing and maintaining reduction of these complex fractures, while minimizing the risk of surgical complications. The potential for serious wound complications is a major concern, particularly breakdown of the lateral calcaneal skin flap with the extensile lateral approach. Various approaches have been developed to try and balance the need for direct reduction of the articular surface while minimizing the potential for wound complications. Palmer originally described a laterally based approach through the sinus tarsi for direct visualization of the articular surface for reduction. He and others have found this approach to be useful and reasonably safe. At times, however, it may be necessary to extend the limits of a small incision over the sinus tarsi to treat adjacent fractures or to aid reduction in more complex fractures. In addition, a limited sinus tarsi incision without elevation of the lateral calcaneal skin flap does not allow for plate fixation, a notable advantage of the extensile lateral approach, particularly in gaining reduction of the body of the calcaneus. The authors have used an extended sinus tarsi approach to include placement of plate percutaneously beneath the lateral calcaneal skin flap through a sinus tarsi approach, and to treat adjacent fractures and soft tissue injuries. A clinical series of 13 patients (including 7 chronic smokers and 1 with diabetes and vascular disease) with closed displaced intra-articular calcaneal fractures (Sanders types II and III) were treated by open reduction and internal fixation via this approach. Adjacent fractures were treated through the same incision. Two patients developed wound complications. No

  4. Case report:Calcaneal fractures in a cat

    OpenAIRE

    Longley, Mark J; Hannes, Bergmann,; Langley-Hobbs, Sorrel J.

    2016-01-01

    A one year four month old male neutered domestic shorthair cat was presented for sudden onset, left pelvic limb lameness. Upon clinical examination, pain was localised to the hock region and the cat was found to have persistent deciduous teeth. No evidence of trauma was apparent. Radiographs revealed a transverse fracture at the base of the calcaneus. The fracture was stabilised with a Steinmann pin and tension band wire. Eleven weeks after fixation of the fracture, the cat presented with lam...

  5. [Vascularization of the lateral heel in relation to extensive skin incisions in osteosynthesis of calcaneal fractures].

    Science.gov (United States)

    Rak, V; Matonoha, P; Otáhal, M; Masek, M M

    2007-09-01

    The aim of the study was to document soft tissue vascularization of the lateral heel on cadavers and, therefore, to indirectly demonstrate the importance to perform perfectly precise incisions, in order to prevent ischemic complications. Sections of 8 human lower limb cadavers were performed in cooperation with the Anatomical Institute of the MU Medical Faculty in Brno, according to current common standards for anatomical preparations. In successive steps, cutaneous and subcutanous covers of the lateral ankle, malleolar and heel regions were preparated. Final branches of the individual arteries were followed and the authors aimed to demonstrate their vascular arcade consisting of anastomosis of the lateral calcaneal artery--LCA (a branch of a. peronea)--which is a clinical term for rami calcaneares laterales, ventrolateral tarsal arteries--LTA (a branch of a. dorsalis pedis) and lateral malleolar artery branching off medially--LMA (a branch of a. tibialis ant.). The course of the arteries and their location is related to a reference point--a lateral tip of the lateral ankle. The investigators found out that all three arteries, as well as the arterial arch, had standard courses. The course of the arch defines the outline of the lateral extensive incision during osteosynthesis in calcaneal fractures, which lies fairly close to the lateral outline of this vascular arcade. Incorrect performance of the incision results, invitably, in serious ischemic complications. Open reduction and internal fixation of intraarticular calcaneal fractures has become a standard surgical method. Correct indication, good timing and saving open reduction, internal fixation using arthroscopy and early mobilization are the prerequisites to prevent further postoperative complications and to achieve complete healing of the fracture. Considering the demandingness of these fractures treatment and their rare incidence, their management should be centred in specialized traumatological clinics. PMID

  6. Study of occurrence, demography and pathomorphology of ankle and foot fractures and evaluation of the treatment outcome of calcaneal fractures

    International Nuclear Information System (INIS)

    This study highlights which injury has greatest burden, how frequent are the injuries of foot and ankle areas, which is an extremely neglected specialty in orthopedics and also the importance of proper diagnosis, classification of fractures, appropriate pre-operative planning and timely conservative as well as surgical intervention of ankle and foot fractures that resulted in a satisfactory outcome Despite the fact, foot and ankle is the most important locomotor unit of our lower limb, there have been few studies addressing the problem and treatment outcome of such fractures. Objective: To determine the occurrence, demography and pathomorphology of ankle and foot fractures, also evaluation of treatment outcome of calcaneal fractures. Methodology: This was a longitudinal interventional study which dealt with acute traumatic ankle and foot fracture patients coming to Accident and Emergency Department of MHL, DOST unit 1, with inclusion and exclusion criteria clearly defined. Results: Total 100 patients were included in the study. Mean age of patients was 35.71+-13.60 years. Minimum age of patients was 14 and maximum age of patients was 70 years respectively. Gender distribution of patients shows that 15 patients were female and the remaining 85 patients were male. Male patients were greater in number as compared to female patients ie. M: F, 6:1. Mechanism of the injury showed that there were 48 patients who suffered from RTA , 37 patients had trauma due to fall from height, 6 patients had industrial injuries, 5 patients had Fire Arm Injury, and 2 patients had injuries due to domestic activity, 1 had trauma due to sports activity and 1 had injury due to agricultural work. There were 41 patients with fractures of calcaneum and out of which 5 had bilateral fracture calcaneum. They were classified according to CT based Sanders classification. Out of these 22 patients were of Sanders type III, 12 patients were of Sander type II, 5 patients were of Sander type IV, 2

  7. Treatment of ipsilateral high energy tibial plateau and calcaneal fractures by a circular wire fixator: a case report

    OpenAIRE

    Dhar, Shabir Ahmed; Butt, Mohammed Farooq; Ali, Murtaza Fazal; Mir, Mohammed Ramzan; Kawoosa, Altaf Ahmed

    2009-01-01

    Introduction High energy tibial plateau fractures along with calcaneal fractures individually produce several challenges for the orthopaedic surgeon. The principles of bony reconstruction include anatomic reduction and rigid internal fixation of intra-articular fractures and accurate restoration of the coronal, sagittal and transverse mechanical axes. Due to the tenuous nature of the soft tissue and devitalisation of the comminuted fragments with open reduction, external fixation of type 6 ti...

  8. Non-union of calcaneum - A rare complication of calcaneal fracture - A case report with brief review of literature.

    Science.gov (United States)

    Kumar, Narinder

    2015-09-01

    Intra-articular fractures of calcaneum are known to be difficult to manage and lead to multiple complications including subtalar arthritis and malunion. However, non-union of calcaneum is rarely encountered. Only a total of six studies reporting on 12 patients could be found on reviewing the available literature (English language only). One such case of non-union of calcaneal fracture and its successful management is being reported in this case report. In addition, extremely limited literature available on calcaneal non-union is also briefly reviewed. Role of subtalar arthrodesis with internal fixation of fracture and bone grafting for successful management of this rare complication is highlighted along with the possibility of under-reporting of this relatively unknown complication. PMID:26155055

  9. Neuspešno primarno zdravljenje zloma petnice: Failed primary treatment of calcaneal fracture: kaj storiti?: what to do?:

    OpenAIRE

    Andoljšek, Matej

    2008-01-01

    Many patients are seriously disabled after failed primary treatment of calcaneal fracture. They complain about pain, swelling of the foot and ankle, stiffness and/or limping. They have problems with walking the uneven ground, standing on their toes or climbing ladders. Complains are related to injuries of the soft tissues (not discussed in this paper) and/or injures of the bones and joints. A decreased Boehler's angle resulting in flatfoot is not always aserious defect, and most patients with...

  10. PERCUTANEOUS BIPLANAR EXTERNAL FIXATOR METHOD FOR TREATMENT OF CALCONEAL FRACTURES

    OpenAIRE

    Jagadeesh Kumar; Parthasaradhy M.; Subramanian,; Thiyageswaran; Abinandharajha; Adhiyamaan; Shivakumar

    2015-01-01

    Calcaneal fracture, the most common tarsal bone fracture, occurs predominantly in manual labors and subsequently has got considerable socioeconomic implications. Treatment modality which can offer early weight bearing and early return to work is therefore needed for those patient s. We have used a biplanar percutaneous external fixator for treating calcaneal fractures per operative visualization of the fractures. We have treated 20 ca...

  11. Operative treatment of calcaneal fractures%跟骨骨折的手术治疗策略及疗效分析

    Institute of Scientific and Technical Information of China (English)

    陈滨; 黎润光; 王钢

    2010-01-01

    目的 探讨跟骨骨折的受伤机制、临床分型、手术治疗方法及其疗效.方法 2005年6月至2009年5月共收治70例(83足)闭合性新鲜跟骨骨折患者,男45例,女25例;年龄18~62岁,平均38.3岁.骨折根据Essex-Lopresti分类:关节外骨折20足(前突骨折5足,体部骨折9足,结节部骨折3足,内外侧突骨折3足),关节内骨折63足(舌状骨折25足,关节压缩型骨折38足).63足关节内骨折根据Sanders分型:Ⅱ型30足,Ⅲ型21足,Ⅳ型12足.采用常规足外侧"L"形切开复位普通钢板或锁定钢板内固定50足,微创切开复位螺钉固定20足,撬拨复位克氏针(或加螺钉)固定13足.20足骨缺损>2 cm3,行骨移植治疗.术后采用美国足踝外科协会(AOFAS)踝与后足评分评价患者足部功能恢复情况. 结果 70例患者术后获12~30个月(平均18个月)随访.末次随访时70例患者83足AOFAS踝与后足评分平均为(90.3±11.0)分(48~100分).20足关节外骨折患者AOFAS踝与后足评分平均为(98.1±2.6)分(90~100分),无并发症发生.63足关节内骨折患者AOFAS踝与后足评分平均为(87.8±11.4)分(48~100分).并发症包括:切口皮缘坏死2足,经换药后创面闭合;腓肠神经损伤4足;距下关节创伤性关节炎10足. 结论 对于不同类型的跟骨骨折,术前慎重评估软组织损伤和骨折类型、程度,采用适当的治疗方法,可以获得较好疗效.关节外骨折的疗效明显优于关节内骨折.%Objective To investigate the injury mechanism, clinical classification, treatment methods and clinical results of calcaneal fractures. Methods From June 2005 to May 2009, 83 feet in 70 patients with calcaneal fractures were treated. According to Sanders and Essex-Lopresti classifications, 63 feet had intra-articular fractures (30 feet of type Ⅱ, 21 type Ⅲ, and 12 type Ⅳ ) and 20 feet had extra-articular fractures (3 feet of lateral condylar fracture, 5 anterior process fracture, 9 calcaneal body fracture

  12. Ligamentotaxis for complex calcaneal fractures using Joshi′s external stabilization system

    OpenAIRE

    Singh Ajai; Srivastava R; Jah M; Kumar Ashish

    2008-01-01

    Background: Controversies exist in the literature regarding the management of complex fractures of the calcaneum. We evaluated a series of complex fractures of the calcaneum managed by ligamentotaxis using Joshi′s external stabilization system (JESS) for its efficacy. Materials and Methods: Forty-five patients having complex (comminuted, intra-articular fracture with compromised soft tissue condition) fractures of the calcaneum, who were treated by external fixator (JESS) based on t...

  13. MANAGEMENT OF INTRA-ARTICULAR CALCANEAL FRACTURES BY CLOSED REDUCTION WITH PERCUTANEOUS STEINMANN PIN

    OpenAIRE

    Padmanabh, MR; Niaz; Ramachandra,

    2014-01-01

    BACKGROUND & OBJECTIVES: Calcaneum is the most common tarsal bone to fracture and is attended by considerable morbidity. Many treatment techniques are described in literature but indications for specific techniques are vague. This study analyzes the outcome of treatment of intra articular calcaneum fractures treated by Essex-Lopresti technique. METHODS: Between January 2011 and December 2012, 20 patients with tongue-type fracture of Calcaneum who got admitted at Srinivas I...

  14. Operative Treatment of Sanders Ⅲ,Ⅳ Type Calcaneal Fracture%Sanders Ⅲ、Ⅳ型跟骨骨折的手术治疗

    Institute of Scientific and Technical Information of China (English)

    赵快平; 王朝晖; 李春艳

    2016-01-01

    Objective:To explore the clinical outcomes of the Sanders Ⅲ ,Ⅳ type calcaneal fracture treated by opetat‐ing .Methods:31 cases(35 feet) being severe calcaneal fracture were analyzed retrospetively from Jun 2011 to Jun 2014 . These cases were treated by operating with L‐shaped lateral approach of calcaneum ,fixing with locking plate and graft‐ing with allogeneic bone .Results:There were 3 cases with approach complication after opetation and the incidence was 8 .6% .The postopetative outcome of the height ,width ,Bohler angle ane Gissane angle of calcaneun was more perfectly than the preoperation .Maryland foot score system was using to evaluate the postoperative fuction when the cases were followed up .The results showed 11 excellent ,18 good ,5 fair and 1 poor .The excellent and good rate was 82 .9% .Con‐clusion:It is a effective method to treat the Sanders Ⅲ ,Ⅳ type calcaneal fracture with L‐shaped lateral approach of cal‐caneum ,locking plate internal fixation and allogeneic bone graft .It is both importance to recover the posterior talocalca‐neal jiont surface and the whole calcaneal anatomic form .%目的:探讨手术治疗SandersⅢ、Ⅳ型跟骨骨折的临床疗效。方法:回顾分析2011年6月-2014年6月采用跟骨外侧“L”型切口手术入路、锁定钢板内固定和同种异体骨植骨治疗31例(35足)的严重跟骨骨折。结果:术后出现切口并发症3例,发生率为8.6%;术后跟骨高度、宽度、Bohler角、Gissane角较手术前明显改善(P<0.05)。随访采用M aryland足部评分,优11足、良18足、可5足、差1足,优良率82.9%。结论:跟骨外侧“L”型切口手术入路、锁定钢板内固定和同种异体骨植骨是治疗Sanders Ⅲ、Ⅳ型跟骨骨折的有效方法,术中在复位跟骨后关节面的同时,注意跟骨整个解剖形态的恢复。

  15. Percutaneous reduction and fixation of an intra-articular calcaneal fracture using an inflatable bone tamp: description of a novel and safe technique

    Directory of Open Access Journals (Sweden)

    Mauffrey Cyril

    2012-03-01

    Full Text Available Abstract Calcaneal fractures are common injuries involving the hind foot and often a source of significant long-term morbidity. Treatment options have changed throughout the ages from periods of preferred nonoperative management to closed reduction with a mallet, and more recently, open reduction and anatomic internal fixation. The current treatment of choice; however, is often debated, as open management of these fractures carries many risks to include wound breakdown and infection. A less invasive form of surgical management through small incisions, while maintaining the ability to obtain joint congruency, anatomic alignment, and restore calcaneal height and width would be ideal. We propose a novel form of fracture reduction using an inflatable bone tamp and percutaneous fracture fixation. Preoperative planning and experienced fluoroscopy is crucial to successful management using this method. Although we achieved successful radiographic outcome in this case, long-term functional outcome of this technique are yet to be published.

  16. Non-union of calcaneum – A rare complication of calcaneal fracture – A case report with brief review of literature

    OpenAIRE

    Kumar, Narinder

    2015-01-01

    Intra-articular fractures of calcaneum are known to be difficult to manage and lead to multiple complications including subtalar arthritis and malunion. However, non-union of calcaneum is rarely encountered. Only a total of six studies reporting on 12 patients could be found on reviewing the available literature (English language only). One such case of non-union of calcaneal fracture and its successful management is being reported in this case report. In addition, extremely limited literatur...

  17. Biomechanics – Elastic Foundation Applied in Modelling of Calcaneal Nails

    Directory of Open Access Journals (Sweden)

    Sejda František

    2015-12-01

    Full Text Available This paper presents a strength analysis of a calcaneal nail (material Ti6Al4V and stainless steel which is used to treat complex heel fractures. The application focuses on a unique calcaneal nail, the C-NAIL, produced by Medin a.s. (Nové Město na Moravě, Czech Republic. The paper first presents an analysis of fracture types, treatment methods and loading of the calcaneus. It then presents an analysis of limit conditions and loading. Calculations (displacement and stress are performed for 6 and 7 fixing screws using FEM (Ansys Workbench 14 software. The calculation involves a new, original application of an elastic foundation, which effectively replaces the complex interaction of the calcaneal nail and the heel bone.

  18. MANAGEMENT OF INTRA-ARTICULAR CALCANEAL FRACTURES BY CLOSED REDUCTION WITH PERCUTANEOUS STEINMANN PIN

    Directory of Open Access Journals (Sweden)

    Padmanabh

    2014-05-01

    Full Text Available BACKGROUND & OBJECTIVES: Calcaneum is the most common tarsal bone to fracture and is attended by considerable morbidity. Many treatment techniques are described in literature but indications for specific techniques are vague. This study analyzes the outcome of treatment of intra articular calcaneum fractures treated by Essex-Lopresti technique. METHODS: Between January 2011 and December 2012, 20 patients with tongue-type fracture of Calcaneum who got admitted at Srinivas Institute of Medical Sciences, Mangalore in the Department of Orthopedics were subjected to closed reduction and percutaneous pin fixation (Method of Essex-Lopresti. Creighton Nebraska Health Foundation Assessment sheet for calcaneum fractures was used for analysis. STATISTICAL ANALYSIS: Wilcoxon Rank-sum test was used to compare repeated measurements on a single sample to assess whether their mean population ranks differ. Kruskal Wallis test was used for analysis of variance. RESULTS: Incidence was more common in males with right and left side involvement being almost equal and no bilateral involvement. The commonest mechanism of injury was fall from height and landing on the heel. It was found to be more common in age group 30-39 years. Associated spine and lower extremity injuries were seen in 30%. There were 45% excellent, 30% good, 25% fair results and no poor results. CONCLUSION: The Essex-Lopresti method of closed reduction and pin fixation is a safe technique with overall good results and an acceptable complication rate for the treatment of tongue-type fracture of calcaneum

  19. Clinical analysis of internal fixation with plastic titanium plate in the treatment of calcaneal fractures%可塑性钛钢板内固定治疗跟骨关节内骨折

    Institute of Scientific and Technical Information of China (English)

    杨新宇; 吴海华

    2012-01-01

    目的 探讨切开复位可塑性跟骨钛钢板内固定治疗跟骨骨折的疗效.方法 SandersⅡ、Ⅲ、Ⅳ型跟骨关节内骨折患者29例共32足,采用手术切开复位并予可塑性跟骨钛钢板进行内固定,观察临床疗效.结果 29例患者均获随访,按照Msryland Foot Score系统进行术后功能评价,其中优21足、良9足、可2足,优良率93.7%.结论 手术切开复位、可塑性钛钢板内固定治疗跟骨关节内骨折是一种有效可靠的治疗方法.%Objective To study the application of open reduction and plasticity titanium plate in the treatment of calcaneal fracture.Methods 29 patients with sanders Ⅱ、Ⅲ、V calcaneal fracture were treated by surgery with open reduction and titanium plate fixation.The clinical effects were observed.Results All patients were followed by Maryland Foot score postoperative functional evaluation system,the group of 29 cases of fracture,excellent 21 cases,good 9 cases,acceptable 2 cases,excellent rate was 93.7%.Condtusion The open reduction and internat fixation with plastic titanic plate was reliable to treat displaced intra-articular fracture of calcaneus.

  20. The new bi - directional compression fracture malunion of calcaneal nail care%新型双向加压钉治疗跟骨骨折畸形愈合的护理

    Institute of Scientific and Technical Information of China (English)

    郑慧琳; 余旭辉; 段清萍; 张弘; 饶绮

    2015-01-01

    ,60 to 70 points in 1 cases,71 - 80 in 5 cases,18 ca-ses of 81 - 90,91 - 100 in 6 cases. Conclusion:The old calcaneal fractures were treated with new bi - directional compression nail for the treatment, and carefully nursing in perioperative period,can effectively reduce the complications,improve the success rate of operation.

  1. Functional outcomes of conservatively treated clavicle fractures

    Directory of Open Access Journals (Sweden)

    Mohd Yazid Bajuri

    2011-01-01

    Full Text Available OBJECTIVE: The main aim of the study was to analyze the outcomes of clavicle fractures in adults treated non-surgically and to evaluate the clinical effects of displacement, fracture patterns, fracture location, fracture comminution, shortening and fracture union on shoulder function. METHODS: Seventy clavicle fractures were non-surgically treated in the Orthopedics Department at the Tuanku Ja'afar General Hospital, a tertiary care hospital in Seremban, Malaysia, an average of six months after injury. The clavicle fractures were treated conservatively with an arm sling and a figure-eight splint for three weeks. No attempt was made to reduce displaced fractures, and the patients were allowed immediate free-shoulder mobilization, as tolerated. They were prospectively evaluated clinically and radiographically. Shoulder function was evaluated using the Constant scoring technique. RESULTS: There were statistically significant functional outcome impairments in non-surgically treated clavicle fractures that correlated with the fracture type (comminution, the fracture displacement (21 mm or more, shortening (15 mm or more and the fracture union (malunion. CONCLUSION: This article reveals the need for surgical intervention to treat clavicle fractures and improve shoulder functional outcomes.

  2. Aspergillus fumigatus Empyema, Arthritis, and Calcaneal Osteomyelitis in a Lung Transplant Patient Successfully Treated with Posaconazole

    OpenAIRE

    Lodge, Barbara Alexander; Ashley, Elizabeth Dodds; Steele, Mark P.; John R Perfect

    2004-01-01

    A 64-year-old male with Aspergillus fumigatus infection that had disseminated from the lung to the ankle and adjacent bone was treated successfully with posaconazole after therapy with itraconazole and amphotericin B lipid complex failed. Marked clinical improvement occurred within 6 weeks of initiation of posaconazole therapy; after 6 months, infection had resolved at all sites. The patient has had no recurrence of infection.

  3. 钢板与克氏针内固定修复跟骨骨折:Gissane角及Bohler角与跟骨高度比较%Internal fixation with plate and Kirschner wire to repair calcaneal fractures:comparison of Gissane angle, Bohler angle and calcaneus height

    Institute of Scientific and Technical Information of China (English)

    马东弟; 杨振建; 宋锦旭; 高志峰; 孙立恒; 潘学文

    2015-01-01

      结果与结论:切开复位重建钢板内固定组治疗后的Gissane角、Bohler角及跟骨高度显著大于经皮撬拨复位克氏针固定组(P 0.05);切开复位重建钢板内固定组治疗后1年随访的足踝功能AOFAS评分显著高于经皮撬拨复位克氏针固定组(P OBJECTIVE:To compare and analyze the prognosis effect of open reduction and internal fixation and percutaneous poking fixation with Kirschner wire for calcaneal fractures. METHODS:A total of 62 patients with calcaneal fractures, who were treated in Tangshan Fengnan District Hospital from March 2012 to September 2013, were selected for this study. The patients were divided into two groups according to the therapy strategy:open reduction and internal fixation group (n=29) and percutaneous poking fixation with Kirschner wire group (n=33). Gissane angle, Bohler angle, calcaneus height, incidence of postoperative complication and AOFAS score (1-year fol ow-up) were compared between the two groups. RESULTS AND CONCLUSION:The Gissane angle, Bohler angle and calcaneus height in open reduction and internal fixation group were higher than percutaneous poking fixation with Kirschner wire group (P0.05). The AOFAS score during 1-year fol ow-up was significantly higher in open reduction and internal fixation group than in the percutaneous poking fixation with Kirschner wire group (P<0.05). Results indicated that open reduction and internal fixation could recover the regular structure of calcaneus and subtalar joint. Surgeon with skil ed operation skil s could ensure the safety of surgery. Open reduction and internal fixation can promote the prognosis of calcaneal fractures, and is better than percutaneous poking fixation with Kirschner wire.

  4. Nanotechnology for treating osteoporotic vertebral fractures

    Science.gov (United States)

    Gao, Chunxia; Wei, Donglei; Yang, Huilin; Chen, Tao; Yang, Lei

    2015-01-01

    Osteoporosis is a serious public health problem affecting hundreds of millions of aged people worldwide, with severe consequences including vertebral fractures that are associated with significant morbidity and mortality. To augment or treat osteoporotic vertebral fractures, a number of surgical approaches including minimally invasive vertebroplasty and kyphoplasty have been developed. However, these approaches face problems and difficulties with efficacy and long-term stability. Recent advances and progress in nanotechnology are opening up new opportunities to improve the surgical procedures for treating osteoporotic vertebral fractures. This article reviews the improvements enabled by new nanomaterials and focuses on new injectable biomaterials like bone cements and surgical instruments for treating vertebral fractures. This article also provides an introduction to osteoporotic vertebral fractures and current clinical treatments, along with the rationale and efficacy of utilizing nanomaterials to modify and improve biomaterials or instruments. In addition, perspectives on future trends with injectable bone cements and surgical instruments enhanced by nanotechnology are provided. PMID:26316746

  5. Fractures of the calcaneum. A review of 70 patients

    OpenAIRE

    Paul, M.; Peter, Robin; Hoffmeyer, Pierre

    2004-01-01

    We have assessed the long-term results after operative and non-operative treatment of undisplaced and displaced calcaneal fractures. At a mean of 6.5 years, we reviewed 70 patients with a calcaneal fracture who were divided into four groups: group 1, 18 patients with undisplaced fractures and a normal Böhler's angle (BA) who had been treated non-operatively; group 2, 23 with intra-articular fractures and a BA < 10 degrees who had been treated non-operatively; group 3, 13 with intra-articular ...

  6. The Current Situation on Treatment of Calcaneal Bone Fractures%跟骨骨折治疗现状

    Institute of Scientific and Technical Information of China (English)

    赵津刚

    2011-01-01

    由于跟骨结构的特异性和复杂性,治疗不当易造成跟骨疼痛、行走困难等严重后遗症,因此追求解剖复位并可靠固定是治疗的目的.近年来,跟骨骨折的治疗,如切开复位锁定板固定、经皮撬拨、关节镜、植骨等取得了较大进展,手术方法多样,在并发症的预防方面也有长足的进步.由于跟骨骨折致残率高,并发症多,多年来对其治疗一直争论很大.%Due to the specificity and the complexity of the calcaneum structure,it's easy to cause calcaneum ache,difficulty walking and other serious sequela if not treated well, therefore the pursuit of anatomical reduction and reliable fixing is the treatment goal.In recent years, the calcaneum bone fracture's treatment,such as the incision replacement lockplate fixing, percutaneous by leverage, the arthroscope, bone grafting and so on, has made great progress, the surgery method was diversified, and it also makes considerable progress in the complication prevention aspect.Because the disability rate of calcaneum bone fracture is high, and many complication are easily caused, it caused big argument for the treatment in many years.

  7. Proximal humeral fractures treated with arthroplasty

    Institute of Scientific and Technical Information of China (English)

    QIAN Qi-rong; WU Hai-shan; ZHOU Wei-jiang; LI Xiao-hua; WU Yu-li

    2005-01-01

    Objective: To explore arthroplasty in treating 3- and 4-part fractures of the proximal humerus.Methods: A total of 132 patients with proximal humeral fractures were treated in our hospital from July 1997 to February 2003. According to Neer's classification, the fractures of 45 patients (14 males and 31 females, aged 31-78 years, 56.1 years±7.8 years on an average) belonged to 3- or 4-part fractures (10 patients with 4-part fracture and 35 with 3-part comminuted fracture) and they were treated with shoulder joint arthroplasty. Unipolar prosthesis replacement of the head of humerus was made in 28 cases, while bipolar prosthesis replacement in 2 cases and total shoulder joint replacement in 15 cases. Results: During the follow-up period (range: 12-72 months, mean: 37.3 months±4.1 months), among the 45 patients who suffered from fractures of the proximal humerus and underwent arthroplasty surgery, 44 patients (97.8%) had no postoperative pain and were satisfied with the active range of motion and with the whole treatment results. And radiography showed that the prostheses were at their good position. One patient had postoperative pain because he had so narrow medullary cavity that the humeral prosthesis could not be put deeply enough and the prosthesis head was a little higher over the anatomic level. He did not have good postoperative active range of motion, either. Then he received a review surgery and got satisfied results. Temporary shoulder stiffness was observed in one patient. Manual release of these adhesions improved the shoulder function. No evidence of nonunion of the fracture segments around the humeral prosthesis stem was found. Conclusions: Shoulder arthroplasty is a dependable method to restore the comfort and function of the should joints of the patients with 3- or 4-part fractures of the proximal humerus.

  8. Nanotechnology for treating osteoporotic vertebral fractures

    Directory of Open Access Journals (Sweden)

    Gao C

    2015-08-01

    Full Text Available Chunxia Gao,1,* Donglei Wei,1,* Huilin Yang,1 Tao Chen,2 Lei Yang1,3 1Department of Orthopaedic Surgery and Orthopaedic Institute, First Affiliated Hospital, 2Robotics and Microsystems Center, Collaborative Innovation Center of Suzhou Nano Science and Technology, Soochow University, Suzhou, 3Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing, People’s Republic of China *These authors contributed equally to this work Abstract: Osteoporosis is a serious public health problem affecting hundreds of millions of aged people worldwide, with severe consequences including vertebral fractures that are associated with significant morbidity and mortality. To augment or treat osteoporotic vertebral fractures, a number of surgical approaches including minimally invasive vertebroplasty and kyphoplasty have been developed. However, these approaches face problems and difficulties with efficacy and long-term stability. Recent advances and progress in nanotechnology are opening up new opportunities to improve the surgical procedures for treating osteoporotic vertebral fractures. This article reviews the improvements enabled by new nanomaterials and focuses on new injectable biomaterials like bone cements and surgical instruments for treating vertebral fractures. This article also provides an introduction to osteoporotic vertebral fractures and current clinical treatments, along with the rationale and efficacy of utilizing nanomaterials to modify and improve biomaterials or instruments. In addition, perspectives on future trends with injectable bone cements and surgical instruments enhanced by nanotechnology are provided. Keywords: nanomaterials, osteoporosis, vertebral fracture, kyphoplasty, bone cement, pedicle screw, radiopacifier

  9. [Outcome of surgically treated lateral clavicle fractures].

    Science.gov (United States)

    Krüger-Franke, M; Köhne, G; Rosemeyer, B

    2000-07-01

    This retrospective study presents the results of 41 patients with a lateral clavicle fracture eight years after the treatment at the Staatliche Orthopädische Klinik of the LMU München in the time between 31.10.1979 and 31.10.1994. It could be shown that the lateral clavicle fractures, due to their variety, hold a special position among the clavicle fractures and thus need a differentiated therapeutic procedure. Among the operation methods the K-wire stabilisation with cerclage was the most often chosen operation technique i.e. in 24 cases. The K-wire without cerclage was used in two cases. Twelve fractures were treated with AO-plate-osteosynthesis. Three fractures had to be treated by resection, as they produced two pseudarthrosis and one serious AC-arthrosis during the conservative therapy. 92.7% of the subjective results of the 41 checked up patients were good and very good. The clinical follow-up of 36 and the radiological follow-up of 33 patients revealed in 97% a good and very good outcome in the Boenisch-Score. PMID:10969540

  10. The lateral calcaneal flap for sensate heel reconstruction revisited.

    Science.gov (United States)

    Korentager, R

    1994-06-01

    Defects of the heel can be difficult to treat because they require a thin, sensate, soft-tissue cover. The lateral calcaneal flap can provide this type of reconstruction in selected patients. A 27-year-old man had a painful defect in a grafted heel that prevented him from working. A satisfactory painless heel was provided by resurfacing the area with a lateral calcaneal flap. The donor defect was minimized by interfascicular dissection of the sural nerve. PMID:8199942

  11. “/\\”形小切口钢板螺栓加压内固定治疗跟骨关节内骨折%The treatment of displaced intra-articular calcaneal fractures by "/\\" shape incision with compression fixation and stud bolts

    Institute of Scientific and Technical Information of China (English)

    曲家富; 闫荣亮; 李生旺; 曹立海; 赵国志; 彭义; 刘洪达; 张英泽

    2013-01-01

    the lateral "/\\" shape incision,namely the straight incision front of achilles tendon and the sinus tarsi oblique incision,140feet with displaced intra-articular calcaneal fractures in 130 patients were treated with calcaneal anatomical plate and compression fixation with stud bolts.There were 117 males and 13 females,with an average age of 42.3 years.According to Sanders classification,the fracture patterns include 49 cases for type Ⅱ,75 for type Ⅲ,and 16 for type Ⅳ.The B(o)hler and Gissane angle as well as the varus angle,the displacement of subtalar articular surface,the width,height and length of the calcaneum were measured on pre-and post-operative radiographs.The Maryland and AOFAS foot score were used to assess the results.Results One hundred and thirty patients got followed up with an average of 20 months (range,15-31 months).There were no incision edge necrosis and wound infection.The time of fracture union was 54.51 ±20.38 d (range,45-86 d).The amount of bleeding was 194.24±104.17 ml.Accorrding to the preoperative and postoperative radiographs,the mean B(o)hler angle was 6.27°±11.81° and 27.21°±8.28°; the mean Gissane angle was 108.36°±21.77° and 117.47°±12.93°,the mean calcaneal width was 47.35±5.85 mm and 35.96±4.14 mm,the mean calcaneal height was 39.79±5.85 mm and 47.64±3.83 mm,the mean calcaneal length was 78.30±5.81 mm and 79.41±5.30 mm.Based on the Maryland foot score,the excellent and good rate was 92.86% (130/140).Based on the AOFAS foot score,the excellent and good rate was 95.71% (134/140).Compared with the normal side,the ankle varus of 12feet were restriction for 5°-8°,3 feet were sufferd for subtalar arthritis.Conclusion Lateral "/\\" shape incision" with compression fixation and stud bolts to is a safe and effective method for the treatmeat for the displaced intra-articular calcaneal fractures,significantly reducing and avoiding the wound complications,restoring calcaneal anatomical morphology and the

  12. 经皮撬拨复位空心钉内固定治疗跟骨关节内骨折%Percutaneous Reduction and Internal Fixation in the Treatment of Intra-articular Calcaneal Fractures

    Institute of Scientific and Technical Information of China (English)

    王先辉; 陈舰; 胡孙君; 应正然

    2013-01-01

    Objective:To sum up the experience of percutaneous and internal fixation of intra-articular calcaneal fracture.Methods:Fom June 2007 to June 2010,Percutaneous reduction and internal fixtion was performed on 24 cases with intra-articular calcaneal fractures.According to Sanders classification,there were 19 feet of type Ⅱ (3 type Ⅱ a,5 type Ⅱ b and 11 type Ⅱ c) and 5 feet of type Ⅲac.Results:All patients were followed up for an average of 16 months (ranged from12 to 24 months).No complications such as wound infection,screw breakage and calcaneum varus were found postoperatively.The average time for bone healing was 14.5weeks.The results were excellent in 17 cases,good in 5 cases,average in 2 cases according to the American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score.The rate of excellent and good clinical results was 91.6%.Radiography showed basic restoration of B(o)hler' s angle,Gissane' s angle and calcaneal shape.Conclusions:Percutaneous reduction and internal fixation is suitable for surgical treatment of Sanders Ⅱ and Ⅲ type calcaneal fractures,with advantages of simple operation,fewer complications and good clinical results.%目的:总结经皮撬拨复位空心钉内固定治疗跟骨关节内骨折的手术经验.方法:2007年6月~2010年6月,采用经皮撬拨复位空心钉内固定治疗跟骨骨折24例,其中SandersⅡ型19例(Ⅱ a型3例,Ⅱ b型5例,Ⅱ c11例),Sanders Ⅲ ac型5例.结果:所有患者术后随访12 ~24个月(平均16个月).术后均未发生切口感染、螺钉断裂及跟骨内翻等并发症.术后平均骨折愈合时间为14.5周.按美国足踝外科协会(AOFAS)后足评分系统评价疗效,优17例,良5例,一般2例,优良率91.6%.X线片检查示B(o)hler角、Gissane角、跟骨外形基本恢复正常.结论:经皮撬拨复位空心钉内固定适用于治疗Sanders Ⅱ,Ⅲ型跟骨骨折,具有操作简单、并发症少和临床疗效好等优点.

  13. An anatomic study and clinical application of sustentaculum talus for displaced intraarticular calcaneal fractures%载距突的解剖学研究及其在跟骨关节内移位骨折手术中的应用

    Institute of Scientific and Technical Information of China (English)

    王志杰; 邹云雯; 钟世镇; 丁自海

    2009-01-01

    Objective To study the anatomy and clinical application of sustentaculum talus for displaced intraarticular calcancal fractures. Methods The anterior tilt angles of the sustentaculum talus and the anterior part of posterior calcaneal facet, the maximal width of the middle calcaneum and the maximal and minimal thicknesses of the sustentaculum talus base were measured in 40 pieces of adult calcaneal spec-imens. The intraarticular structures of normal calcaneum were observed, including anatomical relations of the sustentaculum talus. The internal screw fixation of middle calcaneum was simulated to measure the positions and angles of screws. Follow-ups were conducted in 27 patients with displaced intraarticular calcaneal fractures treated by ORIF through an extensile right-angled lateral incision. The accuracy of screw insertion and func-tional outcome were assessed. Results The anterior tilt angle of the sustentaculum talus is 50°±5°, the anterior tilt angle of anterior part of posterior calcaneal facet is 69°±5°, the width of the middle calcaneum is (41.75±1.76) mm, and the maximal and minimal thicknesses of sustentaculum tali base are (12.14±1.60) mm and (4.81±1.07) mm respectively. The compact structure of bone trabecula beneath the sus-tentaculum talus progresses to the inferior part of the posterior calcaneal facet. The sustentaculum talus is closely connected with the tendons and vessels running along medially. The best 3 positions for screw insertion measured on coronal plane from the posterior facet to the sustentaculum talus are as follows: the lowest position is 25°±5° upwards, the highest point is 3°±3° downwards and the middle position is 13°±3°. The excellent and good rate of functional outcome was 88.9%. Conclusions ORIF through an extensile right-angled lateral incision is effective for displaced intraarticular calcaneal fractures. The sustentaculum talus is a good place for screw insertion. The length of screws can be determined by

  14. Embracing fixator for treating periprosthetic femoral fractures

    Institute of Scientific and Technical Information of China (English)

    张先龙; 章玮; 眭述平; 将垚; 曾炳芳

    2001-01-01

    @@Femoral fractures in the presence of other intramedullary implants are uncommon. These fractures are difficult to manage and the presence of other intramedullary implants creates a complex problem. The rate of these fractures has increased due to an increase in the number of patients having total hip arthroplasty (THA) and the use of various new techniques for femoral fractures.1-5 Literature on the treatment of femoral fractures with other intramedullary implants is rare.2,3 From 1995 to 1998, we reduced these fractures openly and fixed them with a shape memory alloy sawtooth-arm embracing fixator (EF), and the outcomes were satisfactory.

  15. To Investigate the Application of Spiral CT Three-dimensional Reconstruction of the Value of Calcaneal Fractures%跟骨骨折应用螺旋 CT 三维重建的价值探讨

    Institute of Scientific and Technical Information of China (English)

    李海源; 李小满; 高莉丽; 林秀琼; 蔡映红; 梁玉英

    2015-01-01

    Objective Analysis of spiral CT three-dimensional reconstruction imaging in the diagnosis of trauma in the clinical value of calcaneus .Methods Collection the patients with calcaneal injury to our hospital for diagnosis and treatment in November 2 0 1 2 to November 2 0 1 4 ,selection of image data w hich patients had X-ray examination and three-dimensional reconstruction of spiral CT examination ,comparison of X -ray and spiral CT 3 D reconstruction ,by using the SPSS1 9 .0 statistical software using chi square test analysis of the dif-ference between X-ray and spiral CT 3 D reconstruction in diagnosis ,classification of calcaneal fracture .Results X-ray examination and CT 3 D reconstruction for diagnosis if there is no statistical significance of calcaneal fracture(P=0 .371 >0 .05 ) ,the fracture type classification (comminuted ,intra-articular) are highly statisti-cally significant( P<0 .0 1 ) .Conclusion X-ray and spiral CT 3 D reconstruction is the basic way to check the calcaneum bone fracture ,but the spiral CT three-dimensional reconstruction can specifically form more intu-itive ,comprehensive ,clear observation of fracture ,bring convenience for Department of orthopedics diagnosis and treatment .%目的:分析螺旋CT三维重建成像技术在诊断跟骨外伤中临床价值。方法收集2012年11月至2014年11月间到我院接受诊治的跟骨外伤患者,挑选其中患者均有进行X线平片检查及螺旋CT三维重建检查的影像资料,比较X线平片检查及螺旋CT三维重建,采用SPSS 19.0统计软件应用卡方检验分析X线平片检查及螺旋CT三维重建对跟骨骨折诊断、分类的差异。结果 X线平片检查与CT三维重建对于诊断是否有跟骨骨折无统计学意义(P=0.371>0.05),对于骨折类型分类(粉碎性、关节内)有高度统计学意义( P<0.01)。结论 X线平片检查及螺旋CT三维重建都是跟骨骨折检查的基本方式,但螺旋CT三维重

  16. The relationship between restoring Gissane angle and prognosis in calcaneal fracture surgery%跟骨骨折手术Gissane角的恢复与预后的关系

    Institute of Scientific and Technical Information of China (English)

    郑磊; 秦书俭

    2015-01-01

    Objective To explore the relationship between restoring Gissane angle and prognosis in calcaneal fracture surgery. Methods Forty patients with single side calcaneal fracture (SandersⅡ-Ⅲ), Gissane angle changed more than 15°and having performed open reduction and internal fixation with steel plate were enrolled. In them, 25 patients (experimental group) recovered Gissane angle in surgery referencing the healthy side with X-rays. Another 15 patients (control group) didn't recover Gissane angle. The ratio of calcaneum height and length was measured at 1 week after surgery. At 6 and 12 months after surgery, the function were valued by Maryland score. Results The ratio of calcaneum height and length in experimental group was significantly higher than that in control group:0.60± 0.04 vs. 0.55±0.05, and there was statistical difference (P<0.05). All the patients were followed up. At 6 and 12 months after surgery, the Maryland score in experimental group were significantly higher than those in control group:(88.9± 5.7) scores vs. (80.5±7.3) scores and (89.5 ±5.5) scores vs. (82.5 ±6.4) scores, and there were statistical differences (P<0.05). Conclusions Restoring Gissane angle is benefitial for prognosis. So in calcaneal fracture surgery, the Gissane angle should be recovered as much as possible referencing the healthy side.%目的 探讨跟骨骨折手术Gissane角的恢复与预后之间的关系. 方法 选择住院手术治疗的SandersⅡ~Ⅲ型单侧跟骨骨折、Gissane角改变大于15°的患者40例,均进行跟骨骨折切开复位钢板内固定手术治疗.其中25例(试验组)参考健侧足跟骨X线片,术中将Gissane角恢复.另15例(对照组)术中未将Gissane角恢复.在术后1周通过X线片测量两组跟骨高长比,术后6和12个月分别对两组患者进行Maryland评分. 结果 试验组术后跟骨高长比高于对照组(0.60±0.04比0.55±0.05),差异有统计学意义(P<0.05).40例患者均获得随访.术后6和12个月,

  17. Outcome after open reduction and internal fixation of intraarticular fractures of the calcaneum without the use of bone grafts

    OpenAIRE

    Pendse Aniruddha; Daveshwar R; Bhatt Jay; Shivkumar

    2006-01-01

    Background: Intraarticular fractures of calcaneum are commenest type of calcaneal fractures. Lots of controversies exist about the ideal management for them. The focus is now shifting on operative management by open reduction and internal fixation for these fractures with or without the use of bone grafts. Method: Thirty intraarticular fractures classified by Essex Lopresti radiological classification, were treated by open reduction and fixation. The patients were followed over a mean peri...

  18. Navicular stress fractures treated with minimally invasive fixation

    OpenAIRE

    Korula Mani Jacob; Paterson, Roger S

    2013-01-01

    Background: Stress fractures of the naviculum bone are uncommon injuries occurring predominantly in athletes. These fractures are usually treated nonoperatively with a nonweight bearing cast for a minimum of 6 weeks followed by rehabilitation. Further, there is a paucity of literature on the long term clinical followup of these patients. These fractures do not heal predictably with conservative management, which does not inspire great compliance and their clinical outcome is variable. We repo...

  19. PERCUTANEOUS BIPLANAR EXTERNAL FIXATOR METHOD FOR TREATMENT OF CALCONEAL FRACTURES

    Directory of Open Access Journals (Sweden)

    Jagadeesh Kumar

    2015-07-01

    Full Text Available Calcaneal fracture, the most common tarsal bone fracture, occurs predominantly in manual labors and subsequently has got considerable socioeconomic implications. Treatment modality which can offer early weight bearing and early return to work is therefore needed for those patient s. We have used a biplanar percutaneous external fixator for treating calcaneal fractures per operative visualization of the fractures. We have treated 20 calcaneal fractures in 18 patients, 12 intra articular and five extra articular, with our percutaneou s external fixator system with under image intensifier and achieving the fracture reduction. Functional outcome was measured using the American Orthopaedic Foot and ankle society Hind foot score. All fractures united with a mean of 55 days. Partial weight bearing was possible in a mean of 1.8 days and full bearing was possible in a mean of 11.6 days. All the patients were returned to their original work within six weeks. Minor infectious complications occurred in 17.6 percent of cases. The average AOFAS sco re at six months follow up was 83.8. We conclude that our percutaneous external fixator technique for fracture calcaneum is an effective alternative to the currently available – surgical and conservative treatment modalities especially in lower socio econo mic labor population who need to return to their job as early as possible. Level of Evidence – IV Case series

  20. Bifocal mandibular fractures: which should be treated first?

    Science.gov (United States)

    Dell' Aversana Orabona, Giovanni; Iaconetta, Giorgio; Abbate, Vincenzo; Califano, Luigi

    2012-11-01

    Fractures of the mandible have been reported to account between 40% and 62% of all facial fractures. Most surveys show that just under 50% are isolated, the same amount are doubly fractured. This study aims to clarify, according to our experience, the correct surgical sequence which should be followed in order to treat bifocal mandibular fractures. From January 2004 to January 2009, we have conducted a retrospective study on a sample of patients operated on in our department because of bifocal mandibular fractures. We include only those cases in which the jaw was fractured in 2 places, in particular patients who suffer a fracture in tooth-bearing areas (symphysis, parasymphysis, and anterior body) and also contralaterally in non-tooth-bearing areas (posterior body, angle, ramus, and condyle). The sample was divided into 2 groups based on the fracture sequence of reduction. At 1-year follow-up, the group of patients who received first the tooth-bearing fractured areas treatment, followed by treatment of non-tooth-bearing fractured area on bifocal mandibular fracture, showed less postoperative complications and reduced surgical time and costs. It is recommended from this study that reduction of the tooth-bearing fragment be prior to that of the tooth-free fragment for the bifocal mandible. PMID:23147333

  1. Open segmental fractures of the tibia treated by external fixation

    Directory of Open Access Journals (Sweden)

    Golubović Ivan

    2012-01-01

    Full Text Available Introduction. Open segmental fractures of the tibia are rare but severe injuries. In these fractures the wide zone of injury (damage of all structures of the lower leg creates very unsuitable biological conditions for healing of the fracture. Objective. The aim of our work was to present the results of treatment of patients with segmental open fractures of the tibia treated by external fixation. Methods. We analyzed treatment results of 21 patients with open segmental tibial fractures who were treated using the method of external fixation at the Clinical Center Niš from January 1, 1995 to July 31, 2010. The average age of the patients was 53 years; the youngest patient was 27 years and the oldest one 80 years. According to the Gustilo open fracture classification, there were 3 (14.3% type I, 6 (28.6% type II, 8 (38.1% type IIIA, and 4 (19.0% type IIIB. All the patients were treated by a unilateral type Mitković external fixator by Traffix Company. Results. Union was attained in 16 (76.2% fractures without severe complications (pseudoarthrosis, chronic osteitis and angular deformities of over 10 degrees. Among severe complications associated with open segmental tibial fractures, in two cases we registered septic pseudoarthrosis, in one aseptic pseudoarthrosis and in two large angular deformities of the tibia after union, with a valgus of over 10 degrees and extremity shortening of over 2 cm which required additional surgery. Conclusion. External fixation by the use of Mitković external fixator is one of the methods of choice in the treatment of open segmental tibial fractures, which incorporated with antibiotic therapy provides good biomehanical conditions for segmental fracture healing that enables good stability of the segmental tibial fracture and decreases the risk of deep infections. [Projekat Ministarstva nauke Republike Srbije, br. 41017: Virtuelni koštano­zglobni sistem čoveka i njegova primena u pretkliničkoj i kliničkoj praksi

  2. 切开复位内固定术治疗Sanders Ⅱ、Ⅲ型跟骨骨折的疗效观察%The open reduction and internal fixation treatment of Sanders type Ⅱ、Ⅲ calcaneal fracture

    Institute of Scientific and Technical Information of China (English)

    李海峰; 季伟; 白雪东; 贾治伟

    2011-01-01

    目的 分析切开复位内固定术用于Sanders Ⅱ、Ⅲ型跟骨骨折患者的治疗效果.方法 回顾分析2008年6月至2010年6月我科同一组医生实施切开复位、钛板螺钉治疗的21例(23足)Sanders Ⅱ、Ⅲ型跟骨骨折患者.术前、术后在X线片上测量跟骨宽度、Bohler's角以及Gissane's角.伤后5-7 d局部消肿后实施手术,单侧骨折患者采用侧卧位,双侧患者采用俯卧位,选择跟骨外侧切口,采用"不接触技术"保护局部皮瓣,术中直视下用斯氏针辅助将后关节面复位,必要时取髂骨植于骨缺损部位,用钦钛螺钉固定.术后3、6、12个月复查X线及CT检查观察跟骨宽度、Bohler's角以及Gissane's角以及骨折愈合情况.结果 本组21例跟骨骨折切口均愈合良好,术后复查X线和(或)CT显示骨折愈合良好,测量跟骨宽度、Bohler' s角以及Gissane's角均恢复良好,患者下地活动后足跟均无明显不适.结论 加强围手术期管理、选择合适手术时机,掌握必要的手术技巧,切开复位内固定治疗Sanders Ⅱ、Ⅲ跟骨骨折可获得满意效果.%Objective To evaluate the open reduction and internal fixation operation effect of the Sanders type Ⅱ 、 Ⅲ calcaneous fracture. Methods A total 21 cases(23 foots) with Sanders type Ⅱ , Ⅲ calcaneal fracture from Jun 2008 to Jun 2010 underwent surgical treatment of the open reduction and fixation with titanium plates. The Bohler's and Gissane's angle as well as the width of the calcaneum were measured on pre-and postoperative X-ray films. The operation were done by one group experienced trauma surgeon under tourniquet control at 5 days to 7 days after injury. The patient is placed in the lateral decubitus position to treat unilateral fracture. The prone position is selected to treat bilateral fractures, no touch technique were used to protect the skins around incisions through lateral approch. During operation, one or two 3.5 mm Steinmann pins are introduced to

  3. OUTCOME OF INTERTROCHANTERIC FRACTURES TREATED WITH SHORT FEMORAL NAIL

    Directory of Open Access Journals (Sweden)

    Yadkikar Shriniwas V, Yadkikar Vishnu S, Patel Mayank, Dhruvilkumar Gandhi, Kunkulol Rahul

    2015-07-01

    Full Text Available Aim: To study the functional and anatomical outcome of Inter trochanteric fractures of femur treated with Short femoral nail. Method: This was retrospective study carried out in which 60 patients (50 Male & 10 Female of 5th to 8th decade of life who underwent Short femoral nail fixation for both Stable & unstable Inter Trochanteric fractures. From the records each patient data was assessed for time required for mobilization, average fracture healing time, degree and grade of hip range of movements, complications, anatomical reduction achieved using Short femoral nail fixation. Results: 55 cases achieved Anatomical reduction. Good to Excellent Hip range of Motion was in 55 (90 % cases. Fracture union was seen in all cases. No evidence of Z Effect, AVN of femoral head, Implant failure, Fracture of femoral shaft below the Nail tip was seen in any case, However Reverse Z Effect was seen in 4 & shortening of less than 2 cm was seen in 2 cases, External rotation of 10 degree was seen in1 case. Average fracture Union time was 14 weeks. Conclusion: Short femoral nail appears to be better implant for fixation of both Stable & unstable Inter Trochanteric fractures as it fulfills the biomechanical demands being minimally invasive, less blood loss , it prevents excessive varus collapse at fracture site, produces less stress riser effect below the nail tip, Short operative time, Facilitates early mobilization & functional recovery of patients. But Anatomical fracture reduction & optimal implant placement are absolutely must for better results.

  4. Pediatric femoral shaft fractures treated by flexible intramedullary nailing

    Institute of Scientific and Technical Information of China (English)

    K.C.Kapil Mani; R.C.Dirgha Raj; Acharya Parimal

    2015-01-01

    Background:Nowadays pediatric femoral fractures are more commonly managed with operative treatment rather than conservative treatment because of more rapid recovery and avoidance of prolonged immobilization.Children between the ages of 5-13 years are treated either by traction plus hip spica and flexible/elastic stable retrograde intramedullary nail,or external fixators in the case of open fractures.The aim of this study is to evaluate the outcome of pediatric femoral shaft fractures treated by stainless steel flexible intramedullary nail in children between 5 and 13 years of age.Methods:There were 32 cases of femoral shaft fractures which were all fixed with stainless steel flexible intramedullary nail under fluoroscopy.Long leg cast was applied at the time of fixation.Partial weight bearing was started 2 weeks after surgery.Patients were evaluated in follow-up study to observe the alignment of fracture,infection,delayed union,nonunion,limb length discrepancy,motion of knee joint,and time to unite the fracture.Results:We were able to follow up 28 out of 32 patients.The patients were 8.14 years of age on average.The mean hospital stay after operation was 4 days and fracture union time was 9.57 weeks.There were 3 cases of varus angulation,2 cases of anterior angulation,and 4 cases of limb lengthening.Conclusion:Patients aged between 5 and 13 years treated with flexible intramedullary nail for closed femoral shaft fracture have rapid union and recovery,short rehabilitation period,less immobilization and psychological impact,and cost-effective.

  5. Two cases of surgically treated feline patellar fractures.

    Science.gov (United States)

    Guillaumot, P; Scotti, S; Carozzo, C; Bouvy, B; Genevois, J-P

    2008-01-01

    A transverse patellar fracture in a six-month-old cat was successfully treated by figure-of-eight dorsal wiring of the patella. A longitudinal patellar fracture with luxation of a large medial fragment in a 2.5-year-old cat was treated by lateral marginal patellectomy with a positive outcome. While adding material to the few veterinary reports in that species, in this brief communication, the authors discuss the aetiology, diagnosis, and the treatment of the presented cases with regards to findings in previously published feline cases. PMID:18545720

  6. Surgical treatment of displaced intraarticular calcaneal fractures in children%应用跗骨窦有限切口克氏针内固定加植骨治疗儿童跟骨关节内骨折

    Institute of Scientific and Technical Information of China (English)

    李凡; 勘武生; 刘郁东; 徐剑; 李明静

    2015-01-01

    Objective To retrospectively evaluate the surgical outcomes of displaced intraarticular calcaneal fractures in children after open reduction,internal fixation with Kirschner wire and bone grafting via limited tarsal sinus incision.Methods The clinical data of 26 boys (77 sides) with displaced intraarticular calcaneal fractures from June 2010 to February 2014 were collected for respective analyses.Limited open reduction,internal fixation and bone grafting via limited tarsal sinus incision with k-wire were performed.Their average age was 9.6 (2-15) years.Preoperative radiographs and computed tomographic scans were used to classify the fractures.According to the Sanders classification,there were 6 feet of type Ⅱ (4 type Ⅱa,2 type Ⅱb),14 feet of type Ⅲ (6 type Ⅲab,5 type Ⅲac & 3 type Ⅲbc) and 7 feet of type Ⅳ.The functional outcomes were assessed by the modified American Orthopedic Foot & Ankle Society (AOFAS) ankle and hindfoot score.Results The mean follow-up period was 21 (8-30) months.All fractures healed clinically after 4 weeks postoperation.In patients with type Ⅱ fractures,B hler angle was restored from 16.8 ± 12.9 to 36.8 ±7.5 (P<0.05)and Gissane angle from 104.8°± 12.8° to 124.3°± 9.6°(P<0.05); In type Ⅲ fractures,B? hler angle improved from 15.4°± 14.1° to 34.4°± 9.1°(P<0.000 1) and Gissane angle from 100.6° ± 10.1° to 119.8° ± 11.7°(P<0.05) ; In type Ⅳ fractures,B? hler angle was restored from 8.6° ± 10.5° to 34.7° ± 5.3°(P<0.05) and Gissane angle from 105.4° ± 4.0° to 121.4° ± 8.9°(P<0.05).The mean modified AOFAS scores were 65.2 ± 2.5,67.0 ± 1.6 and 65.0 ± 2.8 in patients with type Ⅱ,type Ⅲ and type Ⅳ respectively.The differences of AOFAS scores were not statistically significant among three groups (P<0.05).Pin hole infection occurred in one foot.There was on onset of wound infection,tissue necrosis,osteomyelitis or traumatic arthritis.Conclusions Limited open reduction

  7. Poor accuracy of calcaneous ultrasounds in the selection of postmenopausal women affected by vertebral osteoporosis diagnosed by DXA

    International Nuclear Information System (INIS)

    Aim: Bone Mineral Density (BMD) is the strongest skeletal predictor of fractures. DXA densitometric technique is the reference method to diagnose osteoporosis. Large prospective studies have confirmed that both Broad Band Ultrasound Attenuation (BUA) and Speed Of Sound (SOS) measurements at calcaneus predict vertebral fractures independently of densitometry. The aim of this study was to verify the capacity of calcaneal ultrasound (US) to detect women with vertebral osteoporosis diagnosed by DXA. Material and Methods: 453 women (aged 60-70 yrs), were investigated both with calcaneal US and spine DXA. WHO diagnostic criteria were applied both to DXA and US. Results: 202 and 251 women resulted osteoporotic and non osteoporotic at spine, respectively. Calcaneal US were not able to detect with sufficient accuracy the women diagnosed as osteoporotic at the spine (71-73 % of false negative and 11% of false positive results both for BUA and SOS). Conclusion: In conclusion, calcaneal US do not permit to individually diagnose vertebral osteoporosis

  8. Lateral decubitus for treating pertrochanteric fractures using cephalomedullary nails

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    Elton João Nunes de Oliveira

    2015-08-01

    Full Text Available ABSTRACTOBJECTIVE: To perform a retrospective radiographic evaluation on the fracture reduction and implant position in the femoral head among patients with pertrochanteric fractures who had been treated using a cephalomedullary nail in lateral decubitus; and to assess factors that might interfere with the quality of the fracture reduction and with the implant position in using this technique. METHODS: Nineteen patients with a diagnosis of pertrochanteric fractures of the femur who had been treated using cephalomedullary nails in lateral decubitus were evaluated. For outpatient radiographic evaluations, we used the anteroposterior view of the pelvis and lateral view of the side affected. We measured the cervicodiaphyseal angle, tip-apex distance (TAD, spatial position of the cephalic element in relation to the head, and the bispinal diameter. To make an anthropometric assessment, we used the body mass index. Two groups of patients were created: one in which all the criteria were normal (TAD ≤25 mm, cervicodiaphyseal angle between 130° and 135° and cephalic implant position in the femoral head in the central-central quadrant; and another group presenting alterations in some of the criteria for best prognosis. RESULTS: Female patients predominated (57.9% and the mean age was 60 years. Seven patients presented a central-central cephalic implant position. One patient present a cervicodiaphyseal angle >135° and the maximum TAD was 32 mm; consequently, 12 patients presented some altered criteria (63.2%. None of the characteristics evaluated differed between the patients with all their criteria normal and those with some altered criteria, or showed any statistically significant association among them ( p> 0.05. CONCLUSION: The technique described here enabled good reduction and good positioning of the implant, independent of the anthropometric indices and type of fracture.

  9. Treatment outcomes of intertrochanteric femur fractures treated with DLT™ nail

    Directory of Open Access Journals (Sweden)

    Mehmet Arıcan

    2015-12-01

    Full Text Available Objective: Intramedullary nails frequently use in proximal femur fractures. In this study, 49 patients with intertrochanteric fractures were evaluated clinical and radiological results treated with dyna locking trochanteric (DLT™ nail retrospectively. Methods: Twenty-two (44.9% patients were male and 27 (55.1% patients were female. Mean age was 74.29±1.98 (28-99 years and Followed up for a mean of 14.35±3.43 (9-24 months. Thirty-seven (75.6% of the fractures resulted from simple falls while 6 (12.2% caused from traffic accidents and 6 (12.2% fall down from height. There were 24 (49.0% left and 25 (51.0% right lower extremities fractured. According to Orthopaedic Trauma Association classification system; 21 (42.9%, 21 (42.9% and 7 (14.2% fractures were classified as 31A1, 31A2, and 31A3 respectively. One (2.0% patient had claviculae fracture, 3 (6.1% patients had radius distal fracture and 1 (2.0% patient had total knee arthroplasty. After surgery, X-ray was used for radiological results and functional outcomes were evaluated according to the Harris hip scoring system. Results: The average waiting time for the surgery was 2.02±0.18 (1-7 days and hospitalization time was 6.23±0.29 (4-15 days. Mean fracture healing time was 11.74±1.82 (8-15 weeks. Three patients had screw cut-out in the follow-up time and performed hemiarthroplasty. The average Harris hip score was 88.02±1.21 (42-97 points and included 29 (59.2% excellent cases, 17 (34.7% good and 3 (6.1% poor. Conclusion: DLT ™ nail is a safe and successful method because of low complication rates, and capability of detection.

  10. Navicular stress fractures treated with minimally invasive fixation

    Directory of Open Access Journals (Sweden)

    Korula Mani Jacob

    2013-01-01

    Early intervention with minimally invasive surgery has significantly less morbidity and a reliable early return to active sports and is therefore the best option in high-performance athletes. Materials and Methods: Nine athletes with ten stress fractures of the navicular treated at our institution between April 1991 and October 2000. The mean age of the patients was 22.8 years (range 18-50 years. All patients were treated by minimally invasive screw fixation and early weight bearing mobilization without a cast. The average followup was 7 years (range 2-11 years. Results: Seven of the nine patients returned to their pre-fracture level of sporting activity at an average of 5 months (range 3-9 months. One patient returned to full sporting activity following a delay of 2 years due to an associated tibial stress fracture and one patient had an unsatisfactory result. Long term review at an average of 7 years showed that six of these eight patients who returned to sports remained symptom free with two patients experiencing minimal intermittent discomfort after prolonged activity. Conclusions: We recommend percutaneous screw fixation as a reliable, low morbidity procedure allowing early return to full sporting activity without long term complications or recurrences.

  11. Pediatric and adolescent intra-articular fractures of the calcaneus

    Directory of Open Access Journals (Sweden)

    Marcel Dudda

    2013-06-01

    Full Text Available Calcaneal fractures in childhood are very rare, whereas particularly intra-articular displaced fractures are not typical in skeletally immature children. Various techniques of osteosynthesis have been described. This study aimed to determine clinical and radiological outcome after surgical treatment of intra-articular calcaneal fractures. Fourteen intra-articular fractures of the calcaneus were included in this retrospective study. Eleven children (2 girls and 9 boys aged 6-16 years (average age 11.5 years underwent surgical treatment. One child sustained a Type II open fracture of both calcanei. All injuries occurred after a high-energy trauma; 3 patients had multiple additional fractures. The clinical and radiological postoperative follow up was an average 44 months. In 4 cases, a reduction through a minimally invasive approach and fixation with K-wires or screws could be achieved. Eleven fractures were treated with open reduction and internal fixation with plate osteosynthesis, K-wires or screws. In one case with open fractures of both heel bones, an additional external fixator was applied. The surgical treatment approach adopted enabled the pre-operative Boehler’s angle (average 16° to be improved to an average 30°. In all cases, except for the patient with open fractures, a good functional result and outcome could be achieved. In calcaneal fractures in childhood, anatomical reduction is the determining factor, as in fractures in adults, whereas the surgical technique seems to have no influence on clinical outcome in children. The wound healing problems that have often been described were not observed in this age group.

  12. Acute Lumbar Burst Fracture Treated by Minimally Invasive Lateral Corpectomy

    Directory of Open Access Journals (Sweden)

    Rodrigo Amaral

    2013-01-01

    Full Text Available Burst fractures in acute spinal traumas are a difficult problem to solve. Different approaches and techniques have been utilized, but with high incidence of morbidity and mortality, besides unsatisfactory clinical and radiological results. Mini-open approaches recently emerged and have been shown to be safe and effective in the treatment of several spinal conditions. Here we report a case of acute lumbar burst fracture at L2 treated by minimally invasive true lateral approach posteriorly instrumented with percutaneous pedicle screws. The minimum disruptive access in addition to a rigid construction allowed a lumbar corpectomy without the morbidity of standard open approaches, lowering surgery costs and accelerating the patient recovery with successfully clinical and radiological results.

  13. 外踝后穿支皮瓣修复跟骨骨折钢板内固定术后皮肤缺损%Lateral retrom alleo larperforator flap for repairing soft tissue defects after internal fixation of calcaneal fractures

    Institute of Scientific and Technical Information of China (English)

    张建华; 吴学建

    2014-01-01

    Objective To investigate the clinical effect of the lateral retrom alleo larperforator flap (sural nerve nutritional vessel axial flap) on repairing soft tissue defects after internal fixation of calcaneal fractures.Methods From March 2008 to September 2013,eight cases of the soft tissue defects were repaired by using lateral retrom alleo larperforator flap.Results All of the eight flaps survived.Specifically,the patients were follow-up for 6 to 30 month.It turned out that the appearance and function of the flaps had good recovery.No chronic infection developed during the period.Conclusions Lateral retrom alleo larperforator flap has good repair effect on the reconstruction of the soft tissue defects after internal fixation of calcaneal fractures.%目的 探讨外踝后穿支皮瓣(腓动脉终末穿支蒂腓肠神经营养血管皮瓣)修复跟骨骨折钢板内固定术后皮肤缺损的临床效果.方法 2008年3月至2013年9月对8例跟骨骨折钢板内固定患者术后的皮肤缺损采用外踝后穿支皮瓣修复.结果 术后8例皮瓣全部成活,术后随访时间6~30个月,皮瓣外观及功能恢复良好,无创面再坏死、裂开、感染等情况出现.结论 外踝后穿支皮瓣修复跟骨骨折钢板内固定术后皮肤缺损获得良好的修复效果.

  14. Fatigue Fracture of the Calcaneus: From Early Diagnosis to Treatment: A Case Report of a Triathlon Athlete.

    Science.gov (United States)

    Serrano, Simão; Figueiredo, Pedro; Páscoa Pinheiro, João

    2016-06-01

    Stress fractures are frequently underdiagnosed and undertreated despite being common in sports. Early diagnosis is crucial; therefore, a high index of clinical suspicion is required. Complementary examinations are essential for diagnosis and follow-up. The authors report a clinical case of a young adult triathlon athlete referring mechanical pain in the rear left foot, with 2 weeks' progression. An earlier increase in daily training intensity was recorded. Complementary examinations confirmed a calcaneal fatigue fracture. Immobilization and no weight bearing were introduced for an initial period of 4 weeks, and the rehabilitation process was started. Progressive weight bearing was introduced between fourth and eighth weeks. Sports activity started at the 12th week. Boundaries to sports activity were eliminated by the 24th week, without pain or functional limitation. Repetitive overload to the heel and intense axial weight bearing in association to repetitive concentric/eccentric gastrocnemius contraction are related to calcaneal stress fracture, the second most common stress fracture in the foot. Calcaneal stress fractures can be adequately treated with activity modification, without casting or surgical intervention. When in the presence of bilateral stress fractures, metabolic and nutritional issues must be considered. The case report highlights the importance of sports medicine examination for detecting intrinsic and extrinsic fatigue fracture risk factors. PMID:26945212

  15. A new device to treat intra-capsular fracture neck of femur non-union

    OpenAIRE

    Mukherjee, P.; Ashworth, M. J.

    2010-01-01

    In adolescents and young adults, femoral neck fractures often result from high-velocity trauma. These fractures are usually of vertical shear pattern. There is an increased incidence of avascular necrosis and non-union, which is difficult to treat. Non-union of fractured neck of femur in young adults is a serious problem. There is growing evidence that these fractures should be treated with an angle-stable device to improve biomechanics at the fracture site. An ideal implant should prevent va...

  16. Calcaneal tendon: imaging findings; Tendao calcaneo: avaliacao por imagem

    Energy Technology Data Exchange (ETDEWEB)

    Montandon, Cristiano; Fonseca, Cristiano Rezio; Montandon Junior, Marcelo Eustaquio [Colegio Brasileiro de Radiologia e Diagnostico por Imagem, Sao Paulo, SP (Brazil)]. E-mail: crismontandon@hotmail.com; Lobo, Leonardo Valadares; Ribeiro, Flavia Aparecida de Souza; Teixeira, Kim-Ir-Sen Santos [Goias Univ., Goiania, GO (Brazil). Hospital de Clinicas. Dept. de Diagnostico por Imagem e Anatomia Patologica

    2003-12-01

    We reviewed the radiological and clinical features of 23 patients with calcaneal tendon diseases, who were submitted to ultrasound or magnetic resonance imaging. The objective of this study was to characterize the lesions for a precise diagnosis of calcaneal tendon injuries. A wide range of calcaneal tendon diseases include degenerative lesions, inflammation of the peritendinous tissue such as peritendinitis and bursitis, and rupture. Imaging methods are essential in the diagnosis, treatment and follow-up of calcaneal tendon diseases. (author)

  17. Do we really need radiographic assessment for the diagnosis of non-specific heel pain (calcaneal apophysitis) in children?

    Energy Technology Data Exchange (ETDEWEB)

    Kose, Ozkan [Diyarbakir Education and Research Hospital, Orthopaedics and Traumatology Clinic, Diyarbakir (Turkey); Diclekent Bulvari, Ataslar Serhat Evleri, Diyarbakir (Turkey)

    2010-04-15

    Non-specific heel pain (calcaneal apophysitis) is a common disorder, particularly in physically active growing children. Foot radiographs are usually obtained as part of the clinical evaluation in routine orthopaedic practice. However, there is still controversy about the specific findings on radiographs, and it is unclear what information is present on radiographs that may alter the diagnosis and management. The purpose of this study was to review a consecutive series of patients with the diagnosis of calcaneal apophysitis to assess the yield of routine radiographs of the foot. A prospective study was performed on 61 consecutive patients with a diagnosis of calcaneal apophysitis in a single-surgeon practice. Standard anteroposterior and lateral weight-bearing foot radiographs were obtained for each patient. Seventy-one sets of foot radiographs were reviewed to determine whether radiographs had an impact on diagnosis and management. Patients with antecedent trauma, penetrating injury, foot deformity, achilles tendonitis, bursitis and infections were excluded from the study. Seventy foot radiographs were considered to be normal. The radiographs changed the diagnosis in only one patient, in whom a simple bone cyst of the calcaneous was seen. Calcaneal apophysitis is a self-limiting disease, and patients can be treated conservatively. Neither the sclerosis nor the fragmentation of the apophysis could be used to establish the diagnosis of calcaneal apophysitis. Therefore, obtaining radiographs as an initial step in their evaluation does not seem to be justified. (orig.)

  18. Outcomes of the distal intraarticular humeral fractures treated by olecranon osteotomy

    OpenAIRE

    Erhan Yılmaz; Mehmet Bulut

    2009-01-01

    Objectives: To evaluate the management and outcome of intraarticular fractures of the distal humerus treated by open reduction and internal fixation using the olecranon osteotomy technique. Materials and methods: Twenty-one patients with in-traarticular fractures of the distal humerus were treated by open reduction and internal fixation. The mean age of the patients was 41.6 years and the mean follow-up pe-riod was 25.3 months. All fractures were type C accord-ing to the AO/ASIF fracture clas...

  19. Interventions for treating proximal humeral fractures in adults

    DEFF Research Database (Denmark)

    Handoll, Helen H G; Brorson, Stig

    2015-01-01

    harms) of treatment and rehabilitation interventions for proximal humeral fractures in adults. SEARCH METHODS: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and other databases, conference...

  20. Surgical prosthetic splints as an adjunct in treating facial fractures.

    Science.gov (United States)

    Jackson, M J; Wetmore, S J

    1980-01-01

    Surgical splints are a valuable adjunct in managing certain mandible and maxillary fractures. Of the various splint materials, acrylic is the easiest, fastest, and least expensive. Acrylic splints are rigid, strong, easily adjusted and repaired, translucent, lightweight, and tolerated well by the oral mucosa. Splints are beneficial not only in the edentulous adult, but also in the child with deciduous dentition and in the patient with a partial dentition. Splints are helpful in managing fractures of the symphysis, parasymphyseal region, body, and alveolar ridges of the mandible, sagittal fractures of the hard palate, and severely comminuted mandible fractures. Construction of acrylic splints is simple and rapid if the surgeon uses the services of a dentist or a dental laboratory. PMID:7352891

  1. Epidemiological analysis of mandibular fractures treated in Sao Paulo, Brazil

    Directory of Open Access Journals (Sweden)

    Kelly Marinho

    2015-10-01

    Conclusion: The treatment of mandibular fractures should be aimed at restoring the occlusion and mastication function, with surgery being the most indicated treatment, using reduction and internal fixation with the use of a plates and screws system based on the experience of the authors. Knowledge of surgical techniques and methods of reduction and fixation of fractures, and periodic monitoring allow these patients to receive the appropriate treatment.

  2. Traumatic spinal fracture treated by vertebroplasty: a case report

    Directory of Open Access Journals (Sweden)

    Tender Gabriel

    2012-11-01

    Full Text Available Abstract Introduction Surgical treatment for lumbar burst fractures is complex and typically involves either a retroperitoneal corpectomy and/or a posterior pedicle screw fixation. We describe the case of a patient with a lumbar burst fracture who was cured via a less invasive approach that has not been previously reported as standalone treatment. Case presentation This 25-year-old Caucasian man presented with excruciating axial low back pain exacerbated by any attempt to elevate the head of the bed after a motor vehicle accident. Computed tomography demonstrated a burst L4 fracture without spinal canal compromise. The patient underwent a bilateral vertebroplasty with an injectable polymer that mimics cortical bone. Postoperatively, the patient was progressively mobilized in a thoracolumbar spinal orthosis brace without any recurrence of pain. Postoperative computed tomography showed no loss of height in the L4 vertebral body. At one-year postoperatively, the patient was symptom free and the computed tomography scan showed good fracture healing. Conclusion Retroperitoneal corpectomy and/or posterior multi-segment fixation for lumbar burst fractures without neural compression in young patients are associated with loss of mobility and potential future adjacent level disease. Our limited vertebroplasty intervention with close postoperative clinical monitoring has not been previously described as standalone treatment, and it offers the advantages of less operative morbidity and maintenance of lumbar mobility in selected patients.

  3. Precise and feasible measurements of lateral calcaneal lengthening osteotomies by radiostereometric analysis in cadaver feet

    DEFF Research Database (Denmark)

    Martinkevich, P; Rahbek, Ole; Møller-Madsen, B;

    2015-01-01

    OBJECTIVES: Lengthening osteotomies of the calcaneus in children are in general grafted with bone from the iliac crest. Artificial bone grafts have been introduced, however, their structural and clinical durability has not been documented. Radiostereometric analysis (RSA) is a very accurate and...... precise method for measurements of rigid body movements including the evaluation of joint implant and fracture stability, however, RSA has not previously been used in clinical studies of calcaneal osteotomies. We assessed the precision of RSA as a measurement tool in a lateral calcaneal lengthening...... poorly dispersed markers. Precision was assessed as systematic bias and 95% repeatability limits. RESULTS: Systematic bias was generally below 0.10 mm for translations. Precision of migration measurements was below 0.2 mm for translations in the osteotomy. CONCLUSION: RSA is a precise tool for the...

  4. Fracture risk in perimenopausal women treated with beta-blockers

    DEFF Research Database (Denmark)

    Rejnmark, Lars; Vestergaard, Peter; Kassem, Moustapha;

    2004-01-01

    beta2-Adrenergic receptors have been identified on human osteoblastic and osteoclastic cells, raising the question of a sympathetic regulation of bone metabolism. We investigated effects of treatment with beta-adrenergic receptor antagonists (beta-blockers) on bone turnover, bone mineral density...... (BMD), and fracture risk. Within the Danish Osteoporosis Prevention Study (DOPS) a population based, comprehensive cohort study of 2016 perimenopausal women, associations between treatment with beta-blockers and bone turnover and BMD were assessed in a cross-sectional design at the start of study....... Moreover, in a nested case-control design, fracture risk during the subsequent 5 years was assessed in relation to treatment with beta-blockers at baseline. Multiple regression- and logistic regression-analyses were performed. Treatment with beta-blockers was associated with a threefold increased fracture...

  5. Effect of amalgam cuspal coverage on the fracture resistance of endodontically treated teeth

    OpenAIRE

    Mahshid Mohammdi Basir; Elham Tabatabai Ghomsheh; Abbas Azari; Zahra Malek Hosseini; Majid Vahdati Far

    2013-01-01

      Background and Aims: Endodontically treated teeth are prone to fracture because they loose a big amount of their structure. The treatment plan of those teeth is completed when they are rehabilitated with a strong and functional restoration. The purpose of this study was to evaluate the fracture resistance of endodontically treated teeth restored with amalgam cuspal coverage in comparison with other restorative techniques.   Materials and Methods: 40 human healthy maxillary premolars were di...

  6. Effects of a training program after surgically treated ankle fracture: a prospective randomised controlled trial

    OpenAIRE

    Ekdahl Charlotte S; Jonsson Kjell; Nilsson Gertrud M; Eneroth Magnus

    2009-01-01

    Abstract Background Despite conflicting results after surgically treated ankle fractures few studies have evaluated the effects of different types of training programs performed after plaster removal. The aim of this study was to evaluate the effects of a 12-week standardised but individually suited training program (training group) versus usual care (control group) after plaster removal in adults with surgically treated ankle fractures. Methods In total, 110 men and women, 18-64 years of age...

  7. Fracture Resistance and Failure Mode of Endodontically Treated Premolars Restored with Different Adhesive Restorations

    Directory of Open Access Journals (Sweden)

    Nasrin Sarabi

    2015-03-01

    Full Text Available Introduction: The restoration of endodontically treated teeth is a topic that has been studied extensively but it is still a challenge for dental practitioners. The aim of this study was to evaluate fracture resistance, fracture patterns and fracture location of endodontically treated human maxillary premolars restored with direct and indirect composite resin and ceramic restoration. Methods: Eighty non-carious maxillary premolars were selected and divided into four groups (n=20. Endodontic treatment and mesio-occluso-distal preparations were carried out in all the groups except for the control group (group I. Subsequently, the prepared teeth were restored as follows: group II: indirect composite restoration; group III: ceramic restoration; group IV: direct composite restoration. The specimens were subjected to compressive axial loading until fracture occurred. The mode of failure was also recorded. Results: Group I had higher fracture resistance (1196.82±241.74 than the other groups (P

  8. An interdisciplinary approach to treat crown-root-fractured tooth

    Directory of Open Access Journals (Sweden)

    Ying Chun Sun

    2013-01-01

    Full Text Available Restoration of a crown-root subgingival fractured tooth, especially at anterior aesthetic zones is still a great challenge for restorative dentists. Crown lengthening procedure alone has the disadvantage of high gingival curve of the final restoration, which was not discontinuous to adjacent teeth and thus compromise cosmetic outcomes. The objective of this report is to display a new interdisciplinary approach which combining endodontic root canal treatment, orthodontic extrusion, periodontal crown lengthening surgery and prosthodontic post-core-crown restoration procedures to restore a crown-root subgingival fractured maxillary central incisor and achieved a satisfied cosmetic result. Computer-based spectrophotometer was also used to accurately select colour without objective interference to achieve ideal cosmetic effects.

  9. An interdisciplinary approach to treat crown-root-fractured tooth

    OpenAIRE

    Ying Chun Sun; Ying Li; Jian Tong; Ping Gao

    2013-01-01

    Restoration of a crown-root subgingival fractured tooth, especially at anterior aesthetic zones is still a great challenge for restorative dentists. Crown lengthening procedure alone has the disadvantage of high gingival curve of the final restoration, which was not discontinuous to adjacent teeth and thus compromise cosmetic outcomes. The objective of this report is to display a new interdisciplinary approach which combining endodontic root canal treatment, orthodontic extrusion, periodontal...

  10. Numerical Fracture Analysis of Cryogenically Treated Alloy Steel Weldments

    Science.gov (United States)

    Rasool Mohideen, S.; Thamizhmanii, S.; Fatah, M. M. Muhammed Abdul; Saidin, W. Najmuddin W.

    2016-02-01

    Cryogenic treatment is being used commercially in the industries in the last two decades for improving the life of many engineering component such as bearings and cutting tools. Though their influence in improving the wear resistance of tool materials is well established, the effect of treatment on weldments is not much investigated. In the present work, a two dimensional finite element analysis was carried out on the compact tension specimen model for simulating the treatment process and to study the fracture behaviour. The weldments were modelled by thermo- mechanical coupled field analysis for simulating he temperature distribution in the model during weld pool cooling and introducing thermal stresses due to uneven contraction and cooling. The model was subjected to cryogenic treatment by adopting radiation effect. The fracture analysis was carried out using Rice's J- Integral approach. The analysis produced a similar outcome of experimental results i.e. Increase in the fracture toughness of the specimen after cryogenic treatment in the heat affected zone of weldment.

  11. Fracture behaviour of a magnesium–aluminium alloy treated by selective laser surface melting treatment

    International Nuclear Information System (INIS)

    Highlights: • β-Mg17Al12 presents fragile fracture behavior decreasing the ductility of AZ91D. • SLSM treatment only modifies the β-Mg17Al12 phase whilst α-Mg remains unaltered. • In-situ SEM bending test allows to observe and data record of the crack propagation. • Eutectic microestructure of modified β-phase presents ductile fracture behaviour. • Fracture toughness of laser treated specimen is 40% greater than as-received alloy. - Abstract: Fracture behaviour of AZ91D magnesium alloy is dominated by the brittle fracture of the β-Mg17Al12 phase so its modification is required to improve the toughness of this alloy. The novel laser treatment named as Selective Laser Surface Melting (SLSM) is characterized by the microstructural modification of the β-Mg17Al12 phase without altering the α-Mg matrix. We have studied the effect of the selected microstructural modification induced by the laser treatment in the fracture behaviour of the alloy has been studied using in situ Scanning Electron Microscopy bending test. This test configuration allows the in situ observation of the crack progression and the record of the load–displacement curve. It has been observed that the microstructural modification introduced by SLSM causes an increase of 40% of the fracture toughness of the treated specimen. This phenomenon can be related with the transition from brittle to ductile fracture behaviour of the laser modified β-phase

  12. Fracture analysis of cement treated demolition waste using a lattice model

    NARCIS (Netherlands)

    Xuan, D.; Schlangen, H.E.J.G.; Molenaar, A.A.A.; Houben, L.J.M.

    2013-01-01

    Fracture properties of cement treated demolition waste were investigated using a lattice model. In practice the investigated material is applied as a cement treated road base/subbase course. The granular aggregates used in this material were crushed recycled concrete and masonry. This results in six

  13. Effect of amalgam cuspal coverage on the fracture resistance of endodontically treated teeth

    Directory of Open Access Journals (Sweden)

    Mahshid Mohammdi Basir

    2013-05-01

    Full Text Available   Background and Aims: Endodontically treated teeth are prone to fracture because they loose a big amount of their structure. The treatment plan of those teeth is completed when they are rehabilitated with a strong and functional restoration. The purpose of this study was to evaluate the fracture resistance of endodontically treated teeth restored with amalgam cuspal coverage in comparison with other restorative techniques.   Materials and Methods: 40 human healthy maxillary premolars were divided into 4 groups: group1 (S: sound teeth, group 2(Co: endodontically treated teeth with MOD cavity restored with bonding and composite, group 3(Am-B: endodontically treated teeth with MOD cavity restored with bonding and amalgam and group 4 (Am-CC: endodontically treated teeth with MOD cavity restored with amalgam cuspal coverage. Then the restorations were stored in water and room temperature for 100 days at then thermocycled for 500 cycles between water baths at (5.5 ± 1 and (55 ± 1 0 C. The fracture resistance was evaluated by universal testing machine (Instron, 1195 UK with the compressive force of about 2000 N in 0.5 mm/min. The fracture modes were evaluated in four groups by a stereomicroscope. Statistical analysis (Scheffe test was done for all groups (P0.05. The lowest fracture resistance was found in group 2 (Co (384 ± 137.4 N that had no significant difference with group 3 (Am-B (P>0.05. The fracture resistance in group 4 was significantly higher than group 2 (Co and 3 (Am-B. The fracture mode in group 1 was cohesive within tooth and in group 2 (Co and 3 (Am-B was mixed cohesive and adhesive, and in group 4 was cohesive within in restorative material.   Conclusion: The highest fracture resistance was found in teeth that received amalgam cuspal coverage.

  14. Avaliação biomecânica das fraturas intra-articulares do calcâneo e sua correlação clínica radiográfica Biomechanical evaluation of intra articular calcaneal fracture and clinical radiographic correlation

    Directory of Open Access Journals (Sweden)

    Marcos Emilio Kuschnaroff Contreras

    2004-06-01

    Full Text Available O presente estudo teve o objetivo de oferecer uma avaliação clínica, radiográfica e biomecânica de pacientes com fratura intraarticular de calcâneo, submetidos à redução aberta e fixação interna. A amostra consistiu em 22 pacientes, 20 do sexo masculino e dois do sexo feminino, com idade média de 40,95 (± 11,63 anos. Os autores realizaram avaliações radiográficas do ângulo de Böhler e Gissane, no pré e no pós-operatório, além de utilizarem a tomografia computadorizada para avaliação da classificação de Sanders. A avaliação da Distribuição da Pressão Plantar foi realizada pelo sistema F-scan. Os resultados clínicos encontrados foram satisfatórios apresentando, pontuação média de 75,5 no critério da AOFAS.. A redução cirúrgica resultou em uma melhora dos ângulos de Böhler e Gissane. O estudo mostrou diferenças estatisticamente significantes entre o antepé o retropé fraturados no que tange sobre a área de contato, pressão e força de reação do solo. Os valores encontrados para estes parâmetros foram maiores no retropé que no antepé fraturados. A trajetória de Pressão (COP foi menor no pé fraturado que no pé normal. Encontrou-se correlação entre o Ângulo de Gissane após a redução e o Segundo Pico de Força, indicando que quanto melhor a redução deste ângulo , melhor a impulsão. Também encontrou-se a correlação entre a pontuação AOFAS e o Primeiro Pico de Força, mostrando que quanto melhor o resultado clínico melhor o apoio do retropé.The present study had an objective to perfom a clinical, radiographic and biomechanical evaluation in patients with calcaneal fractures submitted to open reduction with internal fixation. The sample consisted of 22 patients - 20 male and 2 female with an average age of 40,95 (±11,63 years old. The authors have done radiographic evaluation of the pre and post operatory of Böchler and Gissane angles; furthermore, they used a CT scanning for Sander

  15. Acoustic Emission Methodology to Evaluate the Fracture Toughness in Heat Treated AISI D2 Tool Steel

    Science.gov (United States)

    Mostafavi, Sajad; Fotouhi, Mohamad; Motasemi, Abed; Ahmadi, Mehdi; Sindi, Cevat Teymuri

    2012-10-01

    In this article, fracture toughness behavior of tool steel was investigated using Acoustic Emission (AE) monitoring. Fracture toughness ( K IC) values of a specific tool steel was determined by applying various approaches based on conventional AE parameters, such as Acoustic Emission Cumulative Count (AECC), Acoustic Emission Energy Rate (AEER), and the combination of mechanical characteristics and AE information called sentry function. The critical fracture toughness values during crack propagation were achieved by means of relationship between the integral of the sentry function and cumulative fracture toughness (KICUM). Specimens were selected from AISI D2 cold-work tool steel and were heat treated at four different tempering conditions (300, 450, 525, and 575 °C). The results achieved through AE approaches were then compared with a methodology proposed by compact specimen testing according to ASTM standard E399. It was concluded that AE information was an efficient method to investigate fracture characteristics.

  16. Sacral Fracture Nonunion Treated by Bone Grafting through a Posterior Approach

    Directory of Open Access Journals (Sweden)

    Sang Yang Lee

    2013-01-01

    Full Text Available Nonunion of a sacral fracture is a rare but serious clinical condition which can cause severe chronic pain, discomfort while sitting, and significant restriction of the level of activities. Fracture nonunions reportedly occur most often after nonoperative initial treatment or inappropriate operative treatment. We report a case of fracture nonunion of the sacrum and pubic rami that resulted from non-operative initial treatment, which was treated successfully using bone grafting through a posterior approach and CT-guided percutaneous iliosacral screw fixation combined with anterior external fixation. Although autologous bone grafting has been the gold standard for the treatment of pelvic fracture nonunions, little has been written describing the approach. We utilized a posterior approach for bone grafting, which could allow direct visualization of the nonunion site and preclude nerve root injury. By this procedure, we were able to obtain the healing of fracture nonunion, leading to pain relief and functional recovery.

  17. Interobserver evaluation of TLICS system to treat thoracolumbar fractures

    Directory of Open Access Journals (Sweden)

    Bernardo José Moreira Chaves

    2015-06-01

    Full Text Available OBJECTIVE: To evaluate the interobserver agreement regarding the TLICS Classification (Thoracolumbar Injury Classification and Severity Score. Furthermore, evaluate the reliability, analyzing the correlation between the treatment indicated by TLICS system (surgical or conservative and the treatment indicated by each evaluator surgeon.METHODS: Imaging tests and clinical data of 22 patients with thoracolumbar fractures were analyzed by eight spine surgeons, and two main analyzes were performed: the first compared the interobserver agreement related to TLICS and the second compared the agreement between the treatment indicated by TLICS classification (surgical or conservative and treatment indicated by each surgeon - based on his personal experience and the preferred classification.RESULTS: Using the parameters of Landis and Koch for interpretation of Kappa value, the interobserver agreement of TLICS classification was considered moderate in our study (K=0.6. The agreement between the indications of treatment (surgical or conservative dictated by the classification and the indication of each surgeon was considered excellent, with kappa value of 0.89.CONCLUSION: We believe that the classification is a good tool for the evaluation and the treatment indication in thoracolumbar fractures.

  18. Atypical femoral fracture in an osteogenesis imperfecta patient successfully treated with teriparatide

    DEFF Research Database (Denmark)

    Holm, Jakob; Eiken, Pia; Hyldstrup, Lars; Jensen, Jens-Erik Beck

    2014-01-01

    OBJECTIVE: We report a case of a successfully healed atypical femoral fracture (AFF) following treatment with teriparatide in a patient with osteogenesis imperfecta (OI). To our knowledge, no successful treatment of AFFs with teriparatide in this subpopulation has ever been described. METHODS: This...... is a case report of an AFF treated with teriparatide. RESULTS: The patient was treated with hormone replacement therapy for 18 years and bisphosphonates for 9 years before suffering a spontaneous AFF in the form of a dislocated noncomminute transverse fracture of the right femoral shaft, and an open...... reduction and internal fixation (ORIF) with a T2 Femoral Nail was done. Due to nonunion and another fracture distal to the nail, the patient was reoperated on with exchange ORIF and off-label treatment with teriparatide 20 μg/day was started. An X-ray 1 month later showed early signs of fracture healing. A...

  19. The value of calcaneal bone mass measurement using a dual X-ray laser calscan device in risk screening for osteoporosis

    Directory of Open Access Journals (Sweden)

    Gulseren Kayalar

    2009-01-01

    Full Text Available OBJECTIVE: To evaluate how bone mineral density in the calcaneus measured by a dual energy X-ray laser (DXL correlates with bone mineral density in the spine and hip in Turkish women over 40 years of age and to determine whether calcaneal dual energy X-ray laser variables are associated with clinical risk factors to the same extent as axial bone mineral density measurements obtained using dual energy x-ray absorbtiometry (DXA. MATERIALS AND METHODS: A total of 2,884 Turkish women, aged 40-90 years, living in Ankara were randomly selected. Calcaneal bone mineral density was evaluated using a dual energy X-ray laser Calscan device. Subjects exhibiting a calcaneal dual energy X-ray laser T- score <-2.5 received a referral for DXA of the spine and hip. Besides dual energy X-ray laser measurements, all subjects were questioned about their medical history and the most relevant risk factors for osteoporosis. RESULTS: Using a T-score threshold of -2.5, which is recommended by the World Health Organization (WHO, dual energy X-ray laser calcaneal measurements showed that 13% of the subjects had osteoporosis, while another 56% had osteopenia. The mean calcaneal dual energy X-ray laser T-score of postmenopausal subjects who were smokers with a positive history of fracture, hormone replacement therapy (HRT, covered dressing style, lower educational level, no regular exercise habits, and low tea consumption was significantly lower than that obtained for the other group (p<0.05. A significant correlation was observed between the calcaneal dual energy X-ray laser T-score and age (r=-0.465, p=0.001, body mass index (BMI (r=0.223, p=0.001, number of live births (r=-0.229, p=0.001, breast feeding time (r=-0.064, p=0.001, and age at menarche (r=-0.050, p=0.008. The correlations between calcaneal DXL and DXA T-scores (r=0.340, p=0.001 and calcaneal DXL and DXA Z-scores (r=0.360, p=0.001 at the spine, and calcaneal DXL and DXA T- scores (r=0.28, p=0.001 and calcaneal

  20. Outcome of open reduction and internal fixation of volar barton fracture treated with buttress plate

    International Nuclear Information System (INIS)

    Objective: To assess the outcome of volar Barton fracture treated with T-plate and locking plate. Methodology: From December 2011 to August 2014, prospective case series study was conducted at the Department of Orthopaedic Surgery, Dow University of Health Sciences/Civil Hospital, Karachi and included 45 patient of volar Barton fracture treated with buttress plate and locking plate. Colles fracture, dorsal barton and comminuted intraarticular fractures were excluded from the study. Results: Out of 45 patients, 33(73%) were male and 12(27%) female, Age ranged from 20 to 50 years. 17(38%) had fall and 28(62%) road traffic accident. 7(16%) patients were treated with locking plates and 38(84%) with T- buttress plate. Functional outcome was assessed on the basis of modified clinical staging system of Green and O'Brien, which showed excellent result in 20(44%) patient, good in 16(36%), fair in 7(16%), and poor in 2(4%) patients. Volar Barton fracture was associated with concomitant injuries, especially in trauma patients, 4(27%) had mid shaft femur fracture, 2(13%) scaphoid fracture, 4(27%) metacarpals and 5(33%) ulnar styloid fractures. With 9 months follow up, union was observed in all patients within 8 to 12 weeks. Conclusion: volar Barton fractures are unstable injuries; chances of displacement after closed reduction are high. So we recommend open reduction and internal fixation with T- buttress plate or locking plate to get the excellent functional outcome. (author)

  1. Cost implications of the physiotherapy management of complex tibial fractures treated with circular frames

    OpenAIRE

    Barron, E; Rambani, R; Bailey, H; H. K. Sharma

    2013-01-01

    Seventy-three consecutive patients with complex tibial fractures treated with an Ilizarov frame or Taylor Spatial Frame received physiotherapy between April 2008 and April 2010. Data were collected prospectively, and physiotherapy input was recorded (in minutes) for the patients identified. This included treatment received as an inpatient as well as an outpatient. The data were categorized for proximal, middle and distal third tibial fractures for analysis. The average cost of physiotherapy f...

  2. Retrospective review of 234 scaphoid fractures and nonunions treated with arthroscopy for union and complications.

    Science.gov (United States)

    Slade, J F; Gillon, T

    2008-01-01

    The purpose of this paper is to retrospectively review 234 consecutive cases of scaphoid fractures and nonunions treated using arthroscopy with the dorsal percutaneous implantation of a headless compression screw for healing and complications. Solid union of fracture is determined by CT scan. We identified 126 acute injuries, including 65 proximal pole fractures; 67 grossly displaced fractures; 12 trans-scaphoid perilunate dislocations including four trans-scaphoid trans-capitate fractures; and ten combined scaphoid and distal radius fractures. 108 scaphoid nonunions were identified. 98 were correctly aligned and ten had a humpback deformity which was correctable using arthroscopic assisted reduction techniques at the time of surgery. 82 presented with a fracture gap 2mm or greater requiring percutaneous bone grafting. 12 cases of avascular necrosis (AVN) were identified by MRI. 20 nonunions had surgery performed at other institutions. The mean time to surgery for the nonunions was 20 months. 99% union rate of acute scaphoid fractures was obtained by 12 weeks, as determined by CT scan. Two complications were identified (3%). One case of delayed healing was identified. this delayed union was treated with percutaneous bone grafting and continued on to heal uneventfully. The other complication was a case of volar trans-scaphoid peri-lunate dislocation. While the fracture healed, the patient developed a traumatic dislocation requiring a capitate-lunate arthrodesis. Treatment of scaphoid nonunions resulted in ten cases of delayed healing, which were treated with repeat percutaneous bone grafting. This represented a 9% complication rate. of the ten cases of delayed unions that were re-bone grafted, four failed to heal by nine months. This resulted in a 96% union rate of our nonunion group by nine months. when acute fracture healing was compared to nonunions the average healing of acute fractures as determined by CT scanning measuring trabecular bridging was 12 weeks

  3. Fracture resistance of endodontically treated teeth restored with a bulkfill flowable material and a resin composite

    Science.gov (United States)

    Isufi, Almira; Plotino, Gianluca; Grande, Nicola Maria; Ioppolo, Pietro; Testarelli, Luca; Bedini, Rossella; Al-Sudani, Dina; Gambarini, Gianluca

    2016-01-01

    Summary Aim To determine and compare the fracture resistance of endodontically treated teeth restored with a bulk fill flowable material (SDR) and a traditional resin composite. Methods Thirty maxillary and 30 mandibular first molars were selected based on similar dimensions. After cleaning, shaping and filling of the root canals and adhesive procedures, specimens were assigned to 3 subgroups for each tooth type (n=10): Group A: control group, including intact teeth; Group B: access cavities were restored with a traditional resin composite (EsthetX; Dentsply-Italy, Rome, Italy); Group C: access cavities were restored with a bulk fill flowable composite (SDR; Dentsply-Italy), except 1.5 mm layer of the occlusal surface that was restored with the same resin composite as Group B. The specimens were subjected to compressive force in a material static-testing machine until fracture occurred, the maximum fracture load of the specimens was measured (N) and the type of fracture was recorded as favorable or unfavorable. Data were statistically analyzed with one-way analysis of variance (ANOVA) and Bonferroni tests (Pendodontically treated teeth restored with a traditional resin composite and with a bulk fill flowable composite (SDR) was similar in both maxillary and mandibular molars and showed no significant decrease in fracture resistance compared to intact specimens. Conclusions No significant difference was observed in the mechanical fracture resistance of endodontically treated molars restored with traditional resin composite restorations compared to bulk fill flowable composite restorations. PMID:27486505

  4. Atrial fibrillation in fracture patients treated with oral bisphosphonates

    DEFF Research Database (Denmark)

    Abrahamsen, B; Eiken, P; Brixen, K

    2009-01-01

    OBJECTIVES: To determine if patients receiving oral bisphosphonates are at excess risk of atrial fibrillation (AF), stroke and myocardial infarction. DESIGN: Register-based restricted cohort study. SETTING: National Hospital Discharge Register and National Prescriptions Database (1995-2005). SUBJ......OBJECTIVES: To determine if patients receiving oral bisphosphonates are at excess risk of atrial fibrillation (AF), stroke and myocardial infarction. DESIGN: Register-based restricted cohort study. SETTING: National Hospital Discharge Register and National Prescriptions Database (1995...... proportional to adherence. There was no increased risk of ischaemic stroke and an increased risk of myocardial infarction was not significant after adjustment for comorbidity. CONCLUSIONS: The increased occurrence of AF in fracture patients who are users of oral bisphosphonates should be attributed to...

  5. Interventions for treating proximal humeral fractures in adults

    DEFF Research Database (Denmark)

    Handoll, Helen H G; Brorson, Stig

    2015-01-01

    harms) of treatment and rehabilitation interventions for proximal humeral fractures in adults. SEARCH METHODS: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, and other databases, conference...... review authors performed independent study selection, risk of bias assessment and data extraction. Only limited meta-analysis was performed. MAIN RESULTS: We included 31 heterogeneous RCTs (1941 participants). Most of the 18 separate treatment comparisons were tested by small single-centre trials. The...... displacement and non-union (2/52 versus 1/54; 2 trials).One quasi-randomised trial (28 participants) found the Gilchrist-type sling was generally more comfortable than the Desault-type sling (body bandage). One trial (48 participants) testing pulsed electromagnetic high-frequency energy provided no evidence...

  6. The outcome of surgically treated traumatic unstable pelvic fractures by open reduction and internal fixation

    Directory of Open Access Journals (Sweden)

    Keykhosro Mardanpour

    2013-07-01

    Full Text Available BACKGROUND: This study was performed to evaluate functional and radiological results of pelvic ring fractures treatment by open reduction and internal fixation. METHOD: Thirty eight patients with unstable pelvic fractures, treated from 2002 to 2008 were retrospectively reviewed. The mean patients’ age was 37 years (range 20 to 67. Twenty six patients were men (4patients with type B and 22 patients with type C fracture and 12 women (7 patients with type B and 5 patients with type C fracture. The commonest cause was a road traffic accident (N=37, about 97%. Internal fixation was done by plaque with ilioinguinal and kocher-langenbeek approaches for anterior, posterior pelvic wall and acetabulum fracture respectively. Quality of reduction was graded according to Majeed score system. RESULTS: There were 11 type-C and 27 type-B pelvic fractures according to Tile’s classification. Thirty six patients sustained additional injuries. the commonest additional injury was lower extremity fracture. The mean follow-up was 45.6 months (range 16 to 84 months.The functional outcome was excellent in 66%, good in 15%, fair in 11% and poor in 7% of the patients with type B pelvic fractures and functional outcome was excellent in 46%, good in 27%, fair in 27% and poor in 0% of the patients with type C pelvic fractures. There were four postoperative infections. No sexual functional problem was reported. Neurologic problem like Lateral cutaneous nerve of thigh injury recovered completely in 2 patients and partially in 2 patients. There was no significant relation between functional outcome and the site of fracture (P greater than 0.005. CONCLUSION: Unstable pelvic ring fracture injuries should be managed surgically by rigid stabilization. It must be carried out as soon as the general condition of the patient permits, and even up to two weeks

  7. Outcome after open reduction and internal fixation of intraarticular fractures of the calcaneum without the use of bone grafts

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    Pendse Aniruddha

    2006-01-01

    Full Text Available Background: Intraarticular fractures of calcaneum are commenest type of calcaneal fractures. Lots of controversies exist about the ideal management for them. The focus is now shifting on operative management by open reduction and internal fixation for these fractures with or without the use of bone grafts. Method: Thirty intraarticular fractures classified by Essex Lopresti radiological classification, were treated by open reduction and fixation. The patients were followed over a mean period of 30 months (25-40 months. Results: All the fractures united at a mean duration of 14 weeks. 86% patients had excellent functional outcome with one patient having fair and one having poor functional outcome. Conclusion: Open reduction and internal fixation with plate is a good method for treatment of intraarticular fractures of calcaneum to achieve anatomical restoration of articular surface under vision, stable fixation, early mobilization and an option for primary subtalar arthrodesis if deemed necessary.

  8. Fatigue behaviour and fracture mechanism of cryogenically treated En 353 steel

    International Nuclear Information System (INIS)

    An experimental investigation was conducted for a better understanding of fatigue and fracture behaviour of carburized steel used in the manufacture of vehicle transmission elements such as crown wheel and pinion. An attempt was made to study the fatigue strength of En 353 based on failure at 107 cycles after subjecting to three different treatments namely conventional heat treatment, shallow cryogenic treatment and deep cryogenic treatment. Rotating bending fatigue test was performed in air at room temperature for all specimens. Fractured specimen surfaces were examined by scanning electron microscope to identify the mechanism involved during fatigue. The study concludes that shallow and deep cryogenically treated samples show an improvement with an overall fatigue life of 71% and a reduction of 26% over conventionally heat treated samples respectively. The combined presence of retained austenite and fine carbides has resulted in enhanced fatigue strength of shallow cryogenically treated specimens over the conventionally heat treated and deep cryogenically treated specimens.

  9. Comparison of Fracture Strength of Endodontically Treated Teeth Restored with Two Different Cast Metallic Post Systems

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    Borhan Haghighi Z

    2014-12-01

    Full Text Available Statement of Problem: Endodontically treated teeth are more prone to fracture. The post and core are often used to provide the necessary retention for prosthetic rehabilitation. Objectives: The purpose of this study was to: 1 compare the fracture strength of endodontically treated teeth restored either with Nickel-Chromium (Ni- Cr post or Non- Precious Gold-color alloy (NPG post compared to the control group and 2 evaluate the fracture site in each group. Materials and Methods: In this experimental study, endodontic treatment was carried out for 45 extracted maxillary premolars. The specimens were divided into 3 groups (n=15. Group1: restored with NPG post and core, group2: restored with Ni-Cr post and core, and group 3, no post and core were used after endodontic treatment and the access cavity was filled with amalgam. Failure force was recorded in Newton when root or remaining coronal structure fracture was occurred. Data were analyzed using one-way analysis of variance (ANOVA, Student t-test and Tukey HSD test to compare the three groups. Results: There was a statistically significant difference among all groups (P<0.05. Fracture resistance of the teeth restored by NPG posts was significantly higher than those restored by Ni- Cr (P<0.001. Results showed that the fracture mainly occurred in the root of the teeth restored with Ni- Cr and NPG post while fractures occurred in the core portion of the teeth restored with amalgam. Conclusions: The findings of the present study indicated that the fracture strength of the teeth without using cast post and core was significantly lower than the teeth restored with cast post and core. Also the teeth restored by NPG post had a significantly higher fracture resistance than Ni-Cr posts.

  10. CLINICAL OUTCOME OF INTRA - ARTICULAR DISTAL RADIUS FRACTURES TREATED WITH PLATE AND SCREWS

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    Girish

    2015-02-01

    Full Text Available BACKGROUND : Incidence of fractures of distal radius are increasing due to more geriatric population and road traffic accidents. The fundamental goal of distal radius fractures treatment is restoration of normal or near normal alignment and articular congruity. Restoration of the anatomy and articular surface may prevent the onset of arthritis and improve function. AIMS: To determine clinical outcome of intra - articular distal radius fractures treated with plate and screws. METHOD: 20 patients of intra - articular distal radius fracture treated with open reduction and internal fixation with plate and screws between November 2012 and October 2014 were evaluated. Clinical and radiological evaluation was done at 3 weeks, 3 months, 6 months and one year after surgery. Fractures were cla ssified according to Melone fracture classification. There were 8 type - 2 fractures, 5 type - 3 fractures,4 type - 4 fractures, 2 type - 5 and 1 type - 1 fracture. There were 19 (95% males and 1 (5% females. Age range was between 24 to 50 years with average of 34 years. Fracture was stabilized with the plate and screws at an average of 5 to 7 days post trauma. RESULTS: All fractures had sound clinical and radiological union with an average radiological union time of 14 weeks (range between 2.5 – 6 months. Average palmar flexion of wrist was 56deg, dorsi - flexion was 59deg, radial deviation was17deg, ulnar deviation was 23deg, pronation was 65deg and supination was 72degrees. Gartland and Werley system was used to evaluate the function, 80% of patients had excellent to good results out of which 20% were excellent and 60% were good results, and 15% had fair results and poor results were found in 5%. Average radial inclination was 21 degrees and palmar tilt was 9.5 degrees . CONCLUSION: Open reduction and internal fixation with plate and screws is an excellent, and effective technique in management of intra - articular distal radius fractures in terms of high union

  11. Monteggia fracture dislocation equivalents - analysis of eighteen cases treated by open reduction and internal fixation

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    Singh Ajay Pal

    2012-02-01

    Full Text Available 【Abstract】 Objective: Monteggia fracture dislocation equivalent, though already described by Bado, is still an unclassified entity. We aimed to retrospectively analyze 18 cases of Monteggia variants and discuss the injury mechanisms, management, and outcome along with a review of the literature. Methods: A retrospective record of Monteggia fracture dislocation (2003-2008 was reviewed from medical record department of our institute. Classic Monteggia fracture dislocation, children below 12 years or adults over 50 years, as well as open grade II & III cases were excluded from this study. Monteggia variant inclusion criteria included fracture of the proximal ulna together with a fracture of the radial head or neck and skeletal maturity. Totally 26 patients were identified with Monteggia variants and 18 were available for follow-up, including 11 males and 7 females with the mean age of 35 years. The ulna fracture was treated by compression plating along with tension band wiring. Radial head/neck was reconstructed in 12 patients while excised in 6 patients. Results: Follow-up ranged from 1-4 years, mean 2.6 years. Patients were assessed clinicoradiologically. Mayo Elbow Performance Score was employed to assess the outcomes. At final follow-up, the results were excellent in 10 patients, good in 4, fair in 2 and poor in 2. Mean range of motion of the elbow was 20°, 116°, 50° and 55° for extension, flexion, pronation and supination, respectively. Two patients had complications in the form of heterotopic ossification and stiffness of the elbow. One nonunion ulna, primarily treated by tension band wiring, was managed by refixation with locking reconstruction plate and bone grafting. Bone grafting was only required in this patient for nonunion. Another patient had implants removed on his request. The results in our series closely correlated with extent of intraarticular damage, coronoid fracture and comminuted fractures. Conclusions: Monteggia

  12. FUNCTIONAL AND RADIOLOGICAL OUTCOME OF DISTAL FEMORAL FRACTURES TREATED WITH LOCKING COMPRESSION PLATE

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    Muktevi

    2015-05-01

    Full Text Available AIM: To evaluate the clinical and radiological outcome in the management of distal femur fractures treated by distal femoral locking compression plate. BACKGROUND : Distal femur fractures are one of the common fractures occurring in road traffic accidents. Different treatment modalities with varying outcomes are seen in literature in the management of th e s e fractures. MATERIALS & METHODS: The study was con ducted in the department of orthopaedics at the Kamineni Institute of Medical sciences Narketpally. Patients treated for distal femur fractures with ORIF using distal femoral locking compression plates were evaluated to assess their clinical and functional results using Neer’s scoring system and compared with the available literature. RESULTS: The mean time for union was 20 wks. With mean time to full weight bearing being 10.5 wks . CONCLUSION: Surgery in the form of ORIF with distal femoral locking compression plate for Distal femur fracture is a comparatively good treatment option for better out come and early mobilization with minimum complications.

  13. Fracture resistance of endodontically treated teeth restored by different FRC posts: An in vitro study

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    Torabi Kianoosh

    2009-01-01

    Full Text Available Background: Posts and cores are often required for restoration of pulpless teeth and to provide retention and resistance for a complete crown, but conventional posts may increase the root fracture. Objective: This study was performed to compare the root fracture resistance of extracted teeth treated with different fibers reinforced with composite posts and treated teeth with conventional post and core systems. Materials and Methods: Root canal therapy was performed for 50 mandibular first premolars. The coronal portion of each tooth was amputated, and five post and core systems (cast, polyethylene woven, glass, carbon, and quartz fiber posts were compared. Acrylic resin blocks were used for mounting, using a layer of elastomeric impression material covering the roots. The load was applied axially and measured with a universal testing machine. Results and Conclusion: Significantly, cast posts and cores had a higher failure threshold including teeth fracture; whereas, fiber posts failure was due to core fracture, with or without fractures in coronal portion of posts. Difference in FRC posts did not provide any significant difference in the load failure and the mode of fracture.

  14. Review of 509 mandibular fractures treated at the University Hospital, Alexandria, Egypt.

    Science.gov (United States)

    Sakr, Khaled; Farag, Ismail A; Zeitoun, Ibrahim M

    2006-04-01

    Mandibular fracture is one of the most common facial skeletal injuries. Although its main causes are road crashes and violence, the relation between these causes varies from one country to another. We made a retrospective study of the medical records and radiographs of 509 patients treated for mandibular fracture at the University of Alexandria Hospital between 1991 and 2000. The data that we collected included age, sex, aetiology, date of injury, anatomical site of the fracture, associated maxillofacial trauma, and treatment. The prevalence of mandibular fractures was higher in male subjects in all age groups, and the male:female ratio was 3.6:1. Most fractures were sustained by men in the age group 21-30 years and girls between 0 and 10 years, and the monthly incidence was constant. Road crashes were the main cause, followed by falls and assaults. Fractures of the angle were the most common (22%) followed by parasymphyseal fractures (21%) and the lowest was in the coronoid region (1%). PMID:15896887

  15. Fracture resistance of endodontically treated single rooted premolars restored with Sharonlay: An in vitro study

    Science.gov (United States)

    Sharath Chandra, S. M.; Agrawal, Nishtha; Sujatha, I.; Sivaji, K.

    2016-01-01

    Aims: The aim of this study is to compare in vitro the fracture resistance of the endodontically treated tooth restored with a novel design Sharonlay, with the two component restorative method, i.e., post with separate onlay, and onlay without post. Subjects and Methods: 45 single-rooted mandibular second premolars were taken, and root canal treatment was performed. Teeth were then randomly divided into three groups (n = 15) based on the type of restoration given: Group I - metal onlay with cast post extension (Sharonlay), Group II - metal onlay with prefabricated metal post (Mani post system), Group III - metal onlay over endodontically treated tooth obturated with Gutta-percha (control group). Fracture resistance was checked using the Instron universal testing machine and the fracture patterns were analyzed. Results: According to the values recorded, Group I showed maximum mean fracture resistance followed by Groups II and III. Statistically significant difference was found between Groups I and II and Groups I and III and statistically significant difference was found between Groups II and III. Conclusion: A single unit component Sharonlay, gives higher fracture resistance to a premolar as compared to (a) metal onlay with prefabricated metal post and (b) metal onlay over endodontically treated tooth. PMID:27217643

  16. Evaluation of the quality of life after vertebroplasty to treat compressive osteoporotic fractures ,

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    Renato Faria Santos

    2014-10-01

    Full Text Available Objective:with increasing life expectancy around the world, fractures due to osteoporosis have become more common and the expenditure for treating them has also increased. The aim here was to evaluate the improvement in pain and quality of life among patients with compressive osteoporotic vertebral fractures undergoing vertebroplasty.Methods:eighteen patients with 27 fractured vertebrae underwent vertebroplasty and were evaluated using the Oswestry 2.0 limitations questionnaire before the operation and 24 h and six months after the operation.Results:there was a 75% improvement in pain and quality of life, going from a mean preoperative Oswestry of 40% to 10% 24 h after the operation and 9% six months after the operation (p ≤ 0.05.Conclusion:vertebroplasty is effective in managing compressive osteoporotic vertebral fractures, with improvement in pain and quality of life in the immediate postoperative period and over the medium term.

  17. An in vitro comparative evaluation of fracture resistance of endodontically treated teeth obturated with different materials

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    Rupali Chadha

    2010-01-01

    Full Text Available The aim of this study was to evaluate the in vitro effect of various obturating materials on fracture resistance of root canal treated teeth. Sixty freshly extracted human mandibular premolars were used. After standardizing the length to 13 mm, the teeth were biomechanically prepared and divided into four groups based on type of obturating materials used. Teeth were embedded in acrylic resin and fracture strength was measured using a universal testing machine. Data obtained was evaluated statistically using one-way ANOVA and the unpaired t-test. Teeth obturated with AH Plus and gutta percha showed higher fracture resistance than those obturated with Resilon-Epiphany. The results suggested that the group obturated with gutta percha and zinc oxide-eugenol sealer had the lowest fracture resistance. No statistically significant difference was found between the unobturated (control group and the zinc oxide-eugenol group.

  18. Evaluation of Tibial Condyle Fractures Treated with Ilizarov Fixation, A Prospective Study

    Science.gov (United States)

    Reddy R, Sandeep; Shah, Harshad M; Golla, Dinesh Kumar; Ganesh D J, Niranthara; Kumar P, Ashok

    2014-01-01

    Background: Tibial plateau fractures are associated with significant soft tissue injuries which increases the risks of complications and must be considered when managing tibial plateau fractures. Various modalities of treatment are available for treatment of these fractures but Ilizarov fixation has a special advantage over others. Review of literature shows many studies of Ilizarov fixation in the treatment of tibial plateau fractures with variable results. Aim of our study was to evaluate tibial condyle fractures treated by Ilizarov fixation. Materials and Methods: Study included 43 patients with Schatzker type II and above tibial plateau fractures treated by ilizarov fixation. Standard trauma evaluation, a meticulous musculoskeletal and neurologic examination was carried out. All patients underwent Ilizarov fixation by same team of surgeons. Clinicoradilogical assessment of the patients carried out at regular intervals. Results: Our study included 43 cases of tibial plateau of various types except type I. Mean time for radiological union was 24.51 wk (range 15 to 32 wk). Mean fixator period was 26.6 wk( 16-34 wk). The functional results were measured by Lyshom’s and Hohl and Luck score. The mean Lyshom’s score was at the end of one year was 82.16. At end of one year by Hohl and Luck grading 11 patients had fair, 23 had good and 9 had excellent results. Conclusion: High energy tibial plateau fractures can be definitively treated with Ilizarov external fixation. Treatment with this method gives good union rates and less risk of infection. Closed reduction, minimal soft tissue damage and early mobilization are the key to low complications. PMID:25584250

  19. Effect of Different Instrumentation Techniques on Vertical Root Fracture Re-sistance of Endodontically Treated Teeth

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    Saeid Tavanafar

    2015-03-01

    Full Text Available Statement of the Problem: Vertical root fractures are catastrophic events that often result in tooth extraction. Many contributing factor are associated with increasing incidence of vertical root fracture. Root canal preparation is one of the predisposing factors which can increase the root susceptibility to vertical fracture. Purpose: The aim of this study was to compare the effects of three different instrumentation techniques on vertical root fracture resistance of endodontically treated teeth. Materials and Methods: In this study, 120 freshly extracted mandibular premolar teeth of similar dimensions were decoronated and randomly divided into control (n=30, nickel-titanium hand K-file (HF, n=30, BioRaCe rotary file (BR, n=30, and WaveOne reciprocating single-file (WO, n=30 groups. After cleaning and shaping the root canals, AH26 was used as canal sealer, and obturation was completed using the continuous wave technique. The root canals were embedded vertically in standardised autopolymerising acrylic resin blocks, and subjected to a vertical load to cause vertical root fracture. The forces required to induce fractures were measured using a universal testing machine. ANOVA and Tukey’s post-hoc test were used to analyse the data. Results: All experimental groups showed statistically significant reductions in fracture resistance as compared with the control group. There was a statistically significant difference between the HF and BR groups. The WO group did not differ significantly from the HF group or the BR group. Conclusion: All three instrumentation techniques caused weakening of the structure of the roots, and rendered them susceptible to fracture under lesser load than unprepared roots. The fracture resistance of roots prepared with the single-file reciprocating technique was similar to that of those prepared with NiTi hand and rotary instrumentation techniques.

  20. A Comparison of the Fracture Resistance of Endodontically Treated Teeth using Three Different Post Systems

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    M. Sadeghi

    2006-06-01

    Full Text Available Statement of problem: It is yet unclear whether fiber-reinforced composite posts can enhance the mechanical properties and prevent vertical fractures of teeth under chewing loads.Purpose: The purpose of this study was to compare the fracture resistance and failure mode of endodontically treated teeth restored with three different post systems.Materials and Methods: Thirty-six maxillary canines were randomly divided into three groups (n=12. All teeth received endodontic therapy and one of three post systems of cast post-and-core, zirconia fiber post, and quartz fiber post. Cast posts-andcoreswere cemented using zinc phosphate cement, fiber posts were luted with dualcured resin cement, and composite cores were prepared. Compressive load was applied at a 135° angle to the long axis of the tooth at a crosshead speed of 1mm/min until fracture occurred. One-way ANOVA and Tukey-Karmer test were used to determine the difference of the failure loads between the groups (α=0.05.Results: The mean values (SD for fracture resistance were 1631(803, 513(348 and 789(390 N in the cast post-and-core, zirconia fiber post and quartz fiber post groups,respectively. Teeth restored with cast posts-and-cores exhibited significantly higher resistance to fracture (P<0.01; however, 92% of the fractures occurred in the tooth structure. There was no statistically significant difference in fracture resistance between the zirconia fiber and quartz fiber post groups. Fracture mainly occurred in the composite cores of these groups.Conclusion: This study showed that the fracture resistance of cast post-and-core was significantly higher than zirconia and quartz fiber posts; however, the failure mode was more favorable in teeth restored with fiber posts.

  1. FUNCTIONAL OUTCOME OF PATELLAR FRACTURES TREATED BY INTERNAL FIXATION: A RETROSPECTIVE STUDY

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    Sudheendra

    2014-07-01

    Full Text Available BACKGROUND AND OBJECTIVES: Follow-up studies of displaced patellar fractures treated but various accepted contemporary internal fixation techniques have generally shown favorable results. However, reports of modest outcomes are not rare. The aims of this retrospective study were to review a series of patients with closed patellar fractures who a\\were treated by internal fixation, and to determine the final functional outcome. METHODS: In this study of retrospective design, the hospital records and radiographs of the 43 identified patients with 43 closed patellar fractures, treated by internal fixation between November 2000 and June 2005 were reviewed. These patients were called for a final follow-up evaluation, and the latest functional outcome assessed as per the modified Hospital for Special Surgery knee scores. Results were analyzed and statistical significance determined by Chi-square test. RESULTS: Younger patients showed significantly better outcomes. Modified tension band wiring was the most commonly associated with symptomatic hardware requiring removal. Different fixation techniques fared favorably against each other. The final functional outcome assessed using the modified Hospital for Special Surgery scores was encouraging with excellent or good results in 74%. Interpretations and conclusions: Operatively treated closed patellar fracture with accepted fixation techniques eventually result in a satisfactory return of knee function. Complications, particularly symptomatic hardware requiring removal, are not uncommon.

  2. Protocols for treating the postoperative pain of fractures in Dutch hospitals

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    Ossendorp R

    2013-08-01

    Full Text Available Rikkert Ossendorp,1 Tymour Forouzanfar,2 Claire E Ashton-James,2,3 Frank Bloemers11Department of Surgery, VU University Medical Center, 2Department of Oral and Maxillofacial Surgery, VU University Medical Center, 3Department of Social and Organizational Psychology, VU University, Amsterdam, The NetherlandsIntroduction: Every year, over 260,000 patients in the Netherlands are diagnosed with a traumatic fracture. Many patients are treated surgically and need postoperative treatment of pain. Research suggests postoperative pain is often under-treated, leaving a significant proportion of patients in moderate to severe postoperative pain. Specialized, evidence-based pain-management protocols offer patients the best possible pain management, and significantly reduce the risk of pain-related health complications.Objective: Our objective was to review the range of postoperative pain protocols that are currently being used to treat postoperative fracture pain within the Netherlands, and investigate whether a specialized, evidence-based protocol for treating postoperative fracture pain exists within this sample.Methods: A written request for the protocol currently being used for the treatment of postoperative pain following the surgical treatment of a fracture was sent to 101 Dutch hospital departments. The administration and dosage of pain medications used during postoperative pain management were then identified and summarized.Results: Of the contacted hospitals, 57% sent in protocols; 45% of these were eligible for analysis. All of the departments sent a general or acute pain protocol rather than a specialized protocol for the treatment of postoperative pain associated with the surgical treatment of fractures. A total of 22 different analgesics were used for pain management in 135 different administration schemes. Paracetamol, diclofenac, and morphine were used in the majority of protocols. Medication was given via oral, rectal, intravenous

  3. Calcaneal Osteomyelitis due to Non-tuberculous Mycobacteria: A Case Report

    Science.gov (United States)

    Yi, Tae-Im; Choe, Yeo-Reum; Kim, Joo-Sup; Kwon, Kye-Won

    2016-01-01

    Osteomyelitis is a bone infection caused by bacteria or other germs. Gram-positive cocci are the most common etiological organisms of calcaneal osteomyelitis; whereas, non-tuberculous mycobacteria (NTM) are rarely documented. We reported a case of NTM calcaneal osteomyelitis in a 51-year-old female patient. She had been previously treated in many local clinics with multiple local steroid injection over 50 times and extracorporeal shock-wave therapy over 20 times with the impression of plantar fasciitis for 3 years prior. Diagnostic workup revealed a calcaneal osteomyelitis and polymerase chain reaction assay on bone aspirate specimens confirmed the diagnosis of non-tuberculous mycobacterial osteomyelitis. The patient had a partial calcanectomy with antitubercular therapy. Six months after surgery, a follow-up magnetic resonance imaging showed localized chronic osteomyelitis with abscess formation. We continued anti-tubercular therapy without operation. At 18-month follow-up after surgery and comprehensive rehabilitation therapy, she was ambulating normally and able to carry out her daily activities without any discomfort. PMID:26949685

  4. Calcaneal Osteomyelitis due to Non-tuberculous Mycobacteria: A Case Report.

    Science.gov (United States)

    Yi, Tae-Im; Ha, Seung-A; Choe, Yeo-Reum; Kim, Joo-Sup; Kwon, Kye-Won

    2016-02-01

    Osteomyelitis is a bone infection caused by bacteria or other germs. Gram-positive cocci are the most common etiological organisms of calcaneal osteomyelitis; whereas, non-tuberculous mycobacteria (NTM) are rarely documented. We reported a case of NTM calcaneal osteomyelitis in a 51-year-old female patient. She had been previously treated in many local clinics with multiple local steroid injection over 50 times and extracorporeal shock-wave therapy over 20 times with the impression of plantar fasciitis for 3 years prior. Diagnostic workup revealed a calcaneal osteomyelitis and polymerase chain reaction assay on bone aspirate specimens confirmed the diagnosis of non-tuberculous mycobacterial osteomyelitis. The patient had a partial calcanectomy with antitubercular therapy. Six months after surgery, a follow-up magnetic resonance imaging showed localized chronic osteomyelitis with abscess formation. We continued anti-tubercular therapy without operation. At 18-month follow-up after surgery and comprehensive rehabilitation therapy, she was ambulating normally and able to carry out her daily activities without any discomfort. PMID:26949685

  5. Will the untreated ulnar styloid fracture influence the outcome of unstable distal radial fracture treated with external fixation when the distal radioulnar joint is stable

    OpenAIRE

    Chen, Yi-Xin; Zheng, Xin; Shi, Hong-fei; Wangyang, Yu-fan; Yuan, Han; Xie, Xiao-xiao; Li, Dong-ya; Wang, Chang-jun; Qiu, Xu-sheng

    2013-01-01

    Background The ulnar styloid is an important supportive structure for the triangular fibrocartilage complex. However, it remains inconclusive whether or not a fractured ulnar styloid should be fixed in an unstable distal radius fracture (DRF) with a stable distal radioulnar joint (DRUJ). The purpose of this study is to evaluate the effect of an untreated ulnar styloid fracture on the outcome of unstable DRF treated with transarticular external fixation when the DRUJ is stable. Methods 106 pat...

  6. The functional results of tibial shaft fractures treated with intramedullary nail compressed by proximal tube.

    Science.gov (United States)

    Karaarslan, Ahmet Adnan; Acar, Nihat; Aycan, Hakan; Sesli, Erhan

    2016-04-01

    Nailing of tibial shaft fractures is considered the gold standard surgical method by many surgeons. The aim of this retrospective study was to investigate and compare the clinical outcome of tibial shaft fractures treated with intramedullary nails compressed by proximal tube and conventional intramedullary interlocking nails. Fifty-seven patients with tibial shaft fractures, treated with intramedullary nails compressed by proximal tube (n = 32) and the conventional interlocking nails (n = 25), were reviewed. All fractures except for one were united without any additional surgical intervention in the proximal compression tube nail group, whereas in the conventional interlocking nail group, six patients needed dynamization surgery (p = 0.005) and three cases of nonunion were recorded. In the proximal compression tube nail group, faster union occurred in 20 ± 2 (16-24) weeks (mean ± SD; range) without failure of locking screws and proximal nail migration, whereas in the conventional interlocking nail group, union occurred in 22 ± 2.5 (17-27) weeks (p = 0.001) with two failures of locking screws and two proximal nail migration. The proximal compression tube nail system is safer than the conventional nailing methods for the treatment for transverse and oblique tibial shaft fractures with a less rate of nonunion, proximal locking screw failure and proximal nail migration. PMID:26837377

  7. Fracture resistance of endodontically treated teeth restored with ceramic inlays and different base materials.

    Science.gov (United States)

    Saridag, Serkan; Sari, Tugrul; Ozyesil, Atilla Gokhan; Ari Aydinbelge, Hale

    2015-01-01

    This study evaluated the fracture resistance of endodontically treated teeth restored with different base materials and mesioocclusal-distal (MOD) ceramic inlays. Fifty mandibular molars were assigned into five groups (n=10 per group). Group1 (control) comprised intact molar teeth without any treatment. Teeth in other groups were subjected to root canal treatment and restored with MOD ceramic inlays on different base materials. In Group 2, base material was zinc phosphate cement; Group 3's was glass ionomer cement; Group 4's was composite resin, and Group 5's was composite resin reinforced with fiber. Finally, a continuous occlusal load was applied until fracture occurred. Mean fracture resistance of Group 1 (3,027 N) was significantly higher than the other groups (890, 1,070, 1,670, 1,226 N respectively). Fracture resistance of Group 4 was statistically comparable with Group 5 and significantly higher than Groups 2 and 3 (pinlay restorations could affect the fracture resistance of endodontically treated teeth. PMID:25740162

  8. BOTH BONES FOREARM FRACTURES TREATED WITH LC-DCP: A SURGICAL OUTCOME

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    Ranganath

    2014-08-01

    Full Text Available Fractures of the forearm present a unique management problem for years. A forearm fracture involving both bones requires open anatomical reduction with stable fixation.[1] The forearm represents the critical anatomic unit of upper limb, permitting the effect of organ of the upper limb, the hand, to perform multi axial daily activities of living. Historically, the closed management of forearm fractures has been met with frustration in adults and resulted in poor functional outcome, hence perfect fracture reduction and rigid fixation is mandatory and achieved by plating. [2] The number of forearm fractures is increasing faster than the predicted rate due to increasing number of road traffic accidents, increased incidence of violence, rapid industrialization, and various sports activities. Conservative treatment has resulted in malunion, non-union, synostosis and ultimately poor functional outcome. [3] The present study is undertaken to know the functional outcome, advantages and complications of the LC-DCP. Thirty cases of fracture both bones of forearm were selected along the inclusion criteria’s and treated with LC-DCP in Department of Orthopedics, Kempegowda Institute of Medical Sciences, Bangalore

  9. Chronic Bilateral Tibial Stress Fractures with Valgus Treated with Bilateral Intramedullary Nailing: A Case Report

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    Steven K Dailey

    2014-01-01

    Full Text Available 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. We present the case of a non-athletic patient with chronic bilateral tibial stress fractures and associated deformity successfully treated with bilateral intramedullary nails. Case Report: A 23-year-old Caucasian female full-time student presented with chronic bilateral shin pain for approximately five years. She had failed an extensive regimen of conservative management. She was diagnosed with chronic bilateral tibial stress fractures based on history, physical examination, and radiologic findings. She subsequently underwent sequential intramedullary nailing of her tibiae. Both tibiae were in valgus alignment; however, this did not preclude nail placement. The nails deformed upon insertion into the sclerotic canals to conform to the deformation. Post operatively the tibiae united and patient was relieved of her symptoms. Conclusion: Bilateral intramedullary nailing of chronic bilateral tibial stress fractures should be considered as a treatment option for all patients, not just high-level athletes, who fail a trial of conservative management. Additionally, mild to moderate tibial malalignment does not necessarily preclude tibial nailing as the smaller nails placed in sclerotic canals will likely deform on insertion and conform to the canal. Keywords: Bilateral intramedullary nailing, bilateral tibial stress fractures, valgus

  10. Outcomes of the distal intraarticular humeral fractures treated by olecranon osteotomy

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    Erhan Yılmaz

    2009-01-01

    Full Text Available Objectives: To evaluate the management and outcome of intraarticular fractures of the distal humerus treated by open reduction and internal fixation using the olecranon osteotomy technique. Materials and methods: Twenty-one patients with in-traarticular fractures of the distal humerus were treated by open reduction and internal fixation. The mean age of the patients was 41.6 years and the mean follow-up pe-riod was 25.3 months. All fractures were type C accord-ing to the AO/ASIF fracture classification system. Chev-ron type olecranon osteotomy was performed within 12-24 h after the injury in all cases but 4 of them. Physical and radiological examination of patients with the appro-priate range checks were made.Results: All fractures united within average duration of 3.2 months. Excellent or good results were found in pa-tients less than 50 years-old, in women, when passing time from injury to surgery was within 12 hours and when early mobilization was achieved. The complica-tions were seen as 2 (9.6% transient neuropraxia of the ulnar nerve, 2 (9.6% failure of fixation, 1 (4.8% het-erotopic ossification and 1 (4.8% olecranon non-union. Fracture type (C1 and time from occurrence of injury to surgery (<12 hours are the main prognostic factors for achieving the excellent/ good functional results.Conclusions: The critical factors for a successful out-come of intraarticular fractures of the distal humerus in-cluded meticulous surgical technique, stable internal fix-ation, surgical experimentation and early controlled postoperative mobilization.

  11. COMPARATIVE STUDY OF FRACTURE NECK OF FEM UR TREATED WITH UNIPOLAR AND BIPOLAR HEMIARTHROPLASTY

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    Nava Krishna Prasad

    2015-03-01

    Full Text Available OBJECTIVES: This study has been carried out to compare the functional outcome of intracapsular fracture neck of femur treated with unipolar (Austin Moore prosthesis and bipolar prosthesis. METHODS: Fifteen out of thirty patients with displaced fracture of femoral nec k treated with unipolar prosthesis and other fifteen of patients treated with bipolar prosthesis from August 2012 to January 2015 in the Department of Orthopedics, Governmen t medical college, Ananthapuram . Functional outcome was assessed and compared using Modified Harris hip score and radiological assessment with a follow up of one year. RESULTS: Two group s of patients with mean age 72. 2years in AMP and 65.3 years in bipolar were evaluated and the mean hi p score of unipolar was 82.6±8.72and bipolar was 86.17±8.12 respectively. CONCLUSION: Functional outcome with mean Modified Harris hip score is better in Bipolar group than unipolar (Austin Moore prosthesis. Complications like painful hip, acetabular eros ion, periprosthetic fractures are more in unipolar group. Hence bipolar prosthesis is better in elderly patients with fracture neck of femur.

  12. Comparing two intramedullary devices for treating trochanteric fractures: A prospective study

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    Kontogeorgakos Vasileios

    2010-02-01

    Full Text Available Abstract Background Intertrochanteric fractures are surgically treated by using different methods and implants. The optional type of surgical stabilization is still under debate. However, between devices with the same philosophy, different design characteristics may substantially influence fracture healing. This is a prospective study comparing the complication and final functional outcome of two intramedullary devices, the intramedullary hip screw (IMHS and the ENDOVIS nail. Materials and methods Two hundred fifteen patients were randomized on admission in two treatment groups. Epidemiology features and functional status was similar between two treatment groups. Fracture stability was assessed according to the Evan's classification. One hundred ten patients were treated with IMHS and 105 with ENDOVIS nail. Results There were no significant statistical differences between the two groups regarding blood loss, transfusion requirements and mortality rate. In contrast, the number of total complications was significantly higher in the ENDOVIS nail group. Moreover, the overall functional and walking competence was superior in the patients treated with the IMHS nail. Conclusions These results indicate that the choice of the proper implant plays probably an important role in the final outcome of surgical treatment of intertrochanteric fractures. IMHS nail allows for accurate surgical technique, for both static and dynamic compression and high rotational stability. IMHS nail proved more reliable in our study regarding nail insertion and overall uncomplicated outcome.

  13. Occipital Neuralgia after Occipital Cervical Fusion to Treat an Unstable Jefferson Fracture

    OpenAIRE

    Kong, Seong Ju; Park, Jin Hoon; Roh, Sung Woo

    2012-01-01

    In this report we describe a patient with an unstable Jefferson fracture who was treated by occipitocervical fusion and later reported sustained postoperative occipital neuralgia. A 70-year-old male was admitted to our center with a Jefferson fracture induced by a car accident. Preoperative lateral X-ray revealed an atlanto-dens interval of 4.8mm and a C1 canal anterior-posterior diameter of 19.94mm. We performed fusion surgery from the occiput to C5 without decompression of C1. The patient r...

  14. Computed tomography of thoracic and lumbar spine fractures that have been treated with Harrington instrumentation

    International Nuclear Information System (INIS)

    Twenty patients with fractures of the thoracic and lumbar spine underwent computed tomography (CT) following Harrington distraction instrumentation and a spinal fusion. CT was done to search for a cause of persistent cord or nerve root compression in those patients who failed to improve and completely recover their partial neurologic deficit (14 cases). The most common abnormality was the presence of residual bone fragments originating in the burst fracture of a vertebral body displaced posteriorly, into the spinal canal. In patients with complications in the late recovery period, CT found exuberant callus indenting the canal or lack of fusion of the bone grafts placed in the anterolateral aspect of the vertebral bodies. This experience indicates that CT is the modality of choice for spinal canal evaluation in those patients who fail to have an optimal clinical course following fractures of the thoracic and lumbar spine treated with Harrington rods

  15. Clinical effect of distal radius fracture treated with open reduction and internal plate fixation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Pei-xun; XUE Feng; DANG Yu; WANG Tian-bing; CHEN Jian-hai; XU Hai-lin; FU Zhong-guo; ZHANG Dian-ying; JIANG Bao-guo

    2012-01-01

    Background For some specific comminuted unstable intra-articular fracture,the plaster cast can not maintain the alignment of the articular surface effectively.The aim of this study was to evaluate the clinical effects of distal radius fracture treated with open reduction and internal plate fixation retrospectively.Methods From January 2002 to March 2010,539 cases of distal radius fracture were treated with open reduction and internal fixation,including 184 males and 355 females aging 21-72 years (mean 57 years).Fractures were caused by falling to the ground in 459 cases,by traffic accident in 62 cases and by athletic injuries in 18 cases.Of 539 cases,there were 523 cases of closed fracture and 16 cases of open fracture.According to Arbeitsgemeinschaft fur Osteosynthesefragen (AO) standards of classification,there were 14 cases of A2 type,22 of A3 type,18 of B1 type,24 of B2 type,62 of B3 type,91 of C1 type,162 of C2 type and 146 of C3 type.The time from injury to operation was 1-16 days (mean 5 days).All patitents received open reduction and internal plate screw fixation.Forty-seven patients with bone defect were given 6-15 g autologous ilium and 75 cases were given 5 ml calcium sulphate artificial aggregate after reduction.Results All incisions healed by first intention after operation.Patients were followed up for 15 to 32 months postoperatively (mean 22 months).The fractures healed within 10-18 weeks after operation (mean 12 weeks).During the last follow-up,the mean palmar tilt was (7.0±0.9)° and the mean ulnar variance was (21.0±4.2)°,showing significant difference when compared with preoperation ((-5.0±1.2)° and (8.0±3.8)°).The radial heights were not abbreviated.According to Gartland and Werley assessment system,the results were excellent in 314 cases,good in 163 cases,fair in 46 cases,and poor in 16 cases 12 weeks after operation,the excellent and good rate was 88.5%.Conclusions The clinical effect of distal radius fracture treated with open

  16. Delayed recognition of pediatric calcaneal osteomyelitis: a case report

    OpenAIRE

    Mallia, Alvin James; Ashwood, Neil; Arealis, Georgios; Bindi, Frank; Zamfir, Georgiana; Galanopoulos, Ilias

    2015-01-01

    Introduction The diagnosis of calcaneal osteomyelitis is a challenge, and diagnostic delays have been reported in the literature. The progression is often indolent, laboratory results commonly fail to reveal an underlying infectious process and radiographs changes are seen after 7 days. We discuss the literature on the diagnosis and treatment of calcaneal osteomyelitis which can result in long-term sequelae in the pediatric patient. Case presentation A 9-year-old white boy presented to our in...

  17. Contemporary demographics and complications of patients treated for open ankle fractures.

    Science.gov (United States)

    Ovaska, Mikko T; Madanat, Rami; Honkamaa, Maija; Mäkinen, Tatu J

    2015-08-01

    Open ankle fractures are rare injuries with a high likelihood of wound complications and subsequent infections. There is limited information about the complications and outcomes of these injuries in different age groups. The aim of this study was to assess the contemporary demographics and complications related to this injury. We performed a chart review of all the 3030 patients treated for ankle fractures at a Level 1 trauma centre from 2006 to 2011. 137 (4.5%) patients had an open ankle fracture. The demographic data, injury mechanism, comorbidities, and fracture type were collected. Treatment, complications, length of stay and number of outpatient visits were also recorded. The mean age of the patients was 60 years and 56% were women. Most fractures were Weber type B with a medial sided wound (93%). Only 20% of the fractures were the result of high-energy trauma, and 31% were Gustilo grade III injuries. Immediate internal fixation was performed in 82% of patients, and the wound was primarily closed in most cases (80%). The incidence of postoperative wound necrosis and deep infection was 18% and 17%, respectively. There were more deep infections if pulsatile lavage was used during the wound debridement (p=0.029). About 14 (10%) patients required a flap reconstruction to cover the soft-tissue defect. Every other patient (54%) had a complication, and 21 patients (15%) suffered a long-term disability related to the injury. The number complications did not differ for nighttime and daytime operations (p=0.083). High-energy injuries were more common in younger patients (pankle fractures have a high complication rate and often require multiple surgical procedures. In young patients these injuries are more likely to be the consequence of high-energy trauma leading to more complications and subsequently increased healthcare resource utilisation. PMID:25935358

  18. STUDY OF OUTCOME FOLLOWING NAIL DYNAMIZATION FOR TREATING DELAYED HEALING FEMORAL SHAFT FRACTURES

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    Vidya Bhushan

    2015-11-01

    Full Text Available : BACKGROUND: Dynamisation of a previously interlocked intramedullary nail is believed to stimulate an osteogenic response and accelerate union due to increased load across the fracture site. OBJECTIVE: This retrospective study evaluated the role of dynamization of interlocking nails to treat the delayed heeling femoral fractures. MATERIAL AND METHODS: Eighteen static femoral interlocking nails were dynamized after 4 months (Range 3-6 months because of poor fracture healing. The clinical and radiographic healing processes were recorded. All the cases were followed up to monitor the progress of fracture healing till their end results in the form of union or non-union. RESULTS: The time between interlocking nailing and nail dynamization was ranging between 3 to 6 (Mean 4 months. After the dynamization cases were followed for at least 6 months (Range, 4-8 months twelve patients (66.6% achieved a solid union, within a union period of 5.4 months (Range, 3-8 months after dynamization. One patient achieved union with more than 2 cm of femoral shortening. CONCLUSION: Not all cases achieve union after dynamization. It should be reserved for delayed healing axially stable fractures

  19. FUNCTIONAL OUTCOME OF UNSTABLE DISTAL RADIUS FRACTURES - TREATED BY PERCUTANEOUS K-WIRE FIXATION

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    Chatla

    2015-10-01

    Full Text Available BACKGROUND: Distal radius fractures are very common and increasing in incidence, especially in older age group. There are various methods of treatment available each one has its own merits and demerits. Our technique involves closed reduction, percutaneous K-wire fixation, and POP immobilzation of the unstable distal radius fracture for 4-6 weeks. This study aims to examine the functional outcome of percutaneous pinning of these unstable distal radius fractures. MATERIAL AND METHODS: This is a prospective study of 48 patients aged between 35years to 74years, with unstable distal radius fracture. Patients were treated by closed reduction, percutaneous pinning using two to three k-wires. The wires are cut and bent to the outside. A posterior below elbow POP slab was applied for 4-6 weeks. All the patients were fallowed up at regular intervals of 3weeks, 6 weeks, 12 weeks and 24 weeks. The functional evaluation was done at 24 weeks follow-up. We used Sarmiento’s modification of Lindstrom criteria and Gartland & Warley’s criteria for evaluation of results. RESULTS: Excellent to good results were seen in 91.66% of cases, fair results in 8.34%. CONCLUSION: Percutaneous pinning is a simple, functionally effective, safe method to maintain the fracture reduction and prevent stiffness of wrist and hand.

  20. Fracture resistance and histological findings of immature teeth treated with mineral trioxide aggregate

    DEFF Research Database (Denmark)

    Hatibovic-Kofman, S.; Raimundo, L.; Zheng, L.;

    2008-01-01

    with a barbed broach, and the teeth were divided into three experimental groups. Group 1: untreated teeth. Group 2: the root canals were filled with calcium hydroxide paste. Group 3: the root canals were filled with MTA. All specimens were kept in saline with 1% antibiotics at 4 degrees C for certain...... endodontically treated teeth. However, TIMP-2 was only observed in the MTA-treated teeth. In conclusion, the teeth with root treatment with MTA showed the highest fracture resistance at 1 year (P < 0.05). An explanation could be that MTA induced the expression of TIMP-2 in the dentin matrix and thereby possibly...

  1. Normal skeletal development and imaging pitfalls of the calcaneal apophysis: MRI features

    Energy Technology Data Exchange (ETDEWEB)

    Rossi, Ignacio [Musculoskeletal Research Fellow at NYU Langone Medical Center, New York, NY (United States); Centro de Diagnostico Dr. Enrique Rossi, Buenos Aires (Argentina); Rosenberg, Zehava [NYU Langone Medical Center, New York, NY (United States); Zember, Jonathan [Albert Einstein College of Medicine Jacobi Medical Center, Bronx, NY (United States)

    2016-04-15

    Heel pain in children and secondary MR imaging (MRI) of the hindfoot have been increasing in incidence. Our purpose is to illustrate the, previously unreported, MRI stages in development of the posterior calcaneal apophysis, with attention to imaging pitfalls. This should aid in distinguishing normal growth from true disease. Consecutive ankle MRIs in children <18 years, from 2008-2014, were subdivided into 0≤5, 5≤10, 10≤15 and 15≤18 age groups and retrospectively reviewed for development of the calcaneal apophysis. 204 ankle MRI studies in 188 children were identified. 40 studies were excluded with final cohort of 164 studies in 154 patients (82 boys, 72 girls). The calcaneal apophysis was cartilaginous until age 5. Foci of decreased as well as increased signal were embedded in cartilage, prior to ossification. Early, secondary ossification centers appeared in plantar third of the apophysis in 100 % of children by age 7. Increased T2 signal in the ossifications was seen in 30 % of children. Apohyseal fusion began at 12 and was complete in 78 % of 14≤15 year olds and in 88 % of 15≤18 year olds. Curvilinear low signal in the ossification centers, paralleling, but distinguished from growth plate, and not be confused with fracture line, was common. Development of the posterior calcaneus follows a unique sequence. Apophyseal fusion occurs earlier than reported in the literature. Familiarity with this maturation pattern, in particular the apophyseal increased T2 signal and the linear low signal paralleling the growth plate, will avoid misinterpreting it for pathology. (orig.)

  2. Normal skeletal development and imaging pitfalls of the calcaneal apophysis: MRI features

    International Nuclear Information System (INIS)

    Heel pain in children and secondary MR imaging (MRI) of the hindfoot have been increasing in incidence. Our purpose is to illustrate the, previously unreported, MRI stages in development of the posterior calcaneal apophysis, with attention to imaging pitfalls. This should aid in distinguishing normal growth from true disease. Consecutive ankle MRIs in children <18 years, from 2008-2014, were subdivided into 0≤5, 5≤10, 10≤15 and 15≤18 age groups and retrospectively reviewed for development of the calcaneal apophysis. 204 ankle MRI studies in 188 children were identified. 40 studies were excluded with final cohort of 164 studies in 154 patients (82 boys, 72 girls). The calcaneal apophysis was cartilaginous until age 5. Foci of decreased as well as increased signal were embedded in cartilage, prior to ossification. Early, secondary ossification centers appeared in plantar third of the apophysis in 100 % of children by age 7. Increased T2 signal in the ossifications was seen in 30 % of children. Apohyseal fusion began at 12 and was complete in 78 % of 14≤15 year olds and in 88 % of 15≤18 year olds. Curvilinear low signal in the ossification centers, paralleling, but distinguished from growth plate, and not be confused with fracture line, was common. Development of the posterior calcaneus follows a unique sequence. Apophyseal fusion occurs earlier than reported in the literature. Familiarity with this maturation pattern, in particular the apophyseal increased T2 signal and the linear low signal paralleling the growth plate, will avoid misinterpreting it for pathology. (orig.)

  3. Displaced avulsion fractures of the posterior cruciate ligament: Treated by stellate steel plate fixation

    Directory of Open Access Journals (Sweden)

    Lijun Li

    2015-01-01

    Full Text Available Background: The open reduction with internal fixation is an effective approach for treatment of avulsion fracture of posterior cruciate ligament. The previously used internal fixation materials including hollow screws, absorbable screw, tension bands and sutures have great defects such as insufficient fixation strength, susceptibility to re-fracture, etc. Stellate steel plate is novel material for internal fixation which has unique gear-like structure design. We used stellate steel plate for treatment of displaced avulsion fractures of posterior cruciate ligament in this study. Materials and Methods: 14 patients (9 men, 5 women; aged, 19-35 years; mean age, 28 years with displaced avulsion fractures of the tibial insertion of the posterior cruciate ligament were retrospectively analyzed between June 2009 and June 2011. The mean duration from injury to the operation was 8.3 days (range 6-15 days. All the patients were treated with open reduction and internal fixation of a stellate steel plate (DePuy, Raynham, MA 02767, USA. The Lysholm-Tegner knee function score criteria were used to analyze results. Results: The mean followup was 24.6 months (range 18-32 months. After 6 months, all the fractures healed and knee joint activity was normal, with no knee stiffness or instability. The Lysholm-Tegner scores were 97.1 ± 1.7 points at the final followup. Conclusion: Owing to its unique gear structure, the stellate steel plate design can effectively fix an avulsion fracture block and it is a simple operation with short postoperative rehabilitation time and firm fixation.

  4. Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates

    Directory of Open Access Journals (Sweden)

    G Thiruvengita Prasad

    2013-01-01

    Full Text Available Background: Dual plate fixation in comminuted bicondylar tibial plateau fractures remains controversial. Open reduction and internal fixation, specifically through compromised soft tissues, has historically been associated with major wound complications. Alternate methods of treatment have been described, each with its own merits and demerits. We performed a retrospective study to evaluate the functional outcome of lateral and medial plate fixation of Schatzker type V and VI fractures through an anterolateral approach, and a medial minimally invasive approach or a posteromedial approach. Materials and Methods: We treated 46 tibial plateau fractures Schatzker type V and VI with lateral and medial plates through an anterolateral approach and a medial minimal invasive approach over an 8 years period. Six patients were lost to followup. Radiographs in two planes were taken in all cases. Immediate postoperative radiographs were assessed for quality of reduction and fixation. The functional outcome was evaluated according to the Oxford Knee Score criteria on followup. Results: Forty patients (33 men and 7 women who completed the followup were included in the study. There were 20 Schatzker type V fractures and 20 Schatzker type VI fractures. The mean duration of followup was 4 years (range 1-8 years. All patients had a satisfactory articular reduction defined as ≤2 mm step-off or gap as assessed on followup. All patients had a good coronal and sagittal plane alignment, and articular width as assessed on supine X-rays of the knee in the anteroposterior (AP and lateral views. The functional outcome, as assessed by the Oxford Knee Score, was excellent in 30 patients and good in 10 patients. All patients returned to their pre-injury level of activity and employment. There were no instances of deep infection. Conclusions: Dual plate fixation of severe bicondylar tibial plateau fractures is an excellent treatment option as it provides rigid fixation and

  5. Long-term functional results of adult intra-articular distal humeral fractures treated by open reduction and plate osteosynthesis

    OpenAIRE

    Urguden, Mustafa; Soyuncu, Yetkin; Aslan, Tevfik

    2004-01-01

    Objectives: We assessed the long-term functional results of surgical treatment of distal intra-articular humeral fractures, together with the factors having influence on the outcome. Methods: Thirty-four patients (25 males, 9 females; mean age 38 years; range 20 to 78 years) who were treated by open reduction and plate osteosynthesis were retrospectively evaluated. All fractures were type C according to the AO classification. Five patients had open fractures. Thirty-three patients had surg...

  6. Outcomes of trochanteric femoral fractures treated with proximal femoral nail: an analysis of 100 consecutive cases

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    Korkmaz MF

    2014-04-01

    Full Text Available Mehmet Fatih Korkmaz,1 Mehmet Nuri Erdem,2 Zeliha Disli,3 Engin Burak Selcuk,4 Mustafa Karakaplan,1 Abdullah Gogus5 1Department of Orthopedics and Traumatology, Inonu University School of Medicine, Malatya, Turkey; 2Department of Orthopedics and Traumatology, Nisantasi University School of Medicine, Istanbul, Turkey; 3Department of Anesthesiology, Malatya Government Hospital, Malatya, Turkey; 4Department of Family Medicine, Inonu University School of Medicine, Malatya, Turkey; 5Department of Orthopedics and Traumatology, Florence Nightingale Hospital, Istanbul, Turkey Purpose: In this study, we aimed to report the results of a retrospective study carried out at our institute regarding cases of patients who had suffered proximal femoral fractures between January 2002 and February 2007, and who were treated with a proximal femoral nail. Materials and methods: One hundred consecutive cases were included in the study. A case documentation form was used to obtain intraoperative data including age, sex, mechanism of injury, type of fracture according to Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF classification and the American Society of Anesthesiologists' (ASA physical status classification (ASA grade. Clinical and radiographic examinations were performed at the time of admission and at the 6th week; subsequent visits were organized on the 3rd month, 6th month, and 12th month, and in patients with longer follow-up and annually postoperatively. The Harris score of hip function was used, and any change in the position of the implants and the progress of the fracture union, which was determined radiologically, was noted. Results: The mean age of the patients was 77.66 years (range: 37–98 years, and the sex distribution was 32 males and 68 females. Seventy-three fractures were reduced by closed means, whereas 27 needed limited open reduction. The mean follow-up time for the study group was 31.3 months (range

  7. Resistance of Bonded Composite Restorations on Fractures of Endodontically Treated Teeth

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    AR Daneshkazemi

    2005-01-01

    Full Text Available Introduction: This study was performed to evaluate the effect of dentine bonding agents and Glass Ionomer cement beneath composite restorations and its resistance on fractures of endodontically treated teeth. Material and Methods: Forty sound maxillary teeth were selected; ten of them for positive control, and on the rest, RCT and MOD cavity preparations were done with standard methods. Then, the teeth were divided to four groups: 1-Sound teeth for positive control. 2-Prepared without any restoration for negative control. 3-Prepared and restored with Vitrabond(3M, USA, Single bond(3M, USA and Z100(3M, USA resin composite. 4-Prepared and restored by Single bond and Z100 resin composite. Specimens were subjected to compressive load by Instron 8502 until fracture occurred. Results: Group 1 showed the highest resistance to compressive forces followed by group 4,3&2 respectively. ANOVA, t test and Chi-square tests indicated significant difference between all the groups. Conclusion: Use of dentine bonding agents and resin composite increases resistance of endodontically treated teeth to fractures more than teeth restored with sandwich of glass ionomer cements, dentine bonding agents and resin composite.

  8. Promising Effect Of Intraarticular Ropivacaine In Femoral Neck Fractures Treated With Internal Fixation (Best Poster Award)

    DEFF Research Database (Denmark)

    Bech, Rune Dueholm

    2008-01-01

     Promising Effect Of Intraarticular Ropivacaine In Femoral Neck Fractures Treated With Internal Fixation Rune Bech*, Jens Lauritsen*+,Tine Dimon*, Ole Ovesen*, Claus Emmeluth, Søren Overgaard*. *:Dept. Ortopaedic Surgery, Odense University Hospital, +:Institute of Public Health-dept. biostatistics......, Southern Denmark University.   INTRODUCTION Reducing pain is an essential factor for early mobilisation after internal fixation of femoral neck fractures. Systemic opioids have side effects that might obstruct mobilisation and induce deliria and nausea. We hypothesized that intraarticular local anaesthetic...... intraarticular catheter, which was removed after 48 hours. Control Group: 11 patients consecutively diagnosed in Sept. 2006, who received only standard pain treatment. The need for opioid rescue analgesia standardised to mg equivalent of oxycodon was compared between the two groups for the first two days after...

  9. A Novel Thresholding Based Algorithm for Detection of Vertical Root Fracture in Nonendodontically Treated Premolar Teeth

    Science.gov (United States)

    Johari, Masume; Esmaeili, Farzad; Andalib, Alireza; Garjani, Shabnam; Saberkari, Hamidreza

    2016-01-01

    In this paper, an efficient algorithm is proposed for detection of vertical root fractures (VRFs) in periapical (PA), and cone-beam computed tomography (CBCT) radiographs of nonendodontically treated premolar teeth. PA and CBCT images are divided into some sub-categories based on the fracture space between the two fragments as small, medium, and large for PAs and large for CBCTs. These graphics are first denoised using the combination of block matching 3-D filtering, and principle component analysis model. Then, we proposed an adaptive thresholding algorithm based on the modified Wellner model to segment the fracture and canal. Finally, VRFs are identified with a high accuracy through applying continuous wavelet transform on the segmented radiographs and choosing the most optimal value for sub-images based on the lowest interclass variance. Performance of the proposed algorithm is evaluated utilizing the different tested criteria. Results illustrate that the range of specificity deviations for PA and CBCT radiographs are 99.69 ± 0.22 and 99.02 ± 0.77, respectively. Furthermore, the sensitivity changes from 61.90 to 77.39 in the case of PA and from 79.54 to 100 in the case of CBCT. Based on our statistical evaluation, the CBCT imaging has the better performance in comparison with PA ones, so this technique could be a useful tool for clinical applications in determining the VRFs. PMID:27186535

  10. Influence of fiber posts on the fracture resistance of endodontically treated premolars with different dental defects

    Institute of Scientific and Technical Information of China (English)

    Qian-Qian Hou; Yi-Ming Gao; Lei Sun

    2013-01-01

    This study aimed to evaluate the influence of quartz fiber post placement on the fracture resistance of endodontically treated premolars with different dental defects under dynamic loading. Fifty extracted single-rooted mandibular premolars were randomized into five groups. Each group was prepared according to numbers of residual walls ranged from 0 to 4. Then each group was divided into two subgroups with one restored with quartz fiber posts and the other without posts. In no-post groups, gutta percha point 2 mm below cemento-enamel junction was removed. Composite resin was adapted to the well and used to shape the core directly. Each tooth was restored with a complete metal crown. Dynamic loading was carried out in a masticatory simulator with a nominal load of 50 N at 2 Hz for 300 000 loading cycles. Then a quasi-statically load was applied in a universal testing machine 306 to the long axis with a crosshead speed of 1 mm?min21 until fracture. Data were analyzed with one-way analysis of variance and pairwise comparison (P,0.05). No specimens failed during dynamic loading. The fracture resistance enhanced with the increase of numbers of coronal walls and the differences were significant (P,0.05). Placement of fiber posts had a significant effect when fewer than two walls remained (P,0.05), but it had no significant influence in groups with two, three or four walls (P.0.05). Fiber post did not change failure mode, and the fracture pattern was mainly favorable. More dentin walls need to be retained in clinic. When no less than two walls remained, a fiber post is not always necessary.

  11. Mortality and morbidity in elderly patients with fracture neck of femur treated by hemi arthroplasty

    International Nuclear Information System (INIS)

    To determine mortality and morbidity in elderly patients with fracture neck of femur treated by hemiarthroplasty (Austin Moore Prosthesis) during one year postoperatively. During the study period, all patients with fracture neck of femur, who were 65 years of age or above and treated by Austin Moore Prosthesis (AMP), were included. The patients were followed for one year at intervals of 2 weeks, 4 weeks, 6 months, and one year. All surviving patients were assessed for complications, both general and mechanical, related to the implant. The mortality and morbidity were compared for various age subgroups, and in patients with and without systemic co-morbidities.Chi square test was applied to see the significance of results. The total number of patients was 46 with average age of 70 years. Male to female ratio was 1:2. There were 70% patients who had one or more associated systemic disease. The mortality at 2 weeks was 4.3%, 17.4% at 6 months and 26% at one year. The overall dislocation rate was 4.3%. Two patients had infection and 17.4% patients had thigh pain at one year. The mortality and morbidity was high in patients with systemic comorbidities, and those above 70 years of age, but this was statistically not significant (p value >0.05). The functional assessment of surviving patients at one year was graded as excellent or good in 76.4% of patients. (author)

  12. Distal tibial fracture treated by minimally invasive plate osteosynthesis after external fixation Retrospective clinical and radiographic assessment

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    Al. Șerban

    2014-02-01

    Full Text Available Fractures of the horizontal surface of the distal tibia are known commonly as pylon or plafond fractures, and represent 1-5% of lower extremity fractures, 7-10% of all tibial fractures. The protocol consisted of immediate (within eight to 24 hours open reduction and internal fixation of the fibula, using a fibular plate or one third tubular plate and application of an external fixator spanning the ankle joint. In the second stage, the treatment of proximal and distal tibial fractures with close reduction and MIPPO technique can preserve soft tissue, simplify operative procedure and decrease wound, obtain rigid internal fixation and guarantee early function exercises of ankle joint. In this study we evaluated 22 patients treated in Clinical Emergency Hospital Constanta between April 2012 - July 2013 diagnosed with multifragmentary fractures of the distal tibia. This study evaluates the treatment of complex fractures of distal tibia with locked plate after external fixation. There were 17 males and 5 females of mean age 51,7 years (31-68. The mean follow-up period was 14 weeks. (Ranging from 9-16 weeks. All patients were fully weight bearing at 16 weeks (ranging 9-16 weeks showing radiological union. There were no cases of failures of fixation, or rotational misalignment. No significant complication was observed in our patients. MIPO is an effective method of treatment for distal tibial fractures, reduce surgical trauma and maintain a more biologically favorable environment for fracture healing, reducing risks of infection and nonunion.

  13. Incidence and MR imaging features of fractures of the anterior process of calcaneus in a consecutive patient population with ankle and foot symptoms

    International Nuclear Information System (INIS)

    To determine the incidence, appearances and associated injuries of fractures affecting the anterior process of calcaneus from a general population with foot and ankle symptoms. A retrospective review of foot and ankle MR imaging procedures was performed for detection of cases with a fracture affecting the anterior process of calcaneus over a four year period. Radiographs, MR imaging studies, radiology reports, medical records, and operative notes were reviewed. Imaging analysis included fracture pattern, displacement, associated fractures, and presence of tendon and ligamentous injuries. The incidence of anterior process of calcaneus fracture on MR imaging was 0.5% (14/2577). Fractures were more common in female subjects (71%, 10/14). Fracture orientation was predominantly vertical (93%, 13/14). No comminuted fractures were seen and only three fractures were displaced. Three of the eight MR imaging evident fractures of anterior process of calcaneus were seen on radiographs. Associated fractures of the talus (n=5), navicular bone (n=3), cuboid (n=2), and calcaneal body (n=1) were noted. Associated injuries to the anterior talofibular ligament (n=3) and tears of the peroneus brevis (n=3) and peroneus longus (n=1) tendons were present. All fractures were treated non-operatively. Two patients had subtalar joint steroid injection for symptomatic relief

  14. Incidence and MR imaging features of fractures of the anterior process of calcaneus in a consecutive patient population with ankle and foot symptoms

    Energy Technology Data Exchange (ETDEWEB)

    Ouellette, H.; Salamipour, H.; Thomas, B.J.; Kassarjian, A.; Torriani, M. [Division of Musculoskeletal Radiology, Massachusetts General Hospital, Boston, MA (United States)

    2006-11-15

    To determine the incidence, appearances and associated injuries of fractures affecting the anterior process of calcaneus from a general population with foot and ankle symptoms. A retrospective review of foot and ankle MR imaging procedures was performed for detection of cases with a fracture affecting the anterior process of calcaneus over a four year period. Radiographs, MR imaging studies, radiology reports, medical records, and operative notes were reviewed. Imaging analysis included fracture pattern, displacement, associated fractures, and presence of tendon and ligamentous injuries. The incidence of anterior process of calcaneus fracture on MR imaging was 0.5% (14/2577). Fractures were more common in female subjects (71%, 10/14). Fracture orientation was predominantly vertical (93%, 13/14). No comminuted fractures were seen and only three fractures were displaced. Three of the eight MR imaging evident fractures of anterior process of calcaneus were seen on radiographs. Associated fractures of the talus (n=5), navicular bone (n=3), cuboid (n=2), and calcaneal body (n=1) were noted. Associated injuries to the anterior talofibular ligament (n=3) and tears of the peroneus brevis (n=3) and peroneus longus (n=1) tendons were present. All fractures were treated non-operatively. Two patients had subtalar joint steroid injection for symptomatic relief.

  15. 经皮及切开技术治疗跟骨关节内骨折的疗效比较%Minimally-invasive technique versus ORIF in treating intra-articular fractures of the calcaneum

    Institute of Scientific and Technical Information of China (English)

    巫宗德; 徐强; 张宇; 王小兵

    2012-01-01

    Objective To compare clinical effects of minimally-invasive skill with ORIF in treating intra-articular calca-neal fractures. Methods From Dec 2009 to Jul 2011,58 cases of intra-articular calcaneal fractures were divided into 2 groups randomly, all cases were followed as planned. Reduction and fixation with minimally-invasive technique were underwent in 29 cases, 27 males and 2 females with an average of 41. 5 years (range, 20 ~72). ORIF technique were underwent in 29 cases, 26 males, 3 females with an average of 42 years (range, 18 ~69) ,all cases were classified as type II or type III. AOFAS Ankle Hindfoot scale and the difference of Boeler' s angle were compared between 2 groups. The length and complication rate of incision, the duration and cost of hospitalization were also compared. Results There was statistical difference between two groups in the AOFAS scale 2,4 and 6 months post operation,but no statistical differences was found 10 ~ 15 months post operation,the same to the difference of Boeler's angle, not only shorter length and lower complication rate of incision, but also shorter duration and lower cost of hospitalization were found in group A. Conclusion Minimally-invasive technique has advantages of earlier rehabilitation, smaller injury and lower cost with ORIF technique.%目的 比较经皮及切开技术治疗跟骨关节内骨折的临床疗效.方法 2009年12月~2011年7月将58例跟骨关节内骨折患者随机分为A、B两组.A组采用微创复位技术,并以螺钉或钢板微创内固定技术治疗29例,男27例,女2例;年龄20 ~72岁,平均41.5岁.B组采用常规L型切口,切开复位内固定骨折29例,男26例,女3例;年龄18 ~69岁,平均42.0岁.Sander's分型均为Ⅱ型及Ⅲ型.使用AOFAS踝后足评分表对两组患者评分,统计比较两组的手术后及健侧X线片评价Boeler's角的差值△,以及切口长度、切口并发症、住院时间、住院费用等.结果 两组患者术后2、4、6

  16. Repeated Stress Fractures in an Amenorrheic Marathoner: A Case Conference.

    Science.gov (United States)

    Sutton, John R.; Nilson, Karen L.

    1989-01-01

    Presents a case conference by 2 experts on the relationship between a 26-year-old marathoner's amenorrhea and her sustained unusual stress fractures in 4 ribs (plus previous similar fractures of the calcaneal, navicular, metatarsal, and tibial bones). The experts conclude that she suffers many manifestations of overtraining. (SM)

  17. Fracture resistance of endodontically treated canines restored with different sizes of fiber post and all-ceramic crowns

    Science.gov (United States)

    Alkumru, Hasan Necdet; Akalin, Buket

    2016-01-01

    PURPOSE The aim of this study was to determine the fracture resistance and the mode of fracture of endodontically treated teeth restored with different fiber posts and all-ceramic crowns. MATERIALS AND METHODS Two glass fiber reinforced post systems in two different sizes and polyethylene fiber ribbon in two different thicknesses (n=10) were used. The specimens, restored with all-ceramic crowns, were subjected to a compressive load (in N) delivered at a 130-degree angle to the long axis until a fracture could be noted. The results were analyzed statistically with a One-Way ANOVA test (Prestored teeth. PMID:27141261

  18. Effects of a training program after surgically treated ankle fracture: a prospective randomised controlled trial

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    Ekdahl Charlotte S

    2009-09-01

    Full Text Available Abstract Background Despite conflicting results after surgically treated ankle fractures few studies have evaluated the effects of different types of training programs performed after plaster removal. The aim of this study was to evaluate the effects of a 12-week standardised but individually suited training program (training group versus usual care (control group after plaster removal in adults with surgically treated ankle fractures. Methods In total, 110 men and women, 18-64 years of age, with surgically treated ankle fracture were included and randomised to either a 12-week training program or to a control group. Six and twelve months after the injury the subjects were examined by the same physiotherapist who was blinded to the treatment group. The main outcome measure was the Olerud-Molander Ankle Score (OMAS which rates symptoms and subjectively scored function. Secondary outcome measures were: quality of life (SF-36, timed walking tests, ankle mobility tests, muscle strength tests and radiological status. Results 52 patients were randomised to the training group and 58 to the control group. Five patients dropped out before the six-month follow-up resulting in 50 patients in the training group and 55 in the control group. Nine patients dropped out between the six- and twelve-month follow-up resulting in 48 patients in both groups. When analysing the results in a mixed model analysis on repeated measures including interaction between age-group and treatment effect the training group demonstrated significantly improved results compared to the control group in subjects younger than 40 years of age regarding OMAS (p = 0.028, muscle strength in the plantar flexors (p = 0.029 and dorsiflexors (p = 0.030. Conclusion The results of this study suggest that when adjusting for interaction between age-group and treatment effect the training model employed in this study was superior to usual care in patients under the age of 40. However, as only three

  19. Inguinal Abnormalities in Male Patients with Acetabular Fractures Treated Using an Ilioinguinal Exposure

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    Reza Firoozabadi

    2015-09-01

    Full Text Available Purpose: Surgeons performing an ilioinguinal exposure for acetabular fracture surgery need to be aware of aberrant findings such as inguinal hernias and spermatic cord lesions. The purpose of this study is to report these occurrences in a clinical series of adult males undergoing acetabular fracture fixation and a series of adult male cadavers. The secondary aim is to characterize these abnormalities to aid surgeons in detecting these abnormalities preoperatively and coordinating a surgical plan with a general surgeon.Methods: Clinical study- Retrospective review of treated acetabular fractures through an ilioinguinal approach. Incidence of inguinal canal and spermatic cord abnormalities requiring general surgery consultation were identified. Corresponding CT scans were reviewed and radiographic characteristics of the spermatic cord abnormalities and/or hernias were noted.Cadaveric study- 18 male cadavers dissected bilaterally using an ilioinguinal exposure. The inguinal canal and the contents of the spermatic cord were identified and characterized.Results: Clinical Study- 5.7% (5/87 of patients had spermatic cord lesion and/or inguinal hernia requiring general surgical intervention. Preoperative pelvic CT scan review identified abnormalities noted intraoperatively in four of the five patients. Cord lipomas visualized as enlargements of the spermatic cord with homogeneous density. Hernias visualized as enlarged spermatic cords with heterogeneous density. Cadaver Study- 31% (11/36 of cadavers studied had spermatic cord and/or inguinal canal abnormalities. Average cord diameter in those with abnormalities was 24.9 mm (15-28 compared to 16 mm (11-22 in normal cords, which was statistically significant.Conclusion: The clinical and cadaveric findings emphasize the importance of understanding inguinal abnormalities and the value of detecting them preoperatively. The preoperative pelvic CT scans were highly sensitive in detecting inguinal abnormalities.

  20. Postoperative monitoring of distal intraarticular radial fractures treated with osteosynthesis by means of multislice CT

    Energy Technology Data Exchange (ETDEWEB)

    Lorenzen, M.; Wedegaertner, U.; Weber, C.; Adam, G.; Lorenzen, J. [Universitaetsklinik Hamburg-Eppendorf (Germany). Abt. fuer Radiologie

    2011-02-15

    Purpose: This study evaluates multislice CT (MSCT) for the postsurgical control of intraarticular fractures of the distal radius. Materials and Methods: In 131 patients conventional X-rays in two planes and MSCT were performed. In a consensus process two experienced radiologists judged conventional X-ray and computed tomography images in a random view. The correct position of the osteosynthetic material was assessed and it was ascertained whether an articular surface incongruity, a gap between two fracture fragments, or an intraarticular bone element was detectable. For each point of evaluation a confidence level of the evaluation was assessed on a five-point scale. Results: Ninety patients were classified as having correct alignment and osteosynthesis according to conventional X-ray, while when using the findings from axial CT scans only, 82 patients, and after the addition of multiplanar re-constructions (MPR) only 73 patients were found to have almost proper alignment and osteosynthesis. In 42 patients dehiscence of the fragments was diagnosed with MSCT, but was not visualized by X-ray, leading to surgical revision in eight patients, confirming the diagnosis. In five patients an intraarticular position of intraarticular material was confirmed with MSCT and surgical revision. A significant advantage for the evaluation confidence level was achieved for MPRs in comparison with axial CT scans and X-ray. Conclusion: The marked diagnostic advantage with a high evaluation confidence level in comparison with conventional X-ray methods justify the use of MSCT during postoperative monitoring of articular radial fractures treated with osteosynthesis. (orig.)

  1. Postoperative monitoring of distal intraarticular radial fractures treated with osteosynthesis by means of multislice CT

    International Nuclear Information System (INIS)

    Purpose: This study evaluates multislice CT (MSCT) for the postsurgical control of intraarticular fractures of the distal radius. Materials and Methods: In 131 patients conventional X-rays in two planes and MSCT were performed. In a consensus process two experienced radiologists judged conventional X-ray and computed tomography images in a random view. The correct position of the osteosynthetic material was assessed and it was ascertained whether an articular surface incongruity, a gap between two fracture fragments, or an intraarticular bone element was detectable. For each point of evaluation a confidence level of the evaluation was assessed on a five-point scale. Results: Ninety patients were classified as having correct alignment and osteosynthesis according to conventional X-ray, while when using the findings from axial CT scans only, 82 patients, and after the addition of multiplanar re-constructions (MPR) only 73 patients were found to have almost proper alignment and osteosynthesis. In 42 patients dehiscence of the fragments was diagnosed with MSCT, but was not visualized by X-ray, leading to surgical revision in eight patients, confirming the diagnosis. In five patients an intraarticular position of intraarticular material was confirmed with MSCT and surgical revision. A significant advantage for the evaluation confidence level was achieved for MPRs in comparison with axial CT scans and X-ray. Conclusion: The marked diagnostic advantage with a high evaluation confidence level in comparison with conventional X-ray methods justify the use of MSCT during postoperative monitoring of articular radial fractures treated with osteosynthesis. (orig.)

  2. Fragment reconstruction and bone plate fixation versus bridging plate fixation for treating highly comminuted femoral fractures in dogs: 35 cases (1987-1997)

    International Nuclear Information System (INIS)

    To compare fragment reconstruction and bone plate fixation versus bridging plate fixation for treating highly comminuted (> 4 fragments) femoral fractures in dogs. Retrospective study. 35 dogs with highly comminuted fractures of the femur. Medical records of all dogs included in this study were reviewed. Dogs had been treated with fragment reconstruction and bone plate application (n = 20) or major fragment alignment and bridging plate fixation (15). Postoperative and follow-up radiographs were evaluated. Operating and hospitalization times, bone alignment, bone healing, and complications were considered. There were no differences in hospitalization times, limb alignment, and complications between dogs with fractures treated with fragment reconstruction and dogs with fractures treated with bridging plate fixation. Dogs with fractures treated with bridging plate fixation had shorter operative times and faster times to radiographic evidence of bone healing. Bridging plate fixation is quicker to perform and results in faster healing than fragment reconstruction and bone plate fixation when used to treat comminuted femoral fractures

  3. Modified Thompson Quadricepsplasty to Treat Extension Contracture of the Knee after Surgical Treatment of Patellar Fractures

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    Chi-Chuan Wu

    2007-06-01

    Full Text Available Background: This retrospective study reported on the treatment of extension contracture ofthe knee after surgical treatment of patellar fractures.Methods: Twenty-eight patients who sustained extension contractures of the knee aftersurgical treatment of patellar fractures 8-14 months previously (mean, 12months were treated. A midline longitudinal approach was made. Afterimplants were removed, adhesions between the vastus intermedius and thefemur, and in the patellofemoral joint were released completely. The kneewas flexed up to 110 degrees. Postoperatively, a continuous passive motion(CPM machine was used to assist knee flexion. Physical therapy was continuedat local clinics. No aids were necessary for ambulation.Results: Twenty-four patients were followed-up for at least 2 years (range, 2.1-7.6years; mean, 4.6 years. The mean arc of motion of the knee improved from72 degrees preoperatively to 123 degrees (p < 0.001. Knee functionimproved from an unsatisfactory grade in all 24 patients preoperatively to asatisfactory grade in 21 patients (p < 0.001. There were no significant surgicalcomplications.Conclusion: This surgical technique has a high success rate with few complications.Above all, the surgical procedure is relatively simple. Therefore, it can beconsidered for indicated cases.

  4. Long-term results of transpedicle body augmenter in treating burst fractures

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    Li Allen

    2007-01-01

    Full Text Available Background: Short-segment fixation alone to treat thoracolumbar burst fractures is common but it has a 20-50% incidence of implant failure and rekyphosis. A transpedicle body augmenter (TpBA to reinforce the vertebral body via posterior approach has been reported to prevent implant failure and increase the clinical success rate in treating burst fracture. This article is to evaluate the long-term results of short-segment fixation with TpBA for treatment of thoracolumbar burst fractures. Materials and Methods: Patients included in the study had a single-level burst fracture involving T11-L2 and no distraction or rotation element with limited neurological deficit. Patients in the control group (n = 42 were treated with short-segment posterior instrumentation alone, whereas patients in the augmented group (n = 90 were treated with a titanium spacer designed for transpedicle body reconstruction. The follow-up was 48-101 months. The radiographic and clinical results were evaluated and compared by Student′s t test and Fisher′s exact test. Results: The blood loss, operation time and hospitalization were similar in both the groups. The immediate postoperative anterior vertebral restoration rate of the augmented group was similar to that of the control group (97.6% ± 2.4% vs . 96.6% ± 3.2%. The final anterior vertebral restoration was greater in the augmented group than in the control group (93.3% ± 3.4% vs . 62.5% ± 11.2%. Immediate postoperative kyphotic angles were not significantly different between the groups (3.0° ± 1.8° vs . 5.1° ± 2.3°. The final kyphotic angles were less in the augmented group than the control group (7.3° ± 3.5° vs . 20.1° ± 5.4°. The augmented group had less ( P < 0.001 implant failure [0% (n=0 vs . 23.8% (n=10] for the control group and more patients ( P < 0.001 with no pain or minimal or occasional pain (Grade P1 or P2 than the control group [90.0% (n=81 vs . 66.7% (n=28]. All patients in the augmented

  5. Intramedullary nail versus dynamic compression plate fixation in treating humeral shaft fractures: grading the evidence through a meta-analysis.

    Directory of Open Access Journals (Sweden)

    JianXiong Ma

    Full Text Available There is a debate regarding the choice of operative intervention in humeral shaft fractures that require surgical intervention. The choices for operative interventions include intramedullary nailing (IMN and dynamic compression plate (DCP. This meta-analysis was performed to compare fracture union, functional outcomes, and complication rates in patients treated with IMN or DCP for humeral shaft fractures and to develop GRADE (Grading of Recommendations, Assessment, Development, and Evaluation-based recommendations for using the procedures to treat humeral shaft fractures. A systematic search of all the studies published through December 2012 was conducted using the Medline, Embase, Sciencedirect, OVID and Cochrane Central databases. The randomized controlled trials (RCTs and quasi-RCTs that compared IMN with DCP in treating adult patients with humeral shaft fractures and provided data regarding the safety and clinical effects were identified. The demographic characteristics, adverse events and clinical outcomes were manually extracted from all of the selected studies. Ten studies that included a total of 448 patients met the inclusion criteria. The results of a meta-analysis indicated that both IMN and DCP can achieve similar fracture union with a similar incidence of radial nerve injury and infection. IMN was associated with an increased risk of shoulder impingement, more restriction of shoulder movement, an increased risk of intraoperative fracture comminution, a higher incidence of implant failure, and an increased risk of re-operation. The overall GRADE system evidence quality was very low, which reduces our confidence in the recommendations of this system. DCP may be superior to IMN in the treatment of humeral shaft fractures. Because of the low quality evidence currently available, high-quality RCTs are required.

  6. UNSTABLE INTERTROCHANTERIC FRACTURE IN ELDERLY TREATED WITH CEMENTED BIPOLAR HEMIARTHROPLASTY AND TROCHANTERIC RECONSTRUCTION

    Directory of Open Access Journals (Sweden)

    Jagadeesh Kumar

    2015-06-01

    Full Text Available INTRODUCTION : Unstable inter - trochanteric fracture in the geriatric population is a common injury and is associated with poor bone quality, excessive collapse, loss of fixation, and cut - out of the lag screw, are the common problems of attempts to fix these fractures. Pr esent study is an attempt to evaluate the functional outcome of primary cemented bipolar hemiarthroplasty and trochanter reconstruction in these patients. MATERIALS AND METHOD S : This prospective study included 30 cases of elderly osteoporotic patients with mean age of 65.4 years who sustained comminuted inter - trochanteric femur fracture treated with cemented bipolar hemiarthroplasty& tension band wiring for greater trochanter rec onstruction. It is an essential technical step to avoid complication like abductor lurch gait. W e here describe a technique of reconstruction and fixation of greater trochanter using tension band wiring in figure of eight pattern. The patients were followe d up at six week, three month, six month and one year postoperatively and assessed using Harris Hip Score (HHS. RESULTS : The mean HHS score was was 85.6+SD 9.5 (range from 74 to 96. B y the end of one year. The main clinical measures were early post - opera tive full weight bearing, post - operative complication & functional outcome. The time to full weight bearing, the rate of post - operative complications & functional outcome was significantly better in cemented bipolar arthroplasty group . DISCUSSION : The chan ges in HHS up to six months periods are much greater which starts showing a stable trend thereafter. Fair to good scores were observed in all the patients. The purpose of its use was that while Harris Hip Score (HHS provides information on a multitude of factors. Superficial infection in 2 patients, anterior thigh pain in a patient, shortening less than 2cms in 2 patients, abductor lurch in a patient are the complications noted in post - operative period, but no patient required

  7. The effect of post-core and ferrule on the fracture resistance of endodontically treated maxillary central incisors

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    Sendhilnathan Dakshinamurthy

    2008-01-01

    Full Text Available Aim: To evaluate the effect of post reinforcement, post type and ferrule on the fracture resistance of endodontically treated maxillary central incisors. Materials and Methods: Sixty central incisor teeth were selected and grouped into six groups, viz. A, B, C, D, E, and F, each consisting of 10 specimens. Group A specimens were not subjected to any restorative treatment. Group B specimens were endodontically treated and crowned. Specimens of groups C and D were restored with custom cast post and core. Specimens of groups E and F were treated with prefabricated titanium post and composite core. Specimens of groups C and E were restored with porcelain-fused metal (PFM crown having 2 mm ferrule. Specimens of groups D and F were restored with PFM crown having no ferrule. All the specimens were subjected to load (newton, N on the lingual surface at a 135° angle to the long axis with a universal testing machine until it fractured. The fracture load and mode of fracture of each specimen were noted. One-way analysis of variance with Tukey honestly significant difference procedure was employed to identify the significant difference among the groups at 5% level (P < 0.05. Results: There were significant differences among the six groups studied (P < 0.0001. The highest fracture strength was recorded with specimen of group C (1376.7 N. There were significant differences between groups A and D versus groups B, E, and F. There were no significant differences between groups B, E, and F. Cervical root fracture was the predominant mode of failure in all the groups except group A. Conclusion: The results showed that endodontically treated teeth restored with custom cast post core were as strong as the untreated group. Teeth restored with custom cast post core were better resistant to fracture than teeth restored with prefabricated titanium post and composite core. Ferrule is more important in custom cast post core than in prefabricated post and composite core.

  8. Fracture severity of distal radius fractures treated with locking plating correlates with limitations in ulnar abduction and inferior health-related quality of life

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    Tsitsilonis, Serafim

    2016-07-01

    Full Text Available Introduction/background: The operative treatment of distal radius fractures has significantly increased after the introduction of locking plates. The aim of the present study was the evaluation of health-related quality of life, functional and radiological outcome of patients with distal radius fractures treated with the locking compression plate (LCP.Materials and methods: In the present study 128 patients (130 fractures that were operatively treated with the LCP (2.4 mm/3.5 mm, Synthes were retrospectively evaluated. Mean follow-up was (SD 10.6. The fractures were radiographically evaluated (radial inclination, palmar tilt, ulnar variance pre-, postoperatively and at the last follow-up visit. Range of motion (ROM was documented. Grip strength was assessed with the use of a JAMAR dynamometer. The score for disabilities of the arm, shoulder and hand (DASH and the Gartland-Werley score (GWS were evaluated. Health-associated quality of life was assessed with use of SF-36 Health Survey.Results: Postoperative reduction was excellent; at the last follow-up visit only minimal reduction loss was observed. Except for pronation, a statistically significant decrease of ROM was present; in most cases that was not disturbing for the patients. The injured side achieved 83.9% of grip strength of the intact side. Mean DASH was 18.9 and mean GWS was 3.5. Health-associated quality of life was generally not compromised. However, limitations in ulnar abduction correlated with inferior quality of life. Fracture severity correlated with inferior quality of life, despite the absence of correlation with the functional and radiological outcome. Complication rate was low.Conclusions: Fracture severity seems to affect ulnar abduction and therefore patient quality of life, despite almost anatomical reduction; the objective and subjective scores were in most cases excellent. Modern everyday activities, such as keyboard typing, could be associated with the present results.

  9. A comparison of effi cacy of femoral and tibial fractures healing treated by static and dynamic intramedullary nails

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    Đemil Omerović

    2012-12-01

    Full Text Available Introduction: Intramedullary nailing is synthesis and  consolidation of fracture fragments with the main goalto gain strength and permanent placement of the implants. Two techniques of intramedullary osteosynthesis are used: with dynamic or with static intramedullary nail. Dynamization include conversion of static nail by removing screws from the longest fragment. The aim of this study is to determine whether there is a difference in the speed and quality of healing of the type A and B fractures of the femur and tibia treated by static or dynamic intramedullary nails and to compare the results.Methods: The study was conducted on a total of 129 patients with closed fractures of the diaphysis of the femur and tibia type A and type B. Patients were divided into two groups, based on the applied operating method, static or dynamic intramedullary osteosynthesis.Results: The average number of weeks of healing femoral and tibial fractures was slightly in advantage of static intramedullary osteosynthesis, it was 17.08 weeks (SD=3.382. The average number of weeks of healing in 23 patients with fractures of the femur, treated by dynamic intramedullary osteosynthesis was 17.83 (SD=2.978.Conclusion: We can conclude that static intramedullary nailing osteosynthesis unable movements between fragments which directly stimulates bone formation and formation of minimal callus. Static intramedullary ostesinthesys resolve the problem of stabilizing the fracture, limb shortening and rotation of fragments.

  10. Evaluation of Tibial Condyle Fractures Treated with Ilizarov Fixation, A Prospective Study

    OpenAIRE

    Reddy R, Sandeep; Kumar C, Yashavantha; Shah, Harshad M; Golla, Dinesh Kumar; Ganesh D J, Niranthara; Kumar P, Ashok

    2014-01-01

    Background: Tibial plateau fractures are associated with significant soft tissue injuries which increases the risks of complications and must be considered when managing tibial plateau fractures. Various modalities of treatment are available for treatment of these fractures but Ilizarov fixation has a special advantage over others. Review of literature shows many studies of Ilizarov fixation in the treatment of tibial plateau fractures with variable results. Aim of our study was to evaluate t...

  11. Fractures

    Science.gov (United States)

    ... commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the ...

  12. Fracture resistance of endodontically treated teeth restored with indirect composite inlay and onlay restorations – An in vitro study

    Science.gov (United States)

    Alshiddi, Ibraheem F.; Aljinbaz, Amjad

    2015-01-01

    Objective The purpose of this in vitro study was to evaluate and compare the fracture resistance and fracture mode of extensive indirect inlay and onlay composite resin restorations performed for endodontically treated premolars. Materials and methods A total of 55 extracted maxillary premolars were randomly divided into four groups. The first group (n = 15) remained untreated to serve as a positive control; the second group (n = 15) was endodontically treated with inlay cavities prepared and restored with indirect composite inlay restorations; the third group (n = 15) was also endodontically treated with onlay cavities prepared and restored with indirect composite onlay restorations; and the fourth group (n = 10) was endodontically treated with mesio-occlusodistal (MOD) cavities prepared and left unrestored to serve as negative controls. Dual cure indirect composite resin was used to fabricate the inlay and onlay restorations performed for the second and third groups, respectively. All teeth were subjected to compressive axial loading test using a metal ball (6 mm in diameter) in a universal testing machine (Instron 1195) with a cross-head speed of 0.5 mm/min until a fracture occurred. Statistical analysis of fracture resistance and fracture mode were performed with analysis of variance (ANOVA) (α = 0.05) and Kruskal–Wallis (α = 0.05) tests, respectively. Results For the four treatment groups, the mean fracture resistance values were 1326.9 N, 1500.1 N, 1006.1 N, and 702.7 N, respectively. Statistical analyses showed no significant differences between the mean fracture resistance of the intact tooth group and the inlay restoration group (p > 0.05), while significant differences were observed between the mean fracture resistance of all the other groups (p inlay and onlay restorations. However, the fractures that accompanied the inlay restorations were more severe and were unable to be restored. PMID:26792970

  13. Monteggia fracture dislocation equivalents——analysis of eighteen cases treated by open reduction and internal fixation

    Institute of Scientific and Technical Information of China (English)

    Ajay Pal Singh; Ish Kumar Dhammi; Anil Kumar Jain; Rajeev Raman; Prashant Modi

    2011-01-01

    Objective: Monteggia fracture dislocation equivalent, though already described by Bado, is still an unclassified entity. We aimed to retrospectively analyze 18 cases of Monteggia variants and discuss the injury mechanisms, management, and outcome along with a re view of the literature. Methods: A retrospective record of Monteggia fracture dislocation (2003-2008) was reviewed from medical record department of our institute. Classic Monteggia fracture dislocation, children below 12 years or adults over 50 years, as well as open grade Ⅱ & Ⅲ cases were excluded from this study. Monteggia variant inclusion criteria included fracture of the proximal ulna together with a fracture of the radial head or neck and skeletal maturity. Totally 26 patients were identified with Monteggia variants and 18 were available for follow-up, including 11 males and 7 females with the mean age of 35 years. The ulna fracture was treated by compression plating along with tension band wiring. Radial head/neck was reconstructed in 12 patients while excised in 6 patients. Results: Follow-up ranged from 1 -4 years, mean 2.6 years. Patients were assessed clinicoradiologically. Mayo Elbow Performance Score was employed to assess the outcomes. At final follow-up, the results were excellent in 10 patients, good in 4, fair in 2 and poor in 2. Mean range of motion of the elbow was 20°, 116°, 50° and 55° for extension, flexion, pronation and supination, respectively. Two patients had complications in the form of heterotopic ossification and stiffness of the elbow. One nonunion ulna, primarily treated by tension band wiring, was managed by refixation with locking reconstruction plate and bone grafting. Bone grafting was only required in this patient for nonunion. Another patient had implants removed on his request. The results in our series closely correlated with extent of intraarticular damage, coronoid fracture and comminuted fractures. Conclusions: Monteggia fracture dislocation equivalents

  14. Fractures of the radial head treated by internal fixation: late results in 26 cases.

    Science.gov (United States)

    Esser, R D; Davis, S; Taavao, T

    1995-01-01

    Twenty-six patients, ranging in age from 14 to 57 years (average 29 years), were evaluated an average of 7 years and 4 months (range 1-14 years) after open reduction and internal fixation of a displaced radial head fracture. Using Mason's classification, there were 11 type II fractures, 9 type III fractures, and 6 type IV fractures with associated dislocation of the elbow. Seven patients had ipsilateral extremity injuries that included fractures of the coronoid process, capitellum, humerus, and distal radius. Using the Broberg and Morrey elbow score, good or excellent results were achieved in all Mason type II and type III fractures. Four of the six Mason type IV fractures were rated good or excellent. Fair results were obtained in two patients who had an associated dislocation of the elbow and multiple ipsilateral extremity injuries. In these two patients, secondary excision of the radial head relieved pain and yielded some improvement in flexion and forearm rotation. PMID:7562154

  15. Fracture resistance of structurally compromised and normal endodontically treated teeth restored with different post systems: An in vitro study

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    Vajihesadat Mortazavi

    2012-01-01

    Full Text Available Background: With the aim of developing methods that could increase the fracture resistance of structurally compromised endodontically treated teeth, this study was conducted to compare the effect of three esthetic post systems on the fracture resistance and failure modes of structurally compromised and normal roots. Materials and Methods: Forty five extracted and endodontically treated maxillary central teeth were assigned to 5 experimental groups (n=9. In two groups, the post spaces were prepared with the corresponding drills of the post systems to be restored with double taper light posts (DT.Light-Post (group DT.N and zirconia posts (Cosmopost (group Zr.N. In other 3 groups thin wall canals were simulated to be restored with Double taper Light posts (DT.W, double taper Light posts and Ribbond fibers (DT+R.W and Zirconia posts (Zr.W. After access cavity restoration and thermocycling, compressive load was applied and the fracture strength values and failure modes were evaluated. Data were analyzed using two-way ANOVA, Tukey and Fisher exact tests (P<0.05. Results: The mean failure loads (N were 678.56, 638.22, 732.44, 603.44 and 573.67 for groups DT.N, Zr.N, DT.W, DT+R.W and Zr.w respectively. Group DT+R.W exhibited significantly higher resistance to fracture compared to groups Zr.N, DT.W and Zr.w (P<0.05. A significant difference was detected between groups DT.N and Zr.W (P=0.027. Zirconia posts showed significantly higher root fracture compared to fiber posts (P=0.004. Conclusion: The structurally compromised teeth restored with double taper light posts and Ribbond fibers showed the most fracture resistance and their strengths were comparable to those of normal roots restored with double taper light posts. More desirable fracture patterns were observed in teeth restored with fiber posts.

  16. Influence of coronal restorations on the fracture resistance of root canal-treated premolar and molar teeth: a retrospective study.

    Science.gov (United States)

    Dammaschke, Till; Nykiel, Kathrin; Sagheri, Darius; Schäfer, Edgar

    2013-08-01

    To evaluate the influence of coronal restorations on the fracture resistance of endodontically treated teeth, 676 root canal-filled and restored posterior teeth were evaluated after a mean period of 9.7 (± 2.8; minimum: 5) years. A total of 86.2% of the endodontically treated and restored teeth survived the mean observation period of 9.7 years without fracture. The overall survival period was 13.6 (± 0.2) years. All teeth with gold partial crowns survived without fractures (n = 24). Teeth with crowns and adhesively sealed access cavities showed a mean survival period of 15.3 (± 0.4) years, with crown and bridge restorations 14.0 (± 0.3), with individual metal posts 13.9 (± 0.2), with composite fillings 13.4 (± 0.5), with prefabricated metal posts 12.7 (± 0.6), with amalgam fillings 11.8 (± 0.6) and with glass ionomer cements (GIC) 6.6 (± 0.5) years. Teeth with one or two surfaces restored by amalgam, composite or GIC showed a significantly lower fracture rate than teeth with three and more restored surfaces (P < 0.05). The mean fracture rate of teeth restored with GIC was significantly higher when compared with all other groups (P < 0.001). In general, endodontically treated teeth restored with prosthetic restorations demonstrated a significantly lower mean fracture rate than teeth restored with fillings. Cavities with up to three surfaces may well be successfully restored adhesively with composite filling material. PMID:23890259

  17. Frequency of infection after extraction of involved third molar in mandibular angle fractures treated with rigid fixation

    International Nuclear Information System (INIS)

    Objective: To determine the frequency of post-operative infection in patients with mandibular angle fractures treated with rigid fixation after extraction of involved third molar. Materials and Methods: In a total of 100 patients undergoing open reduction and internal fixation of mandibular angle fractures in which involved third molar will be extracted were included from Department of Oral and Maxillofacial Surgery, Mayo Hospital, Lahore. Procedure was performed by the same consultant and post operatively patients were assessed by two post graduate trainees who were trained previously to check Infection, on 1st, 2nd, 4th and 6th weeks post operatively. All the observations were entered on preformed proforma. Data was entered and analyzed by using SPSS version 10.0 Results: According to this study, the mean age of patients was 33.22 + 9.155 years. Minimum and maxi-mum age of patients was 18 years and 50 years with range of 32 years. There were 83 (83.0%) male patients while only 17 (17%) female patients presented with mandibular angle fractures. The rate of infection at week 1 was higher (9 (9.0%) cases), but gradually decreased in next follow up. 8 (8.0%) at 2nd week, 7 (7.0%) at week 4 and only 6 (6.0%) in last follow up at week 6 after open reduction and internal fixation of mandibular angle fractures with extraction of third molar. Conclusion: The frequency of post-operative infection in patients with mandibular angle fractures treated with rigid fixation after extraction of third molar was 30% at different follow ups in which 9% patients had infection at first week, 8 patients had at 2nd week, 7 patients had at 6th week and 6% patients presented with infection at last follow up. Overall the infection rate is lower in patients with mandibular angle fractures treated with rigid fixation after extraction of third molar. (author)

  18. Cartilage defect of lunate facet of distal radius after fracture treated with osteochondral autograft from knee.

    Science.gov (United States)

    Mall, Nathan A; Rubin, David A; Brophy, Robert H; Goldfarb, Charles A

    2013-07-01

    We describe using an osteochondral autograft from the lateral femoral condyle of the knee to treat a symptomatic die-punch lesion of the lunate facet of the distal radius. An 18-year-old woman who sustained a distal radius fracture remained symptomatic after nonoperative treatment and diagnostic wrist arthroscopy with microfracture. We used a commercial harvesting system to transfer an osteochondral plug into a cartilage defect involving the lunate facet of the distal radius. At final follow-up, 34 months after surgery, the patient was assessed with a visual analog scale (VAS) and Disabilities of the Arm, Shoulder, and Hand (DASH) scores and with a comprehensive physical examination. Magnetic resonance arthrogram was used to assess articular cartilage status. VAS pain score improved from 7 before surgery to 0.5 after surgery. Postoperative DASH score was 0. The patient was asymptomatic and had satisfactory wrist motion without mechanical symptoms. Magnetic resonance arthrogram showed the transferred osteochondral autograft incorporated in excellent position. PMID:24078947

  19. Spinal loads after osteoporotic vertebral fractures treated by vertebroplasty or kyphoplasty

    OpenAIRE

    Rohlmann, Antonius; Zander, Thomas; Bergmann, Georg

    2005-01-01

    Vertebroplasty and kyphoplasty are routine treatments for compression fractures of vertebral bodies. A wedge-shaped compression fracture shifts the centre of gravity of the upper body anteriorly and generally, this shift can be compensated in the spine and in the hips. However, it is still unclear how a wedge-shaped compression fracture of a vertebra increases forces in the trunk muscle and the intradiscal pressure in the adjacent discs. A nonlinear finite element model of the lumbar spine wa...

  20. BOTH BONES FOREARM FRACTURES TREATED WITH LC-DCP: A SURGICAL OUTCOME

    OpenAIRE

    Ranganath; Prakash; Ravish; Sumanth

    2014-01-01

    Fractures of the forearm present a unique management problem for years. A forearm fracture involving both bones requires open anatomical reduction with stable fixation.[1] The forearm represents the critical anatomic unit of upper limb, permitting the effect of organ of the upper limb, the hand, to perform multi axial daily activities of living. Historically, the closed management of forearm fractures has been met with frustration in adults and resulted in poor functional ...

  1. Treating postmenopausal osteoporosis in women at increased risk of fracture – critical appraisal of bazedoxifene: a review

    Directory of Open Access Journals (Sweden)

    Peter Vestergaard

    2009-08-01

    Full Text Available Peter Vestergaard, Susanna vid Streym ThomsenDepartment of Endocrinology and Metabolism C, Aarhus University Hospital, Aarhus, DenmarkAbstract: Several categories of drugs to treat osteoporosis exist in the form of bisphosphonates, strontium, parathyroid hormone, and selective estrogen receptor modulators (SERM. Advantages and disadvantages exist for each category as some patients may, for example, not tolerate bisphosphonates for gastrointestinal side effects, and especially in women in whom osteoporosis is frequent, several options for treatment are needed. The objectives of this review were to critically appraise the effects of bazedoxifene on risk of fractures especially in women at high risk of fractures. A systematic literature search was conducted for studies, especially randomized controlled trials with fractures as end-points. Bazedoxifene is a new member of the SERM group. The literature search identified one randomized controlled trial with fractures as end-point. This was a 3-year randomized double-blind placebo controlled trial in which 7492 postmenopausal women aged 55 to 85 years were randomly allocated to 1 bazedoxifene (20 [n = 1886] or 40 [n = 1872] mg/day; 2 raloxifene (60 mg/day, n = 1849; or 3 placebo (n = 1885. The risk of vertebral fractures decreased with both 20 (HR 0.58, 95% CI 0.38 to 0.89 and 40 (HR 0.63, 95% CI 0.42 to 0.96 mg of bazedoxifene per day compared to placebo. There was no reduction in non-vertebral fractures. A subgroup of women with a priori high risk of fractures was identified post hoc. In this subgroup there was a reduction in the risk of non-vertebral fractures with the 20 mg dose of bazedoxifene compared to placebo (HR 0.50, 95% CI 0.28 to 0.90. In the 40 mg bazedoxifene group no significant reduction in non-vertebral fractures was seen in this subgroup (HR 0.70, 95% CI 0.40 to 1.20. In general post-hoc defined subgroup analyses should be interpreted with caution. However, the results indicate that

  2. Osteochondral Fracture Lateral Femoral Condyle Treated with ORIF Using Z-Plasty: A Modification of Coonse and Adams Approach

    Directory of Open Access Journals (Sweden)

    Sanjay Agarwala

    2011-01-01

    Full Text Available Osteochondral fractures of lateral femoral condyle are common in adolescents and young adults. They are usually caused by direct trauma or twisting injuries of the knee. We present a case of large osteochondral fracture of lateral femoral condyle involving the articular surface in a fifteen-year-old male with a positive history of significant weight gain of 5 kilograms in last six months. Blood investigations reported low vitamin D and testosterone levels with elevated alkaline phosphatase. Adequate exposure was achieved by doing Z-plasty of quadriceps apparatus. The fracture was treated with open reduction and internal fixation using Herbert's screws. Medical management in the form of vitamin D and calcium along with testosterone was given. After the surgery, full weight-bearing was allowed at three months. At one year followup, patient has good quadriceps function without any weakness of the muscle.

  3. Comparative study of the results of compound tibial shaft fractures treated by Ilizarov ring fixators and limb reconstruction system fixators

    Institute of Scientific and Technical Information of China (English)

    Chandra Prakash Pal; Harish Kumar; Deepak Kumar; K.S.Dinkar; Vivek Mittal; Naveen Kumar Singh

    2015-01-01

    Purpose: Ilizarov ring fixator and limb reconstruction system (LRS) fixators have been used in the management of complex tibial fractures with severe soft tissue injuries, compound tibial fractures, and infected tibial nonunion for which conventional internal fixation cannot be contemplated.Fracture union and distraction osteogenesis can be done simultaneously with these external fixators, allowing early weight bearing.Several previous studies have shown almost equal results of rail and ring fixators for the compound tibial shaft fractures.Thus we performed a prospective study to evaluate the union rate, functional outcome and amount of limb lengthening after the treatment of compound tibial shaft fractures with or without infected nonunion by ring or LRS fixators.Methods: This prospective study was done at Sarojini Naidu Medical College and Hospital, Agra, India and included 32 patients of compound tibial shaft fractures with or without infected nonunion.There were 26 males and 6 females and the average age was 40 years.Patients were randomly divided into two groups (n =16 for each): one underwent Ilizarov fixation and the other received LRS fixation.Cases were followed up for 3-24 months, 6 months on average from September 2012 to October 2014.Functional and radiological outcomes were assessed using the Association for the Study and Application of Methods of Ilizarov (ASAMI) criteria for both rail and ring fixators.Results: Union was achieved in all cases.Radiological outcome was found excellent in 68.75%, good in 18.75% and fair in 12.50% of cases treated by rail fixators whereas it was excellent in 56.25%, good in 18.75%, fair in 12.50% and poor in 12.50% of cases treated by ring fixators.Functional result was satisfactory in 75.00% of cases treated by rail fixator and 68.75% of cases treated by ring fixators whereas the corresponding rate of unsatisfactory was 25.00% vs.31.25%.Conclusion: In our short-term assessment, LRS fixators show a

  4. The functional outcome of intraarticular distal humeral fractures treated with surgery

    Directory of Open Access Journals (Sweden)

    Ufuk Nalbantoglu

    2013-04-01

    Conclusion: There is no standart treatment for the comminuted distal humeral fractures. Surgical approach, incision, hardware and fixation types should preferred according to fracture type, site and level. Every technique which provides rigid fixation, alingement and early motion can restore elbow motion. [Hand Microsurg 2013; 2(1.000: 28-34

  5. CLINICAL OUTCOME OF INTRA - ARTICULAR DISTAL RADIUS FRACTURES TREATED WITH PLATE AND SCREWS

    OpenAIRE

    Girish; Hosangadi; Suresh; Suryakanth

    2015-01-01

    BACKGROUND : Incidence of fractures of distal radius are increasing due to more geriatric population and road traffic accidents. The fundamental goal of distal radius fractures treatment is restoration of normal or near normal alignment and articular congruity. Restoration of the anatomy and articular surface may prevent the onset of arthritis ...

  6. Pelvic insufficiency fractures in postmenopausal woman with advanced cervical cancer treated by radiotherapy

    International Nuclear Information System (INIS)

    Purpose: To assess the predisposing factors and clinical characteristics of pelvic insufficiency fractures (PIF) in postmenopausal women with pelvic irradiation. Material and methods: A total 335 postmenopausal patients with cervical cancer of the intact uterus treated with radiation therapy between 1983 and 1998 were reviewed. Total external dose was delivered between 45 and 50.4 Gy with parallel opposed anteroposterior portals. Total brachytherapy dose at point A was delivered between 10 and 36 Gy. PIF were diagnosed by bone scintigraphy and confirmed by computed tomography. The cumulative incidence of symptomatic PIF was estimated by actuarial methods. Potential risk factors (age, weight, type II diabetes, delivery, menopause, total external dose, total brachytherapy dose) were assessed. Results: Fifty-seven (17.0%) of 335 patients were diagnosed as having PIF. Forty-seven patients were symptomatic and ten were asymptomatic. Parameters carrying a significant association with PIF were body weight 49 kg or below (P=0.044) in stepwise logistic regression analysis. The cumulative incidence of symptomatic PIF at 5 years was 17.9% calculated by the Kaplan-Meier method. A body weight of 49 kg or below and more than three deliveries were identified as having a significant effect on symptomatic PIF in univariate analysis (P=0.021, P=0.003, log-rank test) and Cox life table regression analysis (P=0.038, P=0.013). Five patients required narcotic agents and eight patients required hospital admission. Conclusions: We should consider reducing the dose contribution to the sacrum and sacroilac joints, without underdosing the tumor, especially in postmenopausal women with many deliveries or low body weight

  7. Plantar calcaneal spurs in older people: longitudinal traction or vertical compression?

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    Landorf Karl B

    2008-08-01

    Full Text Available Abstract Background Plantar calcaneal spurs are common, however their pathophysiology is poorly understood. This study aimed to evaluate the prevalence and correlates of plantar calcaneal spurs in a large sample of older people. Methods Weightbearing lateral foot radiographs of 216 people (140 women and 76 men aged 62 to 94 years (mean age 75.9, SD 6.6 were examined for plantar calcaneal and Achilles tendon spurs. Associations between the presence of spurs and sex, body mass index, radiographic measures of foot posture, self-reported co-morbidities and current or previous heel pain were then explored. Results Of the 216 participants, 119 (55% had at least one plantar calcaneal spur and 103 (48% had at least one Achilles tendon spur. Those with plantar calcaneal spurs were more likely to have Achilles tendon spurs (odds ratio [OR] = 2.0, 95% confidence interval [CI] 1.2 to 3.5. Prevalence of spurs did not differ according to sex. Participants with plantar calcaneal spurs were more likely to be obese (OR = 7.9, 95% CI 3.6 to 17.0, report osteoarthritis (OR = 2.6, 95% CI 1.6 to 4.8 and have current or previous heel pain (OR = 4.6, 95% CI 2.3 to 9.4. No relationship was found between the presence of calcaneal spurs and radiographic measures of foot posture. Conclusion Calcaneal spurs are common in older men and women and are related to obesity, osteoarthritis and current or previous heel pain, but are unrelated to radiographic measurements of foot posture. These findings support the theory that plantar calcaneal spurs may be an adaptive response to vertical compression of the heel rather than longitudinal traction at the calcaneal enthesis.

  8. USE OF THE PFO® NUT IN TREATING FRACTURES OF THE PROXIMAL THIRD OF THE HUMERUS IN PATIENTS WITH BONE FRAGILITY

    OpenAIRE

    Miyazaki, Alberto Naoki; Fregoneze, Marcelo; Santos, Pedro Doneux; da Silva, Luciana Andrade; Pires, Davi Calixto; Mota Neto, Jose da; de Camargo Rossato, Luis Henrique; Checchia, Sergio Luiz

    2015-01-01

    Objective: To evaluate the clinical results from application of the PFO® bone fixation nut, which was developed for use with 4.5 mm cortical screws, and to analyze any complications or bone reactions caused by this synthesis in porotic bone. Method: Between May 1999 and November 2007, the PFO® nut was used on 23 patients who underwent osteosynthesis with a PFS 80® plate in the proximal segment, to treat acute fractures, pseudarthrosis or defective consolidations. The average age of the patien...

  9. In Vitro Evaluation of Access Cavity Location Effect on Fracture Resistance of Maxillary Central Endodontically Treated Teeth

    OpenAIRE

    Shirinzad, M.; Z. Khamverdi; S. Ghorbani

    2014-01-01

    Introduction & Objective: Preparation of access cavity to root canal is a critical phase in endo-dontic treatment. The purpose of this study was to evaluate the effect of access cavity loca-tion (labial or palatal) on fracture resistance of endodontically treated maxillary central teeth. Materials & Methods: In this experimental laboratorial study, 84 intact human maxillary central incisors with similar dimensions were selected. The teeth were divided into 4 test groups as follows: Group 1 : ...

  10. Periprosthetic fracture-dislocation in a loosened total knee replacement treated by knee arthrodesis

    International Nuclear Information System (INIS)

    We present a patient who was operated four years before performing a total knee replacement. She fell down resulting a periprosthetic femoral fracture and a prosthetic dislocation. After evaluating different treatments, we decided to do prosthetic removal and a knee arthrodesis using an intramedullar nail. The femoral fracture was fixed with wire cerclages. Knee arthrodesis is a procedure uses as a last option for the treatment of infected or loosed arthroplasties. In our case it was difficult to consider any other reconstructive procedure due to the association of fracture, dislocation and loosening. The evolution has been satisfactory with good functional result and without pain

  11. Landing on your own two feet: a case report of bilateral calcaneus and open pilon fractures.

    Science.gov (United States)

    Tiedeken, Nathan C; Hampton, David; Shaffer, Gene

    2014-01-01

    High energy fractures of the distal tibial plafond and calcaneus have been associated with high functional morbidity and wound complications. Although both of these fractures result from a similar mechanism, they have rarely been reported to occur on an ipsilateral extremity. The combination of these 2 injuries on the same extremity would increase the likelihood of an adverse surgical or functional outcome. We present the case and management strategy of a 43-year-old male with bilateral open pilon fractures and closed calcaneal fractures after falling from a height. A staged protocol was used for the bilateral pilon fractures, with external fixation until operative fixation on day 9. Nonoperative management of the calcaneal fractures resulted in a successful functional outcome at 10 months of follow-up. Treatment of this fracture pattern must incorporate the condition of the soft tissues, an understanding of the fractures, and minimize patient risk factors to optimize the functional and surgical outcomes. PMID:24856663

  12. SACRAL FRACTURES

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective. To delineate the clinical spectrum and treatment choice of sacral fractures.Methods. In this series, 39 sacral fractures were retrospectively reviewed and classified utilizing Denis′ classification. There were 21 Zone Ⅰ fractures, 6 Zone Ⅱ fractures and 12 Zone Ⅲ fractures. Neurological deficits were present in seven patients. Thirty seven patients were treated conservatively and two underwent surgical management.Results.Thirty eight patients were followed up for three months to 19 years. Thirty three have recovered, four improved, and one remained disabled.Conclusion.The treatment of sacral fractures requires assessment of pelvic stability and existing nerve injury. The patients with pelvic ring instability and neurological deficits should be treated with fracture reduction and stability reconstruction. When the patients with pelvic fracture are complicated with neurological deficits, sacral fracture should be first suspected. Once the diagnosis of sacral fracture is made, fracture reduction should be indicated. Conservative treatment usually permits satisfactory results.

  13. The treatment of complex proximal humeral fractures: analysis of the results of 55 cases treated with PHILOS plate.

    Science.gov (United States)

    Fattoretto, D; Borgo, A; Iacobellis, C

    2016-08-01

    Complex proximal humerus fractures are often difficult to treat. Their frequency is high, especially in the elderly, and their treatment is still controversial. The aim of this study was to analyze the clinical and radiological results achieved by patients with complex proximal humerus fractures, treated with PHILOS plate only. A cohort of 55 patients was selected. The mean age was 63.4 (range 33-89), while the mean follow-up time was 21.5 months (range 6-75). Clinical outcome was evaluated with the "Constant-Murley shoulder score." All the informations about the presence of complications were gathered, and radiological images were used to calculate the head-shaft angle. The overall mean Constant score was 61.93 ± 18.59, the Individual CS was 70 ± 20 % and the Relative CS was 83 ± 23 %. No significant differences were found between fractures Neer 3 and Neer 4 and between the surgical approaches (delta-split vs. delto-pectoral). Six patients had a fracture with dislocation, seven patients (12.7 %) had complications while in four patients a head-shaft angle beyond the normal range was found. Osteosynthesis with PHILOS plate is stable in the greater part of the cases, and it allows an earlier rehabilitation and so a good functional result, which could be compromised by a prolonged immobilization. Therefore, PHILOS plate is a good option for the treatment of complex proximal humerus fractures. PMID:26833189

  14. Relationship between bone mineral density changes and fracture risk reduction in patients treated with strontium ranelate

    DEFF Research Database (Denmark)

    Bruyere, Olivier; Roux, Christian; Detilleux, Johann; Slosman, Daniel O; Spector, Tim D; Fardellone, Patrice; Brixen, Kim; Devogelaer, Jean-Pierre; Diaz-Curiel, Manuel; Albanese, Carlina; Kaufman, Jean-Marc; Pors-Nielsen, Stig; Reginster, Jean-Yves

    2007-01-01

    OBJECTIVE: Our objective was to analyze the relationship between bone mineral density (BMD) changes and fracture incidence during 3-yr treatment with strontium ranelate. PATIENTS: Women from the strontium ranelate arm of the Spinal Osteoporosis Therapeutic Intervention study and the TReatment Of...... Peripheral OSteoporosis study were evaluated. OUTCOME MEASURES: The outcome measures included BMD at the lumbar spine, femoral neck, and total proximal femur assessed at baseline and after a follow-up of 1 and 3 yr; semiquantitative visual assessment of vertebral fractures; and nonvertebral fractures based...... on written documentation. RESULTS: After 3 yr of strontium ranelate treatment, each percentage point increase in femoral neck and total proximal femur BMD was associated with a 3% (95% adjusted confidence interval, 1-5%) and 2% (1-4%) reduction in risk of a new vertebral fracture, respectively. The 3...

  15. Local and Widespread Hyperalgesia After Isolated Tibial Shaft Fractures Treated with Intramedullary Nailing

    DEFF Research Database (Denmark)

    Larsen, Peter; Elsøe, Rasmus; Graven-Nielsen, Thomas;

    2016-01-01

    OBJECTIVES: Knee pain is accepted as a common complication to intramedullary nailing of tibial fractures. However, no studies have systematically studied the pain sequel following tibial fractures. The objective of this study was to assess pain and hyperalgesia from 6 weeks to 12 months...... postoperatively after intramedullary nailing of tibial shaft fracture. METHODS: A total of 39 patients were included in this 12-month follow-up study. After 6 weeks, 3, 6, and 12 months postoperatively the pain intensity was measured on a visual analog scale (VAS) and the pressure pain sensitivity was assessed...... bilaterally by pain pressure thresholds (PPTs). RESULTS: The mean age at the time of fracture was 42.9 years. Twelve months after surgery, the pain intensity for worst pain during the last 24 hours was 1.8 ± 2.7 cm. The PPTs progressively increased from 6 weeks after surgery to 12 months postoperatively for...

  16. The influence of microstruture on fracture toughness of vacuum heat treated HSS AISI M2

    OpenAIRE

    Leskovšek, Vojteh; Ule, Boris; Liščić, Božidar

    2015-01-01

    The microstructure of AISI M2 high-speed can be substantially modified by vacuum heat treatment in order to optimize the ratio between hardness and fracture toughness, which is, however, significantly affected by the volume fractions of retained austenite and undissolved eutectic carbides, as well as the mean distance between these carbides. Calculated fracture toughness values, which were obtained using a newly developed semi-empirical equation, based on the stress-modified critical strain c...

  17. Relationship between the functional outcomes and radiological results of conservatively treated displaced proximal humerus fractures in the elderly: A prospective study

    OpenAIRE

    Mehmet Kerem Canbora; Ozkan Kose; Atilla Polat; Levent Konukoglu; Mucahit Gorgec

    2013-01-01

    Purpose: The purpose of this prospective study is to investigate the relationship between the functional outcome and the radiographic results of conservatively treated two-, three- and four-part proximal humeral fractures in patients aged over 65 years. Materials and Methods: The study comprised 29 prospectively followed cases aged over 65 years who presented with displaced proximal humerus fracture between 2009 and 2011. The fractures were classified according to the Neer classification ...

  18. The conundrum of calcaneal spurs: do they matter?

    LENUS (Irish Health Repository)

    Moroney, Paul J

    2013-12-30

    Background: Chronic plantar heel pain is a common and potentially debilitating condition, often caused by plantar fasciitis. Plantar calcaneal spurs were originally considered the cause of plantar fasciitis but are now regarded as an incidental finding by most authors. We aimed to test this hypothesis and to investigate predisposing factors for the development of spurs. Methods: We reviewed all lateral ankle X rays taken in our institution over a 6-month period and identified all X rays demonstrating calcaneal spurs. Then, we identified a similar number of age- and sex-matched controls without spurs. We contacted both groups by telephone and compared symptoms of heel pain, plantar fasciitis, associated comorbidities, and foot and ankle outcome scores (FAOSs). Results: We reviewed the X rays of 1103 consecutive patients and found a spur prevalence of 12.4%, more common in women and older patients. Questioning of the spur group and control group found a higher body mass index in the spur group. Patients with spurs were 4 times more likely to have diabetes mellitus and 10 times more likely to have lower-limb osteoarthritis. Patients with spurs had more foot pain and poorer FAOS than the control group, even when patients with plantar fasciitis were excluded. Conclusion: Our results demonstrate that the presence of a plantar calcaneal spur may be an indicator of foot pain independent of plantar fasciitis. Although spurs may not cause foot pain themselves, they may be an indication of other associated conditions. Clinical relevance: We have demonstrated the relevance of a radiographic finding once considered irrelevant.

  19. Bone Repair on Fractures Treated with Osteosynthesis, ir Laser, Bone Graft and Guided Bone Regeneration: Histomorfometric Study

    Science.gov (United States)

    dos Santos Aciole, Jouber Mateus; dos Santos Aciole, Gilberth Tadeu; Soares, Luiz Guilherme Pinheiro; Barbosa, Artur Felipe Santos; Santos, Jean Nunes; Pinheiro, Antonio Luiz Barbosa

    2011-08-01

    The aim of this study was to evaluate, through the analysis of histomorfometric, the repair of complete tibial fracture in rabbits fixed with osteosynthesis, treated or not with infrared laser light (λ780 nm, 50 mW, CW) associated or not to the use of hydroxyapatite and guided bone regeneration (GBR). Surgical fractures were created, under general anesthesia (Ketamina 0,4 ml/Kg IP and Xilazina 0,2 ml/Kg IP), on the dorsum of 15 Oryctolagus rabbits that were divided into 5 groups and maintained on individual cages, at day/night cycle, fed with solid laboratory pelted diet and had water ad libidum. On groups II, III, IV and V the fracture was fixed with wire osteosynthesis. Animals of groups III and V were grafted with hydroxyapatite and GBR technique used. Animals of groups IV and V were irradiated at every other day during two weeks (16 J/cm2, 4×4 J/cm2). Observation time was that of 30 days. After animal death (overdose of general anesthetics) the specimes were routinely processed to wax and underwent histological analysis by light microscopy. The histomorfometric analysis showed an increased bone neoformation, increased collagen deposition, less reabsorption and inflammation when laser was associated to the HATCP. It is concluded that IR laser light was able to accelerate fracture healing and the association with HATCP and GBR resulted on increased deposition of CHA.

  20. Inpatient cost of treating osteoporotic fractures in mainland China: a descriptive analysis

    Directory of Open Access Journals (Sweden)

    Yang YC

    2015-04-01

    Full Text Available Yicheng Yang,1 Fen Du,2 Wenyu Ye,3 Yu Chen,4 Jinghu Li,5 Jie Zhang,6 Helen Nicely,7 Russel Burge8 1Patient Outcomes and Real World Evidence, Lilly Suzhou Pharmaceutical Co, Ltd, Shanghai, 2Pharmacoeconomics and Outcomes Research, Beijing Brainpower Pharma Consulting Co, Ltd, Beijing, People's Republic of China; 3Real World Analytics Bio-Medicines, Eli Lilly and Company, Indianapolis, IN, USA; 4Medical Department, Lilly Suzhou Pharmaceutical Co, Ltd, Shanghai, 5Secretariate, 6Technology Standard Department, China Health Insurance Research Association, Beijing, People's Republic of China; 7Medical Writing, inVentiv Health Clinical, San Francisco, CA, 8Global Patient Outcomes and Real World Evidence, Bio-Medicines, Eli Lilly and Company, Indianapolis, IN, USA Purpose: The objective of this study was to provide new estimates on the per-admission inpatient hospital cost and per-admission length of stay (LOS for osteoporosis-related fractures in mainland China. Materials and methods: Data for inpatient hospitalization associated with at least one osteoporosis-related fracture were obtained from the nationwide China Health Insurance Research Association and were analyzed post hoc. Patients' data were included if the patients were ≥50 years old and diagnosed with osteoporosis and pathologic fracture, or osteoporosis therapy and fragility fracture by an International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10 code designation, between 2008 and 2010. Results: The analysis included 830 patients (female: 77.3%; mean age: 73.4±9.8 years. The medians of the per-admission LOS and inpatient costs were 19 days and ¥18,587, respectively. Longer LOS and higher costs per admission were associated with older patients (≥70 years compared to younger patients (<70 years. Hip fracture had the longest median LOS (22 days and highest median cost (¥32,594 among all fracture sites. The per-hospitalization episode and per

  1. Stress Fracture of the Sacrum.

    Science.gov (United States)

    Hearn, Darren W; Humphrey, David W

    2015-11-01

    A physical therapist evaluated a 25-year-old male military trainee, who reported 1 week of left hip pain exacerbated by running and sitting cross-legged. At follow-up, the patient reported unchanged hip pain and new left knee pain. Due to potential for multifocal stress injuries outside the visual field of a single MRI, bone scan and single-photon emission computerized tomography were chosen as imaging modalities. Imaging revealed a nondisplaced lateral left-sided sacral stress fracture and left calcaneal stress fracture. J Orthop Sports Phys Ther 2015;45(11):965. doi:10.2519/jospt.2015.0411. PMID:27136290

  2. Role of Dentin Compositional Changes and Structural Loss on Fracture Predilection in Endodontically Treated Teeth

    Science.gov (United States)

    Ossareh, Arezou

    The aim of this study was to examine the role of chemical compositional changes and iatrogenic dentin structural loss on the mechanical response of teeth to force and resistance to fracture. The experiments were divided into three phases. In phase 1, experimental studies were performed to evaluate the effect of chemicals used during treatment on ultrastructure, composition and resistance to fracture of dentin. In phase 2, experimental studies were used to evaluate the influence of dentin removal and remaining dentin volume on the resistance to fracture and microcrack formation in root dentin. In phase 3 finite element analysis was carried out to examine the influence of dentin loss on the stress distribution in root dentin. The combination of experimental and numerical analysis highlighted the role of remaining dentin volume and moment of inertia on root dentin biomechanics.

  3. Fracture strength of endodontically-treated teeth restored with post and cores and composite cores only.

    Science.gov (United States)

    Ozcan, M; Valandro, L F

    2009-01-01

    This study compared the fracture strength of different conditioned metallic posts, fiber-reinforced-composite posts and composite cores only in teeth without coronal tooth structure and determined failure modes after the fracture test. Post spaces were prepared in the root canals, and the teeth were randomly divided into seven experimental groups: Gr1: Titanium posts (ParaPost) + Silano-Pen (Bredent) + silane; Gr2: Titanium posts + 30 microm CoJet-Sand (3M ESPE) + silane; Gr3: Titanium posts + 50 microm Al2O3 + V-primer (Sun Medical); Gr4: Titanium posts + 50 microm Al2O3 + Alloy primer (Kuraray); Gr5: E-glass FRC post (EverStick); Gr6: Polyethylene fiber (Ribbond) + Resin impregnation and Gr7: Resin composite core only, with no posts. The posts were cemented using Panavia F 2.0 (Kuraray); coronal parts of the roots were etched, primed, bonded and composite cores were built-up. After thermocycling (5 degrees C-55 degrees C, 6000x), the fracture strength test was performed. The fracture strength of titanium posts (408 +/- 122 - 550 +/- 149 N) was significantly higher (pE-glass FRC group, 60% adhesive core fracture occurred, covering >1/3 of the core and, in the polyethylene FRC group, 100% post-core detachment at the canal opening was observed. In all the titanium post applied groups (Gr1-Gr4), the posts remained in place with partial detachment of the core material from the post surface at varying degrees, depending on the conditioning method used. When no coronal tooth structure exist, the metal posts showed higher fracture strength values as opposed to the FRC post or no-post approach. PMID:19678448

  4. Calcaneal Quantitative Ultrasound Indicates Reduced Bone Status Among Physically Active Adult Forager-Horticulturalists.

    Science.gov (United States)

    Stieglitz, Jonathan; Madimenos, Felicia; Kaplan, Hillard; Gurven, Michael

    2016-03-01

    Sedentary lifestyle contributes to osteoporosis and fragility fracture risks among modern humans, but whether such risks are prevalent in physically active preindustrial societies with lower life expectancies is unclear. Osteoporosis should be readily observable in preindustrial societies if it was regularly experienced over human history. In this study of 142 older adult Tsimane forager-horticulturalists (mean age ± SD, 62.1 ± 8.6 years; range, 50 to 85 years; 51% female) we used calcaneal quantitative ultrasonography (qUS) to assess bone status, document prevalence of adults with reduced bone status, and identify factors (demographic, anthropometric, immunological, kinesthetic) associated with reduced bone status. Men (23%) are as likely as women (25%) to have reduced bone status, although age-related decline in qUS parameters is attenuated for men. Adiposity and fat-free mass positively co-vary with qUS parameters for women but not men. Leukocyte count is inversely associated with qUS parameters controlling for potential confounders; leukocyte count is positively correlated within adults over time, and adults with persistently low counts have higher adjusted qUS parameters (6% to 8%) than adults with a high count. Reduced bone status characteristic of osteoporosis is common among active Tsimane with minimal exposure to osteoporosis risk factors found in industrialized societies, but with energetic constraints and high pathogen burden. © 2015 American Society for Bone and Mineral Research. PMID:26460548

  5. Periprosthetic Vancouver type B1 and C fractures treated by locking-plate osteosynthesis

    DEFF Research Database (Denmark)

    Froberg, Lonnie; Troelsen, Anders; Brix, Michael

    2012-01-01

    Historically, the treatment of periprosthetic femoral fractures (PFFs) has been associated with a high frequency of complications and reoperations. The preferred treatment is internal fixation, a revision of the femoral stem, or a combination of both. An improved understanding of plate use during...

  6. Epidemiology and treatment outcome of surgically treated mandibular condyle fractures. A five years retrospective study.

    Science.gov (United States)

    Zrounba, Hugues; Lutz, Jean-Christophe; Zink, Simone; Wilk, Astrid

    2014-09-01

    Surgical management of mandibular condyle fractures is still controversial. Although it provides better outcome than closed treatment questions still remain about the surgical approach and the osteosynthesis devices to be used. Between 2005 and 2010, we managed 168 mandibular condyle fractures with open treatment. Two surgical approaches were used in this study, a pre-auricular and a high submandibular approach (one or the other or as a combined approach). Internal fixation was performed using TCP(®) plates (Medartis, Basel, Switzerland) or with two lag screws (15 and 17 mm). Delta plates were used in 15 cases (8.9%). We report the epidemiology of these fractures and the outcomes of the surgical treatment. We assessed the complications related to the surgical procedure and those related to the osteosynthesis material. The facial nerve related complication rate was very low and the osteosynthesis materials used proved to be strong enough to realize a stable fixation. The two approaches used in this study appeared to be safe with good aesthetic results. Most of the surgical procedure failures occurred in high subcondylar fractures especially when bilateral. PMID:24485271

  7. Bone fractures among postmenopausal patients with endocrine-responsive early breast cancer treated with 5 years of letrozole or tamoxifen in the BIG 1-98 trial

    DEFF Research Database (Denmark)

    Rabaglio, M; Sun, Z; Price, K N;

    2009-01-01

    BACKGROUND: To compare the incidence and timing of bone fractures in postmenopausal women treated with 5 years of adjuvant tamoxifen or letrozole for endocrine-responsive early breast cancer in the Breast International Group (BIG) 1-98 trial. METHODS: We evaluated 4895 patients allocated to 5 years...... of letrozole or tamoxifen in the BIG 1-98 trial who received at least some study medication (median follow-up 60.3 months). Bone fracture information (grade, cause, site) was collected every 6 months during trial treatment. RESULTS: The incidence of bone fractures was higher among patients treated...... with letrozole [228 of 2448 women (9.3%)] versus tamoxifen [160 of 2447 women (6.5%)]. The wrist was the most common site of fracture in both treatment groups. Statistically significant risk factors for bone fractures during treatment included age, smoking history, osteoporosis at baseline, previous...

  8. Outcomes of osteoporotic trochanteric fractures treated with cement-augmented dynamic hip screw

    Directory of Open Access Journals (Sweden)

    Rakesh Kumar Gupta

    2012-01-01

    Full Text Available Background: Dynamic hip screw (DHS has been the standard treatment for stable trochanteric fracture patterns, but complications of lag screw cut out from a superior aspect, due to inadequate bone anchorage, occur frequently in elderly osteoporotic patients. Polymethylmethacrylate (PMMA has been used as an augmentation tool to facilitate fixation stability in cadaveric femora for biomechanical studies and in pathological fractures. However, there are very few reports on the utilization of PMMA cement to prevent these complications in fresh intertrochanteric fractures. A prospective study was conducted to evaluate the outcome and efficacy of PMMA augmented DHS in elderly osteoporotic patients with intertrochanteric fractures. Materials and Methods: The study included 64 patients (AO type31-A2.1 in eight, A2.2 in 29, A2.3 in 17 patients, and 31-A3.1 in five, A3.2 in three, and A3.3 in two patients with an average age of 72 years (60 − 94 years of which 60 were available for final followup. PMMA augmentation of DHS was performed in all cases by injecting PMMA cement into the femoral head with a custommade gun designed by the authors. The clinical outcome was rated as per the Salvati and Wilson scoring system at the time of final followup of one year. Results were graded as excellent (score > 31, good (score 24 − 31, fair (score 16 − 23, and poor (score < 16. Results: Fracture united in all patients and the average time to union was 13.8 weeks (range 12 − 16 weeks. At an average followup of 18 months (range 12 − 24 months, no incidence of varus collapse or superior screw cut out was observed in any of the patients in spite of weightbearing ambulation from the early postoperative period. There was no incidence of avascular necrosis (AVN or cement penetration into the joint in our series. Most of the patients were able to regain their prefracture mobility status with a mean hip pain score of 8.6. Conclusion: Cement augmentation of DHS appears

  9. A Study on Fracture Resistance of Class IV Cavities Treated with Pins

    Directory of Open Access Journals (Sweden)

    Boteva E.

    2014-12-01

    Full Text Available Тhе use of pins in restoration of large cavities with esthetic resin materials appear in the dental literature after 1970 and there are less than 20 publications, focused around restorations of class IV cavities. The aim of the present study is to test the role of pins in the fracture resistance in class IV restorations with resin materials. Materials and methods: 68 matured human upper and lower sound front teeth are included in the study. The groups are upper incisors, lower incisors, canines with or without pins. All cavities are filled with the same resin material, technology and Prime bond NT. Termocycling: 30 days in 30ºС, 100% humidity, 60 days in 100% humidity 2Х12 hours at 35ºС and 40ºС and 100 dry cycles, 20 seconds each in the following order - 45ºС ± 3ºС, room temperature, 5ºС, room temperature, two series, 50 each with two days between in Cultura incubator of Viva Dent 55ºС and ice. Machine for vertical load testing ZD 10/90, load in Newtons (N, from 20 N to 1275 N, speed 0.5 mm/ min, displacement from 0.1 to 1.2 mm. Type of fractures observed: adhesive, cohesive in dentine and in resin material, mixed. Results: The highest proportion of fractures observed was in front teeth with large cavities and with pins, low loading (493-503N. Front teeth with large cavities without pins have better resistance and lower proportion of fractures (488-526N. Canines are more resistible with pins and less without. Lowest resistance is found in lower front teeth when pins are present. Conclusion: In class IV restorations when tissue loses are less than 2/3 of the incisal ridge pins can decrease the fracture resistance of the teeth.

  10. The effect of ferrule presence and type of dowel on fracture resistance of endodontically treated teeth restored with metal-ceramic crowns

    Directory of Open Access Journals (Sweden)

    Vivek Aggarwal

    2014-01-01

    Full Text Available Aim: The purpose of the present study was to comparatively evaluate the effect of presence of a 2 mm ferrule and different type of dowels on fracture resistance of mandibular premolars. Materials and Methods: Fifty uniradicular mandibular premolars were divided into five groups (n = 10. Ten teeth received no treatment (group I. Samples in group II & III were decoronated 2 mm above cemento-enamel junction and received custom cast dowel-core and fiber dowel-composite core respectively, with 2 mm ferrule. Samples in group IV & V were decoronated at CEJ and were restored using cast dowels and fiber dowel-composite cores, without any ferrule. The restored teeth received metal ceramic crowns and were mechanically loaded. The specimens were subjected to a static load, until fracture, to determine the fracture resistance and fracture mode. Results: The samples with 2 mm ferrule had a higher fracture resistance than non ferrule groups. Within non ferrule groups, there were no significant differences in the fracture resistance. Specimen restored with cast dowel had more incidence of non-repairable fracture. Conclusions: Presence of ferrule increased the fracture resistance of endodontically treated teeth. In case of absence of ferrule, fiber dowels had similar fracture resistance as that of cast dowels and showed increased incidence of repairable fracture.

  11. A Study of Inflammatory/Necrosis Biomarkers in the Fracture of the Femur Treated with Proximal Femoral Nail Antirotation

    Directory of Open Access Journals (Sweden)

    Mariapaola Marino

    2015-01-01

    Full Text Available Pertrochanteric fractures are common injuries in adults and source of morbidity and mortality among the elderly. Different surgical techniques were recommended for their treatment but undoubtedly they add an additional inflammatory trauma along the fracture itself. Many attempts to quantify the degree of approach-related trauma are carried out through measurements of systemic inflammatory parameters. In this study we prospectively analyzed laboratory data of 20 patients over eighty with pertrochanteric fracture of the femur treated with proximal femoral nail antirotation (PFNA. This is an excellent device for osteosynthesis because it can be easily and quickly inserted by a mini-incision providing stable fixation and early full mobilization. Serum tumor necrosis factor-alpha (TNF-α, interleukin-6 (IL-6, C-reactive protein (CRP, and plasma creatin kinase (CK were evaluated 1 hour preoperatively and 24 hours postoperatively. Our results show that PFNA did not induce significant increments in serum levels of inflammatory cytokines TNF-α and IL-6; CRP was elevated preoperatively in correlation with waiting time for surgery; CRP and CK showed a significant increment in the first postoperatory day; CK increment was correlated with surgical time length. We conclude that, for the markers we analyzed, PFNA shows a low biomechanical-inflammatory profile that represents an advantage over other techniques.

  12. Implant failure in a proximal femoral fracture treated with dynamic hip screw fixation.

    Science.gov (United States)

    Dabis, John; Abdul-Jabar, Hani B; Dabis, Hosam

    2015-01-01

    Dynamic hip screw fixation is a common orthopaedic procedure and to date, still can cause difficulties to the senior trauma surgeon. We present a case where an extra-capsular fracture of the proximal femur was managed with a dynamic hip screw (DHS) fixation. She proceeded to the operating theatre, where the fracture was stabilized with a 75-mm DHS and short-barrelled plate. The implant position was checked with intraoperative screening and the position accepted. Following attempted mobilization at 11 days post-operatively, the patient developed a recurrence of her preoperative pain. X-ray showed that the implant screw had separated from the barrel. Later scrutiny of the intraoperative screening films revealed that the barrel and screw were not engaged at the time of surgery. Intraoperative screening films should be carefully checked to ensure congruity of implant components. PMID:26136561

  13. Complicated Crown-Root Fracture Treated Using Reattachment Procedure: A Single Visit Technique

    Directory of Open Access Journals (Sweden)

    Akhil Rajput

    2011-01-01

    Full Text Available Complicated crown-root fracture of maxillary central and lateral incisors is common in case of severe trauma or sports-related injury. It happens because of their anterior positioning in oral cavity and protrusive eruptive pattern. On their first dental visit, these patients are in pain and need emergency care. Because of impaired function, esthetics, and phonetics, such patients are quite apprehensive during their emergency visit. Successful pain management with immediate restoration of function, esthetics and phonetics should be the prime objective while handling such cases. This paper describes immediate treatment of oblique crown root fracture of maxillary right lateral incisor with reattachment procedure using light transmitting fiber post. After two and half years, the reattached fragment still has satisfying esthetics and excellent function.

  14. Fracture strength of custom-fabricated Celay all-ceramic post and core restored endodontically treated teeth

    Institute of Scientific and Technical Information of China (English)

    ZHANG Yu-xing; ZHANG Wei-hong; LU Zhi-yue; WANG Ke-li

    2006-01-01

    Background The increased use of ail-ceramic crown provides a rationale for tooth-colored core. Due to superior mechanicai properties, Vita Celay infiltration ceramic developed for crown and bridge works presents the potential for fabricating ail-ceramic posts and cores in one piece. This study was conducted to compare the fracture strength of endodontically treated teeth which were thereafter given different types of posts and cores and crowns restoration, respectively. The evaluated post-and-core systems are: custom-fabricated Celay ail-ceramic post-core, custom cast metal post-core, and prefabricated stainless steel post (Parapost) with and without 2.0 mm dentine ferrule.Methods Sixty freshly extracted human maxillary central incisors were endodonticaily treated and randomly divided into five groups with 12 samples each. Group A: Celay ceramic post-cores restored teeth with 2.0 mm dentine ferrule. Group B: Celay ceramic post-cores restored teeth with no dentine ferrule. Group C: cast metal post-cores restored teeth with 2.0 mm dentine ferrule. Group D: cast metal post-cores restored teeth with no dentine ferrule. Group E: prefabricated post and composite cores restored teeth with 2.0 mm dentine ferrule. All teeth were restored with Celay ceramic crowns. Each specimen was subjected to a load at a 45-degree angle to the long axis on MTS 810 material testing machine until failure, at crosshead speed of 0.02 em/minute. Analysis of variance followed by the Newman-Keuls pairwise multiple comparison tests were used to compare the results of the groups tested.Results There was a statistically significant difference among the five groups (P<0.01). Celay ceramic post-cores restored teeth with 2.0 mm dentine ferrule [(758.35±119.26) N] and cast metal post-cores restored teeth with 2.0 mm dentine ferrule [(756.63 ±166.22) N] had a significantly greater mean fracture strength than the other three groups in which no significant difference was observed. The 2.0 mm dentine

  15. Greater Trochanter Reconstruction in Unstabl Intertrochanteric Fractures Treated With Cemented Bipolar Hemiarthroplasty: A Technical Note.

    Science.gov (United States)

    Subramanian, G V; Guravareddy, A V; Reddy, Anil Kumar K R; Chiranjeevi, T

    2012-01-01

    Cemented Bipolar arthroplasty is an established method for treatment of comminuted Intertrochanteric fractures. Reconstruction of greater trochanter is an essential technical step to avoid complications like abductor lurch gait. We here describe a technique of reconstruction and fixation of greater trochanter using cancellous screws with wide washers made of reconstruction plate and tension band wiring. This gives a stable fixation of greater trochanter and avoids cut out, slippage of implants. PMID:27298870

  16. Greater Trochanter Reconstruction in Unstabl Intertrochanteric Fractures Treated With Cemented Bipolar Hemiarthroplasty: A Technical Note

    OpenAIRE

    Subramanian, G V; Guravareddy, A V; Reddy, Anil Kumar K R; Chiranjeevi, T.

    2012-01-01

    Cemented Bipolar arthroplasty is an established method for treatment of comminuted Intertrochanteric fractures. Reconstruction of greater trochanter is an essential technical step to avoid complications like abductor lurch gait. We here describe a technique of reconstruction and fixation of greater trochanter using cancellous screws with wide washers made of reconstruction plate and tension band wiring. This gives a stable fixation of greater trochanter and avoids cut out, slippage of implants.

  17. Distal tibial pilon fractures (AO/OTA type B, and C treated with the external skeletal and minimal internal fixation method

    Directory of Open Access Journals (Sweden)

    Milenković Saša

    2013-01-01

    Full Text Available Background/Aim. Distal tibial pilon fractures include extra-articular fractures of the tibial metaphysis and the more severe intra-articular tibial pilon fractures. There is no universal method for treating distal tibial pilon fractures. These fractures are treated by means of open reduction, internal fixation (ORIF and external skeletal fixation. The high rate of soft-tissue complications associated with primary ORIF of pilon fractures led to the use of external skeletal fixation, with limited internal fixation as an alternative technique for definitive management. The aim of this study was to estimate efficacy of distal tibial pilon fratures treatment using the external skeletal and minimal internal fixation method. Methods. We presented a series of 31 operated patients with tibial pilon fractures. The patients were operated on using the method of external skeletal fixation with a minimal internal fixation. According to the AO/OTA classification, 17 patients had type B fracture and 14 patients type C fractures. The rigid external skeletal fixation was transformed into a dynamic external skeletal fixation 6 weeks post-surgery. Results. This retrospective study involved 31 patients with tibial pilon fractures, average age 41.81 (from 21 to 60 years. The average follow-up was 21.86 (from 12 to 48 months. The percentage of union was 90.32%, nonunion 3.22% and malunion 6.45%. The mean to fracture union was 14 (range 12-20 weeks. There were 4 (12.19% infections around the pins of the external skeletal fixator and one (3.22% deep infections. The ankle joint arthrosis as a late complication appeared in 4 (12.90% patients. All arthroses appeared in patients who had type C fractures. The final functional results based on the AOFAS score were excellent in 51.61%, good in 32.25%, average in 12.90% and bad in 3.22% of the patients. Conclusion. External skeletal fixation and minimal internal fixation of distal tibial pilon fractures is a good method for

  18. Quality of life after pertrochanteric femoral fractures treated with a gamma nail: a single center study of 62 patients

    Directory of Open Access Journals (Sweden)

    Giessauf Christian

    2012-10-01

    Full Text Available Abstract Background Intramedullary nailing of pertrochanteric femoral fractures has grown in popularity over the past 2 decades likely because this procedure is associated with a low risk for postoperative morbidity and a fast recovery of function. The evaluation of outcomes associated with pertrochanteric nailing has mainly been based on objective measures. The purpose of the present study is to correlate patients’ health-related quality of life results after intramedullary nailing of pertrochanteric fractures with objective outcome measures. Methods We conducted a single-center study including 62 patients (mean age 80 ± 10 years with pertrochanteric fractures treated with a Gamma 3 Nail. Health related quality of life was measured using the Short Form-36. These results were compared to both US and Austrian age and sex-adjusted population norms. The objective outcome measures studied at one year postoperatively included Harris Hip Score, range of motion, leg length, body mass index, neck-shaft angle and grade of osteoarthritis. Results According to the Harris Hip Score 43 patients (67% had excellent or good results. There was no significant difference in the average neck-shaft angle comparing affected hip to non-affected hip at 12 months postoperatively. The average osteoarthritis score, for both the injured and uninjured hip, did not differ significantly. We found significant differences between the bodily pain, social functioning and mental health subscales and two summary scores of the Short-Form 36 in comparison to Austrian population norms. Complication rate was 8%. Conclusions The results of this study confirm that intramedullary nailing with the use of a Gamma Nail is a safe treatment option for stable and unstable pertrochanteric fractures. Despite good functional and radiographic results we noticed a substantial fall off in patients’ quality of life up to 12 months after operation.

  19. Increased mast cell numbers in a calcaneal tendon overuse model

    DEFF Research Database (Denmark)

    Pingel, Jessica; Wienecke, Jacob; Kongsgaard Madsen, Mads;

    2013-01-01

    Tendinopathy is often discovered late because the initial development of tendon pathology is asymptomatic. The aim of this study was to examine the potential role of mast cell involvement in early tendinopathy using a high-intensity uphill running (HIUR) exercise model. Twenty-four male Wistar rats...... were divided in two groups: running group (n = 12); sedentary control group (n = 12). The running-group was exposed to the HIUR exercise protocol for 7 weeks. The calcaneal tendons of both hind limbs were dissected. The right tendon was used for histologic analysis using Bonar score......, immunohistochemistry, and second harmonic generation microscopy (SHGM). The left tendon was used for quantitative polymerase chain reaction (qPCR) analysis. An increased tendon cell density in the runners were observed compared to the controls (P = 0.05). Further, the intensity of immunostaining of protein kinase B, P...

  20. Treating postmenopausal osteoporosis in women at increased risk of fracture - critical appraisal of bazedoxifene: a review

    DEFF Research Database (Denmark)

    Vestergaard, Peter; Thomsen, Iva Susanna vio Streym

    2010-01-01

    Several categories of drugs to treat osteoporosis exist in the form of bisphosphonates, strontium, parathyroid hormone, and selective estrogen receptor modulators (SERM). Advantages and disadvantages exist for each category as some patients may, for example, not tolerate bisphosphonates for...

  1. Complete L5 burst fracture treated by 270-degree decompression and reconstruction using titanium mesh cage via a single posterior vertebrectomy

    Directory of Open Access Journals (Sweden)

    Wang Haibao

    2014-10-01

    Full Text Available 【Abstract】Complete burst fractures of the L5 is relatively uncommon. How to accomplish a rigid internal fixation as well as preserve motor function is an enormous challenge. We report such a case treated via a single posterior vertebrectomy with 270-degree decompression and reconstruction using titanium mesh cage. The disc between L5/S1 was preserved by placing the titanium mesh cage on the inferior endplate of the L5. We hope this method can offer a possible solution for other surgeons when they meet a similar fracture pattern. Key words: Decompression; Spinal fractures; Lumbar vertebrae

  2. Radiofrequency Kyphoplasty - An Innovative Method of Treating Osteoporotic Vertebral Body Compression Fractures

    Directory of Open Access Journals (Sweden)

    Drees P

    2011-01-01

    Full Text Available Osteoporotic vertebral body fractures are encountered increasingly often. Cement augmentation using vertebroplasty or balloon kyphoplasty are standardised and established procedures. However, the optimal cement viscosity at the time of cement augmentation has not yet been satisfactory resolved for either method. In other words, the time point of cement application is left to the surgeon’s subjective estimation. Early application of cement may cause cement leakage whereas late application may cause incomplete filling of the vertebral body. Radiofrequency kyphoplasty is a recently developed augmentation system that enables the surgeon to exert control when creating the cavity, as well as aids him in the placement and application of cement. Cement is applied by remote control and thus uniformly retains its properties. The method is presented in the following.

  3. Outcome of diaphyseal forearm fracture-nonunions treated by autologous bone grafting and compression plating

    Directory of Open Access Journals (Sweden)

    Albertoni Walter

    2009-05-01

    Full Text Available Abstract Background The treatment of forearm fracture-nonunions continues to represent a therapeutic challenge, and reported outcomes are moderate at best. Limiting aspects of this particular anatomic location include the relation between restoration of shaft length with the anatomy and long-term functional outcome of adjacent joints, as well as the risk of elbow and wrist stiffness related to prolonged immobilization. The present study was designed to assess the outcome of autologous bone grafting with compression plating and early functional rehabilitation in patients with forearm fracture non-unions. Methods Prospective follow-up study in 31 consecutive patients presenting with non-unions of the forearm diaphysis (radius, n = 11; ulna, n = 9; both bones, n = 11. Surgical revision was performed by restoring anatomic forearm length by autologous bone grafting of the resected non-union from the iliac crest and compression plating using a 3.5 mm dynamic compression plate (DCP or limited-contact DCP (LC-DCP. The main outcome parameters consisted of radiographic bony union and functional outcome, as determined by the criteria defined by Harald Tscherne in 1978. Patients were routinely followed on a short term between 6 weeks to 6 months, with an average long-term follow-up of 3.6 years (range 2 to 6 years. Results Radiographically, a bony union was achieved in 30/31 patients within a mean time of 3.5 months of revision surgery (range 2 to 5 months. Clinically, 29/31 patients showed a good functional outcome, according to the Tscherne criteria, and 26/31 patients were able to resume their previous work. Two postoperative infections occurred, and one patient developed a persistent infected nonunion. No case of postoperative failure of fixation was seen in the entire cohort. Conclusion Revision osteosynthesis of forearm nonunions by autologous iliac crest bone grafting and compression plating represents a safe and efficacious modality for the

  4. Thoracolumbar fracture dislocations treated by posterior reduction interbody fusion and segmental instrumentation

    Directory of Open Access Journals (Sweden)

    Xiao-Bin Wang

    2014-01-01

    Materials and Methods: A retrospective review of 30 patients who had sustained fracture dislocation of the spine and underwent single stage posterior surgery between January 2007 and December 2011 was performed. All the patients underwent single stage posterior pedicle screw fixation, decompression and interbody fusion. Demographic data, medical records and radiographic images were reviewed thoroughly. Results: Ten females and 20 males with a mean age of 39.5 years were included in this study. Based on the AO classification, 13 cases were Type B1, 4 cases were B2, 4 were C1, 6 were C2 and 3 cases were C3. The average time of the surgical procedure was 220 min and the average blood loss was 550 mL. All of the patients were followed up for at least 2 years, with an average of 38 months. The mean preoperative kyphosis was 14.4° and reduced to -1.1° postoperatively. At the final followup, the mean kyphosis was 0.2°. The loss of correction was small (1.3° with no significant difference compared to postoperative kyphotic angle (P = 0.069. Twenty seven patients (90% achieved definitive bone fusion on X-ray or computed tomography imaging within 1 year followup. The other three patients were suspected possible pseudarthrosis. They remained asymptomatic without hardware failure or local pain at the last followup. Conclusion: Single stage posterior reduction using segmental pedicle screw instrumentation, combined with decompression and interbody fusion for the treatment of thoracic or lumbar fracture-dislocations is a safe, less traumatic and reliable technique. This procedure can achieve effective reduction, sagittal angle correction and solid fusion.

  5. Effect of immobilization on urine calcium excretion in orthopedic patients with pelvic fracture treated by skin traction

    Directory of Open Access Journals (Sweden)

    Ali Derakhshan

    2015-03-01

    Full Text Available Objectives: To determine the effects on urine calcium excretion of immobilization by skin traction in patients with pelvic fracture. Methods: In a prospective study, a consecutive series of patients with pelvic fracture treated by skin traction were enrolled. Serum (calcium, phosphorous, alkaline phosphatase, sodium, potassium, uric acid, BUN, creatinine and fasting urine calcium, creatinine, sodium, potassium and uric acid were checked within 48 hours of hospitalization and at 7, 14 and 21 days of immobilization and then after 3 months of mobilization. Trends in changes of variables were recorded. Results: Fifty five patients were enrolled in this study; they were 45 (81.8% males and 10 (18.2% females with a mean age 19.4 ± 12.7 years. We found that serum levels of calcium (p = 0.004, phosphorous (p = 0.047 and alkaline phosphatase (p = 0.001 increased significantly during the 3 weeks of immobilization. In the same way, urine calcium/ urine creatinine ratio increased significantly in the study period (p = 0.004. No symptomatic renal stone formation was observed during the study period. Conclusions: Immobilization even in short term causes hypercalciuria in orthopedic patients. Although it is transient and improves with subsequent mobilization, it is needed to be considered specifically by the team caring for this group of patients.

  6. [Retrospective analysis of consecutively treated distal radius fractures with the external fixator].

    Science.gov (United States)

    Melik, N; Togninalli, D; Biegger, P

    1994-12-01

    The purpose of this study was to determine retrospectively some subjective and objective parameters following the operative treatment of 32 patients with "complex" (intraarticular and/or comminuted) fractures of the distal radius using the small AO external fixation device. The mean follow-up period was 20 months (minimum 4, maximum 48) and the mean age of the subjects was 62 years (minimum 27, maximum 91). Subjective results such as "general feeling", mobility, strength and pain, expressed with a scoring system (% of maximum obtainable points), showed an overall good result and ranged between 71% (pain), 81% (strength) and 91% (mobility and "general feeling"). Regarding the objective results, no major skin or soft tissue distress (Sudeck dystrophy) was noted. However, there was a general tendency towards a mobility deficit of the wrist operated on, which was statistically significant (P than 10 months), showed no relevant difference between the two groups (age of both similar), as expressed by age ( than 60 years); the data only showed differences in strength and pain (scores by 92% vs 82% for force and 92% vs 76% for pain) and in flexion and extension (-22.8% and -14%, P < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7855610

  7. 根管治疗术后的牙根纵折%Vertical root fractures in endodontically treated teeth

    Institute of Scientific and Technical Information of China (English)

    袁坤; 李娜

    2012-01-01

    Owing to both the effort of completely removing infectious source in root canal and the applica- tion of root canal shaping instruments with a big taper in root canal therapy procedure, root canal preparations are prone to be excessive and overzealous, which may weaken the root and lead to the development of root fracture. Complete horizontal and oblique root fractures can be easily detected by conventional periapical radiographs. However, it may be difficult to diagnose vertical root fracture ( VRF) , because the clinical signs and symptoms associated with VRF as well as radiographic presentations are often similar to those associated with unsuccessful endodontic treatment and with certain forms of periodontal disease. VRF in endodontically treated teeth is one of the most frustrating complications of root canal therapy, which results in tooth or root extraction. The present article systematically summarizes the prevalence, eti-ological factors, clinical presentations, diagnosis and treatment methods of VRF in endodontically treated teeth by reviewing related literatures.%在根管治疗过程中,为了彻底清除根管内感染源和大锥度根管预备器械的使用,常使根管预备过度,导致根管壁变薄而使牙根易发生折裂.通常情况下,完全的牙根横折和斜折,通过常规的X线根尖片即可明确诊断,但当牙根纵折时,则由于其临床症状和X线根尖片表现多与根管治疗失败和某些类型的牙周病类似,而使诊断困难,常导致患牙或病变牙根的拔除.本文通过相关文献回顾,就根管治疗术后牙根纵折的发生率、病因、临床表现、诊断和治疗作一综述.

  8. Results of Patello-Tibial Cerclage Wire Technique for Comminuted Patella Fractures Treated with Partial Patellectomy

    Directory of Open Access Journals (Sweden)

    Ender Alagöz

    2014-12-01

    Full Text Available Aim: Partial patellectomy and patellotibial cerclage technique used in comminuted inferior pole patellar fractures were evaluated and the results were discussed. Methods: Thirteen patients who have undergone partial distal patellar excision were evaluated in the study. In all patients, the inferior pole of the patella was resected, patellar tendon was sutured to the proximal patellar fragment and patellotibial cerclage was performed. At the last visit, the patients were evaluated using measurement of the distance between the superior pole of the patella and the tibial tubercle, the Lysholm knee scoring scale, knee range of motion and thigh circumference measurement. Results: The mean flexion value was 131.10 (±4.6 in normal knees and 117.20 (±8.0 in operated knees. The mean thigh diameter was 49.5 (±3.7 cm and 46.4 (±4.5 cm in normal knees and in operated knees, respectively. The mean Lysholm knee score in the patient group was 84.3 (±17.1 points. The mean distance between the superior pole of the patella and the tibial tubercle was 10.6 (±1.0 cm in normal knees and 10.1 (±1.2 cm in operated knees. The exstensor mechanism was intact in all patients and no revision surgery was performed. Conclusion: Patellotibial cerclage technique performed after partial patellectomy permits early motion and protects patients from harmful effects of immobilization; and good functional results are obtained if patients start early knee motion.

  9. The measurement of the rotational deformities with computed tomography in femoral shaft fractures of the children treated with early spica cast

    International Nuclear Information System (INIS)

    Twenty-eight children with femoral shaft fractures, treated with early spica cast, were evaluated with computed tomography (CT), for their femoral shaft rotational deformities. The femoral torsion angles were measured on both sides. If the torsion angle of the fractured side was more than the other side, it was considered as an internal rotational deformity and if it was less, it was considered as an external rotational deformity. Internal rotational deformities were detected in nine cases and external rotational deformities were detected in 17 cases. Rotational deformity was not observed in two cases. Four cases, with a rotational deformity more than 10 deg. , were corrected with a gypsotomy through the level of the fracture. We concluded that a rotational deformity, which is an important complication in conservative treatment of the femoral shaft fractures in children, can be determined exactly with CT and corrections on the spica cast can be made with a gypsotomy

  10. Plantar fasciitis and calcaneal spur formation are associated with abductor digiti minimi atrophy on MRI of the foot

    Energy Technology Data Exchange (ETDEWEB)

    Chundru, Usha [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States); Liebeskind, Amy; Beltran, Javier [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States); Beachwood, Franklin and Seidelmann Subspecialty Radiology, Beachwood, OH (United States); Seidelmann, Frank; Franklin, Peter [Beachwood, Franklin and Seidelmann Subspecialty Radiology, Beachwood, OH (United States); Fogel, Joshua [Maimonides Medical Center, Department of Radiology, Brooklyn, NY (United States); Brooklyn College, Department of Economics, Brooklyn, NY (United States)

    2008-06-15

    To determine the association of atrophy of the abductor digiti minimi muscle (ADMA), an MRI manifestation of chronic compression of the inferior calcaneal nerve suggesting the clinical diagnosis of Baxter's neuropathy, with MRI markers of potential etiologies, including calcaneal spur formation, plantar fasciitis, calcaneal edema, Achilles tendinosis and posterior tibial tendon dysfunction (PTTD). Prevalence of calcaneal spur formation, plantar fasciitis, calcaneal edema, Achilles tendinosis and PTTD was assessed retrospectively on 100 MRI studies with ADMA and 100 MRI studies without ADMA. Patients ranged in age from 10-92 years. Pearson chi-square analyses and Fisher's exact test were used to compare prevalence of the above findings in patients with and without ADMA. Logistic regression was used to determine which variables were significantly associated with ADMA. Among patients with ADMA, there was significantly greater age (57.2 years vs 40.8 years, p < 0.001), presence of Achilles tendinosis (22.0% vs 3.0%, P<0.001), calcaneal edema (15.0% vs 3.0%, P = 0.005), calcaneal spur (48.0% vs 7.0%, P < 0.001), plantar fasciitis (52.5% vs 11.0%, P<0.001), and PTTD (32.0% vs 11.0%, P<0.001). After multivariate logistic regression analysis, only age [odds ratio (OR) 1.06, 95% confidence interval (CI) 1.03, 1.09], calcaneal spur (OR 3.60, 95% CI 1.28, 10.17), and plantar fasciitis (OR 3.35, 95% CI 1.31, 8.56) remained significant. Advancing age, calcaneal spur, and plantar fasciitis are significantly associated with ADMA. Their high odds ratios support the notion of a possible etiologic role for calcaneal spur and plantar fasciitis in the progression to Baxter's neuropathy. (orig.)

  11. Surface-enhanced Raman scattering study of the healing of radial fractures treated with or without Huo–Xue–Hua–Yu decoction therapy

    International Nuclear Information System (INIS)

    This study aimed to assess, through surface-enhanced Raman scattering (SERS) spectroscopy, the incorporation of calcium hydroxyapatite (CHA ∼960 cm−1) and other biochemical substances in the repair of complete radial fractures in rabbits treated with or without Huo–Xue–Hua–Yu decoction (HXHYD) therapy. A total of 18 rabbits with complete radial fractures were randomly divided into two groups; one group was treated with HXHYD therapy and the other without therapy acted as a control. The animals were sacrificed at 15, 30 and 45 d after surgery. Specimens were routinely prepared for SERS measurement and high quality SERS spectra from a mixture of bone tissues and silver nanoparticles were obtained. The mineral-to-matrix ratios from the control and treated groups were calculated. Results showed that both deposition content of CHA measured by SERS spectroscopy and the mineral-to-matrix ratio in the treated group were always greater than those of the control group during the experiment, demonstrating that HXHYD therapy is effective in improving fracture healing and that SERS spectroscopy might be a novel tool to assess fracture healing. (letter)

  12. Pilon骨折治疗的临床观察%The clinical observation of treating Pilon fracture

    Institute of Scientific and Technical Information of China (English)

    何文元

    2013-01-01

    Objective:To study the clinical effect of treating Pilon fracture. Methods:Choosed 87 patients of pilon fracture from Jan.2007 to Jan. 2013 to observe prognosis evaluation of different type patients. Results:The prognosis of type I, II, III patients had no difference, but recoverment of type IV, V patients were worse than other three types (P<0.05). According Kel an-Wadda types, recoverment of type A was bet er than type B (P<0.05). Conclusion: The violence in patients with injury and the position of the ankle joint, and the choice of operation time and directly affect the prognosis of Pilon fractures.%目的:探讨Pilon骨折治疗的临床观察。方法:选取并回顾性研究2007-01至2013-01于我院治疗严重Pilon骨折患者87例。对骨折不同分型患者预后进行评估。结果:参照 Ovadia-Beals 分型对术后恢复情况进行统计,Ⅰ、Ⅱ、Ⅲ型患者中恢复良好者无明显差异,但Ⅳ、Ⅴ型患者中恢复良好少于前三型,差异存在统计学意义(p<0.05)。参照Kel am-Wadda分型对术后恢复情况进行统计,A型恢复良好患者明显多于B型,差异存在统计学差异(p<0.05)。结论:患者暴力方式、程度,损伤部位与踝关节的位置以及手术时机与方式的选择都直接影响Pilon骨折预后。

  13. Tensile properties of fresh human calcaneal (Achilles) tendons.

    Science.gov (United States)

    Louis-Ugbo, John; Leeson, Benjamin; Hutton, William C

    2004-01-01

    The purpose of this study was to measure the tensile properties of fresh human calcaneal (Achilles) tendons. Twenty fresh cadaveric (age range = 57-93 years) bone-Achilles tendon complexes were harvested within 24 hr postmortem. The calcaneus together with 15 cm of the Achilles tendon extending proximally from the insertion on the calcaneus was clamped and biomechanically tested. Each tendon was firmly fixed in clamps in an MTS Systems Corporation MTS testing machine and tension was applied at a displacement rate of 8 cm per minute until the tendon failed. The tensile force and tensile strain (as measured using an extensometer) were recorded and plotted using onboard software. The narrow age range of our donors prevented any meaningful correlation between age and tensile properties; however, the results showed that: 1) the average ultimate tensile strength (UTS) of the human Achilles tendon was 1189 N (range = 360-1,965), 2) there was a correlation between left and right legs for UTS, 3) there was a correlation between left and right legs in regard to cross sectional area, and 4) there was no correlation between UTS and cross-sectional area. PMID:14695585

  14. Treatment of the calcaneal spur with infrared laser

    International Nuclear Information System (INIS)

    The treatment with low power laser offers a beneficial and regenerating effect over nervous, muscular and skeletal tissues, soft tissues, and skin. This therapy has been used for more than three decades, based on the properties and effects of lasers in almost all medical specialties, due to it constitutes a novel, painless, non invasive, and easy to apply, in addition to the absence of any risk for patient and to have very good clinical results. Knowing the biological effects of the low power laser therapy (analgesic, anti-inflammatory, an tissue regenerator), we were dedicated to investigate the analgesic effect achieved with the application of infrared laser radiation in patients that suffering form calcaneal spur, who attended to the Natural and Traditional Medical Service of the clinic '30 de november', from January 2005 to January 2008. The whole of patients was 62, and the sample included 52 individuals from different sexes, races, and ages between 20 and 80 years, excluding pregnant women and neoplasia patients. Pain relief was achieved since second session of treatment, with 61,5 % of cases cured and 38,5 % improved, no one was worse, neither keep the same initial symptoms. (Author)

  15. 无髓牙根纵裂的诊断%Diagnosis of vertical root fracture in endodontically treated teeth

    Institute of Scientific and Technical Information of China (English)

    范亚贤; 李华

    2014-01-01

    Objective To discuss the characteristics and diagnosis of vertical root fracture(VRF) in endodontically treated teeth. Methods Fourteen patients were diagnosed definitely by radiological examinations, flap elevations and being extracted, and retrospectively analysed the history, signs and the results of X-ray or cone beam computed tomography(CBCT) examinations. Results There were 6 molars, 4 premolars and 4 front teeth, respectively. All the 14 teeth had crown and 10 of them had posts. Conclusion The diagnosis of vertical root fracture in endodontically treated teeth is difficult. We should make diagnosis synthetically according to the history and clinical traits of patients.%目的:探讨无髓牙(即经过根管治疗的牙)根纵裂的临床特点和诊断依据。方法14例患牙经影像学检查、翻瓣或拔除等方法确诊的根纵裂无髓牙,回顾性分析其病史、临床体征及影像学检查结果。结果14例确诊患牙中,磨牙6颗,前磨牙4颗,前牙4颗。14例患牙均有牙冠修复(其中10例有桩核)。14例牙周探诊均可及局限性的深牙周袋(≥7 mm),根尖片表现以牙槽骨垂直吸收为主。5例患者有锥形束 CT 检查,其中1例通过 CT 直接诊断为根纵裂。结论无髓牙根纵裂的诊断可根据病史、临床特点、影像学检查等综合判断。

  16. Intrinsic mechanical behavior of femoral cortical bone in young, osteoporotic and bisphosphonate-treated individuals in low- and high energy fracture conditions

    Science.gov (United States)

    Zimmermann, Elizabeth A.; Schaible, Eric; Gludovatz, Bernd; Schmidt, Felix N.; Riedel, Christoph; Krause, Matthias; Vettorazzi, Eik; Acevedo, Claire; Hahn, Michael; Püschel, Klaus; Tang, Simon; Amling, Michael; Ritchie, Robert O.; Busse, Björn

    2016-02-01

    Bisphosphonates are a common treatment to reduce osteoporotic fractures. This treatment induces osseous structural and compositional changes accompanied by positive effects on osteoblasts and osteocytes. Here, we test the hypothesis that restored osseous cell behavior, which resembles characteristics of younger, healthy cortical bone, leads to improved bone quality. Microarchitecture and mechanical properties of young, treatment-naïve osteoporosis, and bisphosphonate-treated cases were investigated in femoral cortices. Tissue strength was measured using three-point bending. Collagen fibril-level deformation was assessed in non-traumatic and traumatic fracture states using synchrotron small-angle x-ray scattering (SAXS) at low and high strain rates. The lower modulus, strength and fibril deformation measured at low strain rates reflects susceptibility for osteoporotic low-energy fragility fractures. Independent of age, disease and treatment status, SAXS revealed reduced fibril plasticity at high strain rates, characteristic of traumatic fracture. The significantly reduced mechanical integrity in osteoporosis may originate from porosity and alterations to the intra/extrafibrillar structure, while the fibril deformation under treatment indicates improved nano-scale characteristics. In conclusion, losses in strength and fibril deformation at low strain rates correlate with the occurrence of fragility fractures in osteoporosis, while improvements in structural and mechanical properties following bisphosphonate treatment may foster resistance to fracture during physiological strain rates.

  17. Radiological and functional outcome in extra-articular fractures of lower end radius treated conservatively with respect to its position of immobilization

    Directory of Open Access Journals (Sweden)

    Rajan Sunil

    2008-01-01

    Full Text Available Background: Extra-articular fractures of lower end radius are conventionally immobilized in palmar flexion and ulnar deviation. In view of poor functional results, the conventional method of immobilization is giving way to dorsiflexed-immobilized method. The aim of our study is to evaluate and compare the radiological and functional outcome in extra-articular fractures of lower end radius treated conservatively with respect to its position of immobilization. Materials and Methods: Sixty-four patients, all above 20 years of age with closed extra-articular fractures of lower end radius who were treated conservatively by close reduction and below elbow cast application constitute the clinical material. Irrespective of fracture geometry the patients were randomly allocated to dorsal or palmar flexed immobilized position of wrist. Patients were followed up for a minimum six-month period. The radial tilt, palmar tilt and ulnar variance are measured at prereduction, postreduction and at 6 month followup. The results were scored by Demerit Scoring System of Saito. Results: All fractures united. Individual movement of dorsiflexion, palmar flexion, supination, pronation and radial-ulnar deviation were all significantly better in the dorsiflexed-immobilized group as compared with the palmar flexed immobilized group. Grip strength recovery with subjective assessment was better in the dorsiflexed group (77% as compared to the palmar flexed group (23%. Radiological parameters were markedly better in the dorsiflexed group. Ninety-one per cent of patients in the dorsiflexed group had excellent to good results as compared to 66% in the palmar flexed group. Conclusion: Functional results of extra-articular fractures of lower end radius are superior if the fractures after reduction are immobilized in dorsiflexion of wrist rather than in conventional palmar flexion position.

  18. A comparison between the effect of zirconia-coated FRC and glass fiber posts on the fracture resistance of endodontically treated teeth

    Directory of Open Access Journals (Sweden)

    Ezatollah Jalalian

    2014-04-01

    Full Text Available   Background and Aims : The root fracture resistance of endodontically treated teeth depends on the types of posts. The aim of this study was to compare the effect of two types of bonded non-metallic posts with different elasticity modulus on the fracture resistance of endodontically treated teeth under compressive loads.   Materials and Methods: In this in vitro experimental study, 20 fresh extracted mandibular premolars were selected and sectioned adjacent to the CEJ and then were endodontically treated. The specimens were randomly divided into two groups (n=10. After post space preparations, the fiber RTD Light posts (R.T.D, France and zirconia coated fiber posts (ICE light, Danville were cemented into the root canals. Composite resin (Lumiglass R.T.D, France cores were built up. Aluminium foil was used to mimic the PDL, and the specimens were embedded in acrylic resin and tested in a Universal Testing Machine. A compressive load was applied at a 90 degree angle until fracture at a crosshead speed of 1mm/min. Data were analyzed using one-way ANOVA and T test .   Results: The mean fracture resistance of R.T.D group was (1083.11 ± 156.74 (N and the mean of ICE light group was (865.18 ± 106.24 (N. The highest mean fracture resistance was observed in RTD fiberglass and a statistically significant difference was observed between the two groups (P<0.001.   Conclusion: FRC posts with zirconia coating due to unfavorable fractures of the teeth should be used with caution, and thus, fiber posts are preferred.

  19. Analysis the outcome of proximal humeral fracture in eld treated with locking plates%锁定钢板治疗老年肱骨近端骨折

    Institute of Scientific and Technical Information of China (English)

    张虎; 张凯宁; 任延军

    2011-01-01

    ObjectiveTo observe the clinical effect of proximal humeral fracture in eld treated with locking plates. Method From March 2007 to September 2009, 34 patients with proximal humeral fracture were all treated with locking plates.The average age of patients was 69.5 years(range 60~81).According to Neer classification :2 parts fracture 9cases, 3 parts fracture 19cases, 4 parts fracture 6 cases. Result All patients were all followed up for 8~ 18 months(average 9 months), all fractures occurred bone union, the average time for fracture healing was 3~5 months.The shoulder joint function was evaluated by Neer functional assessment system:excellent 25 cases, good 9 cases. Conclusion Locking plate in treating proximal humeral fracture in eld can obtain satisfactic result and is a good method internal fixation of proximal humeral fracture in eld at present.%目的 探讨应用肱骨近端锁定钢板治疗老年人肱骨近端骨折的疗效.方法 2007年3月~2009年9月使用肱骨近端锁定钢板治疗肱骨近端骨折34例,年龄60~81岁,平均69.5岁.骨折按Neer分型:2部分骨折9例、3部分骨折19例、4部分骨折6例.结果 34例均获随访,随访8~18个月,平均(7.5+1.5)个月.均获骨性愈合,平均愈合时间3~5月.肩关节功能按Neer疗效评分系统评定,优25例、良9例.结论 锁定加压钢板治疗老年人骨折疗效满意,是目前治疗肱骨近端骨折较理想的内固定方法.同时重视肩袖损伤的修复,术后能早期进行功能锻炼,功能恢复良好.

  20. EARLY FUNCTIONAL RESULTS OF UNSTABLE PERTROCHANTERIC FRACTURES TREATED WITH PROXIMAL FEMORAL NAILS IN A PERIPHERAL TERTIARY CARE CENT RE

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    Bharath Kumar

    2015-05-01

    Full Text Available BACKGROUND : Pertrochanteric fractures forms a major share of proximal femoral fractures in young and old . Proper implant selection and surgical planning plays a pivotal role in providing fracture union and early rehabilitation of patients to prevent complications due to recumbency . AIM : The aim of this retrospective study is to assess the results of proximal femoral nails in unstable pertrochanteric f ractures . MATERIALS AND METHODS : This study was performed in the Department of Orthopaedic Surgery , Chettinad hospital and research institute , Kelambakkam between November 2012 and December 2014 . 15 patients with pertrochanteric fractures were retrospectively followed . Among the fifteen 9 were male and 6 were female with an average age of 43 . Eleven patients sustained Intertrochanteric fractures , 8 of A2 type and 3 of A3 type according to AO classification . 4 patients had subtroch anteric fractures of seinseimer Type 5 . RESULTS : Short PFN was used in all the 11 Intertrochanteric fractures and long PFN was used in the 4 subtrochanteric fractures . All fractures healed by around 3 . 5 months . There is one case of varus malunion and one c ase of screw pullout which required implant removal . The limitations of this study are its retrospective nature , small sample size and short follow up . CONCLUSION : Our results show that proximal femoral nails being load sharing implants form an ideal choic e for stabil ising pertrochanteric fractures . Minimally invasive technique of insertion with less blood loss make it an ideal choice in such complex scenarios .

  1. Subtrochanteric hip fractures treated with cerclage cables and long cephalomedullary nails: a review of 17 consecutive cases over 2 years.

    LENUS (Irish Health Repository)

    Kennedy, Muiris T

    2011-11-01

    The conflict between the anatomist and biologist surgeons is exemplified by the debate about subtrochanteric hip fractures. Closed intramedullary nailing is biologically friendly but may result in prolonged procedures and malunion. By contrast, accurate anatomical open reduction may disturb the biological composition of the fracture environment.

  2. A comparative evaluation of the fracture resistance of three different pre-fabricated posts in endodontically treated teeth: An in vitro study

    Directory of Open Access Journals (Sweden)

    Padmanabhan Prabeesh

    2010-01-01

    Full Text Available Aims : To compare the fracture resistance and primary mode of failure of three different pre- fabricated posts like stainless steel, carbon fiber and ceramic posts in endodontically treated crowned permanent maxillary central incisors. Materials and Methods : Root canal treatment was performed on all 30 maxillary central incisors. Post space was prepared and samples were divided into three groups of 10 each. The teeth were inserted with pre-fabricated stainless steel, carbon fiber and ceramic post and cemented using adhesive resins, core fabricated and crowns placed. Mode of failure was carried out by immersing the teeth in black ink for 12 h and then sectioning them mesio-distally. Fracture above the embedded resin was considered favorable and fracture below the resin level was considered unfavorable. Statistical Analysis : Fracture strength was measured using a universal testing machine. Data were evaluated statistically using the Kruskal Wallis test and the Mann Whitney " U"-test. Mode of failure was evaluated statistically using the chi-square test. Results : There was a statistically significant difference showing that the stainless steel post had a better fracture resistance when compared with the other two posts and the carbon fiber showed a statistically more favorable fracture when compared with the other two posts. Conclusions : Within the limitations of this study, it can be concluded that the pre-fabricated stainless steel post exhibited a significantly higher fracture resistance at failure when compared with the carbon fiber post and the ceramic post. The mode of failure of the carbon fiber post was more favorable to the remaining tooth structure when compared with the pre-fabricated stainless steel post and the ceramic post.

  3. Metaphyseal locking plate as a definitive external fixator for treating open tibial fractures--clinical outcome and a finite element study.

    Science.gov (United States)

    Ma, Ching-Hou; Wu, Chin-Hsien; Tu, Yuan-Kun; Lin, Ting-Sheng

    2013-08-01

    We evaluated both the outcome of using a locking plate as a definitive external fixator for treating open tibial fractures and, using finite element analysis, the biomechanical performance of external and internal metaphyseal locked plates in treating proximal tibial fractures. Eight open tibial patients were treated using a metaphyseal locked plate as a low-profile definitive external fixator. Then, finite element models of internal (IPF) as well as two different external plate fixations (EPFs) for proximal tibial fractures were reconstructed. The offset distances from the bone surface to the EPFs were 6 cm and 10 cm. Both axial stiffness and angular stiffness were calculated to evaluate the biomechanical performance of these three models. The mean follow-up period was 31 months (range, 18-43 months). All the fractures united and the mean bone healing time was 37.5 weeks (range, 20-52 weeks). All patients had excellent or good functional results and were walking freely at the final follow-up. The finite element finding revealed that axial stiffness and angular stiffness decreased as the offset distance from the bone surface increased. Compared to the IPF models, in the two EPF models, axial stiffness decreased by 84-94%, whereas the angular stiffness decreased by 12-21%. The locking plate used as a definitive external fixator provided a high rate of union. While the locking plate is not totally rigid, it is clinically stable and may be advisable for stiffness reduction of plating constructs, thus promoting fracture healing by callus formation. Our patients experienced a comfortable clinical course, excellent knee and ankle joint motion, satisfactory functional results and an acceptable complication rate. PMID:23706173

  4. A CLINICO-METALLURGICAL STUDY OF IMPLANT BREAKAGE IN DIAPHYSEAL FRACTURES OF HUMERUS, TREATED BY PRIMARY 316L SS DCP FIXATION

    Directory of Open Access Journals (Sweden)

    Rahul

    2014-11-01

    Full Text Available : Implant breakage is a catastrophic event for the patient and for the surgeon. Hence our aim was to assess the reasons for plate breakage in humeral diaphyseal fractures treated by 316 L SS DCP.A total of ten cases in Govt. medical college Trivandrum during period of June 2011 to November 2013, who were treated initially by plating of humerus presented with plate breakage were studied. Factors like weight bearing, osteoporosis and infection the usual confounding factors in any study does not feature in our study as only diaphyseal humeral fractures fixed with stainless steel DCP were studied and all patients were young. Pre and post-operative X-rays were evaluated by two surgeons to assess fracture and quality of fixation. Removed failed plates and controls were sent for metallurgical analysis. Presence of far cortex commination and empty screw hole (70% at fracture site were the commonest clinical cause and corrosion especially pitting (90% was the commonest metallurgic cause of plate breakage. When more than two clinical and metallurgical factors coincided implants failed within two years denoting a cumulative effect.

  5. Hip and fragility fracture prediction by 4-item clinical risk score and mobile heel BMD: a women cohort study

    Directory of Open Access Journals (Sweden)

    Thulesius Hans

    2010-03-01

    Full Text Available Abstract Background One in four Swedish women suffers a hip fracture yielding high morbidity and mortality. We wanted to revalidate a 4-item clinical risk score and evaluate a portable heel bone mineral density (BMD technique regarding hip and fragility fracture risk among elderly women. Methods In a population-based prospective cohort study we used clinical risk factors from a baseline questionnaire and heel BMD to predict a two-year hip and fragility fracture outcome for women, in a fracture preventive program. Calcaneal heel BMD was measured by portable dual X-ray laser absorptiometry (DXL and compared to hip BMD, measured with stationary dual X-ray absorptiometry (DXA technique. Results Seven women suffered hip fracture and 14 women fragility fracture/s (at hip, radius, humerus and pelvis among 285 women; 60% having heel BMD ≤ -2.5 SD. The 4-item FRAMO (Fracture and Mortality Index combined the clinical risk factors age ≥80 years, weight Conclusions In a follow-up study we identified high risk groups for hip and fragility fracture with our plain 4-item risk model. Increased fracture risk was also related to decreasing heel BMD in calcaneal bone, measured with a mobile DXL technique. A combination of high FRAMO Index, prior fragility fracture, and very low BMD restricted the high risk group to 11%, among whom most hip fractures occurred (71%. These practical screening methods could eventually reduce hip fracture incidence by concentrating preventive resources to high fracture risk women.

  6. Redislocation After a Failed Surgery to Treat C6/7 Fracture-Dislocation With Pedicular Fracture of the C6 Vertebra: Case Report of a Successful Revision Surgery, Analysis of the Causes, and Discussion of Revision Surgical Strategies.

    Science.gov (United States)

    Yang, Yi; Ma, Litai; Li, Tao; Liu, Hao

    2016-03-01

    Cervical spinal fracture-dislocation with pedicular fracture of the vertebra has been little reported and the management of such a patient is difficult. Considering the little knowledge of this area, we present this special case of a successful revision surgery for the treatment of redislocation after a failed surgery to treat C6/7 fracture-dislocation with pedicular fracture of the C6 vertebra to share our experience.A 45-year-old male patient presented to our hospital with history of neck pain for 4 months. According to his medical records, he was involved in an architectural accident and diagnosed with C6/7 fracture-dislocation with pedicular fracture of the C6 vertebra (ASIA: D). A surgery of posterior lateral mass screw fixation (bilateral in C5 and C7; left side in C6) was performed in a different institution. However, 4 months after his primary surgery, he was still troubled by serious neck pain and muscle weakness in all right side limbs. The physical examination of the patient showed hypoesthesia in the right side limbs, myodynamia of the right side limbs weakened to Grade 4. Cervical X-rays, computed tomography (CT), and magnetic resonance imaging confirmed the redislocation of C6/7. A successful revision surgery of anterior cervical corpectomy and fusion (ACCF) with nanohydroxyapatite/polyamide 66 composite fulfilled with vertebral autograft plus anterior plate was performed. The 3 months postoperative X-rays and CT scan showed the good position of the implant and bony fusion. The patient's neck pain was relived and the neurological function recovered to ASIA E grade at the 3rd month follow-up.ACCF with nanohydroxyapatite/polyamide 66 composite fulfilled with vertebral autograft plus anterior plate is effective for the treatment of redislocation after a failed surgery in patients of fracture-dislocation with pedicular fracture. The best method to avoid such a failed surgery is a combined anterior-posterior approach surgery in our opinion. PMID:26962843

  7. Proximal Femoral Nail Antirotation Versus Reverse Less Invasive Stabilization System-distal Femur for Treating Proximal Femoral Fractures: A Meta-analysis.

    Science.gov (United States)

    Jiang, Xuan; Wang, Ying; Ma, XinLong; Ma, JianXiong; Wang, Chen; Zhang, ChengBao; Han, Zhe; Sun, Lei; Lu, Bin

    2016-04-01

    The aim of this study was to compare the effectiveness and safety of 2 surgical techniques that are used to treat proximal femoral fractures.A systematic literature search (up to December 2014) was conducted in Medline, Embase, PubMed, and The Cochrane Central Register of Controlled Trials to screen for studies comparing proximal femoral nail antirotation (PFNA) with less invasive stabilization system-distal femur (LISS-DF) for proximal femoral fractures. Two authors independently assessed the methodological quality of the included studies and extracted data. Surgical information and postoperative outcomes were analyzed.A total of 7 studies with 361 patients who satisfied the eligibility criteria included 3 randomized controlled trials and 4 case-controlled trials associated with PFNA versus LISS in treating proximal femoral fractures. Our results demonstrated that there was a significant reduction in hospital stay and time to weight-bearing ambulation and bone healing for PFNA compared with LISS (odds ratio [OR] -1.48, 95% confidence interval [CI] -2.92 to -0.05; OR -7.08, 95% CI -8.32 to -5.84; OR -2.71, 95% CI -4.76 to 0.67). No statistically significant difference was observed between the 2 groups for operative time, blood loss volume, Harris hip score, and incidence of complications.Based on the results of this analysis, we inferred that PFNA is safer and more effective than reverse LISS-DF in patients undergoing osteosynthesis for proximal femoral fractures, and that PFNA is associated with reduced hospital stays and reduced time to weight-bearing ambulation and bone healing. Nonetheless, in certain cases in which PFNA is not suitable due to abnormal structure of the proximal femur or particularly unstable fractures, the LISS plate technique could be a useful alternative. PMID:27057840

  8. The reinforcement effect of polyethylene fibre and composite impregnated glass fibre on fracture resistance of endodontically treated teeth: An in vitro study

    Directory of Open Access Journals (Sweden)

    Archana Luthria

    2012-01-01

    Full Text Available Aim: The aim of this study was to evaluate the fracture resistance of endodontically treated maxillary premolars with wide mesio-occluso-distal (MOD cavities restored with either composite resin, or composite resin reinforced with different types of fibres. Materials and Methods: Fifty human maxillary premolars were selected. Five intact teeth served as positive controls. Endodontic therapy was carried out in the remaining forty-five teeth. Standardized MOD cavities were prepared in all the teeth. The teeth were restored with a nanocomposite using an incremental technique. These forty five teeth were randomly divided into three experimental groups (Group A, B and C (n = 15. The teeth in Group A did not undergo any further procedures. The teeth in Group B and C were reinforced with composite impregnated glass fibre and polyethylene fibre, respectively. Fracture resistance was measured in Newtons (N. Results: The positive controls showed the highest mean fracture resistance (811.90 N, followed by Group B (600.49N, Group A (516.96N and Group C (514.64N, respectively. One Way analysis of variance (ANOVA test revealed a statistically significant difference between all the groups (P = 0.001. Post-hoc Tukey test revealed a moderately significant difference (P = 0.034 between Control and Group B, and a strongly significant difference between Control and Group A (P = 0.002, and Control and Group C (P = 0.001. Conclusions: Endodontic therapy and MOD cavity preparation significantly reduced the fracture resistance of endodontically treated maxillary premolars (P = 0.001. No statistically significant difference was found between the experimental groups (Group A, B and C (P > 0.1. However, the fracture resistance of the composite impregnated glass fibre reinforced group was much higher than the others.

  9. Balance in single-limb stance after surgically treated ankle fractures: a 14-month follow-up

    OpenAIRE

    Ageberg Eva; Nilsson Gertrud; Ekdahl Charlotte; Eneroth Magnus

    2006-01-01

    Abstract Background The maintenance of postural control is fundamental for different types of physical activity. This can be measured by having subjects stand on one leg on a force plate. Many studies assessing standing balance have previously been carried out in patients with ankle ligament injuries but not in patients with ankle fractures. The aim of this study was to evaluate whether patients operated on because of an ankle fracture had impaired postural control compared to an uninjured ag...

  10. Fracture resistance of endodontically treated permanent anterior teeth restored with three different esthetic post systems: An in vitro study

    OpenAIRE

    Ameet J Kurthukoti; Jaya Paul; Kapil Gandhi; Divya B J Rao

    2015-01-01

    Background: Esthetic coronal reconstruction of fractured anterior teeth is often performed using intra radicular posts. Most of the commonly used commercially esthetic post systems do not exhibit similar physical properties as dentin resulting in failures. Aim: To evaluate and compare the fracture resistance and mode of failure of simulated traumatized permanent central incisors restored with three different post systems including biologic dentin posts. Materials and Methods: A total of 40 re...

  11. The new concept of the monitoring and appraisal of bone union inflexibility of fractures treated by Dynastab DK external fixator.

    Science.gov (United States)

    Lenz, Gerhard P; Stasiak, Andrzej; Deszczyński, Jarosław; Karpiński, Janusz; Stolarczyk, Artur; Ziółkowski, Marcin; Szczesny, Grzegorz

    2003-10-30

    Background. This work focuses on problems of heuristic techniques based on artificial intelligence. Mainly about artificial non-linear and multilayer neurons, which were used to estimate the bone union fractures treatment process using orthopaedic stabilizers Dynastab DK. Material and methods. The author utilizes computer software based on multilayer neuronal network systems, which allows to predict the curve of the bone union at early stages of therapy. The training of the neural net has been made on fifty six cases of bone fracture which has been cured by the Dynastab stabilizers DK. Using such trained net, seventeen fractures of long bones shafts were being examined on strength and prediction of the bone union as well. Results. Analyzing results, it should be underlined that mechanical properties of the bone union in the slot of fracture are changing in nonlinear way in function of time. Especially, major changes were observed during the forth month of the fracture treatment. There is strong correlation between measure number two and measure number six. Measure number two is more strict and in the matter of fact it refers to flexion, as well as the measure number six, to compression of the bone in the fracture slot. Conclusions. Consequently, deflection loads are especially hazardous for healing bone. The very strong correlation between real curves and predicted curves shows the correctness of the neuronal model. PMID:17679847

  12. A CURRENT 4-YEARS RETROSPECTIVE SURVEY OF 64 SURGICALLY TREATED ZYGOMA COMPLEX FRACTURES IN DEPARTMENT OF MAXILLO-FACIAL SURGERY, UNIVERSITY HOSPITAL ‘ST. ANNA’, SOFIA, BULGARIA.

    Directory of Open Access Journals (Sweden)

    Elitsa G. Deliverska

    2013-04-01

    Full Text Available Purpose: The goal of this material was to be an example of the complications that can occur in cases of zygoma fractures and to draw the attention of the clinicians to the need of accurate diagnose and early treatment of the associated with zygoma fractures traumas. Materials and methods: Medical records of 276 patients with different traumas in face and neck area treated in our department ware reviewed. Of those 64 suffered from zygoma fractures and they ware classified according to age, sex, cause of trauma, presence or absence of associated trauma, etc.Results: As other studies also show, we determined that the most common cause of injury was assault and road accidents, fallowed by sport, industrial, etc. Males between 20 and 40 years old ware the biggest group of patients, often after alcohol consumption.Associated traumas occurred more frequently in cases of motor vehicle accident than in other cases and ware presented by closed head trauma, ophthalmologic problems, extremities fractures, etc.Conclusion: Delayed treatment of zygoma injuries is feasible and yields in good results when the severity of trauma needs it, but early repair of such injuries prevent late complications and should be preferred when possible.

  13. Evaluation of fracture resistance of endodontically treated teeth restored with composite resin along with fibre insertion in different positions in vitro.

    Science.gov (United States)

    Rahman, Hena; Singh, Shailja; Chandra, Anil; Chandra, Ramesh; Tripathi, Supratim

    2016-08-01

    This study was carried out to compare the different techniques of placement of polyethylene fibre (Ribbond) on reinforcement of endodontically treated teeth with MOD cavities in vitro. Forty extracted human premolars were randomly assigned to four groups (n = 10). Teeth in Groups I-IV received root canal treatment and a MOD cavity preparation, with gingival cavosurface margin 1.5 mm in coronal to cementoenamel junction. Group I served as no fibre group, Group II as occlusal fibre group, Group III as base fibre group and Group IV as dual-fibre group (occlusal and base both). Subsequent to restoring with composite resin and thermocycling, a vertical compressive force was applied at a cross-head speed of 0.5 mm min(-1) using universal testing machine until fracture. Data were analysed using one-way analysis of variance and Tukey's post hoc tests. Fracture resistance was significantly highest in dual-fibre group (P root canal-treated teeth and maximum fracture resistance was observed when cavity was restored using dual-fibre technique. PMID:26419210

  14. PEADIATRIC LONG BONES FRACTURE IN LOWER LIMBS TREATED BY TENS (TITANIUM ELASTIC NAILING SYSTEM NAIL: A SURGICAL OUTCOME

    Directory of Open Access Journals (Sweden)

    Suresh

    2014-08-01

    Full Text Available In the last two decades, there was an increased interest in the operative treatment of pediatric fractures, although debate persisted over its indications. There is a little disagreement concerning the treatment of long bone fractures in children less than 6 years (POP cast and adolescents, older than 16 years (locked intramedullary nailing. 1 Controversy persists regarding the age between 6 to 16 years, with several available options: traction followed by hip Spica, external fixation, flexible, stable intramedullary nails, plate fixation, and locked intramedullary nailing. As no clear guidelines have been available until now despite efforts done initially by French surgeons, later on by European surgeons and recently by the Paediatric Orthopaedic Society of North America (POSNA2Titanium elastic nail (TEN fixation was originally meant as an ideal treatment method for femoral fractures, but was gradually applied to other long bone fractures in children, as it represents a compromise between conservative and surgical therapeutic approaches with satisfactory results and minimal complications3. Hence we have undertaken a prospective study of 30 cases in our institution about the outcome and efficacy of paediatric femoral and tibial diaphyseal fracture between age 6 to 16 years.

  15. Low bone mineral density is not related to failure in femoral neck fracture patients treated with internal fixation

    DEFF Research Database (Denmark)

    Viberg, Bjarke; Ryg, Jesper; Overgaard, Søren;

    2014-01-01

    new hip fracture). A stratified Cox regression model on fracture displacement was applied and adjusted for age, sex, quality of reduction, implant positioning, comorbidity, and walking disability. Results - 49 patients had a T-score below -2.5 (standard deviation from the young normal reference mean......, implant positioning, and quality of reduction. From a questionnaire completed during admission, 2 variables for comorbidity and walking disability were chosen. Primary outcome was low hip BMD (amount of mineral matter per square centimeter of hip bone) compared to hip failure (resection, arthroplasty, or...

  16. A Gustilo Type IIIB Open Forearm Fracture Treated by Negative Pressure Wound Therapy and Locking Compression Plates : A Case Report

    OpenAIRE

    Takeuchi, Naohide; Mae, Takao; Hotokezaka, Shunsuke; Sasaki, Kosuke; Matsushita, Akinobu; Miake, Go; Kuchishi, Rintaro; Noguchi, Yasuo

    2011-01-01

    A 91-year-old female sustained injuries to her left forearm while walking across a crosswalk. X-rays showed left radial shaft and ulna shaft fractures, and the injury was a type IIIB open fracture. On the day of admission, irrigation and debridement of the open wound, and temporary fixation of the radius and ulna using an external fixator and a Kirschner wire were peformed. Six days after the surgery, we used negative pressure wound therapy (NPWT) using the V.A.C.ATS® system for the open woun...

  17. A Study of Incidence of calcaneal spurs in North Indian population: A dry bone study

    Directory of Open Access Journals (Sweden)

    G. S. Ghindha

    2015-07-01

    Full Text Available The calcaneal spurs are the most common cause of pain in heel. The pain appears when patient stands on the foot for walking and pain disappears when patient walks some distance. The most common causes of spur formation is chronic fasciitis, wears and tears of ligaments and fascia present in the sole of foot. When the fasciitis heals, during the healing process the calcification of fascia or ligaments takes place, which results into the spur formation. The present study has been conducted on 325 dry human calcanei, irrespective of their sex, in the Department of Anatomy of M. M. Medical College and Hospital, Kumarhatti, District Solan (Himachal Pradesh. The objective of this study is to assess the rate of incidence of the presence of spurs in the calcanei and their types present in these calcanei. The photographs of all types of calcaneal spurs are taken and recorded and the study is compared with the standard literature and previous studies done by other authors. Out of 325 calcanei, 150 (35.38 % cases are having inferior, posterior calcaneal spurs. In 28 (8.62 % cases both types of spurs have been found. Other calcanei are having either inferior or posterior calcaneal spurs. The inferior spurs are more common on right and left side i.e out of 325 cases 75 (23.08 % cases, and posterior spurs found in 40 (12,31 % cases, respectively. In 2 (0.61 % cases a scale type of spurs was present which was attached in the middle of the inferior surface of the calcanei and their anterior ends are free, sharp and pointing forwards. These observations are definitely helpful to the orthopedician, traumatologist and surgeons in their diagnosis and treatment.

  18. Cusp deflection, infraction and fracture in endodontically treated teeth filled with three temporary filling materials (in vitro

    Directory of Open Access Journals (Sweden)

    Ali Eskandarizade

    2015-12-01

    Full Text Available Aim: the aim of this study was to compare cusp deflection, infraction and fracture in teeth filled with three temporary filling materials. Materials & method: Forty five extracted human premolar teeth were chosen. After root canal therapy and mesio-occluso-distal cavity preparation, samples were randomly divided into three groups , each contained 15 teeth and filled with three temporary filling materials: Cavisol (Golchai-Iran, Coltosol F (Coltene,Swiss and Coltene (Ariadent,Iran. Teeth were kept in normal saline at room temperature and every day the intercuspal distance was measured under stereomicroscope for 20 days. Infractions as well as fractures were also noted. Data were analyzed in SPSS 17 using Repeated measurement ANOVA test to evaluate the intercuspal distance and expansion of each sample every day. Results: Intercuspal distance increased in all three groups but was significantly more in Coltosol F group. On the days 10 and 16 two teeth filled with Coltosol F had cusp fracture. Conclusion: Temporary filling materials have hygroscopic expansion and cause cusp deflection which may lead to cusp fracture, so it is recommended to use them in short period of time.

  19. [Anatomical variants of the medial calcaneal nerve and the Baxter nerve in the tarsal tunnel].

    Science.gov (United States)

    Martín-Oliva, X; Elgueta-Grillo, J; Veliz-Ayta, P; Orosco-Villaseñor, S; Elgueta-Grillo, M; Viladot-Perice, R

    2013-01-01

    The tarsal tunnel is composed of the posterior border of the medial malleoulus, the posterior aspect of the talus and the medial aspect of the calcaneus. The medial calcaneal nerve emerges from the posterior aspect of the posterior tibial nerve in 75% of cases and from the lateral plantar nerve in the remaining 25%. Finally, the medial calcaneal nerve ends as a single terminal branch in 79% of cases and in numerous terminal branches in the remaining 21%. To describe the anatomical variants of the posterior tibial nerve and its terminal branches. To describe the steps for tarsal tunnel release. To describe Baxter nerve release. The anatomical variants of the posterior tibial nerve and its terminal branches within the tarsal tunnel were studied. Then the Lam technique was performed; it consists of: 1) opening of the laciniate ligament, 2) opening of the fascia over the abductor hallucis muscle, 3) exoneurolysis of the posterior tibial nerve and its terminal branches, identifying the emergence and pathway of the medial calcaneal branch, the lateral plantar nerve and its Baxter nerve branch and the medial plantar nerve. Baxter nerve was found in 100% of cases. In 100% of cases in our series the nerve going to the abductor digiti minimi muscle of the foot was found; 87.5% of cases had two terminal branches. The dissections proved that a crucial step was the release of the distal tarsal tunnel. PMID:24701749

  20. Displaced tibia shaft fractures in children treated by elastic stable intramedullary nailing: results and complications in children weighing 50 kg (110 lb) or more.

    Science.gov (United States)

    Marengo, Lorenza; Paonessa, Matteo; Andreacchio, Antonio; Dimeglio, Alain; Potenza, Alberto; Canavese, Federico

    2016-04-01

    The main objective of this study was to retrospectively evaluate the clinical and radiographic outcomes of displaced tibia shaft fractures in children weighing 50 kg (110 lb) or more treated by elastic stable intramedullary nailing (ESIN). Translation, sagittal and coronal angulations were assessed on plain radiographs in all the patients. Twenty-six out of 106 patients met the inclusion criteria. The average patient age at the time of injury was 13.5 ± 1.3 years (range 11.3-16.1). The mean patient weight was 57 ± 8 kg (range 50-80). This study demonstrates that the use of ESIN for displaced tibia shaft fractures in children and adolescents weighing 50 kg (110 lb) or more, or older than 13 years of age, is not contraindicated. In contrast to data in femoral shaft fractures, we did not find poorer outcomes in older or heavier patients. No correlation between nail size/medullary canal diameter ratio and outcome was observed. PMID:26662289

  1. Fracture Resistance of Endodontically-treated Maxillary Premolars Restored with Composite Resin along with Glass Fiber Insertion in Different Positions

    OpenAIRE

    2012-01-01

    Background and aims The aim was to evaluate the effect of three methods of fiber insertion on fracture resistance of root-filled maxillary premolars in vitro. Materials and methods Sixty extracted human maxillary premolars received endodontic treatment followed by preparation of mesioocclusodistal (MOD) cavities, with gingival cavosurface margin 1.5 mm coronal to the cementoenamel junction (CEJ). Subsequently, the samples were randomly divided into four groups: no-fiber group; occlusal fiber ...

  2. FUNCTIONAL AND RADIOLOGICAL OUTCOME OF TIBIAL PLATEAU FRACTURES (SCHATZKER TYPE 5 & 6 TREATED WITH ILIZAROV CIRCULAR EXTERNAL RING FIXATOR

    Directory of Open Access Journals (Sweden)

    Sheshagiri

    2016-01-01

    Full Text Available INTRODUCTION Fractures of the tibial plateau are the result of high energy trauma. Because of the nature of the trauma and the relative high frequency of soft tissue injuries, the rate of complications is high. Complications include joint stiffness, compartment syndrome, malunion, skin loss, osteomyelitis, and possible amputation. The Ilizarov external fixator helps in minimizing these complications by allowing early mobilization and weight bearing, minimal soft tissue injury and blood loss along with a stable fixation MATERIAL AND METHODS In our prospective study of 20 patients which included adults with open/closed Schatzker type 5 and 6 tibial plateau fractures, we studied the outcome following surgery with Ilizarov external fixation using the modified Hohl and Luck criteria which includes functional (extensor lag, valgus or varus instability, knee range of movement, walking distance and pain and radiological parameters (valgus/varus deformity, depression of articular surface and osteoarthritis. RESULTS All patients (n = 20 started weight bearing the day after the surgery. Functionally, 55% (n=11 had a excellent result, 40% (n=8 had a good result. 75% (n=15 had an excellent result radiologically. 3 patients out of 20 had a pin tract infection and one patient had an early implant removal due to non-compliance. CONCLUSION Treatment of open/ closed tibial plateau fractures with Ilizarov circular external ring fixator has proven to be advantageous in terms of early weight bearing and minimal soft tissue compromise. Excellent Radiological outcome is not necessarily associated with similar functional outcome.

  3. Treating occult fractures around the knee in TCM%中医分期论治膝关节周围隐性骨折

    Institute of Scientific and Technical Information of China (English)

    李现林; 仝彦格

    2014-01-01

    Occult fracture is a kind of actual existence fracture, but cannot diagnose by X-ray and manifestation. Occult fracture often occurred around the knee joint, the outset of the disease is related to trauma, or related to osteoporosis and strain. The diagnosis mainly depended on the MRI check. Due to the concealment of fracture, many patients often misdiagnosed as soft tissue injury of knee, knee joint synovitis and osteoarthritis of the knee, causing loss of governance and mistreatment, and even the formation of disability. Fracture of three period of treatment based on syndrome differentiation by the author treating occult fractures around the knee in TCM received good curative effect, now introduce as follows.%隐性骨折是指实际存在而不能根据 X 线和临床表现而确诊的骨折。隐性骨折多发生在膝关节周围,以股骨髁和胫骨髁多见,一部分患者因外伤而发病,而另一部分患者则无明显外伤史,与骨质疏松和劳损有关。其确诊主要依赖磁共振(MRI)检查。由于隐性骨折的隐蔽性,许多患者常常被误诊为膝部软组织损伤、膝关节滑膜炎或膝关节骨性关节炎,导致失治误治,延误病情,甚至形成残疾。2011年3月-2013年9月笔者采用中医骨折三期辨证论治膝关节周围隐性骨折,收到良好疗效,现介绍如下。

  4. Autologous grafts of double-strut fibular cortical bone plate to treat the fractures and defects of distal femur: a case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    CHEN Xu; LI Jian-jun; KONG Zhan; YANG Dong-xiang; YUAN Xiang-nan

    2011-01-01

    We reported a 23-year-old man who was involved in a high-speed motorcycle accident. He sustained a closed fracture at the right distal femur. The primary fracture happened on February 2008. He underwent open reduction and internal fixation with cloverleaf plate. And one hundred days after the surgery, the proximal screws were pulled-out, but the bone union was not achieved. Treat ment consisted of exchanging the cloverleaf plate with a locking compression plate and using an auto-iliac bone graft to fill the nonunion gap. In July 2009, the patient had a sharp pain in the right lower limb. The X-ray revealed that the plate implanted last year was broken, causing a nonunion at the fracture site. Immediately the plate and screws were removed and an intramedullary nail was inserted reversely from the distal femur as well as a 7 cm long bone from the right fibula was extracted and longitudinally split into two pieces to construct cortical bone plates. Then we placed them laterally and medially to fracture site, drilled two holes respectively, and fastened them with suture. We carried on auto-iliac bone grafting with the nonunion bone grafts. The follow-up at 15 months after operation showed that the treatment was successful, X-ray confirmed that there was no rotation and no angular or short deformity. We briefly reviewed the literature regarding such an unusual presentation and discussed in details the possible etiology and the advantages of autologous double-strut fibular grafts to cope with such an intractable situation.

  5. Experience of using locking plates to treat distal radial fractures%掌侧入路锁定钢板治疗桡骨远端骨折

    Institute of Scientific and Technical Information of China (English)

    凌晓冬; 尚希福

    2012-01-01

    Objective To summarize the clinical experience of using locking plates to treat distal radial fractures. Methods Eighteen patients with distal radial fractures enrolled from January 2010 to February 2012 were treated with locking plates in our department. A retrospective analysis was performed. Results All 18 patients were followed up for 3 ~24 months. According to the Dient score, 13 cases were excellent, 4 cases were good and 1 case was poor, and the excellent rate was 94. 4% . Conclusion It is less invasive and simple to use locking plates in the treatment of distal radial fractures, for the reduction is fine and the fixation is rigid. It is good for early exercises.%目的 总结掌侧入路锁定钢板治疗桡骨远端骨折的临床经验.方法 回顾分析2010年1月至2012年2月收治的18例行掌侧入路锁定钢板治疗的桡骨远端骨折病例.结果 18例患者均获得随访,随访时间3~24个月,按Dient功能评定标准[1],优13例,良4例,可1例,优良率94.4%.结论 掌侧入路锁定钢板治疗不稳定性桡骨远端骨折,具有复位效果满意,早期功能锻炼,减少长期制动带来的并发症等优点.

  6. Balance in single-limb stance after surgically treated ankle fractures: a 14-month follow-up

    Directory of Open Access Journals (Sweden)

    Ageberg Eva

    2006-04-01

    Full Text Available Abstract Background The maintenance of postural control is fundamental for different types of physical activity. This can be measured by having subjects stand on one leg on a force plate. Many studies assessing standing balance have previously been carried out in patients with ankle ligament injuries but not in patients with ankle fractures. The aim of this study was to evaluate whether patients operated on because of an ankle fracture had impaired postural control compared to an uninjured age- and gender-matched control group. Methods Fifty-four individuals (patients operated on because of an ankle fracture were examined 14 months postoperatively. Muscle strength, ankle mobility, and single-limb stance on a force-platform were measured. Average speed of centre of pressure movements and number of movements exceeding 10 mm from the mean value of centre of pressure were registered in the frontal and sagittal planes on a force-platform. Fifty-four age- and gender-matched uninjured individuals (controls were examined in the single-limb stance test only. The paired Student t-test was used for comparisons between patients' injured and uninjured legs and between side-matched legs within the controls. The independent Student t-test was used for comparisons between patients and controls. The Chi-square test, and when applicable, Fisher's exact test were used for comparisons between groups. Multiple logistic regression was performed to identify factors associated with belonging to the group unable to complete the single-limb stance test on the force-platform. Results Fourteen of the 54 patients (26% did not manage to complete the single-limb stance test on the force-platform, whereas all controls managed this (p Conclusion One in four patients operated on because of an ankle fracture had impaired postural control compared to an age- and gender-matched control group. Age over 45 years and decreased strength in the ankle plantar flexors and dorsiflexors

  7. Size and separability of the calcaneal and the medial and lateral plantar nerves in the distal tibial nerve

    DEFF Research Database (Denmark)

    Struijk, Lotte N. S. Andreasen; Birn, Henrik; Teglbjærg, Peter Stubbe; Haase, Jens; Struijk, Johannes

    2010-01-01

    The tibial nerve (TN) has three main terminal branches: the medial and lateral plantar nerves and the calcaneal branch (CB), which innervates the foot sole. The design and implantation of nerve cuff electrodes with separate channels for each of these three terminal branches would provide signific......The tibial nerve (TN) has three main terminal branches: the medial and lateral plantar nerves and the calcaneal branch (CB), which innervates the foot sole. The design and implantation of nerve cuff electrodes with separate channels for each of these three terminal branches would provide...... electrodes. Therefore, the branching pattern, the fascicular separability and the fascicular size of the TN posterior to the medial malleolar-calcaneal axis were examined in this study, using ten human TN specimens. The TN branching patterns were highly dispersed. For the CBs, multiple branches were...

  8. The computed tomographic evaluation of patellofemoral joint in patellar fractures treated with open reduction and internal fixation

    Energy Technology Data Exchange (ETDEWEB)

    Benli, I.T.; Akalin, S.; Mumcu, E.F.; Citak, M.; Kilic, M.; Pasaoglu, E. (Ankara Social Security Hospital (Turkey))

    1992-08-01

    In this study, we examined 97 patella fractures in which open reduction and internal fixation had been performed at the 1st Orthopaedics and Trauma Clinic of Social Security Ankara Hospital between January 1983 and December 1988. After 24 to 96 months, on an average of 48.4 months follow-up period, the cases were evaluated clinically for knee function complaints and by CT and roentgenography for patellofemoral articulation. In 11 of the patients (11.5%) there was patellar displacement, 2 of the patients had patellar tilt (2.1%) and in 14 patients (14.5%) there was malalignment in which 1 patient (1.1%) had both patellar tilt and displacement. This data was obtained by measuring femoral trochlear angle (FTA) and patellar tilt angle (PTA) by CT at various degrees of knee flexion. Thirty three patients (34%) had slight and 19 patients (19.6%) had severe degenerative changes in the patellofemoral articulation. It is found that there is close relation between the variability of the pain complaints of the patients and the type of the fracture and the time of management and the postoperative rehabilitation. (author).

  9. The computed tomographic evaluation of patellofemoral joint in patellar fractures treated with open reduction and internal fixation

    International Nuclear Information System (INIS)

    In this study, we examined 97 patella fractures in which open reduction and internal fixation had been performed at the 1st Orthopaedics and Trauma Clinic of Social Security Ankara Hospital between January 1983 and December 1988. After 24 to 96 months, on an average of 48.4 months follow-up period, the cases were evaluated clinically for knee function complaints and by CT and roentgenography for patellofemoral articulation. In 11 of the patients (11.5%) there was patellar displacement, 2 of the patients had patellar tilt (2.1%) and in 14 patients (14.5%) there was malalignment in which 1 patient (1.1%) had both patellar tilt and displacement. This data was obtained by measuring femoral trochlear angle (FTA) and patellar tilt angle (PTA) by CT at various degrees of knee flexion. Thirty three patients (34%) had slight and 19 patients (19.6%) had severe degenerative changes in the patellofemoral articulation. It is found that there is close relation between the variability of the pain complaints of the patients and the type of the fracture and the time of management and the postoperative rehabilitation. (author)

  10. Biomechanical Evaluation of a Mandibular Spanning Plate Technique Compared to Standard Plating Techniques to Treat Mandibular Symphyseal Fractures

    Directory of Open Access Journals (Sweden)

    Matthew Richardson

    2015-01-01

    Full Text Available Purpose. The purpose of this study is to compare the biomechanical behavior of the spanning reconstruction plate compared to standard plating techniques for mandibular symphyseal fractures. Materials and Methods. Twenty-five human mandible replicas were used. Five unaltered synthetic mandibles were used as controls. Four experimental groups of different reconstruction techniques with five in each group were tested. Each synthetic mandible was subjected to a splaying force applied to the mandibular angle by a mechanical testing unit until the construct failed. Peak load and stiffness were recorded. The peak load and stiffness were analyzed using ANOVA and the Tukey test at a confidence level of 95% (P<0.05. Results. The two parallel plates’ group showed statistically significant lower values for peak load and stiffness compared to all other groups. No statistically significant difference was found for peak load and stiffness between the control (C group, lag screw (LS group, and the spanning plate (SP1 group. Conclusions. The spanning reconstruction plate technique for fixation of mandibular symphyseal fractures showed similar mechanical behavior to the lag screw technique when subjected to splaying forces between the mandibular gonial angles and may be considered as an alternative technique when increased reconstructive strength is needed.

  11. Assessment of the influence of Laser phototherapy on the bone repair process of complete fractures in tibiae of rabbits stabilized with semi-rigid internal fixation treated with or without MTA graft: a histological study

    Science.gov (United States)

    Soares, Luiz G. P.; Silva, Aline C. P.; Silva, Anna Paula L. T.; Neves, Bruno Luiz R. C.; Santos, Nicole R. S.; dos Santos, Jean N.; Pinheiro, Antonio L. B.

    2016-03-01

    Beside biomaterials, Laser phototherapy has shown positive effects as auxiliary therapy in bone repair process, especially when involving large bone losses. The aim of this histological study was to evaluate, by light microscopy, the influence of laser phototherapy on the repair of complete tibial fractures in rabbits treated or not with semi-rigid internal fixation and Mineral Trioxide Aggregate - MTA graft. Twelve Rabbits were randomly divided into four groups with three animals each. After general anesthesia, complete fractures were created in one tibia with a carborundum disk. All animals (groups I-IV) had the fracture stabilized with semi-rigid fixation (wire osteosynthesis - WO). Group I was routinely fixed with WO; groups II and IV fracture was filled by blood clot and MTA implant. In Groups III and IV fracture was filled by blood clot and further irradiated with laser (λ780 nm, 70 mW, CW, Φ = 0.04 cm2, 20.4 J/cm2, per session, t = 300s, 142.8 J/cm2 per treatment). The phototherapy protocol was applied immediately after the surgery and repeated each 48 hours during 15 days. Animal death occurred on the 30th postoperative day. After removal of the specimens, the samples were routinely processed, stained with HE and evaluated by light microscopy. Histologically, the group treated with MTA graft and irradiated with laser showed the fracture filled by a more organized and mature trabecular bone, when compared with all other groups. From the results of the present study, it may be concluded that the association of Laser phototherapy + MTA graft in fractures treated with WO improved bone repair when compared with fractures treated only with WO.

  12. Calcaneal acrometastasis from urothelial carcinoma of the ureter: a case report and literature review

    Directory of Open Access Journals (Sweden)

    Ryder JH

    2013-04-01

    Full Text Available Jonathan H Ryder,1 Sean V McGarry,2 Jue Wang1  1Division of Oncology/Hematology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, Nebraska, USA; 2Department of Orthopaedic Surgery and Rehabilitation, University of Nebraska Medical Center, Omaha, Nebraska, USA Purpose: Ureteral cancer is a rare entity. Typical symptoms are painless hematuria as well as flank pain. Bone metastasis of ureteral cancer can occur in nearby bone structures, such as the spine, pelvis, and hip bone. Distal bone metastasis, such as that in the calcaneus bone, however, is rare. Case report: An 82-year-old woman presented to the orthopedic clinic at the university hospital with a 3-month history of left heel pain. A magnetic resonance imaging (MRI of her foot demonstrated a calcaneal lytic lesion. A biopsy of the lytic lesion showed urothelial carcinoma with squamous differentiation. A computed tomography (CT scan of the abdomen and pelvis showed left hydronephrosis and an obstructive mass in the left ureter, at the iliac crossing. The patient received combined therapy that included local radiation, bisphosphonate, and chemotherapy, with complete resolution of her cancer-related symptoms. However, she eventually died from the progressive disease, 20 months after the initial diagnosis. Conclusion: This case highlights the rare presentation of ureter cancer with an initial presentation of foot pain, secondary to calcaneal metastasis. Multimodality therapy provides effective palliation of symptoms and improved quality of life. We also reviewed the literature and discuss the clinical benefits of multidisciplinary cancer care in elderly patients. Keywords: urothelial carcinoma, elderly, calcaneal acrometastasis, multimodality therapy, chemotherapy, radiation

  13. Relationship between the functional outcomes and radiological results of conservatively treated displaced proximal humerus fractures in the elderly: A prospective study

    Science.gov (United States)

    Canbora, Mehmet Kerem; Kose, Ozkan; Polat, Atilla; Konukoglu, Levent; Gorgec, Mucahit

    2013-01-01

    Purpose: The purpose of this prospective study is to investigate the relationship between the functional outcome and the radiographic results of conservatively treated two-, three- and four-part proximal humeral fractures in patients aged over 65 years. Materials and Methods: The study comprised 29 prospectively followed cases aged over 65 years who presented with displaced proximal humerus fracture between 2009 and 2011. The fractures were classified according to the Neer classification and all met the displacement criteria described by Neer. Standard physical therapy program was applied. Patients were evaluated clinically using Constant shoulder score, quick form of disabilities of arm, shoulder and hand score and visual analog scale. At the final follow-up, humeral head position in the coronal plane was assessed with neck-shaft angle. Any complication was recorded during the treatment period. Correlation between the functional outcomes and final radiologic results were statistically analyzed. Results: Data were analyzed from 29 cases (21 female, 8 male) with a mean age was 78 ± 8.6 years (range 65-93 years). The mean follow-up period was 18.2 ± 4.07 months (range 12-26 months). Functional results were significantly related with initial fragmentation. However, there was no correlation between the functional outcomes and the final geometry of the humeral head. Despite the union occurred with deformity, the functional outcome were satisfactory. Conclusion: The results of this study show that initial fragmentation has a negative effect on the functional results. However, the changed position of the humeral head on coronal plane does not affect the final functional results. PMID:24167402

  14. The vertical hip fracture – a treatment challenge. A cohort study with an up to 9 year follow-up of 137 consecutive hips treated with sliding hip screw and antirotation screw

    Directory of Open Access Journals (Sweden)

    Enocson Anders

    2012-09-01

    Full Text Available Abstract Background Femoral neck fractures with a vertical orientation have been associated with an increased risk for failure as they are both axial and rotational unstable and experience increased shear forces compared to the conventional and more horizontally oriented femoral neck fractures. The purpose of this study was to analyse outcome and risk factors for reoperation of these uncommon fractures. Methods A cohort study with a consecutive series of 137 hips suffering from a vertical hip fracture, treated with one method: a sliding hips screw with plate and an antirotation screw. Median follow-up time was 4.8 years. Reoperation data was validated against the National Board of Health and Welfare’s national registry using the unique Swedish personal identification number. Results The total reoperation rate was 18%. After multivariable Logistic regression analysis adjusting for possible confounding factors there was an increased risk for reoperation for displaced fractures (22% compared to undisplaced fractures (3%, and for fractures with poor implant position (38% compared to fractures with adequate implant position (15%. Conclusions The reoperation rate was high, and special attention should be given to achieve an appropriate position of the implant.

  15. THE FUNCTIONAL OUTCOME OF MANAGEMENT OF SCHATZKER TYPE II AND III TIBIAL PLATEAU FRACTURES TREATED WITH INDIRECT ELEVATION, PERCUTANEOUS FIXATION AND BONE GRAFTING

    Directory of Open Access Journals (Sweden)

    Sheshagiri

    2016-02-01

    . There was no complication like infection or loss of reduction in the follow-up. CONCLUSION This minimally invasive approach is technically easy, offers good results in Schatzker II & III fractures, but since the inside of the joint is not visualized, meniscal and cruciate injuries can be missed, which can be treated later.

  16. Preliminary screening of osteoporosis and osteopenia in middle aged urban women from Hyderabad (INDIA using calcaneal QUS

    Directory of Open Access Journals (Sweden)

    Ashwin Kasturi

    2015-08-01

    Conclusions: A substantial female population was screened for osteoporosis and osteopenia using calcaneal QUS method utilizing same WHO T score criteria that otherwise shall remain undiagnosed and face the complications and menace of osteoporosis. [Int J Res Med Sci 2015; 3(8.000: 2029-2033

  17. Radiological dorsal tilt analysis of AO type A, B, and C fractures of the distal radius treated conservatively or with extra-focal K-wire plus external fixateur

    International Nuclear Information System (INIS)

    Fractures of the distal radius are amongst the most common injury patterns. The dorsal tilt represents an important co-factor determining functional outcome. The purpose of this study was to analyze the radiological dorsal tilt and identify critical time frames in conservative and operative treatment of distal radius fractures. Eighty-seven conservatively treated (hematoma block assisted reduction and splinting) and 37 operatively treated (reduction, extra-focal K-wire fixation, bridging external fixateur) AO type A, B, and C fractures of the distal radius in 124 females were retrospectively analyzed. The dorsal tilt at the initial, post-reduction, and 2 weeks post-reduction stages was correlated with the final radiographic outcome at 6 weeks. Mean initial dorsal tilt was 16.53 in the conservatively treated group and 26.76 in the operatively treated group. Mean dorsal tilt after 6 weeks showed significant differences from the mean initial dorsal tilt at time of presentation within both groups (both groups p < 0.000). No significant differences between the two groups were found after 6 weeks of treatment (p = 0.194) regardless of the underlying AO fracture type. Conservatively treated radius fractures showed a significantly higher slip rate within the first 2 weeks (primary slip rate), whereas the operative group presented a significantly higher slip rate between the 2-week and 6-week radiographic checks (secondary slip rate). In terms of dorsal tilt, conservative (cast immobilization) and operative (K-wire fixation plus external fixateur) treatment demonstrated no significant differences at the final radiographic examination (6 weeks) regardless of the underlying AO fracture type. Both treatment groups showed treatment-associated different primary and secondary slip rates, indicating a need for more frequent radiographic checks within these critical time frames. (orig.)

  18. Radiological dorsal tilt analysis of AO type A, B, and C fractures of the distal radius treated conservatively or with extra-focal K-wire plus external fixateur

    Energy Technology Data Exchange (ETDEWEB)

    Hoffmann, Michael [University Medical Center Hamburg-Eppendorf, Department of Trauma, Hand and Reconstructive Surgery, Hamburg (Germany); Borders General Hospital, Department for Trauma and Orthopaedic Surgery, Melrose, Roxburghshire, Scotland (United Kingdom); Schroeder, Malte; Gruber-Rathmann, Michaela; Ruecker, Andreas H. [University Medical Center Hamburg-Eppendorf, Department of Trauma, Hand and Reconstructive Surgery, Hamburg (Germany); Kossow, Kai [Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg (Germany)

    2012-09-15

    Fractures of the distal radius are amongst the most common injury patterns. The dorsal tilt represents an important co-factor determining functional outcome. The purpose of this study was to analyze the radiological dorsal tilt and identify critical time frames in conservative and operative treatment of distal radius fractures. Eighty-seven conservatively treated (hematoma block assisted reduction and splinting) and 37 operatively treated (reduction, extra-focal K-wire fixation, bridging external fixateur) AO type A, B, and C fractures of the distal radius in 124 females were retrospectively analyzed. The dorsal tilt at the initial, post-reduction, and 2 weeks post-reduction stages was correlated with the final radiographic outcome at 6 weeks. Mean initial dorsal tilt was 16.53 in the conservatively treated group and 26.76 in the operatively treated group. Mean dorsal tilt after 6 weeks showed significant differences from the mean initial dorsal tilt at time of presentation within both groups (both groups p < 0.000). No significant differences between the two groups were found after 6 weeks of treatment (p = 0.194) regardless of the underlying AO fracture type. Conservatively treated radius fractures showed a significantly higher slip rate within the first 2 weeks (primary slip rate), whereas the operative group presented a significantly higher slip rate between the 2-week and 6-week radiographic checks (secondary slip rate). In terms of dorsal tilt, conservative (cast immobilization) and operative (K-wire fixation plus external fixateur) treatment demonstrated no significant differences at the final radiographic examination (6 weeks) regardless of the underlying AO fracture type. Both treatment groups showed treatment-associated different primary and secondary slip rates, indicating a need for more frequent radiographic checks within these critical time frames. (orig.)

  19. Mechanical resistance evaluation of a novel anatomical short glass fiber reinforced post in artificial endodontically treated premolar under rotational/lateral fracture fatigue testing.

    Science.gov (United States)

    Wang, Hsuan-Wen; Chang, Yen-Hsiang; Lin, Chun-Li

    2016-01-01

    This study develops a novel anatomical short glass fiber reinforced (anatomical SGFR) post and evaluates the mechanical performance in artificial endodontically treated premolars. An anatomical SGFR fiber post with an oval shape and slot/notch designs was manufactured using an injection-molding machine. The three-point bending test and crown/core restorations using the anatomical SGFR and commercial cylindrical fiber posts under fatigue test were executed to understand the mechanical resistances. The results showed that static and dynamic rotational resistance were found significantly higher in the anatomical SGFR fiber post than in the commercial post. The endurance limitations at 1.2×10(6) cycles were 66.81 and 64.77 N for the anatomical SGFR and commercial fiber posts, respectively. The anatomical SGFR fiber post presented acceptable value of flexural strength and modulus, better fit adaption in the root canal resist torque more efficiency but was not a key issue in the lateral fracture resistance in an endodontically treated premolar. PMID:27041013

  20. 跟骨骨折内固定手术并发症58例分析%Analysis of complication of the fixed surgery of calcaneum bone fracture in 58 cases

    Institute of Scientific and Technical Information of China (English)

    王春辉; 吴兵; 盛文辉; 王自钢

    2011-01-01

    Objective To discuss complications of the fixed surgery of internal fixation of intra- articular calcaneal fracture. Methods Totally 64 sides of calcaneal fracture in 58 patients were treated with open reduction and Y-shaped plate fixation through lateral approach. All the cases were followed up, and the associated complications were analyzed retrospectively. Results The clinical results were evaluated according to Maryland Foot Score.Excellent and good results were acchieved in 55 cases. The precentage of complication was 85.9%. The complications were foud in 9 cases, including postoprerative wound dehiscence,malunion,infection etc. Conclusions The complications of internal fixations treating fractures arc related to anatomic features of calcaneus.%目的 探讨跟骨关节内骨折内固定手术并发症的发生原因、预防和对策.方法 收集2004年9月至2009年7月在石河子市人民医院采用切开复位+"Y"形钢板内固定伴必要时自体植骨治疗的Ⅱ~Ⅳ型跟骨骨折58例(共64足)患者的临床资料进行回顾性分析.结果 采用Maryland足部评分标准评价手术效果:优良55足,优良率为85.9%,9足发生术后复位不佳、畸形愈合、切口延迟愈合、感染等并发症.发生明确的早期并发症6足,发生率15.5%.结论 跟骨骨折内固定手术并发症与其解剖特点和骨折机制有关,采取相应措施可有效减少并发症的发生.

  1. Bone scintigraphy, radiography and MRI in the diagnosis and evaluation of treatment response of calcaneal tuberculosis

    International Nuclear Information System (INIS)

    Aim: We describe the role of various imaging modalities in the diagnosis and follow up of calcaneal tuberculosis. Materials and methods: Six patients (5 males, 1 female; age range 16-49 years) presented with heel pain. All patients underwent routine laboratory and radiological investigations e.g. radiographs, MRI and skeletal scintigraphy as part of initial diagnostic work-up. In all patients the diagnosis of tuberculosis was confirmed based on histopathology or culture. Standard multi-drug anti-tubercular therapy (ATT) was administered for 15 months. All patients were subsequently followed up with clinical evaluation, laboratory investigations and imaging. Skeletal scintigraphy, MRI and radiographs were repeated at 12 to 15 months from the initiation of anti-tubercular treatment in all patients. Results: Five out of six patients had lytic lesions at presentation on radiographs. Four of these 5 patients also had surrounding sclerosis. Follow-up radiographs obtained 12-15 months after starting ATT, showed an increase in surrounding sclerosis with progressive reduction in area of osteopenia in four and mild sclerotic changes in one. In the remaining one patient radiograph were normal both at presentation and follow up. Three phase bone scintigraphy revealed increased blood flow and blood pool activity and 'hot spots' in 5 and a central photopenic area in the calcaneum in one patient at the time of diagnosis. After starting ATT, significant reduction in vascularity and reactive bone changes in 5 patients and mild improvement in one patient. MRI was done in three patients, which revealed hyperintense lesion with erosion of the superior articular surface in 2 and 'Bull's eye' lesion with a hypointense centre and a surrounding hyperintense rim on post contrast T1W images in one patient. Follow-up MRI showed intermediate signal intensity on T2 weighted images that corresponded to caseous necrosis and high signal intensity related to granulomas or effusion. Conclusion

  2. Comparative evaluation of the effect of different crown ferrule designs on the fracture resistance of endodontically treated mandibular premolars restored with fiber posts, composite cores, and crowns: An ex-vivo study

    Science.gov (United States)

    Dua, Nikita; Kumar, Bhupendra; Arunagiri, D.; Iqbal, Mohammad; Pushpa, S.; Hussain, Juhi

    2016-01-01

    Introduction: In cases of severe hard tissue loss, 2 mm circumferential ferrule is difficult to achieve which leads to incorporation of different ferrule designs. Aim: To compare and evaluate the effect of different crown ferrule designs on the fracture resistance of mandibular premolars restored with fiber posts, composite cores, and crowns. Materials and Methods: Fifty freshly extracted mandibular premolars were endodontically treated and divided into five groups: Group I - 2 mm circumferential ferrule above the cementoenamel junction (CEJ); Group II - 2 mm ferrule on the facial aspect above CEJ; Group III - 2 mm ferrule on the lingual aspect above CEJ; Group IV - 2 mm ferrule on the facial and lingual aspects above CEJ with interproximal concavities, and Group V - no ferrule (control group) and were later restored with fiber posts, composite cores, and crowns. Specimens were mounted on a universal testing machine, and compressive load was applied at a crosshead speed of 1 mm/min until fracture occurred. Results: The results showed that circumferential ferrule produced the highest mean fracture resistance and the least fracture resistance was found in the control group. Conclusion: Circumferential ferrule increases the fracture resistance of endodontically treated teeth restored with bonded post, core, and crown. PMID:27217642

  3. 动力髁螺钉内固定治疗股骨粗隆部骨折对早期功能锻炼的影响%Influence of dynamic condylar screw treating intertrochanteric fracture of the femur on early funtion exercise

    Institute of Scientific and Technical Information of China (English)

    洪加源; 康两期; 郭林新; 练克俭; 丁真齐; 郭延杰; 翟文亮; 郭志民

    2002-01-01

    @@ Most of patients with intertrochanteric fracture of femur were treated by operations, such as Duogensi needle,Jewett pin,AO angle steel plate, Gamma pin and Richards pin. We treated 28 cases of intertrochanteric fracture of the femur with dynamic condylar screw from January 1997 to January 2000. Report as follow:

  4. Previous physical exercise slows down the complications from experimental diabetes in the calcaneal tendon

    Science.gov (United States)

    Bezerra, Márcio Almeida; da Silva Nery, Cybelle; de Castro Silveira, Patrícia Verçoza; de Mesquita, Gabriel Nunes; de Gomes Figueiredo, Thainá; Teixeira, Magno Felipe Holanda Barboza Inácio; de Moraes, Silvia Regina Arruda

    2016-01-01

    Summary Background the complications caused by diabetes increase fragility in the muscle-tendon system, resulting in degeneration and easier rupture. To avoid this issue, therapies that increase the metabolism of glucose by the body, with physical activity, have been used after the confirmation of diabetes. We evaluate the biomechanical behavior of the calcaneal tendon and the metabolic parameters in rats induced to experimental diabetes and submitted to pre- and post-induction exercise. Methods 54-male-Wistar rats were randomly divided into four groups: Control Group (CG), Swimming Group (SG), Diabetic Group (DG), and Diabetic Swimming Group (DSG). The trained groups were submitted to swimming exercise, while unexercised groups remained restricted to the cages. Metabolic and biomechanical parameters were assessed. Results the clinical parameters of DSG showed no change due to exercise protocol. The tendon analysis of the DSG showed increased values for the elastic modulus (ptendinopathy process, but prevent the progress of degeneration. PMID:27331036

  5. Ultrasound parameters of calcaneal bone density in girls with anorexia nervosa.

    Science.gov (United States)

    Kutílek, S; Bayer, M

    2001-12-01

    Osteoporosis is common in patients with anorexia nervosa (AN), but ultrasound has so far been scarcely used to detect it We measured calcaneal broadband ultrasound attenuation (BUA) and velocity of sound (VOS) in 26 AN girls (mean age 15.1+/- 1.5 years) using a Cuba Clinical device (McCue Ultrasonics, UK). Basic anthropometric (body weight, height and body mass index--BMI) and clinical data (mean duration of AN, number of absent cycles, weight loss) were collected. All of the girls reported that they did at least one hour's vigorous exercise a day. BUA was significantly lower (pmeasurements were significantly lower than the reference data (pphysical activity may lead to the increase in VOS. In conclusion, girls with AN have low BUA and high VOS values, neither of which correlate with the duration of AN or the number of missed cycles. PMID:11808818

  6. Pelvic Insufficiency Fractures

    OpenAIRE

    O’Connor, Timothy J.; Cole, Peter A.

    2014-01-01

    Pelvic insufficiency fractures may occur in the absence of trauma or as a result of low-energy trauma in osteoporotic bone. With a growing geriatric population, the incidence of pelvic insufficiency fracture has increased over the last 3 decades and will continue to do so. These fractures can cause considerable pain, loss of independence, and economic burden to both the patient and the health care system. While many of these injuries are identified and treated based on plain radiographs, some...

  7. Assessment of the bone quality of black male athletes using calcaneal ultrasound: a cross-sectional study

    OpenAIRE

    Sendeht Ayuba J; Obadofin Michael O; VanderJagt Dorothy J; Laabes Emmanuel P; Glew Robert H

    2008-01-01

    Abstract Background Lifestyle, genetics and environmental factors are established determinants of bone density. We aimed to describe the bone characteristics of competitive top-ranked Nigerian male athletes using calcaneal ultrasound and to assess whether intensive training promotes higher bone density in an environment with reportedly low calcium intake; to compare the bone characteristics of footballers with runners and other sportsmen; and to assess the correlation of stiffness index (SI) ...

  8. Normative calcaneal quantitative ultrasound data for the indigenous Shuar and non-Shuar Colonos of the Ecuadorian Amazon

    OpenAIRE

    Madimenos, FC; Snodgrass, JJ; Blackwell, AD; Liebert, MA; Cepon, TJ; Sugiyama, LS

    2011-01-01

    Summary Minimal data on bone mineral density changes are available from populations in developing countries. Using calcaneal quantitative ultrasound (QUS) techniques, the current study contributes to remedying this gap in the literature by establishing a normative data set on the indigenous Shuar and non-Shuar Colonos of the Ecuadorian Amazon. Purpose The paucity of bone mineral density (BMD) data from populations in developing countries partially reflects the lack of diagnostic resources in ...

  9. A new measurement for posterior tilt predicts reoperation in undisplaced femoral neck fractures: 113 consecutive patients treated by internal fixation and followed for 1 year

    DEFF Research Database (Denmark)

    Palm, Henrik; Gosvig, Kasper; Krasheninnikoff, Michael;

    2009-01-01

    posterior tilt was an accurate predictor of failure (p = 0.002). 14/25 of posteriorly tilted fractures > or = 20 degrees were reoperated, as compared to 12/88 of fractures with less tilt (p < 0.001). In multiple logistic regression analysis including sex, age, ASA score, cognitive function, new mobility...

  10. Urinary Mineral Concentrations in European Pre-Adolescent Children and Their Association with Calcaneal Bone Quantitative Ultrasound Measurements †

    Science.gov (United States)

    Van den Bussche, Karen; Herrmann, Diana; De Henauw, Stefaan; Kourides, Yiannis A.; Lauria, Fabio; Marild, Staffan; Molnár, Dénes; Moreno, Luis A.; Veidebaum, Toomas; Ahrens, Wolfgang; Sioen, Isabelle

    2016-01-01

    This study investigates differences and associations between urinary mineral concentrations and calcaneal bone measures assessed by quantitative ultrasonography (QUS) in 4322 children (3.1–11.9 years, 50.6% boys) from seven European countries. Urinary mineral concentrations and calcaneal QUS parameters differed significantly across countries. Clustering revealed a lower stiffness index (SI) in children with low and medium urinary mineral concentrations, and a higher SI in children with high urinary mineral concentrations. Urinary sodium (uNa) was positively correlated with urinary calcium (uCa), and was positively associated with broadband ultrasound attenuation and SI after adjustment for age, sex and fat-free mass. Urinary potassium (uK) was negatively correlated with uCa but positively associated with speed of sound after adjustment. No association was found between uCa and QUS parameters after adjustment, but when additionally adjusting for uNa, uCa was negatively associated with SI. Our findings suggest that urinary mineral concentrations are associated with calcaneal QUS parameters and may therefore implicate bone properties. These findings should be confirmed in longitudinal studies that include the food intake and repeated measurement of urinary mineral concentrations to better estimate usual intake and minimize bias. PMID:27164120

  11. Stress fractures in athletes.

    Science.gov (United States)

    Hulkko, A; Orava, S

    1987-06-01

    During the 14-year period of 1971-1985, 368 stress fractures in 324 athletes were treated. The series contained 268 fractures in males and 100 fractures in females; 32 fractures occurred in children (less than 16 years), 117 in adolescents (16-19 years), and 219 in adults. Forty-six fractures were incurred by athletes at an international level, 274 by athletes at a national or district level and 48 by recreational athletes. Of the total cases, 72% occurred to runners and a further 12% to athletes in other sports after running exercises. The distribution of the stress fractures by site was: tibia 182, metatarsal bones 73, fibula 44, big toe sesamoid bones 15, femoral shaft 14, femoral neck 9, tarsal navicular 9, pelvis 7, olecranon 5 and other bones 10. Of the total fractures, 342 were treated conservatively and 26 fractures required surgical treatment. The operative indication was dislocation in 5 cases and delayed union/nonunion in 21 cases. The sites most often affected by delayed union were: anterior midtibia, sesamoid bones of the big toe, base of the fifth metatarsal, olecranon, and tarsal navicular. The athletes at an international level experienced the greatest risk of multiple separate fractures, protracted healing, or fractures requiring surgery. PMID:3623785

  12. Stabilisation of the fractured fibula plays an important role in the treatment of pilon fractures: a retrospective comparison of fibular fixation methods

    OpenAIRE

    Lee, Yih-Shiunn; Chen, Shu-Wen; Chen, Shih-Hao; Chen, Wen-Chiao; Lau, Ming-Jye; Hsu, Tzu-Liang

    2008-01-01

    Ninety-eight pilon fractures associated with ipsilateral distal fibular fracture were included in this study. The pilon fractures were treated by open reduction and plating. The 98 fractures were divided into three groups based on the treatment method of fractured fibula. Group A was composed of 50 fibular fractures treated by open reduction and plate fixation. Group B was composed of 23 fibular fractures treated by open reduction and pin fixation. Group C was composed of 25 fibular fractures...

  13. Femur ultrasound (FemUS)-first clinical results on hip fracture discrimination and estimation of femoral BMD

    DEFF Research Database (Denmark)

    Barkmann, R; Dencks, S; Laugier, P; Padilla, F; Brixen, K; Ryg, J; Seekamp, A; Mahlke, L; Bremer, A; Heller, M; Glüer, C

    2010-01-01

    the correlation with femur bone mineral density (BMD) were assessed. RESULTS: Hip fracture discrimination using the FemUS device was at least as good as with hip DXA and calcaneal QUS. Significant correlations with total hip bone mineral density were found with a correlation coefficient R (2) up to 0......A quantitative ultrasound (QUS) device for measurements at the proximal femur was developed and tested in vivo (Femur Ultrasound Scanner, FemUS). Hip fracture discrimination was as good as for DXA, and a high correlation with hip BMD was achieved. Our results show promise for enhanced QUS...

  14. 经内侧入路利用解剖钢板治疗股骨髁间骨折病例报告%Anatomical plate through medial operative approach to treat femoral condylar fractures:a case report

    Institute of Scientific and Technical Information of China (English)

    姬文晨; 李新友; 邱裕生; 焦帅; 张小卫

    2015-01-01

    Femoral condylar fracture is a common disease which usually caused by a high-energy violence,that choice of a suitable therapeutic schedule has become a hotspot in clinical practice. Surgery is preferred to be the suitable method for most of the doctors to treat supracondylar comminuted fracture which is usually done through the lateral operative approach,only a few surgery through medial operative approach for treating it. Internal fixation of the equipment which is used in this disease including the following:less invasive stabilization system (LISS),dynamic condyle screw fixation(DCS),kitchen wire fixation and condyle plate fixation. This is a case report of a patient who received anatomical plate which is usually utilized in proximal tibia fracture to treat femoral condylar fracture through the medial operative way and avulse fragment was successfully fixed which introduce a new idea for treating the disease.%股骨髁间骨折是一种常见的骨科疾病,通常由高能量暴力所致,如何选择合适的治疗方法是临床讨论的热点.经外侧入路利用解剖钢板治疗股骨髁间骨折是最常用的方案,经内侧入路治疗的报道较为罕见.股骨髁间骨折的内固定一般包括:微创内固定系统,动力髁间螺钉固定、克氏针固定、髁间钢板固定.该文报道的病例采用了胫骨近端解剖钢板经内侧入路治疗股骨髁间骨折,成功的固定了骨折,为治疗股骨髁间骨折提供了新思路.

  15. Fractures on the calcaneus

    OpenAIRE

    Tanke, Gerhardus Marinus Henricus

    1982-01-01

    ln 823 patients with a displaced calcaneus fracturea study was carried out to assess the difference in the duration until recovery between those patients who were treated by operation and those who were treated conservatively. This was preceded by a study of the literature in which the accent was placed on the various types of calcaneus fractures regarding fracture mechanism, epidemiology, diagnostics and symptomatology as well as the different methods of treatment (chaptersl I to IV). ... Zi...

  16. Effects of low-intensity non-coherent light therapy on the inflammatory process in the calcaneal tendon of ovariectomized rats.

    Science.gov (United States)

    Helrigle, Carla; de Carvalho, Paulo deTarso Camilo; Casalechi, Heliodora Leão; Leal-Junior, Ernesto Cesar Pinto; Fernandes, Guilherme Henrique Cardoso; Helrigel, Panmera Almeida; Rabelo, Rogério Leão; de Oliveira Aleixo-Junior, Ivo; Aimbire, Flavio; Albertini, Regiane

    2016-01-01

    The aim of this experimental study was to investigate the effects of low-intensity light-emitting diode (LED) phototherapy on the inflammatory process in the calcaneal tendon of ovariectomized rats (OVX) through the involvement of the inflammatory mediators interleukin (IL)-6, IL-10, and tumor necrosis factor-alpha (TNF-α). Thirty-five female Wistar rats were divided into 4 groups: 3 groups of OVX rats totaling 30 rats (untreated OVX rats [OVX injury group], treated OVX rats [OVX LED group], and control OVX rats; subgroups existed based on the sampling times, which were 3, 7, and 14 days) and 1 group of non-OVX rats (not OVX; n = 5). Tendon injury was induced by trauma using a 208-g mass placed at 20 cm from the right tendon of each animal with energy of 0.70 J. The animals were treated 12 h after tendonitis with LED therapy and every 48 h thereafter until euthanasia (at 3, 7, or 14 days). The tendons were dissected and stored in liquid nitrogen at -196 °C, thawed only at the time of immunoenzymatic testing (ELISA). Groups treated with LED showed a decrease in the number of pro-inflammatory cells, IL-6, and TNF-α (p LED treatment using the parameters and wavelength of 945 nm in the time periods studied reduced the release of IL-6 and TNF-α and increased the release of IL-10, thereby improving the inflammatory response in OVX rats. PMID:26507001

  17. Genu Recurvatum Deformity in a Child due to Salter Harris Type V Fracture of the Proximal Tibial Physis Treated with High Tibial Dome Osteotomy

    OpenAIRE

    Theodoros Beslikas; Andreas Christodoulou; Anastasios Chytas; Ioannis Gigis; John Christoforidis

    2012-01-01

    Salter-Harris type V fracture is a very rare injury in the immature skeleton. In most cases, it remains undiagnosed and untreated. We report a case of genu recurvatum deformity in a 15-year-old boy caused by a Salter-Harris type V fracture of the proximal tibial physis. The initial X-ray did not reveal fracture. One year after injury, genu recurvatum deformity was detected associated with significant restriction of knee flexion and limp length discrepancy (2 cm) as well as medial and posterio...

  18. CURBSIDE CONSULTATION IN FRACTURE MANAGEMENT: 49 CLINICAL QUESTIONS

    Directory of Open Access Journals (Sweden)

    Walter W. Virkus

    2008-12-01

    displaced bimalleolar fracture in insulin dependant middle aged woman; Man-agement of calcaneal fractures; Fixation technic for a displaced talar neck fracture in a patient in ER; Indica-tions for surgical treatment of metatarsal fractures; Bone grafting in acute fractures; Management of a nonunion of plated midshaft tibia fracture; Management of a child with a twisted ankle and normal x-rays; Assessment of com-partment syndrome in foot.The Section III is about “GENERAL FRACTURE CARE” including: Management of multiple orthopedic injuries and damage control orthopedics; Bone stimula-tion in nonunion; Indications for locking plates; Fractures requiring anatomic reduction.AUDIENCE: Mainly trauma fellows and practicing or-thopedists are the targeted audience of the book, but not only the basic knowledge for the orthopedic residents but also the expert advices for complicated and controversial cases pointing experienced surgeons widen the spectrum of audience. Also non-physician personnel may benefit the basic knowledge from brief answers given in a casual format.ASSESMENT: “Curbside Consultation in Fracture Man-agement:49 Clinical Questions” offering practical, brief, evidence based answers to frequently asked questions especially those have been often left controversial related with the treatment of fractures of upper and lower extrem-ity, pelvic fractures is a useful resource mainly for resi-dents, fellows and junior orthopedists. Casual format that mimics a “curbside” dialog of colleagues and also the rich illustrations by images and diagrams makes the advanced knowledge in the text easier to understand and learn. Questions are carefully chosen from a wide spectrum of subjects related to fracture management to form a unique reference including high and low energy trauma fractures, pediatric fractures, fractures in elderly, multiple orthope-dic injury, and general fracture care. Assessment of frac-tures and diagnostic approach, postoperative care and

  19. Fracture characteristics in Japanese rock

    International Nuclear Information System (INIS)

    It is crucial for the performance assessment of geosphere to evaluate the characteristics of fractures that can be dominant radionuclide migration pathways from a repository to biosphere. This report summarizes the characteristics of fractures obtained from broad literature surveys and the fields surveys at the Kamaishi mine in northern Japan and at outcrops and galleries throughout the country. The characteristics of fractures described in this report are fracture orientation, fracture shape, fracture frequency, fracture distribution in space, transmissivity of fracture, fracture aperture, fracture fillings, alteration halo along fracture, flow-wetted surface area in fracture, and the correlation among these characteristics. Since granitic rock is considered the archetype fractured media, a large amount of fracture data is available in literature. In addition, granitic rock has been treated as a potential host rock in many overseas programs, and has JNC performed a number of field observations and experiments in granodiorite at the Kamaishi mine. Therefore, the characteristics of fractures in granitic rock are qualitatively and quantitatively clarified to some extent in this report, while the characteristics of fractures in another rock types are not clarified. (author)

  20. Transstyloid, transscaphoid, transcapitate fracture: a variant of scaphocapitate fractures.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2014-01-01

    Transstyloid, transscaphoid, transcapitate fractures are uncommon. We report the case of a 28-year-old man who sustained this fracture following direct trauma. The patient was successfully treated by open reduction internal fixation of the scaphoid and proximal capitate fragment, with a good clinical outcome at 1-year follow-up. This pattern is a new variant of scaphocapitate fracture as involves a fracture of the radial styloid as well.

  1. Early results of reverse less invasive stabilization system plating in treating elderly intertrochanteric fractures: a prospective study compared to proximal femoral nail

    Institute of Scientific and Technical Information of China (English)

    YAO Chen; ZHANG Chang-qing; JIN Dong-xu; CHEN Yun-feng

    2011-01-01

    Background Intertrochanteric femur fracture is common in elderly population. Though multiple treatment options are available, the choice of implant remains controversial. The reverse less invasive stabilization system (LISS) plating was introduced for treatment of a patient with ipsilateral intertrochanteric and midshaft femoral fractures. The aim of this research was to compare such technique to intramedullary nailing (proximal femoral nail, PFN) for intertrochanteric fractures.Methods Fifty-six patients with an age of at least sixty-five years and an AO/OTA type-A1 or A2 fractures were included and divided into LISS and PFN treatment group. Background parameters, fracture and surgery details were documented. Follow-up time was at least 12 months. Radiology, complication, Harris Hip Score and Rapid Disability Rating Score (RDRS) were recorded to evaluate fixation status and hip function for each patient during follow-up.Results There was no significant difference between the two groups in surgical time ((48.0±8.6) minutes, vs.(51.8±10.8) minutes, P=0.3836) and intraoperative blood loss ((149.1±45.1) ml vs. (176.4±25.4) ml, P=0.0712). The LISS group had less postoperative haemoglobin (Hb) reduction ((10.2±4.5) g/L Hb, vs. (15.1~5.9) g/L Hb, P=0.0475). There was no complication observed in PFN group. All 31A1 type fracture in LISS group showed 100% maintenance of reduction. One nonunion with locking screw breakage and 2 varus union were found in the LISS group. Postoperative hip function was similar between the two groups.Conclusions Though reverse LISS plating may not be recommended as a routine fixation method for elderly unstable intertrochanteric fractures compared to PFN, it may possibly be reserved for rapid fixation and damage control in polytrauma patients and ORIF of subtrochanteric and reverse oblique intertrochanteric fractures.

  2. Complications in Ankle Fracture Surgery

    OpenAIRE

    Ovaska, Mikko

    2014-01-01

    Mikko Ovaska. Complications in Ankle Fracture Surgery. Helsinki Bone and Joint Research Group, Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, University of Helsinki, Finland. Helsinki 2014. Ankle fractures are among the most frequently encountered surgically treated fractures. The operative treatment of this fracture may be associated with several complications. The most frequently encountered complications are related wound healing, and deep infection may have d...

  3. The short term effect of locking plate in treating the proximal humeral Fractures%锁定接骨板治疗老年肱骨近端骨折的近期疗效

    Institute of Scientific and Technical Information of China (English)

    方铭; 孙贤杰; 曹铨; 石钢

    2012-01-01

    Objective To discuss the short term effect of locking plate to treat the proximal humeral fractures. Methods The 26 patients were treated with locking plate internal fixation for proximal humeral fractures. Results All patients were followed up for 6 months to 2 years. All patients got osseous healing. There was no infection bone nonunion, and no break of internal fixation. According to Neer criteria,the results were excellent in 17 cases,good in 7, and fair in 2. Conclusions The treatment of the proximal humerus fractures with the locking proximal humerus plate has the advantages of stable fixation, earlier rehabilitation, and satisfactory functional recovery. It is an effective method to treat proximal humeral fracture for the senile patients.%目的 探讨锁定接骨板治疗老年肱骨近端骨折的近期疗效.方法 采用切开复位锁定接骨板内固定治疗26例老年肱骨近端骨折患者.结果 26例均获随访,时间6个月~2年.患者全部获得骨性愈合.未出现切口感染、骨不连及内固定物断裂等并发症.肩关节功能按照Neer评分标准:优17例,良7例,可2例.结论 肱骨近端锁定接骨板治疗老年肱骨近端骨折,损伤小、固定可靠,可提供早期功能锻炼、术后功能恢复好,近期疗效满意.

  4. 经皮椎体成形术联合金乌骨通治疗椎体骨质疏松性骨折%Vertebral Osteoporotic Fractures Were Treated by Percutaneous Vertebroplasty and Jinwugutongjiaonang

    Institute of Scientific and Technical Information of China (English)

    吴立明

    2011-01-01

    Objective: To evaluate the clinical efficacy of percutaneous vertebroplasty (percutaneous vertebroplasty, PVP) combined with Jinwugutongjiaonang in treating of vertebral osteoporotic compression fractures. Methods: 135 patients (146 vertebras) who suffered with vertebral osteoporotic compression fractures were randomly divided into two groups, patients (74 cases) in the treatment group were treated by PVP combined with Jinwugutongjiaonang, patients (61 cases) in the control group were treated by PVP, the pain relief, the ability of walking, fracture healing, long-term recurrence of fracture and bone mineral density were recorded separately on admission, 24 hours N 4 weeks and 6 months postoperation for all the patients. Results: All operations were successfully completed, and no obvious complications happened. There were significant differences in the pain relief, the ability of walking, fracture healing, long-term recurrence of fracture and bone mineral density between the treatment group and control group (P<0. 05). Conclusion:There was good clinical efficacy in the pain relief, fracture healing, long-term recurrence of fracture and bone mineral density for the patients with vertebral osteoporotic compression fractures treated by Percutaneous vertebroplasty (PVP) combined with Jinwugutongjiaonang, and It was worthyof application for clinic.%目的:评价经皮椎体成形术(percutaneous vertebroplasty,PVP)联合金乌骨通治疗椎体骨质疏松性骨折的临床疗效。方法:将135例椎体骨质疏松性骨折患者(146椎体),随机分为两组,其中治疗组行PVP联合金乌骨通胶囊治疗74例,对照组单独应用pvp治疗61例,分别记录病人入院时、术后24h、4周、6个月疼痛缓解情况、行走能力、骨折愈合、远期再发骨折及骨密度情况。结果:所有手术均顺利完成,未发生明显并发症,治疗组与对照组比较,病人在术后疼痛缓解情况、行走能力、骨折愈合、

  5. Assessment of bone healing on tibial fractures treated with wire osteosynthesis associated or not with infrared laser light and biphasic ceramic bone graft (HATCP) and guided bone regeneration (GBR): Raman spectroscopy study

    Science.gov (United States)

    Bastos de Carvalho, Fabíola; Aciole, Gilberth Tadeu S.; Aciole, Jouber Mateus S.; Silveira, Landulfo, Jr.; Nunes dos Santos, Jean; Pinheiro, Antônio L. B.

    2011-03-01

    The aim of this study was to evaluate, through Raman spectroscopy, the repair of complete tibial fracture in rabbits fixed with wire osteosynthesis - WO, treated or not with infrared laser light (λ 780nm, 50mW, CW) associated or not to the use of HATCP and GBR. Surgical fractures were created under general anesthesia (Ketamine 0.4ml/Kg IP and Xilazine 0.2ml/Kg IP), on the tibia of 15 rabbits that were divided into 5 groups and maintained on individual cages, at day/night cycle, fed with solid laboratory pelted diet and had water ad libidum. On groups II, III, IV and V the fracture was fixed with WO. Animals of groups III and V were grafted with hydroxyapatite + GBR technique. Animals of groups IV and V were irradiated at every other day during two weeks (16J/cm2, 4 x 4J/cm2). Observation time was that of 30 days. After animal death the specimens were kept in liquid nitrogen for further analysis by Raman spectroscopy. Raman spectroscopy showed significant differences between groups (p<0.001). It is concluded that IR laser light was able to accelerate fracture healing and the association with HATCP and GBR resulted on increased deposition of calcium hydroxyapatite.

  6. Nursing Care for the Children with Femoral Fracture Treated by Titanium Elastic Intramedullary Nail%弹性钛制髓内钉治疗儿童股骨干骨折的护理

    Institute of Scientific and Technical Information of China (English)

    许丽芬; 董亚萍

    2013-01-01

    Objective: To introduce Nursing care methods of the children femoral fracture treated by Tianium elastic intramedullary nail. Methods:Nursing care for 43 cases of children with femoral fracture treated by Titanium elastic intramedullary nail. Results:43 cases obtained bony union; the excellent and good rate was 100%. Conclusion: This method is an operation with low damage, low physiological influence for fracture, short hospitalization time, easy care, less complications. The proper nursing care and rehabilitation training during perioperative period is the essential important guarantee.%目的:介绍弹性钛制髓内钉治疗儿童股骨干骨折的护理方法。方法:通过对43例弹性钛制髓内钉治疗儿童股骨干骨折的护理。结果:43例皆获骨性愈合,优良率为100%。结论:该方法是一种损伤小、对骨折处生理影响小、住院时间短、易于护理、并发症少的手术,同时做好手术前后护理、术后康复训练是患儿全面恢复的重要保证。

  7. Efficacy Observation on Artificial Humeral Head Replacement Treating Senile Proximal Humerus Complex Fractures%人工肱骨头置换术治疗高龄肱骨近端复杂骨折疗效观察

    Institute of Scientific and Technical Information of China (English)

    邓崇礼; 梁祖建; 张百挡

    2014-01-01

    目的:探讨人工肱骨头置换术治疗高龄肱骨近端复杂骨折的疗效。方法:对26例高龄肱骨近端复杂骨折患者行人工肱骨头置换术治疗,观察其临床疗效。结果:优6例,良13例,可5例,差2例,优良率为73.08%。结论:人工肱骨头置换术治疗高龄肱骨近端复杂骨折能有效减轻创伤后肩关节疼痛,提供肩关节早期活动,获得良好关节功能。%Objective:To investigate the curative effects of artificial humeral head replacement treating senile proximal humerus complex fractures. Methods:26 cases of patients with senile proximal humerus complex fractures underwent artificial humeral head replacement, whose efficacy was observed. Results:6 cases were excellent, 13 cases were good, 5 cases were qualified, 2 cases were poor, the excellent and good rate was 73.08%. Conclusion:Artificial humeral head replacement treating senile proximal humerus complex fractures can effectively reduce the posttraumatic shoul-der pain and provide early activity of shoulder joint, which get good joint function.

  8. 膝关节骨折的影像诊断及微创内固定系统治疗的护理%Nursing of peri knee joint fracture treated with LISS

    Institute of Scientific and Technical Information of China (English)

    鲁劲松; 宋玉芝; 赖建君

    2011-01-01

    Objective:To investigate the nursing on patient with peri knee joint fracture treated with LISS(Less Iinvasive Stabilization System). Methods:42 patients with peri knee joint fracture were adopted in the group, and were cared with proper nursing before and after operation to observe the curative effect. Results: In the group, all the fractures healed well, motion range of knee joint of 41 patients was satisfied, only one patient had limited knee joint flexion extension. Conclusion: Careful observation and proper nursing methods can improve the reconery of patients with peri knee joint fractrues treated with LISS.%目的:探讨微创内固定系统LISS治疗膝关节周围骨折的护理方法.方法:选取42例膝关节周围骨折的患者,给予相应术前、术后护理,观察其预后效果.结果:42例患者,骨折均愈合,41例患者膝关节活动功能恢复满意,仅1例患者膝关节活动严重受限.结论:严密观察,恰当的术前、术后护理,可提高LISS治疗膝关节周围骨折的预后效果.

  9. Complications of the surgical treatment early and tardy of supracondylar fractures of the humerus in children: a retrospective study of 111 patients treated at the Hospital Nacional de Ninos Carlos Saenz Herrera in the period January 2010 to January 2011

    International Nuclear Information System (INIS)

    Supracondylar fractures of the humerus up much of the emergency consultation of any pediatric orthopedic service, of them, Gartland III fractures are usually treated by closed reduction and percutaneous fixation with nails smooth. Often treatment has been delayed by factors such as the unavailability of an orthopedic specialist or local anesthesia or an operating room. At other times, the patient has come belatedly to consult. This retrospective study has analyzed whether a delay greater than 12 hours in the surgical treatment of supracondylar fractures of the humerus in children is associated with an increased risk of perioperative complications. Of 111 children who have been treated surgical in national children's hospital, underwent 59 surgeries before 12 hours from the trauma and 52 underwent surgery after 12 hours of trauma. The groups have developed without significant differences in terms of iatrogenic neurological injury, tract infection of the nails, vascular complications and compartment syndrome. Surgical time and hospital stay neither have had differences. In 2 cases of the tardy treatment group has been necessary to perform a opened reduction. As for the bad union, 9 cases (8%) have been of elbow varus radiological and clinical, of these 5 cases (4.5%) have occurred in the tardy treatment group and 4 cases (3,5) in the group early treatment. Findings of similar studies are confirmed in which the rate of perioperative complications is significantly unchanged if the surgical treatment is carried out before 12 hours or after 12 hours after the trauma. (author)

  10. Effects of recombinant human Bone Morphogenetic Protein-2 (rhBMP-2) in grade III open tibia fractures treated with unreamed nails-A clinical and health-economic analysis.

    Science.gov (United States)

    Alt, Volker; Borgman, Benny; Eicher, Alexander; Heiss, Christian; Kanakaris, Nikolaos K; Giannoudis, Peter V; Song, Fujian

    2015-11-01

    Recombinant human Bone Morphogenetic Protein-2 (rhBMP-2) is licensed in Europe for open tibia fractures treated with unreamed nails. However, there is limited data available on the specific use of rhBMP-2 in combination with unreamed nails for open tibia fractures. The intention of the current study was to evaluate the medical and health-economic effects of rhBMP-2 in Gustilo-Anderson grade III open tibia fractures treated with unreamed nails based on individual patient data from two previously published studies. Linear regression analysis was performed on raw data of 90 patients that were either treated by standard of care with soft tissue management and unreamed nailing (SOC group) (n=50) or with rhBMP-2 in addition to soft tissue management and unreamed nailing (rhBMP-2 group) (n=40). For all types of revision, a significant lower percentage of patients (27.5%) of the rhBMP-2 group had to be revised compared to 48% of the patients of the SOC group (p=0.04). When only invasive secondary interventions such as bone grafting and nail exchange were considered, there was also a statistically significant reduction in the rhBMP-2 group with a revision rate of 10.0% (4 of 40 patients) compared to the SOC group with a revision rate of 28.0% (14 of 50 patients) (p=0.01). Mean fracture healing time of 228 days in the rhBMP-2 compared to 266 days in the SOC group was not statistically significant (p=0.24). Health-economic analysis based on a societal perspective with calculation of overall treatment costs after initial surgery and including productivity losses revealed savings of €6,239 per patient for Germany and €4,752 for the UK in favour of rhBMP-2 which was mainly driven by reduction of productivity losses. In conclusion, rhBMP-2 reduces secondary interventions in patients with grade III open tibia fractures treated with an unreamed nail and its use leads to financial savings for Germany and the UK from a societal perspective. PMID:26374949

  11. Conservative Management of Paediatric Clavicle Fractures

    Directory of Open Access Journals (Sweden)

    Barry J. O'Neill

    2011-01-01

    Full Text Available Paediatric clavicle fractures have traditionally been treated nonoperatively. Recent studies have recommended operative management for displaced midshaft fractures. We conducted a retrospective review of all clavicle fractures in children aged one to sixteen over a two-year period. We classified fractures and evaluated followup and clinical outcome. We identified 190 fractures. There were 135 boys and 55 girls. 65% of fractures were displaced and 35% undisplaced. Mean radiographic and clinical followup was 35 days and 44 days, respectively. Clavicle fractures in children heal with nonoperative management. Radiographs of clavicle fractures in children are unnecessary in the absence of clinical symptoms.

  12. THORACIC SPINE FRACTURES

    Institute of Scientific and Technical Information of China (English)

    戴力扬

    2001-01-01

    Objective. To investigate the unique characteristics and treatment of thoracic spine fractures.Methods. Severty-seven patients with thoracic spine fractures were retrospectively reviewed. Of these, therewere 37 compressior fractures, 34 fracture-dislocations, 3 burst fractures and 3 burst-dislocations. Twenty-six pa-tients had a complete lesion of the spinal cord, 14 sustained a neurologically incomplete injury, and 37 wereneurologically intact. Fifty-three patients were treated nonoperatively and 24 treated operatively.Results. All patients were followed up for 2 ~ 15 years. None of the 26 patients with a complete lesion recov-ered any significant function. Of 37 neurologically intact patients, 13 had local pain although all of them re-mained normal function. Two of 14 patients with incomplete paraplegia returned to normal, 7 recovered some func-tion and 5 did not recovered.Conclusions. E ecause of the unique anatomy and biomechanics of the thoracic spine, the classification common-ly applied to thoracolumbar fractures is not suitable for thoracic fractures. Fusion and instrumentation are indicat-ed when the fractures are unstable, while patients with incomplete lesion of the spinal cord may be the candidatesfor supplemented decompression.

  13. Shoulder Fractures

    Science.gov (United States)

    ... a Hand Therapist? Media Find a Hand Surgeon Shoulder Fractures Email to a friend * required fields From * ... can create difficulty with its function. Types of Shoulder Fractures The type of fracture varies by age. ...

  14. Erratum to: The effect of postoperative wound infections on functional outcome following intra-articular calcaneal fractures.

    Science.gov (United States)

    Backes, Manouk; Schep, Niels W L; Luitse, Jan S K; Goslings, J C; Schepers, Tim

    2015-08-01

    Erratum to: Arch Orthop Trauma Surg DOI 10.1007/s00402-015-2219-5. The original version of this article unfortunately contained a mistake and has been corrected. The fourth author J. Carel Goslings' family name has been published incorrectly. The correct family name should be Goslings. PMID:26099514

  15. Oblique Axis Body Fracture

    DEFF Research Database (Denmark)

    Takai, Hirokazu; Konstantinidis, Lukas; Schmal, Hagen;

    2016-01-01

    type" fracture pattern. The first patient was treated conservatively with cervical spine immobilization in a semirigid collar. However, gross displacement was noted at the 6-week follow-up visit. The second patient was therefore treated operatively by C1-C3/4 posterior fusion and the course was...

  16. [Current diagnosis and therapy of anterior mandibular fracture associated with condyle fractures].

    Science.gov (United States)

    Xu, Xiaofeng; Xu, Bing

    2014-04-01

    Anterior mandibular fracture, which includes symphyseal and parasymphyseal mandibular fractures, is one of the most common types of fracture in clinical work, and is usually associated with condyle fracture. This type of fracture predisposes the patients to facial widening, malocclusion, and ankylosis when not properly and timely treated because of the influence of its anatomic structure. This article reviews the characteristics, complication, diagnosis, and therapy of this type of fracture. PMID:24881222

  17. A comparative evaluation of fracture resistance of endodontically treated teeth, with variable marginal ridge thicknesses, restored with composite resin and composite resin reinforced with Ribbond: An in vitro study

    Directory of Open Access Journals (Sweden)

    Vaishali Kalburge

    2013-01-01

    Full Text Available Background: The anatomic shape of maxillary premolars show a tendency towards separation of their cusps during mastication after endodontic treatment. Preservation of the marginal ridge of endodontically treated and restored premolars can act as a strengthening factor and improve the fracture resistance. Objectives: To evaluate the effect of varying thickness of marginal ridge on the fracture resistance of endodontically treated maxillary premolars restored with composite and Ribbond reinforced composites. Materials and Methods: One hundred and twenty, freshly extracted, non carious human mature maxillary premolars were selected for this experimental in vitro study. The teeth were randomly assigned in to twelve groups ( n = 10. Group 1 received no preparation. All the premolars in other groups were root canal treated. In subgroups of 3 and 4, DO cavities were prepared while MOD cavities were prepared for all subgroups of group 2, the dimensions of the proximal boxes were kept uniform. In group 3 and 4 the dimensions of the mesial marginal ridge were measured using a digital Vernier caliper as 2 mm, 1.5 mm, 1 mm and 0.5 mm in the respective subgroups. All samples in groups 2.2 and all the subgroups of 3 were restored with a dentin bonding agent and resin composite. The teeth in group 2.3 and all subgroups of 4 were restored with composite reinforced with Ribbond fibers. The premolars were submitted to axial compression up to failure at 45 degree angle to a palatal cusp in universal testing machine. The mean load necessary to fracture was recorded in Newtons and the data was analysed. Results: There was a highly significant difference between mean values of force required to fracture teeth in group 1 and all subgroups of group 2, 3 and 4 (i.e., P < 0.01 Conclusion: On the basis of static loading, preserving the mesial marginal ridge with thicknesses of mm, 1.5 mm, 1 mm and 0.5 mm, composite restored and Ribbond reinforced composite restored

  18. 微创内固定系统治疗膝关节周围骨折临床疗效分析%Clinical Efficacy Analysis of Minimally Invasive Internal Fixation System Treating Fracture Around Knees

    Institute of Scientific and Technical Information of China (English)

    崔志民; 张国峰; 周天宝; 冷雪; 陈韶丽

    2013-01-01

      目的:研究微创内固定系统治疗膝关节周围骨折的治疗效果,为治疗膝关节周围骨折提供临床参考。方法:60例膝关节周围骨折患者分为采用微创内固定系统治疗的微创组和常规治疗的传统组,观察两组的治疗效果及恢复状况。结果:微创组在平均手术所需时间、手术中的出血量、骨折愈合时间、肢体缩短长度、关节功能外形及患者痛感等各项指标上均较优于传统组。结论:微创内固定系统治疗膝关节周围骨折治疗效果及关节功能恢复较好,值得在临床实践中推广应用。%Objective:To study the therapeutic effects of minimally invasive internal fixation system treating fractures around knees, and provide clini-cal reference for the treatment of fractures around knees. Methods:60 cases of patients with fractures around knees were divided into minimally inva-sive group treated with minimally invasive internal fixation system and traditional group with conventional therapy, to observe the efficacy and recov-ery of two groups. Results:The average required operation time, amount of bleeding, fracture healing time, limbs shortening length, joint function shape, pain perception of patients and other indicators of minimally invasive group were all better than the those of traditional group. Conclusion:The therapeutic effects of minimally invasive internal fixation system treating fractures around the knees, and its recovery of joint function are better, being worthy of popularization and application in clinical practice.

  19. Fracture resistance exhibited by endodontically treated and retreated teeth shaped by ProTaper NEXT versus WaveOne: An in vitro study

    Directory of Open Access Journals (Sweden)

    Neha Deepak Khalap

    2015-01-01

    Full Text Available Aim: To compare the fracture resistance exhibited by teeth after primary endodontic treatment and retreatment. Materials and Methods: One hundred freshly extracted human teeth were selected. 20 samples served as control (untreated. Eighty experimental samples were divided into two groups (n = 40 for instrumentation using rotary Protaper NEXT (PTN or reciprocating WaveOne (WO files and obturated using warm lateral compaction. Half of the samples (n = 20 from each group were subjected to a load. The remaining half were subjected to retreatment using Protaper universal retreatment files (RFs followed by a file larger than the master apical file used in groups 1 and 2 and reobturated. Group A: Control, Group B: PTN + obturation, Group C: WO + obturation, Group D: RF + PTN + obturation and Group E: RF + WO + obturation. The retreatment specimens were also subjected to load and the readings acquired were statistically analyzed. Result: When compared between the groups, control group exhibited the highest fracture resistance (P < 0.01. When multiple tests were performed, Group E exhibited significantly less fracture resistance (P < 0.01. Conclusion: Endodontic treatment and retreatment both results in lowering the fracture resistance of a tooth.

  20. Arthroscopic assistance does not improve the functional or radiographic outcome of unstable intra-articular distal radial fractures treated with a volar locking plate: a randomised controlled trial.

    Science.gov (United States)

    Yamazaki, H; Uchiyama, S; Komatsu, M; Hashimoto, S; Kobayashi, Y; Sakurai, T; Kato, H

    2015-07-01

    There is no consensus on the benefit of arthroscopically assisted reduction of the articular surface combined with fixation using a volar locking plate for the treatment of intra-articular distal radial fractures. In this study we compared the functional and radiographic outcomes of fluoroscopically and arthroscopically guided reduction of these fractures. Between February 2009 and May 2013, 74 patients with unilateral unstable intra-articular distal radial fractures were randomised equally into the two groups for treatment. The mean age of these 74 patients was 64 years (24 to 92). We compared functional outcomes including active range of movement of the wrist, grip strength and Disabilities of the Arm, Shoulder, and Hand scores at six and 48 weeks; and radiographic outcomes that included gap, step, radial inclination, volar angulation and ulnar variance. There were no significant differences between the techniques with regard to functional outcomes or radiographic parameters. The mean gap and step in the fluoroscopic and arthroscopic groups were comparable at 0.9 mm (standard deviation (SD) 0.7) and 0.7 mm (SD 0.7) and 0.6 mm (SD 0.6) and 0.4 mm (SD 0.5), respectively; p = 0.18 and p = 0.35). Arthroscopic reduction conferred no advantage over conventional fluoroscopic guidance in achieving anatomical reduction of intra-articular distal radial fractures when using a volar locking plate. PMID:26130352

  1. Surgical Treatment of Calcaneal Spur. Tratamiento quirúrgico del espolón calcáneo.

    Directory of Open Access Journals (Sweden)

    Juan Carlos Cabrera Suárez

    2007-02-01

    Full Text Available

    Background: Pain in the plantar region of the heel is technically known as talalgia, and it is a very frequent complaint in the orthopaedic service in Guyana. Due to its frequent mortality, the current investigation was carried out. Objectives: To characterize the application of the surgical treatment to a group of patients in Guyana. Method: 70 patients surgically treated were studied presenting rebel talalgia with no responses to the conservative treatment. Age, sex, race, educational level, antibiotic prophylaxis, final outcomes, and patient's satisfaction with the treatment were the set of variables selected. Results: High morbidity of the heel pain syndrome was evidenced in this studied. The most frequent cause was the calcaneal spur. There is predominance in female Indian race. The high influenced of the socio-cultural factor in the genesis of this disease is proved as well as the impossibility of carrying out the conservative treatment due to high cost of medications. Conclusions: The efficacy achieved with combined treatment technique allowed the results obtained. All this contributed to achieve high satisfaction levels.

    Fundamento: El dolor en la región plantar del talón, conocido técnicamente como talalgia, es motivo frecuente de consulta en el servicio de ortopedia de la República de Guyana. Objetivo: Caracterizar la aplicación del tratamiento quirúrgico a un grupo de pacientes de la República Cooperativa de Guyana, con diagnóstico de espolón calcáneo. Método: Se realizó un estudio descriptivo longitudinal de 70 pacientes tratados quirúrgicamente, por presentar talalgia rebelde al tratamiento conservador; las variables analizadas fueron: edad, sexo, raza, nivel cultural, profilaxis antibiótica y satisfacción con el resultado del tratamiento. Resultados: Se

  2. Lateral Calcaneal Artery Flaps in Atherosclerosis: Cadaveric Study, Vascular Assessment and Clinical Applications

    Science.gov (United States)

    Tanthanatip, Pattaya; Kuhaphensaeng, Paiboon; Ruamthanthong, Anuchit; Pitiseree, Anont; Suwantemee, Chaichoompol

    2015-01-01

    Background: Soft tissue defects of the lateral malleolus (LM) and Achilles tendon pose difficult reconstructive problems due to the bony prominence and limited local tissue available. The objectives were to study the anatomical landmarks of the lateral calcaneal artery (LCA) and patency of LCA in atherosclerotic patients. Methods: Part I: Thirty-four cadaveric feet were dissected to identify the LCA. The distance between the LCA and the most prominent point of the LM was measured horizontally (LCAa-LM), obliquely (LCAb-LM), and vertically (LCAc-LM). Part II: Thirty-two patients were divided in 2 groups as nonatherosclerotic and atherosclerotic groups. The LCA was assessed by both Doppler ultrasonography and computed tomographic angiography (CTA). Part III: Clinical applications were demonstrated. Results: Part I: Mean distances of LCAa-LM, LCAb-LM, and LCAc-LM were 24.76, 33.68, and 35.03 mm, respectively. The LCA originated 94.12% from the peroneal artery. Part II: Doppler ultrasonography detected the LCA at 90.62% and 87.50% in nonatherosclerotic and atherosclerotic groups, respectively, whereas 100.00% and 93.75%, respectively, were detected by CTA. No statistically significant difference was found in the patency of the LCA between nonatherosclerotic and atherosclerotic patients. Part III: Clinical applications were performed in atherosclerotic patients. Conclusions: The LM is a reliable point to identify the LCA, and the LCA flap can be raised safely in atherosclerotic patients. Preoperative CTA should be performed in severely atherosclerotic patients or cases of major lower extremity vascular injuries. PMID:26495230

  3. The lateral calcaneal artery: Anatomic basis for planning safe surgical approaches.

    Science.gov (United States)

    Elsaidy, Mohamed A; El-Shafey, Khaled

    2009-10-01

    The proximity of the lateral calcaneal artery (LCA) to surgical incisions applied to the lateral hindfoot makes it vulnerable to iatrogenic injury and subsequent postoperative skin necrosis. This study aimed to investigate the course of the LCA and to define anatomical points that can be used by surgeons during lateral approaches to the calcaneus. Thirteen leg-ankle-foot specimens were dissected and the superficial course of the LCA was outlined by three anatomic points: (a) tip of lateral malleolus, (b) the point where it pierces the deep fascia, and (c) the point where it crosses the line connecting the lateral malleolus with the insertion of Achilles tendon. Fifteen healthy volunteers were investigated by color Doppler ultrasound where the diameter and depth of LCA were measured. The LCA pierced the deep fascia at a maximum height of 4.5 cm (mean 3.78) above the midpoint of a line extending from the lateral malleolus to the insertion of Achilles tendon. It crossed the previous line at a maximum distance of 3 cm (mean 2.6) posterior to lateral malleolus. At this point, its mean diameter was 1.75 mm on the right and 1.73 mm on the left sides, while its mean depth was 7.73 mm on the right and 8.0 mm on the left sides. A dangerous triangle that contained the superficial course of the artery was mapped out in the lower lateral part of the leg. This triangle should be considered during surgical approaches applied to the lateral hindfoot to avoid damage of the LCA. PMID:19637301

  4. Inverse fracture network modelling

    International Nuclear Information System (INIS)

    The basic problem in analyzing flow and transport in fractured rock is that the flow may be largely governed by a poorly connected network of fractures. Flow in such a system cannot be modeled with traditional modelling techniques. Fracture network models also have a limitation, in that they are based on geological data on fracture geometry even though it is known that only a small portion of fractures observed is hydraulically active. This paper discusses a new technique developed for treating the problem as well as presents a modelling example carried out to apply it. The approach is developed in Lawrence Berkeley Laboratory and it treats the fracture zone as an 'equivalent discontinuum'. The discontinuous nature of the problem is represented through flow on a partially filled lattice. An equivalent discontinuum model is constructed by adding and removing conductive elements through a statistical inverse technique called 'simulated annealing'. The fracture network model is 'annealed' until the modified systems behaves like the observed. The further development of the approach continues at LBL and in a joint LBL/VTT collaboration project the possibilities to apply the technique in Finnish conditions are investigated

  5. Facial nerve palsy after mandibular fracture.

    Science.gov (United States)

    Weinberg, M J; Merx, P; Antonyshyn, O; Farb, R

    1995-05-01

    A 19-year-old man sustained a right parasymphyseal fracture and bilateral condylar neck fractures in a motor vehicle accident. The parasymphyseal fracture was treated by open reduction and internal fixation, and the subcondylar fractures were treated with closed reduction and maxillomandibular fixation. Three days postoperatively, a near-complete left facial nerve palsy developed. Facial nerve recovery was not full. The literature is reviewed, and possible mechanisms of this rare and devastating complication are discussed. PMID:7639495

  6. STUDY OF THE EFFECT OF DIRECT & INDIRECT COMPOSITE RESTORATIONS ON RESISTANCE TO MAXILLARY PREMOLLAR TEATH FRACTURE TREATED BY ROOT CANAL METHOD

    OpenAIRE

    M Mousavinasab; S. Ashrafijoo

    2003-01-01

    Finding a universally approved system to restore pulpess teeth has been a goal of many of dental researches. The restorative system should have enough ability to withstand masticator forces, while preserving as much tooth structure as possible. The purpose of this study was to compare the effects of light and heat curing composite with light curing composite restoration method on fracture resistance of restored teeth. Forty healthy maxillary premolar teeth were chosen, in thirty of sampl...

  7. Ex vivo fracture resistance of endodontically treated maxillary central incisors restored with fiber-reinforced composite posts and experimental dentin posts

    OpenAIRE

    Ambica Kathuria; Kavitha, M.; Suchit Khetarpal

    2011-01-01

    Aim : To compare the fracture resistance of teeth restored with fiber-reinforced composite (FRC) posts and experimental dentin posts milled from human root dentin. Materials and Methods : Thirty maxillary central incisors were divided into three groups of ten each. Twenty teeth were restored with FRC posts and solid dentin posts and numbered as Groups 2 and 3 respectively while Group 1 acted as the control, without any post. The teeth were loaded at 135° angle to their long axes after co...

  8. 两种镍钛系统预备根管对牙根抗折强度的影响%Influence of two Ni-Ti instrumentation techniques on fracture resistance of endodontically treated roots

    Institute of Scientific and Technical Information of China (English)

    窦磊; 谭红

    2013-01-01

    Objective To compare the influence of root canal preparation using K3 and ProTaper Ni-Ti instruments on the fracture resistance of endodontically treated roots. Methods Thirty extracted single-rooted mandibular teeth were randomly divided into three groups according to the preparation instrument used: K3 group, ProTaper group and control group with stainless steel K-file. The root canals of three groups were filled by cold lateral condensation with gutta-percha and AH-plus sealer. The specimens were loaded to root fracture. The fracture pattern was evaluated using an optical stereomicroscope and the location of the failure was recorded. Results The mean values of fracture loads of the K3 group and ProTaper group is 206.05±73.31N and 210.04±64.57N respectively. The control group displayed higher mean values of fracture loads (269.10±56.64N) than the K3 group and ProTaper group, but no significant difference was found (P>0.05). 83.3 percent of root fracture lines were found in the buccolingual direction. Conclusion Preparation with K3 or ProTaper files did not significantly reduce the in vitro fracture resistance of endodontically treated roots compared with K file. The fracture resistance after preparation with K3 and ProTaper files did not differ significantly.%目的 比较ProTaper和K3镍钛预备系统预备根管对牙根抗折载荷的影响.方法 30颗完整的离体单根恒牙根管预备后随机分成三组,两个实验组分别采用ProTaper和K3镍钛预备系统预备根管,对照组采用不锈钢K锉逐步后退法预备根管,三组均采用冷牙胶侧压充填根管.将标本用万能试验机垂直加载直至标本发生纵裂,记录牙根纵裂时的最大抗压载荷和纵裂的类型.结果 两个实验组的平均抗压载荷值分别是206.05±73.31N和210.04±64.57N,两个实验组之间无明显统计学差异.对照组平均抗压载荷值(269.10±56.64N)高于两实验组,但差异不具有统计学意义.83.3

  9. An in vitro comparative evaluation of different intraorifice barriers on the fracture resistance of endodontically treated roots obturated with gutta-percha

    Science.gov (United States)

    Gupta, Abhishek; Arora, Vipin; Jha, Padmanabh; Nikhil, Vineeta; Bansal, Parul

    2016-01-01

    Aim: To compare and evaluate the root reinforcement potential of four different intraorifice barriers: Mineral trioxide aggregate (MTA), resin-modified glass ionomer cement (RMGIC), fiber-reinforced composite (FRC), and nanohybrid composite (NC). Materials and Methods: Seventy-five mandibular premolars were decoronated to a standardized length, and prepared and obturated with gutta-percha and AH Plus sealer. Except for control specimens, the coronal 3-mm gutta-percha was removed and filled with different materials. The specimens (75) were divided into five groups (n = 15) on the basis of the intraorifice barrier material used. Group 1: MTA, Group 2: RMGIC, Group 3: FRC, Group 4: NC, Group 5: no barrier (control). Fracture resistance of the specimens was tested. Results: Fracture resistance of roots was significantly affected by the type of intraorifice barrier used and the following pattern was observed: RMGIC > FRC > NC > MTA. Conclusion: Intraorifice barriers can be regarded as a viable choice to reduce the occurrence of postendodontic root fractures. Among the four tested materials, RMGIC showed the maximum reinforcement. PMID:27099413

  10. Stable relocation of the radial head without annular ligament reconstruction using the Ilizarov technique to treat neglected Monteggia fracture: two case reports

    Directory of Open Access Journals (Sweden)

    Wani Shareef A

    2010-10-01

    Full Text Available Abstract Introduction A Monteggia facture dislocation is not an uncommon injury, and the diagnosis can often be missed. Long-term follow-up of untreated Monteggia fracture dislocations reveals development of premature arthritis, pain, instability, and loss of pronation and supination. Methods involving annular ligament reconstruction require post-operative immobilization and use of transcapitellar pinning for maintenance of reduction, and thus a delay in rehabilitation. The literature reports satisfactory results with methods that involve ulnar osteotomy and open reduction of the radial head without annular ligament reconstruction. We used the Ilizarov method in two cases with neglected Monteggia fracture dislocations to stably reduce the radial head without open reduction and annular ligament reconstruction. Case presentation We report two cases of neglected Monteggia fracture dislocation, in two Kashmiri boys aged four and six years. Using ulnar osteotomy with distraction osteogenesis, we were able to relocate the radial head gradually and maintain the reduction without a requirement for open reduction and annular ligament reconstruction. Conclusion Distraction lengthening and hyperangulation in different planes by use of the Ilizarov technique effectively reduces the radial head without open reduction and annular ligament reconstruction.

  11. The economic impact of surgically treated peri-prosthetic hip fractures on a university teaching hospital in Wales 7.5-year study.

    Science.gov (United States)

    Jones, Andrew R; Williams, Tim; Paringe, Vishal; White, Simon P

    2016-02-01

    The number of total hip replacements taking place across the UK continues to grow. In an ageing population, with people placing greater demands on their prostheses, the number of peri-prosthetic fractures is increasing. We studied the economic impact this has on a large teaching hospital. All patients with peri-prosthetic femoral fracture in a 7.5 year period were identified. Radiographic and case note analysis was performed. Costings from the finance departments were obtained. 90 cases were identified, 58 female and 32 male, with a mean age of 76 (range: 38-91). 89 of the cases were managed surgically, 66% undergoing revision and 33% receiving open reduction and internal fixation. According to the Vancouver Classification, 3% were Type A, 79% Type B and 18% Type C. The mean length of stay was 43 days. The mean cost of management was £31,370 (range: £6885-£112,327). Patients with type C fractures had the highest mean length of stay at 53 days and mean cost of £33,417. Including rehabilitation costs, our study illustrated a mean cost of £31,370, roughly four times the current basic NHS tariff of £8552. Although implant costs are greater, treatment with revision where appropriate allows earlier weight bearing, reduced length of stay and lower overall cost. PMID:26689495

  12. A Single Case of Rosai-Dorfman Disease Marked by Pathologic Fractures, Kidney Failure, and Liver Cirrhosis Treated with Single-Agent Cladribine

    Directory of Open Access Journals (Sweden)

    Koji eSasaki

    2014-10-01

    Full Text Available Rosai-Dorfman disease (RDD is a proliferative histiocytic disorder of unknown etiology which is characterized by sinus histiocytosis with massive lymphadenopathy. In most cases, RDD has a benign course and treatment is not necessary. However, severe cases of RDD require treatment, and the treatment strategy is determined on the basis of the severity of the disease or the extranodal involvement of vital organs. We report a single case of RDD with atypical presentation of persistent constitutional symptoms, progressing pathologic fractures, and end-organ dysfunction, including acute kidney failure and liver cirrhosis with esophageal varices.

  13. Fractures in the growing foal. Part 1: Epiphyseal fractures

    International Nuclear Information System (INIS)

    This paper discusses general considerations for epiphyseal fractures and the anatomical differences which led to the Salter-Harris-classification are explained. The various locations and fracture configurations in the different bones are mentioned, and suggestions for their treatment are made. Epiphyseal fractures in growing foals have generally a favourable prognosis for healing, if treated properly. However, the prognosis for future use as an athlete has to be judged as guarded. The limb with an epiphyseal fracture should under any circumstances be splinted or cast for the transport to hospital. Epiphyseal fractures of the distal portions of the limb may be treated by cast application in some cases. More frequently, however, surgical reduction followed by some form of internal fixation is preferred. It is important to follow the basic principles of internal fixation. The implants should be removed at the earliest convenience, to prevent undue growth disturbances. Epiphyseal fractures should be treated as soon as possible to avoid further destruction of the growth plate through continuous movement at the fracture site. Growth disturbances are the most frequently encountered complications with epiphyseal fractures. Other complications include infection, osteomyelitis, degenerative joint disease and breakdown of the fracture fixation

  14. Use TOS Fixation Device to Treat Vertically Unstable Pelvic Fractures%使用TOS装置固定术治疗垂直不稳定型骨盆骨折

    Institute of Scientific and Technical Information of China (English)

    田素魁; 房晓彬; 王振强; 肖飞; 张玉兴; 陈劲松

    2012-01-01

    Objective To study the application of triangular Osteosynthesisto to treat vertically unstable pelvic fractures. Methods From May 2008 to December 2010,11 cases of vertically unstable pelvic fractures were treated with surgery trough the posterior midline incision. Pedicle screws in L4-5 and posterior superior iliac spine were im-pantcd. The vertical and rotating dislocation was reducted. 11 case were Tile C fracture. There are 7 males and 4 females. Results 10 of the 11 patients were followed up for 6~20 months. Postoperative X-ray showed that and the pelvic fractures were reducted. According to Matta pelvic fractures reduction evaluation standard, there were excellent in 7 cases,good in 3 cases. Preoperative there were 4 cases of di plexus nerve lesion,3 cases of them recovered post-operation. There were no nerve or vessel lesion. Function recovery was satisfactory. And there was one case of infection and delayed healing. Conclusion The use of the TOS with pedical screws to treat vertically unstable pelvic fractures has good clinical effect.%目的 探讨应用脊柱钉棒系统类似三角形的骨折固定技术(triangufar osteo synthesis,TOS)治疗垂直不稳定型骨盆骨折的临床效果.方法 对2008年5月至2010年12月收治的11例垂直不稳定型骨盆骨折患者进行手术治疗,采用后路腰骶部正中切口人路,安装L4-5椎弓根及髂后上棘椎弓根螺钉,将垂直、旋转移位复位固定.11例病人均属于Tile C型骨折,男7例,女4例.年龄20~48岁,平均34岁.结果 11例患者术后10例获得6~20个月随访,平均12.7个月.术后X线片均示骨盆骨折复位满意.根据Matta骨盆骨折复位评定标准,优7例,良3例.术前有4例骶丛神经损伤,术后3例神经症状恢复,1例解.未出现医源性神经、血管损伤.下肢行走、蹲屈功能恢复满意.有1例伤口感染,延迟愈合.结论 使用脊柱钉棒系统TOS装置固定术治疗垂直不稳定型骨盆骨折具有疗效满意,器械操

  15. Experiment study on fracture resistance of endodontically treated residual root by polylatic acid absorbable intracanal post%聚乳酸可吸收根管桩修复残根后的抗折力研究

    Institute of Scientific and Technical Information of China (English)

    陈爱华; 黄华

    2014-01-01

    AIM:To investigate the fracture resistance of endodontically treated residual root by polylatic acid absorbable intracanal post restoration.METHODS:24 extracted human mandibular premolars were treated by root canal therapy and canal obturation,then divided into 3 groups randomly(n=8).The teeth in group A,B and C were restored with polylatic acid absorbable intracanal posts covered with PLA film,glass fiber posts and short compos-ite resin post respectively,and with composite resin crowns.Each specimen was subjected to a load on INSTRON 5567 material testing machine until failure.Then fracture resistance was compared statistically by one-way ANOVA and fol-lowed by LSD test for multiple comparisons.Fracture modes were visually examined.RESULTS:The of fracture re-sistance(N)of group A,B and C was 1022.44 ±359.70,1168.33 ±193.50 and (1767.36 ±677.20)respectively (P0.05),group C vs group A or B (P<0.05).The fracture modes of all the teeth were favorable.CONCLUSION:Fracture resistance of residual roots endodontically treated by polylatic acid intraca-nal posts and PLA film is lower than that by short composite resin post,but might meet the needs of clinical practice.%目的:探讨聚乳酸(PLA)可吸收根管桩修复残根后的抗折力。方法:选择牙根长度、形态一致的离体下颌前磨牙24个,常规根管治疗和充填后,去除牙冠,并将其随机分为3组(每组8个);分别采用PLA可吸收根管桩覆以PLA薄膜、玻璃纤维桩及复合树脂短桩固位,进行桩核树脂冠修复;然后采用电子万能材料测验机检测各组试件的抗折力,并观察其折裂模式,所得数据用LSD双侧检验进行两两比较。结果:PLA可吸收根管桩组和玻璃纤维桩组的抗折力(N)分别为1022.44±359.70、1168.33±193.50(P>0.05),而分别与复合树脂短桩组(1767.36±677.20)相比,差异均有统计学意义(P<0.05);3组试件的折裂模式均为有利

  16. Intramedullary nail combined with blocking screws for treating distal tibial fractures%髓内钉结合阻挡螺钉修复胫骨远段骨折

    Institute of Scientific and Technical Information of China (English)

    侯靖钊; 张秋林; 包洪卫; 吴锦春; 唐昊; 汤旭日

    2016-01-01

    BACKGROUND:For the treatment of distal tibial fractures, open reduction and plate fixation, minimal y invasive percutaneous plate fixation and intramedul ary nail fixation are effective, but each has advantages and disadvantages. OBJECTIVE:To compare the effects of intramedul ary nail combined with blocking screws versus minimal y invasive percutaneous plate fixation in treating distal tibial fractures. METHODS:Fifty-one cases of distal tibial fractures were divided into two groups. The blocking screw group (23 cases) was treated with closed reduction and internal fixation with interlocking nail combined with blocking screws. The plate fixation group (28 cases) was treated with minimal y invasive percutaneous plate fixation. Fracture healing time, recovery of tibial function and complication occurrence were observed during fol ow-up. RESULTS AND CONCLUSION:Al patients were fol owed up for 8 to 32 months. (1) Except one patient in the plate fixation group, the other patients had bony union. The healing time was (4.6±1.7) months in the blocking screw group and (6.9±2.3) months in the plate fixation group. Significant differences in healing time were detected between the two groups (P0.05). (4) Results suggested that interlocking intramedul ary nail combined with blocking screw fixation in the treatment of distal tibial fractures can promote fracture healing and joint function recovery.%背景:对于胫骨远段骨折,采用切开复位钢板内固定、经皮微创钢板固定及髓内钉固定均是有效修复方法,但各有优缺点。目的:比较髓内钉结合阻挡螺钉技术与经皮微创钢板固定置入治疗胫骨远段骨折的疗效。方法:纳入51例胫骨远段骨折患者,按治疗方法分为2组,阻挡螺钉组(n=23)应用交锁髓内钉闭合穿钉结合阻挡螺钉置入固定,钢板固定组(n=28)采用经皮微创钢板固定。随访观察骨折愈合时间、胫骨功能恢复及并发症发生情

  17. Fraturas em duas e três partes do úmero proximal tratadas com sutura não absorvível Two- and three-part fractures of the proximal humerus treated with non-absorbable suture

    Directory of Open Access Journals (Sweden)

    Marco Antônio de Castro Veado

    2007-10-01

    150° (106°-210° nas fraturas em três partes, sendo verificada consolidação em valgo em nove pacientes (59% e, em varo, em dois pacientes. De acordo com o escore da UCLA, verificaram-se 88,8% de bons e excelentes resultados e 11,2% de maus resultados, para ambos os tipos de fratura. Os últimos, representados por um caso de pseudartrose e outro, por uma capsulite adesiva no pós-operatório. CONCLUSÃO: As fraturas em duas e três partes do úmero proximal podem ser satisfatoriamente tratadas com sutura não absorvível com incorporação do manguito rotador, particularmente nos idosos. Complicações relacionadas aos metais estão afastadas. Pacientes com fraturas do tubérculo maior tratados com suturas podem ter resultados similares aos daqueles com fraturas do colo cirúrgico. Embora o objetivo da cirurgia seja a reconstrução anatômica, alguma deformidade residual não impede resultado satisfatório. O método é pouco invasivo, permite estabilidade razoável dos fragmentos, com altos índices de consolidação óssea e satisfação do paciente. A cooperação do paciente é crucial para o sucesso terapêutico.OBJECTIVE: To evaluate the clinical and radiographic results of patients with two- and three-part fractures of the proximal end of the humerus treated with non-absorbable sutures and with incorporation of the rotator cuff, which allows for increased stability of the fixation, mainly in patients with low bone quality. METHODS: 19 patients were operated on, fifteen female and four male, with a mean age of 57.4 years (23-79 years and a mean follow-up of 53.4 months (seven to 144 months. Based on Neer classification, the authors found ten three-part fractures (surgical neck and larger tuberosity, and nine two-part fractures (two of the larger tuberosity and seven of the surgical neck. All of them were operated in the beach chair position with endotracheal anesthesia and brachial plexus blockade. Deltopectoral approach was used for two-part fractures of

  18. Effect of proximal humeral internal locking system in treating complex proximal humeral fractures in elderly patients%应用PHILOS接骨板治疗复杂老年肱骨近端骨折

    Institute of Scientific and Technical Information of China (English)

    苑娜; 郑继会; 胡思斌; 孙宏辉; 赵爱军

    2011-01-01

    目的 探讨肱骨近端内固定锁定系统(PHILOS)接骨板治疗复杂老年肱骨近端骨折的疗效.方法 回顾性分析我院2005年6月~2008年12月应用PHILOS接骨板手术治疗复杂老年肱骨近端骨折27例临床资料,其中男性15例,女性12例;平均年龄74岁(59~83岁).按Neer分型:三部分骨折19例,四部分骨折8例,均有原发性骨质疏松.复位后PHILOS接骨板固定.结果 术后随访8~36个月,平均13个月.骨折全部愈合,2例出现肱骨头坏死.按照Neer肩关节功能评分标准:优6例,良14例,可4例,差3例;优良率74%.结论 应用PHILOS接骨板治疗复杂老年肱骨近端骨折固定可靠,可以早期功能锻炼,术后功能恢复满意,对复杂老年肱骨近端骨折是一种有效的治疗方法.%Objective To summarize the treatment effect of proximal humeral internal locking system( PHILOS ) for complex proximal humeral fractures in old patients. Methods A retrospective study was done on 27 cases of complex proximal humeral fracture treated with PHILOS plate from Jun. 2005 to Dec. 2008, including 15 males and 12 females aged 59-83 years ( average 74 years). According to the Neer classification, 19 cases were three-part fractures, 8 cases were four-part fractures, and all cases were observed primary osteoporosis. A deltoid-pectoral approach was used in all patients and fixed the fracture with PHILOS plate after reduction, the tubercle fragments were sutured with non-absorbable ethibond. Results The follow-up time ranged from 8 to 36 months,with mean of 13 months. All fractures got bone union and humeral head necrosis was observed in 2 cases. By Neer shoulder scoring system, 6 cases were excellent,14 cases were good,4 cases were fair and 3 cases were poor. Conclusion Applying PHILOS plate in treatment of the complex proximal humeral fractures in old patients provides a stable fixation and earlier rehabilitation. It is an effective method for complex proximal humeral fractures in old patients.

  19. Importance of initial fracture crack width in minimally dislocated fractures of humeral lateral condyle in children for evaluation of fracture stability and treatment choice

    OpenAIRE

    Rakonjac Zoran; Brdar Radivoj

    2009-01-01

    Introduction. The fracture of the external condyle is the most common fracture of the distal end of the humerus. This is an intraarticular fracture, which, if not properly treated, can cause serious complications, difficult to treat. Objective. To define the importance of the initial width of the fracture crack for the evaluation of stability of the minimally dislocated fractures of the humeral lateral condyle and for the selection of the method of treatment. Methods. The target group include...

  20. Unstable Pelvic Fractures Associated with Femoral Shaft Fractures: A Retrospective Analysis

    Directory of Open Access Journals (Sweden)

    Chun-Liang Wu

    2013-04-01

    Full Text Available Background: Both pelvic fractures and femoral shaft fractures are caused by high-energy injuries. When unstable pelvic fractures and femoral shaft fractures occur concomitantly, the optimal treatment method is controversial. The aim of this study was to establish a reasonable principle for treating such complicated injuries. Methods: Forty patients sustaining unstable pelvic fractures and concomitant femoral shaft fractures were treated in a 7-year period. The initial management of the fractures was started at the emergency service according to the Advanced Trauma Life Support protocol. Unstable pelvic fractures were wrapped by cloth sheets and femoral shaft fractures were immobilized with a splint. Angiography was performed on patients with unstable hemodynamic status. The definitive treatment for combined fractures was performed after stabilizing the hemodynamics. Closed nailing was used for femoral shaft fractures, and pelvic fractures were treated with various techniques. Results: The mortality rate was 12.5% (5/40 during admission. Thirty-three patients were followed up for an average of 32 months (range, 12-76 months. There were 33 cases of unstable pelvic fractures and 36 instances of femoral shaft fractures. The union rate for pelvic fractures was 100% (33/33, while femoral shaft fractures had a 94.4% (34/36 union rate. The average healing time was 3.3 months (range, 1.6-8.1 months and 4.1 months (range, 2.5-18.2 months for pelvic and femoral shaft fractures, respectively. After fracture, 34 hips (94% achieved a satisfactory result in the Harris hip score and 30 knees (83% achieved a satisfactory result in the Mize knee score. Conclusions: Stabilization of the hemodynamics in patients with combined fractures should be the first aim. Angiography to stop arterial bleeding in the pelvis is often life-saving. The definitive treatment for combined fractures, such as pelvic fractures and femoral shaft fractures, should wait until hemodynamics

  1. The Practice of Scottish Urologists in the Assessment and Management of Fracture Risk in the Ageing Male being Treated for Prostate Cancer

    Directory of Open Access Journals (Sweden)

    Wee Sing Ngu

    2007-01-01

    Full Text Available The aim of this study was to ascertain the practice of urologists in Scotland in the assessment and prevention of fracture risk in males starting castration-type therapy for prostate cancer. A questionnaire survey was sent to all practicing consultant urologists in Scotland. A majority of urologists, 25 (64.1%, did not consider the state of their patients' bone mineral density (BMD before commencing castration-type therapy. The rest used various methods to assess BMD, including clinical impression alone, plain bone radiographs, and dual-energy X-ray absorptiometry (DEXA. Various methods were used in the prophylaxis and treatment of osteoporosis, including avoidance of castration type therapy and the use of bisphosphonates and bicalutamide along with castration-type therapy. This study has shown that there is no consensus as to the assessment and management of fracture risk in patients with prostate cancer commencing or on established castration-type therapy. The situation needs to be addressed with some consensus guidance.

  2. Rib Fractures

    Science.gov (United States)

    ... 2 Diabetes, Heart Disease a Dangerous Combo Are 'Workaholics' Prone to OCD, Anxiety? ALL NEWS > Resources First ... Rib Fractures Traumatic Pneumothorax Tension Pneumothorax Rib fractures cause severe pain, particularly when a person breathes deeply. ...

  3. Tibial pilon fractures treated by interlocking intramedullary nail with distal multi-directional locking%多向锁定带锁髓内钉治疗胫骨pilon骨折的疗效分析

    Institute of Scientific and Technical Information of China (English)

    熊庆广; 王永清; 张庆杰; 毕红宾; 孙晋保; 赵志辉; 杨志强; 李毅

    2015-01-01

    目的 探讨多向锁定带锁髓内钉治疗胫骨pilon骨折的临床疗效.方法 回顾性分析2010年6月至2013年1月,采用多向锁定带锁髓内钉治疗并获得随访的23例胫骨pilon骨折患者资料,男15例,女8例;年龄32~ 61岁,平均36.9岁;左侧10例,右侧13例;均为新鲜骨折,其中闭合性骨折22例,开放性骨折1例(Tscherne分类1级).pilon骨折采用AO/OTA分型:C1型10例,C2型8例,C3型5例.根据骨折线及骨折块分布情况选择入路行有限切开复位内固定,经撬拨复位后,使用非限制性锁钉将C型骨折变为A型骨折后使用髓内钉固定.术后以Burwell-Charnley放射学评价标准判定关节面复位质量,根据Teeny-Wiss踝关节临床症状和功能评分系统对术后功能进行评估.结果 23例患者均获得随访,随访时间18~ 24个月,平均(20.6±2.3)个月;骨折均愈合,愈合时间14~ 28周,平均(16.8±4.0)周.根据Burwell-Charnley放射学评价标准判定关节面复位质量,其中解剖复位20例,复位一般2例,复位差1例,解剖复位率为87.0%(20/23);踝关节Teeny-Wiss评分为60~ 100分,平均(91.6±9.5)分;其中优12例,良8例,可2例,差1例,优良率为87.0% (20/23).7例出现张力性水疱;1例出现皮肤坏死.术后随访期间无一例出现感染、螺钉松动及断裂、畸形愈合、不愈合等并发症.结论 多向锁定带锁髓内钉治疗胫骨pilon骨折可获得良好复位和满意临床疗效,是一种安全可供选择的治疗方案.%Objective To explore the clinical efficacy of pilon fracture treated by tibial multi-directional interlocking intramedullary nail.Methods From June 2010 to January 2013,data of 23 patients with pilon fracture who were treated by tibial multi-directional interlocking intramedullary nail were retrospectively analyzed.There were 15 males and 8 females,with an average age of 36.9 years (range,32-61 years).They were all fresh fractures,including 22 cases of closed fractures and 1 case of

  4. Root fractures

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Christensen, Søren Steno Ahrensburg; Tsilingaridis, Georgios

    2012-01-01

    The purpose of this study was to analyze tooth loss after root fractures and to assess the influence of the type of healing and the location of the root fracture. Furthermore, the actual cause of tooth loss was analyzed.......The purpose of this study was to analyze tooth loss after root fractures and to assess the influence of the type of healing and the location of the root fracture. Furthermore, the actual cause of tooth loss was analyzed....

  5. Como são tratadas as fraturas diafisárias fechadas do fêmur no Brasil? Estudo transversal How are closed femoral diaphyseal fractures treated in Brazil? A cross-sectional study

    Directory of Open Access Journals (Sweden)

    Robinson Esteves Santos Pires

    2006-01-01

    topics: fracture trace configuration and injuries of soft parts or neurovascular structures as key parameters for determining treatment; fractures classification, in which AO was most frequently adopted; milled blocked anterograde intramedullary nail for treating cross-sectioned and short oblique factures at the isthmus; bridge plate for treating complex trace fractures; pre-operative skeletal traction; infection as the most frequent complication, and; postoperative low molecular weight heparin. There were opinion conflicts for the following topics: use of traction table for performing intramedullary osteosynthesis, time interval between trauma and surgery; time of antibiotics use, and; mean hospitalization time. Regarding literature, there was agreement concerning key parameters for determining treatment; fixation method for simple-traces fractures at the isthmus; adopted classification; antithrombotic prophylaxis. Issues such as fixation method for complex-traced fractures; time of antibiotics use; average interval between trauma and osteosynthesis, and; hospitalization time were different from literature.

  6. Percutaneous cannulated screw fixation of sacral fractures and sacroiliac joint disruptions with CT-controlled guidewires performed by interventionalists: Single center experience in treating posterior pelvic instability

    International Nuclear Information System (INIS)

    Highlights: • Minimally invasive sacroiliac screw fixation can be performed under CT-imaging. • Guidewires help in precise placement of cannulated sacroiliac screw. • Only a diminishing rate of misplacements can be seen. • The method appears to be a safe and very accurate procedure. - Abstract: Objective: The purpose of our study was to evaluate minimally invasive sacroiliac screw fixation for treatment of posterior pelvic instability with the help of CT controlled guidewires, assess its accuracy, safety and effectiveness, and discuss potential pitfalls. Methods: 100 guidewires and hollow titan screws were inserted in 38 patients (49.6 ± 19.5 years) suffering from 35 sacral fractures and/or 16 sacroiliac joint disruptions due to 33 (poly-)traumatic, 2 osteoporotic and 1 post-infectious conditions. The guidewire and screw positions were analyzed in multiplanar reconstructions. Results: The mean minimal distance between guidewire and adjacent neural foramina was 4.5 ± 2.01 mm, with a distinctly higher precision in S1 than S2. Eight guidewires showed cortical contacts, resulting in a total of 2% mismatched screws with subsequent wall violation. The fracture gaps were reduced from 3.6 ± 0.53 mm to 1.2 ± 0.54 mm. During follow-up 3 cases of minor iatrogenic sacral impaction (<5 mm) due to the bolting and 2 cases of screw loosening were observed. Interventional time was 84.0 min with a mean of 2.63 screws per patient whilst acquiring a mean of 93.7 interventional CT-images (DLP 336.7 mGy cm). Conclusions: The treatment of posterior pelvic instability with a guidewire-based screw insertion technique under CT-imaging results in a very high accuracy and efficacy with a low complication rate. Careful attention should be drawn to radiation levels

  7. Percutaneous cannulated screw fixation of sacral fractures and sacroiliac joint disruptions with CT-controlled guidewires performed by interventionalists: Single center experience in treating posterior pelvic instability

    Energy Technology Data Exchange (ETDEWEB)

    Fischer, Sebastian, E-mail: sebastian.fischer@kgu.de [Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Vogl, Thomas J. [Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Marzi, Ingo [Department of Trauma, Hand and Reconstructive Surgery, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Zangos, Stephan; Wichmann, Julian L.; Scholtz, Jan-Erik; Mack, Martin G. [Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany); Schmidt, Sven [Orthopaedic University Hospital Friedrichsheim, Marienburgstraße, 260528 Frankfurt (Germany); Eichler, Katrin [Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt (Germany)

    2015-02-15

    Highlights: • Minimally invasive sacroiliac screw fixation can be performed under CT-imaging. • Guidewires help in precise placement of cannulated sacroiliac screw. • Only a diminishing rate of misplacements can be seen. • The method appears to be a safe and very accurate procedure. - Abstract: Objective: The purpose of our study was to evaluate minimally invasive sacroiliac screw fixation for treatment of posterior pelvic instability with the help of CT controlled guidewires, assess its accuracy, safety and effectiveness, and discuss potential pitfalls. Methods: 100 guidewires and hollow titan screws were inserted in 38 patients (49.6 ± 19.5 years) suffering from 35 sacral fractures and/or 16 sacroiliac joint disruptions due to 33 (poly-)traumatic, 2 osteoporotic and 1 post-infectious conditions. The guidewire and screw positions were analyzed in multiplanar reconstructions. Results: The mean minimal distance between guidewire and adjacent neural foramina was 4.5 ± 2.01 mm, with a distinctly higher precision in S1 than S2. Eight guidewires showed cortical contacts, resulting in a total of 2% mismatched screws with subsequent wall violation. The fracture gaps were reduced from 3.6 ± 0.53 mm to 1.2 ± 0.54 mm. During follow-up 3 cases of minor iatrogenic sacral impaction (<5 mm) due to the bolting and 2 cases of screw loosening were observed. Interventional time was 84.0 min with a mean of 2.63 screws per patient whilst acquiring a mean of 93.7 interventional CT-images (DLP 336.7 mGy cm). Conclusions: The treatment of posterior pelvic instability with a guidewire-based screw insertion technique under CT-imaging results in a very high accuracy and efficacy with a low complication rate. Careful attention should be drawn to radiation levels.

  8. New C2 synchondrosal fracture classification system

    International Nuclear Information System (INIS)

    Excessive cervical flexion-extension accompanying mild to severe impact injuries can lead to C2 synchondrosal fractures in young children. To characterize and classify C2 synchondrosal fracture patterns. We retrospectively reviewed imaging and medical records of children who were treated for cervical spine fractures at our institution between 1995 and 2014. We reviewed all fractures involving the five central C2 synchondroses with regard to patient demographics, mechanism of injury, fracture pattern, associated fractures and other injuries, treatment plans and outcome. Fourteen children had fractures involving the central C2 synchondroses. There were nine boys and five girls, all younger than 6 years. We found four distinct fracture patterns. Eleven complete fractures were further divided into four subtypes (a, b, c and d) based on degree of anterior displacement of the odontoid segment and presence of distraction. Nine of these 11 children had fractures through both odontoneural synchondroses and the odontocentral synchondrosis; one had fractures involving both neurocentral synchondroses and the odontoneural synchondrosis; one had fractures through bilateral odontoneural and bilateral neurocentral synchondroses. Three children had incomplete fractures, defined as a fracture through a single odontoneural synchondrosis with or without partial extension into either the odontocentral or the adjacent neurocentral synchondroses. All complete fractures were displaced or angulated. Four had associated spinal cord injury, including two contusions (subtype c fractures) and two fatal transections (subtype d fractures). Most children were treated with primary halo stabilization. Subtype c fractures required surgical fixation. We describe four patterns of central C2 synchondrosal fractures, including two unique patterns that have not been reported. We propose a classification system to distinguish these fractures and aid in treatment planning. (orig.)

  9. New C2 synchondrosal fracture classification system

    Energy Technology Data Exchange (ETDEWEB)

    Rusin, Jerome A.; Ruess, Lynne [Department of Radiology, Nationwide Children' s Hospital, Columbus, OH (United States); The Ohio State University College of Medicine and Public Health, Columbus, OH (United States); Daulton, Robert S. [Department of Radiology, Nationwide Children' s Hospital, Columbus, OH (United States)

    2015-06-15

    Excessive cervical flexion-extension accompanying mild to severe impact injuries can lead to C2 synchondrosal fractures in young children. To characterize and classify C2 synchondrosal fracture patterns. We retrospectively reviewed imaging and medical records of children who were treated for cervical spine fractures at our institution between 1995 and 2014. We reviewed all fractures involving the five central C2 synchondroses with regard to patient demographics, mechanism of injury, fracture pattern, associated fractures and other injuries, treatment plans and outcome. Fourteen children had fractures involving the central C2 synchondroses. There were nine boys and five girls, all younger than 6 years. We found four distinct fracture patterns. Eleven complete fractures were further divided into four subtypes (a, b, c and d) based on degree of anterior displacement of the odontoid segment and presence of distraction. Nine of these 11 children had fractures through both odontoneural synchondroses and the odontocentral synchondrosis; one had fractures involving both neurocentral synchondroses and the odontoneural synchondrosis; one had fractures through bilateral odontoneural and bilateral neurocentral synchondroses. Three children had incomplete fractures, defined as a fracture through a single odontoneural synchondrosis with or without partial extension into either the odontocentral or the adjacent neurocentral synchondroses. All complete fractures were displaced or angulated. Four had associated spinal cord injury, including two contusions (subtype c fractures) and two fatal transections (subtype d fractures). Most children were treated with primary halo stabilization. Subtype c fractures required surgical fixation. We describe four patterns of central C2 synchondrosal fractures, including two unique patterns that have not been reported. We propose a classification system to distinguish these fractures and aid in treatment planning. (orig.)

  10. 经跗骨窦入路拉力螺纹钉加克氏针内固定治疗跟骨关节内骨折%Treatment of Intra-articular Fracture of the Calcaneum by Lag Screw and K-wire through Sinus Tarsi Approach

    Institute of Scientific and Technical Information of China (English)

    王庆贤; 张英泽; 潘进社; 吴希瑞; 张国川; 李衡; 焦振清

    2011-01-01

    目的:探讨经跗骨窦入路拉力螺纹钉加克氏针内固定治疗跟骨关节内骨折的临床疗效.方法:采用经跗骨窦入路克氏针加拉力螺纹钉内固定术治疗跟骨关节内骨折31例(42侧),其中Sanders分型II型23侧,III型17侧,IV型2侧.术后4周拔除外露克氏针,术后6~12个月去除拉力螺纹钉.结果:术后并发切口皮缘坏死2例,经清创换药后,局麻下直接缝合治愈.术后随访8.5~25个月,平均12.7个月.所有患者跟骨后关节面复位满意,跟骨外形及高度恢复满意,但部分患者跟骨宽度恢复不满意.根据Maryland后足功能评价标准,本组90~100分18侧,80~90分12侧,70~80分9侧,60~70分3侧.结论:经跗骨窦入路拉力螺纹钉加克氏针内固定术具有显露充分、复位满意、内固定可靠、软组织创伤小、切口感染风险低等优点,是治疗跟骨关节内骨折的方法之一.%Objective : To observe the operative treatment of intra - articular fracture of the calcaneus by K - wire and lag screw through the sinus tarsi approach. Methods :31 patients with 42 calcaneal fractures were treated with K - wire and lag screw through sinus tarsi approach. According to Sanders classification, there were 23 type Ⅱ fractures, 17 type Ⅲ fractures and 2 type Ⅳ fractures. The K - wires were pulled out at 4 weeks after operation. The lag screws were pulled out from 6 to 12 months after operation. Results : Two cases had incision - edge necrosis and treated by dress - changing and direct suture at the second stage. All of the cases had follow - up from 8. 5 ~ 25 months ( averaged 12. 7 months ). The reduction of the posterior facet was graded as nearly anatomical ( less than 3 mm articular displacement ) in all cases. The conture and height of the calcaneus were regained satisfactorily, but the width was not regained satisfactorily in some patients. According to Maryland hindfoot scoring system, 18 feet scored 90 ~ 100 points, 12 feet scored

  11. Tibial Plateau Fractures

    DEFF Research Database (Denmark)

    Elsøe, Rasmus

    This PhD thesis reported an incidence of tibial plateau fractures of 10.3/100,000/year in a complete Danish regional population. The results reported that patients treated for a lateral tibial plateau fracture with bone tamp reduction and percutaneous screw fixation achieved a satisfactory level of...... radiological outcomes and a level of health related quality of life (Eq5d) below but not significantly different from the Danish reference population at a mean of 5.2 years follow-up. Furthermore, a knee injury-specific questionnaire (KOOS) reported a level of disability close to a reference population with...... only the subgroup Sport significantly below the age matched reference population. The thesis reports a level of health related quality of life (Eq5d) and disability (KOOS) significantly below established reference populations for patients with bicondylar tibial plateau fracture treated with a ring...

  12. Combination of diagnostic medial calcaneal nerve block followed by pulsed radiofrequency for plantar fascitis pain: A new modality

    Directory of Open Access Journals (Sweden)

    Deepak Thapa

    2014-01-01

    Full Text Available Plantar fasciitis (PF is the most common cause of chronic heel pain which may be bilateral in 20 to 30% of patients. It is a very painful and disabling condition which can affect the quality of life. The management includes both pharmacological and operative procedures with no single proven effective treatment modality. In the present case series, we managed three patients with PF (one with bilateral PF. Following a diagnostic medial calcaneal nerve (MCN block at its origin, we observed reduction in verbal numerical rating scale (VNRS in all the three patients. Two patients has relapse of PF pain which was managed with MCN block followed with pulsed radio frequency (PRF. All the patients were pain-free at the time of reporting. This case series highlights the possible role of combination of diagnostic MCN block near its origin followed with PRF as a new modality in management of patients with PF.

  13. Assessment of the bone quality of black male athletes using calcaneal ultrasound: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Sendeht Ayuba J

    2008-05-01

    Full Text Available Abstract Background Lifestyle, genetics and environmental factors are established determinants of bone density. We aimed to describe the bone characteristics of competitive top-ranked Nigerian male athletes using calcaneal ultrasound and to assess whether intensive training promotes higher bone density in an environment with reportedly low calcium intake; to compare the bone characteristics of footballers with runners and other sportsmen; and to assess the correlation of stiffness index (SI with activity level, since energy expenditure correlates with length of training and by extension, magnitude of skeletal loading. Methods We recruited 102 male athletes: these included football (n = 68, running (n = 15, handball (n = 7, taekwando (n = 6, cycling (n = 2, judo (1, badminton (1 and high jump (1. Anthropometric data were first recorded on a structured form and energy expenditure was indirectly estimated with a validated questionnaire. Bone density was assessed using the Lunar Achilles+ calcaneal ultrasonometer. Results The mean age of athletes was 25 ± 6 years. The means of BMI and energy expenditure were 21.9 ± 2.0 kg/m2 and 35.0 ± 13.7 kcal/kg/day, respectively. Footballers were younger (p Conclusion Repetitive skeletal loading at the heel has the potential to improve bone density in black male athletes. The magnitude of increase may be higher in medium impact sports such as soccer and running compared with low or non-impact sports such as judo or taekwando, and is independent of age and BMI. However, future longitudinal data will be required to support our observations.

  14. Elastic nails for fibular fracture in adult tibiofibular fractures.

    Science.gov (United States)

    Wang, Qiang; Xu, Hong-Guang; Zhang, Yin-Chang; Dong, Li-Jun

    2015-01-01

    Treatment of adult tibiofibular fractures, especially severely comminuted fractures, is technically challenging due to the lack of reduction markers and difficulty in restoring the alignment. Fixation of the fibula can facilitate reduction of the tibia fracture and restoration of the lower-extremity alignment. However, there are few literatures mentioned using intramedullary nail fixation for fibular fractures. Twenty-three cases of tibiofibular fractures were treated with elastic nails fixation fibular fractures and intramedullary nail or plate stabilization tibial fractures between January 2012 and December 2012. Adult tibiofibular fractures with fibular neck fractures or fibular fracture line apart from the ankle joint surface within 8 cm was ruled out. There were 19 males and 4 females with an average age of 41 years (range, 21-59 years). The injury causes included 11 falls and 12 traffic accidents. The left side was involved in 11 cases and the right side was involved in 12 cases. Seventeen cases were closed fractures and 6 cases were open fractures, all were Gustilo type I and II fractures. According to the AO classification, six fractures were defined as type 42A, 11 as type 42B, and 6 as type 42C. The average interval between injury and surgery was 5.8 d (range, 3-22 d). The operation time of elastic nails fixation fibular fractures was 24 minutes (range, 15-42 minutes). Primary wound healing was achieved in all patients. No complications such as infection and wound necrosis occurred. Twenty-one patients were followed up for a mean follow-up period of 16.3 months (range, 12-26 months). The mean duration of fracture healing in the radiographs was 4.1 months (range, 3-8 months). No recurrent fracture dislocation and breakage of implant were observed. At the last follow-up visit, the lower-extremity alignment was excellent. Two degrees of varus deformity was found in 3 cases, and 2 degrees of valgus deformity was observed in 2 cases, but there were no serious

  15. Repair of horizontal root fracture: A case report

    OpenAIRE

    Laila Shafie; Farhad Farzaneh; Maryam Alsadat Hashemipour

    2011-01-01

    ABSTRACT: Horizontal root fractures in permanent teeth are uncommon injuries among dental traumas. The principle of treating horizontal root fractures of permanent teeth is repositioning and fixation of fractured segment. Diagnosis of tooth fractures based on radiographic findings and the fracture healing process are affected by factors before and after injury. The present case reports the treatment of horizontal root fracture located at the apical-third of upper left and right central inciso...

  16. Emergency department external fixation for provisional treatment of pilon and unstable ankle fractures

    Directory of Open Access Journals (Sweden)

    Craig R Lareau

    2015-01-01

    Full Text Available Unstable ankle fractures and impacted tibial pilon fractures often benefit from provisional external fixation as a temporizing measure prior to definitive fixation. Benefits of external fixation include improved articular alignment, decreased articular impaction, and soft tissue rest. Uniplanar external fixator placement in the Emergency Department (ED ex-fix is a reliable and safe technique for achieving ankle reduction and stability while awaiting definitive fixation. This procedure involves placing transverse proximal tibial and calcaneal traction pins and connecting the pins with two external fixator rods. This technique is particularly useful in austere environments or when the operating room is not immediately available. Additionally, this bedside intervention prevents the patient from requiring general anesthesia and may be a cost-effective strategy for decreasing valuable operating time. The ED ex-fix is an especially valuable procedure in busy trauma centers and during mass casualty events, in which resources may be limited.

  17. Comparative Prospective Study of Load Distribution Projection Among Patients with Vertebral Fractures Treated with Percutaneous Vertebroplasty and a Control Group of Healthy Volunteers

    Energy Technology Data Exchange (ETDEWEB)

    Kelekis, Alexios, E-mail: akelekis@med.uoa.gr; Filippiadis, Dimitrios K., E-mail: dfilippiadis@yahoo.gr; Vergadis, Chrysovalantis, E-mail: valvergadis@yahoo.gr; Tsitskari, Maria, E-mail: mariadote@hotmail.com; Nasis, Nikolaos, E-mail: nnasis@cc.uoa.gr; Malagari, Aikaterini, E-mail: kmalag@otenet.gr; Kelekis, Nikolaos, E-mail: kelnik@med.uoa.gr [University General Hospital “ATTIKON”, 2nd Department of Radiology (Greece)

    2013-04-12

    PurposeThrough a prospective comparison of patients with vertebral fractures and normal population, we illustrate effect of percutaneous vertebroplasty (PV) upon projection of load distribution changes.MethodsVertebroplasty group (36 symptomatic patients with osteoporotic vertebral fractures) was evaluated on an electronic baropodometer registering projection of weight bearing areas on feet. Load distribution between right and left foot (including rear-front of the same foot) during standing and walking was recorded and compared before (group V1) and the day after (group V2) PV. Control group (30 healthy asymptomatic volunteers-no surgery record) were evaluated on the same baropodometer.ResultsMean value of load distribution difference between rear-front of the same foot was 9.45 ± 6.79 % (54.72–45.28 %) upon standing and 14.76 ± 7.09 % (57.38–42.62 %) upon walking in the control group. Respective load distribution values before PV were 16.52 ± 11.23 and 30.91 ± 19.26 % and after PV were 10.08 ± 6.26 and 14.25 ± 7.68 % upon standing and walking respectively. Mean value of load distribution variation between the two feet was 6.36 and 14.6 % before and 4.62 and 10.4 % after PV upon standing and walking respectively. Comparison of load distribution variation (group V1–V2, group V1-control group) is statistically significant. Comparison of load distribution variation (group V2-control group) is not statistically significant. Comparison of load distribution variation among the two feet is statistically significant during walking but not statistically significant during standing.ConclusionsThere is a statistically significant difference when comparing load distribution variation prior vertebroplasty and that of normal population. After vertebroplasty, this difference normalizes in a statistically significant way. PV is efficient on equilibrium-load distribution improvement as well.

  18. Distal clavicle fractures in children☆

    Science.gov (United States)

    Labronici, Pedro José; da Silva, Ricardo Rodrigues; Franco, Marcos Vinícius Viana; Labronici, Gustavo José; Pires, Robinson Esteves Santos; Franco, José Sergio

    2015-01-01

    Objective To analyze fractures of the distal clavicle region in pediatric patients. Methods Ten patients between the ages of five to eleven years (mean of 7.3 years) were observed. Nine patients were treated conservatively and one surgically. All the fractures were classified using the Nenopoulos classification system. Results All the fractures consolidated without complications. Conservative treatment was used for nine patients, of whom three were in group IIIB, three IIb, two IIa and one IV. The only patient who was treated surgically was a female patient of eleven years of age with a group IV fracture. Conclusion The treatment indication for distal fractures of the clavicle in children should be based on the patient's age and the displacement of the fragments. PMID:26962489

  19. An Unusual Combination of Acetabular and Pelvic Fracture: Is This a New Subtype of Acetabular Fracture?

    Directory of Open Access Journals (Sweden)

    Reza Tavakoli Darestani

    2013-01-01

    Full Text Available Introduction: Acetabular fractures are a common problem among young males. An acetabular fracture with disruption of the joint surface, if untreated, will rapidly lead to post-traumatic osteoarthritis. Proper reduction and internal fixation depend on accurate classification and the quality of imaging.Case Presentation: We present an unusual form of acetabular fracture, which is not included in the conventional classification (Judet and Letournel ; this occurred in a middle-aged male who was operatively treated without any complications. In this case due to posterior extension of the fracture into the SI joint and concomitant anterior column fracture in the area above the acetabular dome, no portion of the acetabular anterior surface remained connected to the innominate bone.Conclusions: We recognized this type of fracture and treated it similarly to both column fractures. We recommend that the classification of acetabular fractures be modified to include this type of fracture.

  20. Management of penile fractures

    International Nuclear Information System (INIS)

    Objective was to present our experience with surgical and conservative management of penile fracture. This prospective study was carried out in the Urology and Nephrology Center, at Al-Thawra General and Teaching Hospital, Sana'a, Yemen from June 2003 to September 2007 and included 30 patients presenting with penile fracture. Diagnosis was made clinically in all our patients. Six patients with simple fracture were treated conservatively while 24 patients with more severe injuries were operated upon. Patient's age ranged from 24-52 years (mean 31.3 years) 46.7% of patients were under the age of 30 years and 56.7% were unmarried. Hard manipulation of the erect penis for example during masturbation was the most frequent mechanism of fracture in 53.3% of patients. Solitary tear was found in 22 patients and bilateral corporal tears associated with urethral injury were found in 2 patients. Corporal tears were saturated with synthetic absorbable sutures and urethral injury was repaired primarily. All operated patients described full erection with straight penis except 3 of the 8 patients who were managed by direct longitudinal incision, in whom mild curvature during erection was observed. The conservatively treated patients described satisfactory penile straightness and erection. The optimal functional and cosmetic results are achieved following immediate surgical repair of penis fracture. Good results can also be obtained in some selected patients with conservative management. (author)

  1. Post-surgical care of a professional ballet dancer following calcaneal exostectomy and debridement with re-attachment of the left Achilles tendon

    OpenAIRE

    Kobsar, Bradley; Alcantara, Joel

    2009-01-01

    The extraordinary physical demands placed upon ballet dancers are only now being appreciated as comparable to that of other highly competitive athletic pursuits. The professional ballet dancer presents with an array of injuries associated with their physically vigorous performance requirements. In keeping with evidence-based practice, we describe the chiropractic care of a professional ballet dancer following surgical calcaneal exostectomy and debridement with re-attachment of the left Achill...

  2. 髌骨粉碎性骨折3种固定方式比较分析%Comparison of clinical effects for three methods in treating comminuted patellar fractures

    Institute of Scientific and Technical Information of China (English)

    于治涛; 余俊东

    2011-01-01

    Objective:To compare clinical effects of different fixations in order to provide the best therapeutic choice for comminuted patellar fractures. Methods: From February 2003 to June 2009,56 patients with comminuted patellar fractures were treated with three methods of fixation. Of them, 18 patients (group A ) were treated with Kirschner-wire with steel wire fixation,there were 9 males and 9 females,ranging in age from 32 to 52 years with an average of (47.62±4.82) years; 13 patients (group B) with circular silk thread fixation and plaster immobilization ,there were 3 males and 10 females,ranging in age from 38 to 65 years with an average of (48.58±8.28) years;25 patients (group C) with memory alloy patella holder fixation ,there were 9 males and 16 females,ranging in age from 32 to 68 years with an average of (48.36±9.59) years. According to criteria of B(o)stman, eight indexes were compared, including the range of motion of the knee, pain, walking and so on. Results: All patients were followed up from 8 to 26 months with an average of 15.6 months. All the fractures healed. The B(o)stman scoring of group A, B,C were respectively 26.00±4.16,22.08±5.31,26.44±3.77. The clinical effects of group A and C were better than that of group B(P<0.05 ). Conclusion:The method of Kirschner-wire with steel wire fixation or memory alloy patella holder fixation can obtain satisfactory effects in treating comminuted patellar fractures because of steady fixation and early function recovery.%目的:通过对比髌骨粉碎性骨折不同固定方法的临床疗效,为髌骨粉碎性骨折的治疗提供选择依据.方法:2003年2月至2009年6月采用3种固定方式治疗56例髌骨粉碎性骨折,其中采用克氏针钢丝固定(A组)18例,男9例,女9例;年龄32~52岁,平均(47.62±4.82)岁;丝线环扎配合石膏固定(B组)13例,男3例,女10例;年龄38~65岁,平均(48.58±8.28)岁;记忆舍金聚髌器固定(C组)25例,男9例,女16例;年龄32~68岁,平均(48

  3. Hip fracture - discharge

    Science.gov (United States)

    Inter-trochanteric fracture repair - discharge; Subtrochanteric fracture repair - discharge; Femoral neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge

  4. Comparing Single Versus Double Screw-Rod Anterior Instrumentation for Treating Thoracolumbar Burst Fractures with Incomplete Neurological Deficit: A Prospective, Randomized Controlled Trial.

    Science.gov (United States)

    Yu, Yu; Wang, Juan; Shao, Gaohai; Wang, Qunbo; Li, Bo

    2016-01-01

    BACKGROUND Following a thoracolumbar burst fracture (TCBF), anterior screw-rods apply pressure upon the graft site. However, there is limited evidence comparing single screw-rod anterior instrumentation (SSRAI) to double screw-rod anterior instrumentation (DSRAI) for TCBFs. Our objective was to compare SSRAI versus DSRAI for TCBFs with incomplete neurological deficit. MATERIAL AND METHODS A total of 51 participants with T11-L2 TCBFs (AO classification: A3) were randomly assigned to receive SSRAI or DSRAI. Key preoperative, perioperative, and postoperative data were collected. Statistical analysis was conducted to determine the independent factors associated with inferior clinical outcomes, as well as the comparative efficacy of SSRAI and DSRAI. RESULTS There were no significant differences in the key demographic and clinical characteristics between the two groups (all p>0.05). Smoking status was significantly associated with inferior three-month and six-month Denis pain scores (Wald statistic=4.246, p=0.039). Both SSRAI and DSRAI were significantly effective in improving three-month and six-month postoperative degree of kyphosis, three-month and six-month postoperative ASIA impairment scale scores, three-month and six-month postoperative Denis pain score, and three-month and six-month postoperative Denis work score (all p0.05), DSRAI displayed significantly longer operating times, as well as significantly larger operative blood losses (both p<0.001). CONCLUSIONS SSRAI may be preferable over DSRAI for TCBFs with incomplete neurological deficit due to its lower operating time and amount of operative blood loss. PMID:27197020

  5. Discriminatory Performance of the Calcaneal Quantitative Ultrasound and Osteoporosis Self-Assessment Tool to Select Older Women for Dual-Energy X-ray Absorptiometry.

    Science.gov (United States)

    McLeod, Katherine M; Johnson, Shanthi; Rasali, Drona; Verma, Ashok

    2015-01-01

    The objective of this cross-sectional study was to evaluate the accuracy of the calcaneal quantitative ultrasound (QUS) and the Osteoporosis Self-Assessment Tool (OST) in identifying older women with osteoporosis as defined by dual-energy X-ray absorptiometry (DXA), and to establish optimal cutoffs to determine risk. We assessed bone mineral density of the femoral neck and lumbar spine using DXA and subsequent calcaneal QUS and OST measurements in 174 women aged 50-80 years. Pearson product correlation coefficients between QUS, OST, and DXA parameters were calculated. Receiver operating characteristic curves were constructed and areas under the curves (AUCs) and optimal thresholds for QUS and OST were defined based on sensitivity, specificity, and likelihood ratio analysis. The ability of calcaneal QUS to identify women with a T-score ≤-2.5 at the femoral neck (AUC = 0.892) consistently outperformed a T-score ≤-2.5 at the lumbar spine (AUC = 0.696) and OST at both the femoral neck and lumbar spine (AUC = 0.706-0.807). Stiffness index cutoff values that fall between 65 and 78 were found to warrant DXA screening, with a cutoff <65 indicating high likelihood of osteoporosis. Further prospective research is needed to examine the gender-related differences of QUS and OST diagnostic performance and their usefulness in clinical practice. PMID:25937306

  6. Usefulness of calcaneal quantitative ultrasound stiffness for the evaluation of bone health in HIV-1-infected subjects: comparison with dual X-ray absorptiometry

    Science.gov (United States)

    Fantauzzi, Alessandra; Floridia, Marco; Ceci, Fabrizio; Cacciatore, Francesco; Vullo, Vincenzo; Mezzaroma, Ivano

    2016-01-01

    Objectives With the development of effective treatments and the resulting increase in life expectancy, bone mineral density (BMD) alteration has emerged as an important comorbidity in human immunodeficiency virus type-1 (HIV-1)-infected individuals. The potential contributors to the pathogenesis of osteopenia/osteoporosis include a higher prevalence of risk factors, combined antiretroviral therapy (cART)-exposure, HIV-1 itself and chronic immune activation/inflammation. Dual-energy X-ray absorptiometry (DXA) is the “gold standard” technique for assessing bone status in HIV-1 population. Methods We conducted a cross-sectional study to investigate bone mineral status in a group of 158 HIV-1-infected subjects. The primary endpoint was the feasibility of calcaneal quantitative ultrasound (QUS) as a screening tool for BMD. All subjects were receiving stable cART and were virologically suppressed (HIV-RNA vitamin D levels ng/mL (P-values: 0.004, 0.016, and 0.015, respectively). Conclusion As an alternative and/or integrative examination to DXA, calcaneal QUS could be proposed as a useful screening in HIV-1-infected patients for assessing bone health impairment. In fact, the results obtained confirm that calcaneal QUS may be useful for monitoring bone status, being a noninvasive and inexpensive technique, especially in those subjects with the classical traditional risk factors for bone damage that were observed earlier in HIV-1 population. PMID:27330330

  7. Segond Fractures

    OpenAIRE

    Arneja, Shalinder S.; Furey, Matthew J.; Alvarez, Christine M.; Reilly, Christopher W.

    2010-01-01

    Initially described following cadaveric studies in the late 19th century by Dr. Paul Segond, the Segond fracture is now widely accepted as a pathognemonic radiographic marker of anterior cruciate ligament injury. This fracture in a skeletally immature 16-year-old was not seen with an anterior cruciate ligament injury, but with a Salter-Harris type IV fracture of the tibial plateau. A nonweightbearing knee immobilizer with the leg in full extension was used for 6 weeks. Recovery was uncomplica...

  8. 长型肱骨近端锁定钢板治疗肱骨近端并肱骨干骨折★%Long proximal humeral locking compression plate treats proximal humerus and humeral shaft fractures

    Institute of Scientific and Technical Information of China (English)

    吴旭; 黄强; 蔡丰; 郭震; 姚勐炜; 杨安礼; 刘亮

    2013-01-01

    BACKGROUND:The domestic and international literatures have confirmed that the internal fixation of long proximal humeral locking compression plate has satisfactory effect on the treatment of proximal humerus fractures. OBJECTIVE:To investigate the clinical effect of internal fixation of long proximal humeral locking compression plate on the treatment of proximal humerus and humeral shaft fractures. METHODS:Sixteen cases with the proximal humerus and humeral shaft fractures were treated with long proximal humeral locking compression plate internal fixation, including seven males and nine females, aged 45-83 years old (average 71 years old). According to the Neer classification of proximal humerus, five cases had two parts of fracture, eight cases had three parts of fracture, and three cases had four parts of fracture;and according the AO classification of humeral shaft, five cases were classified as A1, six cases as B1, two cases as B2, two cases as C1 and one case as C3. Postoperatively, Constant-Murley scoring system was employed to evaluate the function of shoulder joint, and then the percentage was calculated for the corresponding evaluation. Modified Hospital for Special Surgery scoring system was adopted to evaluate the function of elbow joint. RESULTS AND CONCLUSION:Al cases were fol owed-up for 12-24 months (average 14.9 months), and al the cases had bone union in 8-17 weeks (average 12.1 weeks) after operation. Postoperatively, two cases suffered from fat liquoring, but healed after dressing. One case had the symptoms of radial nerve paralysis, one case had subacromial impingement syndrome and improved after treatment. No complications such as screw loosening, screw cut out or humeral head ischemic necrosis were observed. After treated for 12 months, the Constant-Murley score on fracture side was 76.87 in average (ranged 65-90), which was 83.41%in average (ranged 71.4%-93.8%) to the normal side, the clinical outcomes on shoulder were excel ent or good in

  9. Tendon entrapments and dislocations in ankle and hindfoot fractures: evaluation with multidetector computed tomography.

    Science.gov (United States)

    Ballard, David H; Campbell, Kevin J; Blanton, Lee E; Williams, Jason T; Sangster, Guillermo; Hollister, Anne M; Simoncini, Alberto A

    2016-08-01

    The purpose of this study was to assess the incidence of tendon entrapments and tendon dislocations associated with ankle and hindfoot fractures in patients studied by multidetector computed tomography (MDCT). Additionally, we describe particular tendon injuries associated with specific fractures. This was a retrospective review of all individuals with a trauma-protocol CT for suspected ankle and/or hindfoot fractures during a consecutive 41-month time period at a single Level I Trauma Center. Each patient's images were evaluated by two radiologists and an orthopedic surgeon for tendon entrapment, tendon dislocation, and bone(s) fractured or dislocated. There were 398 patients with ankle and/or hindfoot fractures that showed tendon entrapment or dislocation in 64 (16.1 %) patients. There were 30 (46.9 %) patients with 40 tendon entrapments, 31 (48.4 %) patients with 59 tendon dislocations, and three (4.7 %) patients with both tendon entrapment and dislocation. All patients with tendon entrapments were seen with either pilon fractures and/or a combination of posterior, medial, or lateral malleolar fractures. The most frequently entrapped tendon was the posterior tibialis tendon (PTT) in 27 patients (27/30, 90.0 %). The peroneal tendons were the most frequently dislocated, representing 27 (87.1 %) of patients with tendon dislocation; all resulted from a talar or calcaneal fracture or subluxation. This study demonstrates that tendon entrapments and tendon dislocations are commonly seen in complex fractures of the ankle and hindfoot. Pilon fractures were associated with the majority of tendon entrapments, whereas calcaneus fractures were associated with the majority of tendon dislocations. PMID:27234977

  10. Bilateral Occipital Condyle Fracture: Report of Two Cases

    OpenAIRE

    Schrödel, Markus H.; Kestlmeier, Ralph; Trappe, Anna E.

    2002-01-01

    Occipital condyle fractures are a rare finding in trauma victims. Bilateral fractures are even more unusual and have typically been reported in autopsy studies. We treated two patients with bilateral occipital condyle fractures who had only minor symptoms. Anderson and Montesano's classification,1 possible cranial nerve palsies, diagnosis, and treatment of this rare fracture are discussed.

  11. Open fracture of tibia and fibula comminuted fracture treated with interlocking intramedullary nail fixation for 68 cases with peri operation period nursing%开放性胫腓骨多节段粉碎性骨折行带锁髓内钉固定术68例围手术期护理

    Institute of Scientific and Technical Information of China (English)

    顾明莉

    2013-01-01

    目的:探讨带锁髓内钉固定术治疗开放性胫腓骨多节段粉碎性骨折患者的围手术期护理方法。方法:对68例开放性胫腓骨多节段粉碎性骨折患者行带锁髓内钉固定术,术前做好体位护理,术后注意观察患肢情况,指导患者进行早期功能锻炼。结果:本组住院9—31d,平均(25.0±2.3) d。术后随访6—13个月,平均(10.0±1.8)个月,所有患者骨折均骨性愈合,优良率为94.12%,无一例并发症发生。结论:带锁髓内钉固定术是治疗开放性胫腓骨多节段粉碎性骨折的有效方法,个体化护理是胫腓骨功能恢复的必要条件。%Objective:Explore the interlocking intramedullary nail fixation for the treatment of open tibial multi-segment comminuted fracture operation period nursing method.Method:In 68 cases of open tibial multi-segment comminuted fracture treated with interlocking intramedullary nail fixation, preoperative fully prepared.,surgery with intraoperative well,after close observation of patient's condition, Postoperative observation of limb case, guide patients the early functional exercise.Results:This group in hospital 9--31d,average(25.0±2.3)d. Postoperative follow-up 6--13 months,average (10.0±18)months,All fractures healed,There is no case of complications.Conclusions:Interlocking intramedullary nail fixation is the treatment of open tibia and fibula comminuted fracture effective method, Individual nursing care is the functional recovery of the necessary conditions of tibia and fibula.

  12. Percutaneous Vertebroplasty for Osteoporotic Compression Fracture: Multivariate Study of Predictors of New Vertebral Body Fracture

    International Nuclear Information System (INIS)

    Purpose. To investigate the risk factors and relative risk of new compression fractures following vertebroplasty. Methods. Initially, we enrolled 104 consecutive patients with vertebral compression fractures caused by osteoporosis. A total of 83 of the 104 patients visited our hospital for follow-up examinations for more than 4 weeks after vertebroplasty. Logistic regression analysis of the data obtained from these 83 patients was used to determine relative risks of recurrent compression fractures, using 13 different factors. Results. We identified 59 new fractures in 30 of the 83 patients: 41 new fractures in vertebrae adjacent to treated vertebrae; and 18 new fractures in vertebrae not adjacent to treated vertebrae. New fractures occurred in vertebrae adjacent to treated vertebrae significantly more frequently than in vertebrae not adjacent to treated vertebrae. Only cement leakage into the disk was a significant predictor of new vertebral body fracture after vertebroplasty (odds ratio = 4.633). None of the following covariates were associated with increased risk of new fracture: age, gender, bone mineral density, the number of vertebroplasty procedures, the number of vertebrae treated per procedure, the cumulative number of vertebrae treated, the presence of a single untreated vertebra between treated vertebrae, the presence of multiple untreated vertebrae between treated vertebrae, the amount of bone cement injected per procedure, the cumulative amount of bone cement injected, cement leakage into the soft tissue around the vertebra, and cement leakage into the vein

  13. Alternative analyses for handling incomplete follow-up in the intention-to-treat analysis: the randomized controlled trial of balloon kyphoplasty versus non-surgical care for vertebral compression fracture (FREE

    Directory of Open Access Journals (Sweden)

    Ranstam Jonas

    2012-03-01

    Full Text Available Abstract Background Clinical trial participants may be temporarily absent or withdraw from trials, leading to missing data. In intention-to-treat (ITT analyses, several approaches are used for handling the missing information - complete case (CC analysis, mixed-effects model (MM analysis, last observation carried forward (LOCF and multiple imputation (MI. This report discusses the consequences of applying the CC, LOCF and MI for the ITT analysis of published data (analysed using the MM method from the Fracture Reduction Evaluation (FREE trial. Methods The FREE trial was a randomised, non-blinded study comparing balloon kyphoplasty with non-surgical care for the treatment of patients with acute painful vertebral fractures. Patients were randomised to treatment (1:1 ratio, and stratified for gender, fracture aetiology, use of bisphosphonates and use of systemic steroids at the time of enrolment. Six outcome measures - Short-form 36 physical component summary (SF-36 PCS scale, EuroQol 5-Dimension Questionnaire (EQ-5D, Roland-Morris Disability (RMD score, back pain, number of days with restricted activity in last 2 weeks, and number of days in bed in last 2 weeks - were analysed using four methods for dealing with missing data: CC, LOCF, MM and MI analyses. Results There were no missing data in baseline covariates values, and only a few missing baseline values in outcome variables. The overall missing-response level increased during follow-up (1 month: 14.5%; 24 months: 28%, corresponding to a mean of 19% missing data during the entire period. Overall patterns of missing response across time were similar for each treatment group. Almost half of all randomised patients were not available for a CC analysis, a maximum of 4% were not included in the LOCF analysis, and all randomised patients were included in the MM and MI analyses. Improved estimates of treatment effect were observed with LOCF, MM and MI compared with CC; only MM provided improved

  14. Tibial shaft fracture

    DEFF Research Database (Denmark)

    Larsen, Peter

    The overall purpose of the present PhD thesis was to provide up-to-date information of the epidemiology of tibial shaft fractures and to investigate the development in quality of life, pain and functional outcomes from surgery and onwards, following a tibial shaft fracture treated with...... intramedullary nailing. Study I reported an incidence of 16.9/100,000/year from a complete population. Study II reported the long-term patient-reported outcomes and showed that approximately 8 years after the fracture patients reported significantly worse outcome for 4 of the 5 KOOS subscales compared to the...... IV also showed a significant worse outcome in 3 of the 5 KOOS subscales compared to a reference population at 12-months follow-up. Moreover, this study showed that increasing difference in muscle strength for knee extension between legs was associated with a decreasing QOL. The results of this thesis...

  15. Fracture Mechanics

    CERN Document Server

    Zehnder, Alan T

    2012-01-01

    Fracture mechanics is a vast and growing field. This book develops the basic elements needed for both fracture research and engineering practice. The emphasis is on continuum mechanics models for energy flows and crack-tip stress- and deformation fields in elastic and elastic-plastic materials. In addition to a brief discussion of computational fracture methods, the text includes practical sections on fracture criteria, fracture toughness testing, and methods for measuring stress intensity factors and energy release rates. Class-tested at Cornell, this book is designed for students, researchers and practitioners interested in understanding and contributing to a diverse and vital field of knowledge. Alan Zehnder joined the faculty at Cornell University in 1988. Since then he has served in a number of leadership roles including Chair of the Department of Theoretical and Applied Mechanics, and Director of the Sibley School of Mechanical and Aerospace Engineering.  He teaches applied mechanics and his research t...

  16. Stress fractures of the olecranon in javelin throwers.

    Science.gov (United States)

    Hulkko, A; Orava, S; Nikula, P

    1986-08-01

    Between the years 1977 and 1984, four javelin throwers with a stress fracture of the olecranon were seen and treated. In one patient, acute painful dislocation of the fracture occurred during a competitive throw. Two patients had stress fracture of the tip. The fracture treated conservatively healed in 18 months. The patient treated by excision of the tip was able to throw after 2 months. Two patients had slightly oblique, more distally located stress fractures, which were treated with a tension band and 2 Kirschner wires. The fractures healed in 4 months. One of the patients had a refracture 11 months after the primary operation. It was successfully treated with a compression screw and two bone pegs. Because of the high risk of delayed union and nonunion, stress fractures of the olecranon should be treated operatively in javelin throwers. PMID:3759300

  17. Fracturing rigid materials.

    Science.gov (United States)

    Bao, Zhaosheng; Hong, Jeong-Mo; Teran, Joseph; Fedkiw, Ronald

    2007-01-01

    We propose a novel approach to fracturing (and denting) brittle materials. To avoid the computational burden imposed by the stringent time step restrictions of explicit methods or with solving nonlinear systems of equations for implicit methods, we treat the material as a fully rigid body in the limit of infinite stiffness. In addition to a triangulated surface mesh and level set volume for collisions, each rigid body is outfitted with a tetrahedral mesh upon which finite element analysis can be carried out to provide a stress map for fracture criteria. We demonstrate that the commonly used stress criteria can lead to arbitrary fracture (especially for stiff materials) and instead propose the notion of a time averaged stress directly into the FEM analysis. When objects fracture, the virtual node algorithm provides new triangle and tetrahedral meshes in a straightforward and robust fashion. Although each new rigid body can be rasterized to obtain a new level set, small shards can be difficult to accurately resolve. Therefore, we propose a novel collision handling technique for treating both rigid bodies and rigid body thin shells represented by only a triangle mesh. PMID:17218752

  18. Fractures of the ankle Fractures of the ankle

    OpenAIRE

    Taser, Omer; Goksan, Alp; Asik, Mehmet

    2004-01-01

    In this study 151 patients who were operated for the ankle fracture between 1980 and 1988 and also 277 patients who were conservatively treated between January 1987 and April 1988 in Orthopaedics and Traumatology Department of Istanbul Medical Faculty were taken into consideration. It has been seen that ankle fractures which comprised a high percent (%1.6) in all patients who applied to our emergency department. We showed that the ratio of patients who had operative treatment had been steadi...

  19. [Recent progress in orthopaedic managements of osteoporosis-related fractures].

    Science.gov (United States)

    Yamamoto, Seizo

    2011-07-01

    Recent progress in orthopaedic treatment of osteoporosis-related fractures was reviewed. In the treatment of femoral neck fractures, impacted or nondisplaced type is treated by three cannulated cancellous pins. Displaced type of femoral neck fracture is treated by bipolar prosthesis. Results of femoral neck fractures are influenced by the complications of each patients. Osteoporotic spine fractures are commonly healed within 2 or 3 months. Spinal compression with paraparesis or paraplegia is unusual complication in burst type of spine fractures. Surgical decompression, bone grafting and stabilization with instrumentation can result in some correction of deformity and neurogenic recovery. Distal radius fractures are common fractures in the eldery. Recently advances includes external fixation and plate fixation for the comminuted fractures in the distal radius. Treatments of osteoporosis-related fractures are still difficult problems to be resolved. PMID:21774371

  20. Hoffa fracture associated with ipsilateral femoral shaft fracture: clinical feature and treatment

    Institute of Scientific and Technical Information of China (English)

    GONG Yu-bao; LI Qing-song; YANG Chen; LI Shu-qiang; LIU Jian-guo; QI Xin

    2011-01-01

    Hoffa fracture associated with ipsilateral femoral shaft fracture is very rare.Three cases of this rare type of injury were retrospectively reviewed.The sites of femoral shaft fractures and Hoffa fractures were documented.All femoral shaft fractures were managed with internal fixation.The rate of misdiagnosis for the Hoffa fractures was documented.Functions of the affected knees were evaluated according to the modified Hospital for Special Surgery (HSS) scores at two years follow-up.Femoral fractures were either transverse or composite in all three cases.Ipsilateral Hoffa fractures occurred at medial condyle in two cases,and lateral condyle in one case.Only one Hoffa fracture was identified preoperatively.All the femoral shaft fractures healed uneventfully.In the patient whose Hoffa fracture was correctly diagnosed,the modified HSS score was 94.In another patient,whose Hoffa fracture was treated by a second operation,the modified HSS score was 93.And in the third case,who refused additional operation for the Hoffa fracture,the modified HSS score was only 70.Conclusively femoral shaft fracture can be associated with ipsilateral Hoffa fracture,especially in motorcycle accident.This type of injury is very rare and misdiagnosis is common.

  1. Tooth fractures in canine clinical practice

    International Nuclear Information System (INIS)

    Tooth fractures constitute a considerable fraction of all tooth diseases. Out of the 5,370 dogs treated during four years, 492 were presented with dental problems and 28.3 % of the latter were treated for tooth fractures. Canines were the most frequently affected teeth (38.8 %), followed by premolars (33.1 %), incisors (25.9 %), and molars (2.2 %), 55.4 % of the patients with canine and incisor fractures being large breed dogs. Fractures of premolars (mostly of 108, 208) were divided evenly irrespective of breed or body size. Nonsurgical endodontic treatment yielded good therapeutic results in most cases, but repeated treatment was necessary in some patients

  2. 后路手术治疗脊柱胸腰段骨折临床疗效观察%Thoracic Lumbar Spine Fractures Treated by Posterior Surgery Clinical Effect Observation

    Institute of Scientific and Technical Information of China (English)

    尹玉龙

    2015-01-01

    Objective To analyze posterior approach to the clinical treatment effect of thoracic lumbar spine fractures. Methods Our hospital between March 2014 ~ March 2015 treated 98 cases of patients with fracture of thoracic lumbar spine as research object, USES the random, it can be divided into observation group and control group (n = 49). Control group patients with anterior surgical procedure for treatment; Observation group were treated by posterior surgical procedure for treatment. To observe the clinical therapeutic effect compared two groups of patients. Results The observation group of patients with postoperative wound edge height ratio before and after the job is better than the control group patients, Cobb Angle to improve the situation, degree of pain were significantly better than the control group patients patients with lighter than the control group, the differences between groups with statistical significance (P < 0.05). At the same time observation group of patients to nursing service satisfaction is better than the control group patients, statisticaly significant difference (P < 0.05).Conclusion The application of posterior approach in patients with thoracic lumbar fracture treatment has good therapeutic effect, relative to the anterior surgical procedure, the treatment of patients with total effective rate higher satisfaction, more beautiful.%目的 分析探讨后路手术对于脊柱胸腰段骨折的临床治疗效果.方法 选择我院2014年3月~2015年3月之间收治的98例脊柱胸腰段骨折患者作为观察对象,采用随机的方式将其分为观察组和对照组各49例.对照组患者使用前路手术方式进行治疗;观察组患者采用后路手术方式进行治疗.观察对比两组患者的临床治疗效果.结果 观察组患者术后的伤椎前后缘高度比值优于对照组患者、Cobb角度改善情况优于对照组患者、疼痛程度要显著轻于对照组患者,组间的差异具有统计学意义(P < 0.05).同

  3. Urinary cadmium excretion is correlated with calcaneal bone mass i Japanese women living in an urban area

    International Nuclear Information System (INIS)

    Nine hundred eight women aged 40-88 years living in a non-Cd-polluted area in Japan were analyzed for urinary cadmium (Cd) N-acetyl-β-D-glucosaminidase (NAG) activity, β2-microglobuli (B2MG) concentration, and for the stiffness index (STIFF) of calcaneal bone using an ultrasound method. The urinary Cd in the subjects, with a mean an range of 2.87 and 0.25-11.4 μg/g creatinine, respectively, showed significant correlation with NAG but not with B2MG. STIFF was significantly inversely correlated with urinary Cd, and the association remaine significant after adjusting for age, body weight, and menstrual status suggesting a significant effect of Cd on the bone loss in these subject without signs of Cd-induced kidney damage. A two-fold increase in urinary C was accompanied by a decrease in STIFF corresponding to a 1.7-year rise in age. These results emphasize the need for reassessment of the significance of Cd exposure in the general Japanese population

  4. Subtalar Joint Distraction Arthrodesis to Correct Calcaneal Valgus in Pediatric Patients with Tarsal Coalition: A Case Series.

    Science.gov (United States)

    Schwartz, Jaclyn M; Kihm, Carl A; Camasta, Craig A

    2015-01-01

    Subtalar joint middle facet coalitions commonly present in children who have a painful, rigid, pes planovalgus foot type. The middle facet coalition allows rearfoot forces to be distributed medially through the coalition, and this can result in arthritis or lateral tarsal wedging. The senior author has used a wedged bone graft distraction subtalar joint arthrodesis to correct calcaneal valgus and restore the talar height in these patients. The tight, press-fit nature of the tricortical iliac crest allograft provides stability and can negate the need for internal fixation. We retrospectively reviewed 9 pediatric subtalar joint distraction arthrodesis procedures performed on 8 patients during a 6-year period. All patients began weightbearing at 6 weeks after surgery. All patients had osseous union, and no complications developed that required a second surgery. The clinical outcomes, assessed at a mean of 25.5 (range, 6.3 to 75.8) months postoperatively, were satisfactory. The mean American Orthopaedic Foot and Ankle Society score was 90.1 (range, 79 to 94), on a 94-point scale. The wedged distraction arthrodesis technique has not been previously described for correction of pediatric patients with lateral tarsal wedging, but it is an effective option and yields successful outcomes. PMID:25704449

  5. Fraturas odontomaxilares e mandibulares em eqüídeos tratados por diferentes técnicas de osteossíntese Odontomaxillares and mandibularies fractures in equides treated with different osteosynthesis techniques

    Directory of Open Access Journals (Sweden)

    G.E.S. Alves

    2008-12-01

    Full Text Available Oito eqüinos e um muar com fraturas odontomaxilares e mandibulares foram tratados com diferentes técnicas de osteossíntese modificadas, consistindo de cerclagens associadas ou não a bandas de tensão, placa de neutralização e pino intraosseo, sendo este aplicado com metodologia não encontrada na literatura consultada. Os procedimentos cirúrgicos nos eqüideos foram realizados com os animais em estação mediante contenção física, em brete, e química, com sedação ou neuroleptoanalgesia associada a bloqueios anestésicos regionais. Os animais apresentaram capacidade de mastigação e ingestão voluntária no pós-operatório imediato e recuperação óssea adequada.Eight equines and one mule with odontomaxillaries and mandibularies fractures were treated with different osteosynthesis modified techniques, consisting of cerclages with or without tension bands, neutralization plates, and intraosseous pin applied by a methodology which was not found in the literature. The surgery procedures in equides were performed with the animals in stand position under physical contention, sedation, or neuroleptoanalgesy and regional nerve block. All animals were able to eat voluntarily in the immediate post-operatory time and had good bone recuperation.

  6. Distribution and natural history of stress fractures in U.S. Marine recruits

    International Nuclear Information System (INIS)

    In a prospective study of stress injuries of the lower extremities of U.S. Marine recruits, researchers derived a frequency distribution of stress fractures. The most frequently fractured bone was the tibia (73%), while the single most common site was the posterior calcaneal tuberosity (21%). The natural history of stress fractures by scintigraphy and radiography has been outlined, showing the evolutionary changes on either study as a universal progression independent of injury site or type of stress. An identical spectrum of changes should be present within any group undergoing intense new exercise. The frequency distribution of stress fractures should be a function of differing forms and intensities of exercise, therefore, our figures should not be applied to other groups. Researchers used the presence of a scintigraphic abnormality at a symptomatic site as the criterion for diagnosis of stress fracture. Since the distribution of skeletal radiotracer uptake is directly dependent on local metabolic activity, it is expected that a focal alteration in bone metabolism will result in a scintigram approaching 100% sensitivity for the abnormality (9). In the proper clinical setting, the specificity should approximate this figure; however, a focal, nonstress-related bone abnormality which has not manifested any radiographic change, such as early osteomyelitis, could result in a false-positive examination. Specificity cannot, therefore, be accurately determined without an actual determination of the pathologic changes within the bone, necessarily involving biopsy

  7. Stress fractures

    International Nuclear Information System (INIS)

    The diagnosis of a stress fracture should be considered in patients presented with pain after a change in activity, especially if the activity is strenuous and the pain is in the lower extremities. Since evidence of the stress fracture may not be apparent for weeks on routine radiographs, proper use of other imaging techniques will allow an earlier diagnosis. Prompt diagnosis is especially important in the femur, where displacement may occur

  8. Toddler's fracture.

    OpenAIRE

    Shravat, B P; Harrop, S N; Kane, T P

    1996-01-01

    "Toddler's fracture" can be difficult to diagnose but should be suspected whenever a child presents to the accident and emergency department with a limp or fails to bear weight on the leg. Irritable hip and subacute osteomyelitis must feature in the differential diagnosis. The history may or may not include an obvious traumatic episode. Rather than fracture, elastic bowing of the bone and consequent periosteal stripping may explain symptoms in some cases.

  9. Open reduction internal fixation of lateral humeral condyle fractures in children. A series of 105 fractures from a single institution

    OpenAIRE

    Leonidou, Andreas; Chettiar, Krissen; Graham, Simon; Akhbari, Pouya; Antonis, Konstantinos; Tsiridis, Eleftherios; Leonidou, Omiros

    2014-01-01

    Lateral humeral condyle fractures account for 17 % of the distal humeral condyle fractures. Displaced and/or rotated fractures require appropriate reduction and stabilisation. There are, however, a number of controversies in the surgical management of these patients. The aim of the present study was to review the results of patients with a displaced lateral humeral condyle fracture treated with open reduction and internal fixation (ORIF). We retrospectively reviewed children treated with ORIF...

  10. Management of distal humerus fractures.

    Science.gov (United States)

    McCarty, L Pearce; Ring, David; Jupiter, Jesse B

    2005-09-01

    Fractures of the distal humerus are complex injuries that can be effectively treated with open reduction and internal fixation (ORiF). Exposure of a complex intra-articular fracture may best be achieved through a posterior approach with osteotomy of the olecranon process. The ulnar nerve must be identified and protected, the articular surface must be reduced anatomically, and rigid fixation must be applied to both the medial and lateral columns of the distal humerus. Range of motion should be initiated as soon as possible postoperatively. Complications such as ulnar neuropathy, elbow stiffness, heterotopic ossification, and nonunion should be treated aggressively. Total elbow arthroplasty represents an effective option for fractures that cannot be treated with ORIF. PMID:16250484

  11. 碳素棒外固定支架治疗跟骨开放性骨折的疗效观察%Treatment of open fracture of the calcaneum with a new external fixation

    Institute of Scientific and Technical Information of China (English)

    丁亮; 薛锋; 肖海军; 何志敏; 张东

    2013-01-01

    目的 探讨外支架治疗跟骨开放性骨折的技术方法和治疗效果.方法 2005年3月~2011年12月,对24例跟骨开放性骨折,经急诊清创后实施外固定支架治疗,骨折按按Sanders分型,Ⅱ型12例,Ⅲ型9例,Ⅳ型3例.软组织损伤按Gustilo分类:Ⅰ型12例,Ⅱ型10例,ⅢA型2例.结果 随访5~26个月(平均13.1月),按Maryland足部评分系统评价手术效果,优8例,占33.3%,良12例,占50.0%,可4例,占16.7%,优良率为83.3%.后关节面、B(o)hler角及Gissane角均得到良好的恢复.结论 采用外固定支架治疗跟骨开放性骨折,手术效果良好,且便于软组织损伤的处理,是一种效果理想的治疗方法.%OBJECTIVE To investigate the operative treatment of open fractures of the calcaneus by using a new external fixation.METHODS We have treated 19 displaced intra-articular calcaneal fractures (Sanders type Ⅱ 12,Ⅲ 9,Ⅳ 3).Soft tissue injury according to Gustilo classification:12 cases of type Ⅰ,10 cases of type Ⅱ,2 cases of ⅢA.The patients were treated by reduction and a new external fixation.RESULTS After an average follow-up of 13.1 months (range,5 to 26 months),no complications were found.and all had acceptable reduction.Based on the Maryland grading system,8 feet were excellent,12 good and 4 fair.CONCLUSION The new external fixation approach is a good option for management of open calcaneus fractures.It is simple and effective and easy to deal with soft tissue injury.

  12. Hexapod External Fixation of Tibia Fractures in Children.

    Science.gov (United States)

    Iobst, Christopher A

    2016-06-01

    Most tibia fractures in children can be treated nonoperatively. For fractures that do require surgery, however, the most common methods of management include plating or flexible nail insertion. Some fracture patterns, such as periphyseal fractures, fractures with bone and/or soft tissue loss, or fractures with delayed presentation, are not easily amenable to these techniques. Hexapod external fixators are especially helpful in these difficult cases. The purpose of this review is to discuss the principles of performing hexapod circular external fixation applied to pediatric tibia fractures. Some of the additional capabilities of the hexapod external fixator will also be highlighted. PMID:27078228

  13. Association between vitamin D status and serum parathyroid hormone concentration and calcaneal stiffness in Japanese adolescents: sex differences in susceptibility to vitamin D deficiency.

    Science.gov (United States)

    Tsugawa, Naoko; Uenishi, Kazuhiro; Ishida, Hiromi; Ozaki, Reo; Takase, Tomoki; Minekami, Takuya; Uchino, Yuri; Kamao, Maya; Okano, Toshio

    2016-07-01

    There is currently insufficient information on serum 25-hydroxyvitamin D (25OHD) and parathyroid hormone (PTH) concentrations, and bone mineral status in healthy adolescents to allow reference values to be set. This study aimed to provide comparable data on vitamin D status in Japanese adolescents and to assess sex differences in susceptibility to vitamin D insufficiency. Serum 25OHD and PTH concentrations were measured in 1,380 healthy adolescents (aged 12-18 years). Subjects completed a questionnaire on exercise history, diet, and lifestyle factors. Calcaneal stiffness was evaluated by quantitative ultrasound. Serum 25OHD concentrations in boys and girls were 60.8 ± 18.3 and 52.8 ± 17.0 nmol/L, respectively. Approximately 30 % of boys and 47 % of girls had suboptimal 25OHD concentrations (<50 nmol/L). Serum PTH concentration was negatively correlated with serum 25OHD concentration in boys, but negatively correlated with calcium intake rather than serum 25OHD in girls. In contrast, the increment in calcaneal stiffness as a result of elevation of serum 25OHD was higher in girls than in boys. As vitamin D deficiency is common in Japanese adolescents, it was estimated that intakes of ≥12 and ≥14 μg/day vitamin D would be required to reach 25OHD concentrations of 50 nmol/L in boys and girls, respectively. Moreover, the results of the present study indicate that vitamin D deficiency has a greater association with calcaneal stiffness in girls than in boys. PMID:26260151

  14. Gravity-Driven Hydraulic Fractures

    Science.gov (United States)

    Germanovich, L. N.; Garagash, D.; Murdoch, L. C.; Robinowitz, M.

    2014-12-01

    This study is motived by a new method for disposing of nuclear waste by injecting it as a dense slurry into a hydraulic fracture that grows downward to great enough depth to permanently isolate the waste. Disposing of nuclear waste using gravity-driven hydraulic fractures is mechanically similar to the upward growth of dikes filled with low density magma. A fundamental question in both applications is how the injected fluid controls the propagation dynamics and fracture geometry (depth and breadth) in three dimensions. Analog experiments in gelatin [e.g., Heimpel and Olson, 1994; Taisne and Tait, 2009] show that fracture breadth (the short horizontal dimension) remains nearly stationary when the process in the fracture "head" (where breadth is controlled) is dominated by solid toughness, whereas viscous fluid dissipation is dominant in the fracture tail. We model propagation of the resulting gravity-driven (buoyant or sinking), finger-like fracture of stationary breadth with slowly varying opening along the crack length. The elastic response to fluid loading in a horizontal cross-section is local and can be treated similar to the classical Perkins-Kern-Nordgren (PKN) model of hydraulic fracturing. The propagation condition for a finger-like crack is based on balancing the global energy release rate due to a unit crack extension with the rock fracture toughness. It allows us to relate the net fluid pressure at the tip to the fracture breadth and rock toughness. Unlike the PKN fracture, where breadth is known a priori, the final breadth of a finger-like fracture is a result of processes in the fracture head. Because the head is much more open than the tail, viscous pressure drop in the head can be neglected leading to a 3D analog of Weertman's hydrostatic pulse. This requires relaxing the local elasticity assumption of the PKN model in the fracture head. As a result, we resolve the breadth, and then match the viscosity-dominated tail with the 3-D, toughness

  15. Presence of a long accessory flexor tendon of the toes in surgical treatment for tendinopathy of the insertion of the calcaneal tendon: case report

    Directory of Open Access Journals (Sweden)

    Nelson Pelozo Gomes Júnior

    2016-02-01

    Full Text Available ABSTRACT The presence of accessory tendons in the foot and ankle needs to be recognized, given that depending on their location, they may cause disorders relating either to pain processes or to handling of the surgical findings. We describe the presence of an accessory flexor tendon of the toes, seen in surgical exposure for transferring the long flexor tendon of the hallux to the calcaneus, due to the presence of a disorder of tendinopathy of the insertion of the calcaneal tendon in association with Haglund's syndrome.

  16. Presence of a long accessory flexor tendon of the toes in surgical treatment for tendinopathy of the insertion of the calcaneal tendon: case report☆

    Science.gov (United States)

    Gomes Júnior, Nelson Pelozo; Andreoli, Carlos Vicente; Pochini, Alberto de Castro; Raduan, Fernando Cipolini; Ejnisman, Benno; Cohen, Moisés

    2015-01-01

    The presence of accessory tendons in the foot and ankle needs to be recognized, given that depending on their location, they may cause disorders relating either to pain processes or to handling of the surgical findings. We describe the presence of an accessory flexor tendon of the toes, seen in surgical exposure for transferring the long flexor tendon of the hallux to the calcaneus, due to the presence of a disorder of tendinopathy of the insertion of the calcaneal tendon in association with Haglund's syndrome. PMID:26962495

  17. Elastic intramedullary nail for treatment of extremity fractures in children

    Institute of Scientific and Technical Information of China (English)

    MA Hong-ru; MA Shu-lin; ZHANG Wen-lu; YANG Jin-chang; CUI Hou-xuan

    2008-01-01

    Objective: To assess the clinical therapeutic effects of elastic intramedullary nail on extremity fractures in children. Methods: From June 2005 to March 2008, 40 children with extremity fractures were treated by elastic intramedullary nail, in whom femoral shaft fractures occurred in 26 cases, tibiofibular fractures in 8 cases, radial capitular fractures in 4 cases, ulnoradial fractures in 2 cases. All patients were treated by closed reduction and elastic intramedullary nail fixation. Results: All the fractures gained satisfactory reduc-tion and healing. The average duration needed for fracture healing was 1-2 months. Postoperative follow-up confirmed a sound functional recovery. Conclusions: The elastic intramedullary nail is a minimally invasive and effective surgical approach for treatment of extremity fractures in children. It allows early functional exercises after operation and secures a satisfactory bone union and functional recovery.

  18. Arthroscopy assisted management of tibia plateau fractures

    OpenAIRE

    Cetik, Ozgur; Asik, Mehmet; Sozen, Yunus V.; Taser, Omer F.; Cetinkaya, Sarper M.

    2004-01-01

    We report our experience with the arthroscopy management of tibial plateau fractures. Twenty eight closed tibial plateau fractures in twenty seven patients were treated with arthroscopy assisted reduction between January 1993 and December 1997. The mean follow-up period was 25 months (range 6 months to 55 months). Schatzker classification system was used for evaluation and classification of the fractures patterns. The plateau depression has been reconstructed with elevation through a window...

  19. Fractures of distal radius: an overview.

    Science.gov (United States)

    Meena, Sanjay; Sharma, Pankaj; Sambharia, Abhishek Kumar; Dawar, Ashok

    2014-01-01

    Fractures of distal radius account for up to 20% of all fractures treated in emergency department. Initial assessment includes a history of mechanism of injury, associated injury and appropriate radiological evaluation. Treatment options include conservative management, internal fixation with pins, bridging and non-bridging external fixation, dorsal or volar plating with/without arthroscopy assistance. However, many questions regarding these fractures remain unanswered and good prospective randomized trials are needed. PMID:25657938

  20. Epidemiology of tibial shaft fractures

    Directory of Open Access Journals (Sweden)

    Grecco Marco Aurélio Sertório

    2002-01-01

    Full Text Available In this work an epidemiological analysis on tibial shaft fractures was performed. During four years, our service treated 179 fractures, 132 in male, 47 in female, aged 14 to 83 years. The 21 to 30-year-old patiens were the more injured. Of these, 120 were open and 59 close fractures of which prevailing cause was road traffic accident. The study based on patients promptuaries analyses and radiographs. The fractures occurred 97 times in the middle third (54.18%; 102 times (56.98% presented simple fragments, and 57 (31.38% oblique lines. We treated close and open fractures, respectively, 48 and 38 cases with plaster cast immobilization; 3 and 67 with external fixation after plaster cast immobilization; 5 and 12 with osteosynthesis by means of plate and screws, and 2 and 3 with external fixation only. In both close and open fractures, respectively, 7 and 20 cases of pseudarthrosis and 1 and 11 of infections have occurred. With the data obtained we verified an actual validity of the epidemiological studies as a contribution for better identifying lesions features and their treatment and complications. This allows proceedings and apprenticeship refinement.

  1. The X-ray attenuation characteristics and density of human calcaneal marrow do not change significantly during adulthood

    Science.gov (United States)

    Les, C. M.; Whalen, R. T.; Beaupre, G. S.; Yan, C. H.; Cleek, T. M.; Wills, J. S.

    2002-01-01

    Changes in the material characteristics of bone marrow with aging can be a significant source of error in measurements of bone density when using X-ray and ultrasound imaging modalities. In the context of computed tomography, dual-energy computed techniques have been used to correct for changes in marrow composition. However, dual-energy quantitative computed tomography (DE-QCT) protocols, while increasing the accuracy of the measurement, reduce the precision and increase the radiation dose to the patient in comparison to single-energy quantitative computed tomography (SE-QCT) protocols. If the attenuation properties of the marrow for a particular bone can be shown to be relatively constant with age, it should be possible to use single-energy techniques without experiencing errors caused by unknown marrow composition. Marrow was extracted by centrifugation from 10 mm thick frontal sections of 34 adult cadaver calcanei (28 males, 6 females, ages 17-65 years). The density and energy-dependent linear X-ray attenuation coefficient of each marrow sample were determined. For purposes of comparing our results, we then computed an effective CT number at two GE CT/i scan voltages (80 and 120 kVp) for each specimen. The coefficients of variation for the density, CT number at 80 kVp and CT number at 120 kVp were each less than 1%, and the parameters did not change significantly with age (p > 0.2, r2 0.8 where the minimum acceptable r2 = 0.216). We could demonstrate no significant gender-associated differences in these relationships. These data suggest that calcaneal bone marrow X-ray attenuation properties and marrow density are essentially constant from the third through sixth decades of life.

  2. Incomplete linear tibial fractures in two horses

    International Nuclear Information System (INIS)

    Incomplete linear tibial fractures were identified in two horses with the aid of scintigraphy. Both horses were treated successfully by strict stall confinement, and both returned to normal athletic activity. Scintigraphy can be used to facilitate the generally difficult diagnosis of incomplete tibial fractures

  3. Triplane fracture of the distal radius

    OpenAIRE

    Christopher Pearce; Raymond Chung

    2011-01-01

    We report the case of a 14-year-old boy who sustained a displaced triplane fracture of the distal radius. This was treated with closed reduction and application of a cast with good clinical and radiological results. We discuss (for the first time) the reasons for the rarity of this fracture at the distal radius compared to the distal tibia.

  4. Discrete fracture modelling for the Stripa site characterization and validation drift inflow predictions

    International Nuclear Information System (INIS)

    Groundwater flow through three-dimensional networks of discrete fractures was modeled to predict the flux into a fifty meter long drift, as part of the site characterization and validation project conducted during phase 3 of the Stripa project. Predictions were made on the basis of a site scale discrete fracture conceptual model developed by synthesis of geological, geophysical, and hydrological site characterization data. Individual fractures were treated as stochastic features, described by probability distributions of geometric and hydrologic properties. Fractures were divided into three populations: Fractures within fracture zones near the drift, non-fracture zone fractures near the drift, and fractures in fracture zones over 20 meters from the drift. Fractures outside fracture zones are not modelled beyond 20 meters from the drift. Both data analysis and flow predictions were produced using the FracMan discrete fracture modelling package. Probabilistic flow predictions were produced in seven formats specified by the Stripa task force on fracture flow modelling. (au)

  5. Fracture source

    Directory of Open Access Journals (Sweden)

    2003-07-01

    Full Text Available The fracture properties of many different types of fibers are covered in a timely new book that will prove to be a tremendous source of information and references for researchers in the wide and diverse field of fibers and composites, says Bill Clegg.

  6. 应用T型接骨板治疗以内踝后丘为主的pilon骨折%Applying T-shaped plate to treat pilon fracture combined with posterior colliculus of medial malleolus and posterior malleolus injuries

    Institute of Scientific and Technical Information of China (English)

    王秀会; 王喆

    2014-01-01

    Background: In pilon fracture of malleolus, posterior colliculus of medial malleolus is mostly interfered, and bone shards are extremely unstable. Postoperative displacement is often found after plaster fixation or cannulated scew fixation. Objective:To explore the clinical effect of T-shaped plate in the treatment of pilon fracture combined with posterior collicu-lus of medial malleolous and posterior malleolus injuries. Methods:From January 2009 to December 2013, 17 patients with pilon fracture combined with posterior colliculus of medi-al malleolous and posterior malleolus injuries underwent surgical treatment by implanting T-shaped locking plates through bilateral malleolus approaches. There were 8 males and 9 females with a mean age of 52.3 years (range, 28-67 years). Of them, 11 cases were treated within 6 h after trauma and 6 cases in 4d after trauma. American Orthopaedic Foot and Ankle Society Ankle-Hindfoot (AOFAS-AH) score was used to evaluate functions of ankle after operation. Results:All the 17 patients were followed-up for 14 months on average (range, 3-24 months). All incisions were normally-healed. The injured bone began to be healed from 6-10 weeks postopeartively by X-ray. The mean AOFAS-AH score was 92.6 points one year after surgery. Conclusions:The internal fixation with T-shaped plate can effectively prevent from the re-displacement of medial malleolus posterior colliculus in the treatment of pilon fracture combined with posterior malleolus injuries, which shows the stress-shielding reaction and definitely reduces the risk of traumatic arthritis.%背景:在踝关节pilon骨折中,波及踝内后丘骨折块的较多见,而且骨块极不稳定。以往使用非手术石膏固定或者空心钉固定的病例易发生后期移位。目的:探讨T型接骨板在治疗以内后踝骨折为主要损伤的pilon骨折的临床效果。方法:2009年1月至2013年12月,采用T型锁定接骨板治疗合并内踝

  7. Management of Typical and Atypical Hangman's Fractures

    Science.gov (United States)

    Al-Mahfoudh, Rafid; Beagrie, Christopher; Woolley, Ele; Zakaria, Rasheed; Radon, Mark; Clark, Simon; Pillay, Robin; Wilby, Martin

    2015-01-01

    Study Design Retrospective study of a prospectively maintained database. Objective Our aim was to retrospectively review management and outcomes of patients with low-grade hangman's fractures, specifically looking at differences in outcomes between collars and halo immobilization. We also studied fracture patterns and their treatment outcomes. Methods Forty-one patients with hangman's fractures were identified from 105 patients with axis fractures between 2007 and 2013. Typical hangman's fractures were defined as traumatic spondylolisthesis of the axis causing a bilateral pars interarticularis fracture. Fractures involving the posterior cortex of C2 on one or both sides or an asymmetrical pattern were defined as atypical. Results There were 41 patients with a mean age of 59 years, with 13 (31.7%) typical and 28 (68.2%) atypical fractures. There were 22 (53.6%) type 1 fractures, 7 (41.4%) type 2 fractures, and 2 (4.9%) type 2a fractures in this series. Cervical collars were used to manage 11 patients (27% of all patients with hangman's fractures) and halo orthosis was used in 27 (65.8%). Three (7.3%) patients underwent surgical fixation of the fracture. Bony union was achieved in all patients on radiologic follow-up. Permanent neurologic deficit occurred in one patient due to associated injuries. Neck pain and stiffness were reported more commonly in the atypical group, but this finding was not statistically significant. Conclusions The majority of hangman type fractures can be treated nonoperatively. We found no difference in outcomes between a rigid collar or halo immobilization for treatment of low-grade fractures. Radiologic follow-up is essential to identify cases of nonunion. PMID:27099816

  8. The influence of microstruture on fracture toughness of vacuum heat treated HSS AISI M2: Vpliv mikrostrukture na lomno žilavost vakuumsko toplotno obdelanega hitroreznega jekla M2:

    OpenAIRE

    Leskovšek, Vojteh; Liščić, Božidar; Ule, Boris

    2001-01-01

    The microstructure of AISI M2 high-speed can be substantially modified by vacuum heat treatment in order to optimize the ratio between hardness and fracture toughness, which is, however, significantly affected by the volume fractions of retained austenite and undissolved eutectic carbides, as well as the mean distance between these carbides. Calculated fracture toughness values, which were obtained using a newly developed semi-empirical equation, based on the stress-modified critical strain c...

  9. Surgical treatment of orbital floor fractures.

    Science.gov (United States)

    Rankow, R M; Mignogna, F V

    1975-01-01

    Ninety patients with orbital floor fractures were treated by the Otolaryngology Service of the Columbia-Presbyterian Medical Center. Of these 90 patients, 58 were classified as coexisting and 32 as isolated. All fractures with clinical symptoms and demonstrable x-ray evidence should be explored. Despite negative findings by routine techniques, laminography may confirm fractures in all clinically suspicious cases. In this series, 100% of the patients explored had definitive fractures. A direct infraorbital approach adequately exposes the floor of the orbit. An effective and cosmetic subtarsal incision was utilized. Implants were employed when the floor could not be anatomically reapproximated or the periorbita was destroyed. PMID:1119982

  10. Nonunion of paediatric talar neck fracture

    Directory of Open Access Journals (Sweden)

    Jindal Nipun

    2014-02-01

    Full Text Available 【Abstract】Fractures of the paediatric talus are infrequent injuries, most complicated by posttraumatic arthrosis and avascular necrosis in the course of treatment. Non- union in children has not been reported before in literature. We report a case of a 12-year-old boy who had a nonunion of Hawkins type II fracture of talar neck. The nonunion was treated surgically with a good clinical outcome. The goals of management in nonunion of paediatric talar neck fracture are different from those in fresh fractures. A suboptimal reduction should be acceptable without trying a radical surgery which may cause further impairment.

  11. Open reduction and internal fixation in treatment of pilon tibial fractures

    OpenAIRE

    Yorgancigil, Ekmel; Baran, Ayhan; Yıldız, Muzaffer; Aksu, Sırrı; Gürbüz, Aydın

    2004-01-01

    Pilon fractures are the most serious fractures among the ankle fractures and generally occur after high energy trauma. The main goalfor the treatment of these fractures is to obtain a good functioned ankle joint as in all intraarticular fractures by achieving anatomicalreduction and fulljoint restoration. We evaluated 26 .cases with 28 pilon fractures hospitalized and treated at our Orthopaedie and Traumatology Clinic at Ministery of Health Kartal Training and Research Hospitalunder the light...

  12. [Dislocated intra-articular calcaneus fractures. Long-term follow-up after open reposition and osteosynthesis].

    Science.gov (United States)

    Funk, E M; Wiedemann, M; Bickel, R; Rüter, A

    1995-10-01

    A series of 98 patients with a total of 105 intra-articular fractures of the os calcis were operated on during a 10-year period between 1983 and 1992. We were able to follow up 60 patients with 64 fractures an average of 44 months (range, 18-105 months) postoperatively. At the time of follow up, 83.9% of patients had been back to work, 78.6% with the same employer as before. Five of the patients followed up had had to retire from work; each of these had one or more severe coexisting injuries. A compromising nerve injury occurred postoperatively in 3 out of 58 patients with closed fractures, in all cases following surgery with a medial or bilateral approach. In only 1 of the 58 patients followed up after closed fractures did a deep infection requiring arthrodesis occur. One patient had sympathetic reflex dystrophy (Sudeck). A good functional result in the lower ankle joint correlated with a good outcome. In contrast, postoperative improvement of the tuber angle and the degree of arthrosis seen radiographically did not. We conclude that operative repair of intraarticular calcaneal fractures is a procedure that can safely be procedure used to restore the ability to work in the majority of patients. The medial approach should preferably not be used, nor should the metal be extracted from the medial approach if this can be avoided. PMID:7502082

  13. Fracture mechanics

    International Nuclear Information System (INIS)

    This book entitle ''Fracture Mechanics'', the first one of the monograph ''Materiologie'' is geared to design engineers, material engineers, non destructive inspectors and safety experts. This book covers fracture mechanics in isotropic homogeneous continuum. Only the monotonic static loading is considered. This book intended to be a reference with the current state of the art gives the fundamental of the issues under concern and avoids the developments too complicated or not yet mastered for not making reading cumbersome. The subject matter is organized as going from an easy to a more complicated level and thus follows the chronological evolution in the field. Similarly the microscopic scale is considered before the macroscopic scale, the physical understanding of phenomena linked to the experimental observation of the material preceded the understanding of the macroscopic behaviour of structures. In this latter field the relatively recent contribution of finite element computations with some analogy with the experimental observation is determining. However more sensitive analysis is not skipped

  14. Discontinuation of denosumab and associated fracture incidence

    DEFF Research Database (Denmark)

    Brown, Jacques P; Roux, Christian; Törring, Ove; Ho, Pei-Ran; Jensen, Jens-Erik Beck; Gilchrist, Nigel; Recknor, Christopher; Austin, Matt; Wang, Andrea; Grauer, Andreas; Wagman, Rachel B

    2012-01-01

    Osteoporosis is a chronic disease and requires long-term treatment with pharmacologic therapy to ensure sustained anti-fracture benefit. Denosumab reduced the risk for new vertebral, nonvertebral, and hip fractures over 36 months in the FREEDOM trial. While discontinuation of denosumab has been...... associated with transient increases in bone remodeling and declines in bone mineral density (BMD), the effect on fracture risk during treatment cessation is not as well characterized. To understand the fracture incidence between treatment groups after cessation of investigational product, we evaluated...... 797 subjects (470 placebo, 327 denosumab), who were evaluable during the off-treatment period, showed similar baselinecharacteristics for age, prevalent fracture, and lumbar spine and total hip BMD T-scores. During treatment, more placebo-treated subjects as compared with denosumab-treated subjects...

  15. Traumatic transverse fracture of sacrum with cauda equina injury--a case report and review of literature.

    Directory of Open Access Journals (Sweden)

    Singh H

    1998-01-01

    Full Text Available Fractures of the sacrum are rare and generally associated with fracture of the pelvis. Transverse fractures of the sacrum are even less frequent and neurological deficit may accompany these fractures. A case of transverse fracture sacrum with cauda equina injury treated by sacral laminectomy and root decompression, is reported.

  16. Split Fracture: A Complication of Cerclage Wiring of Acute Patellar Fracture

    OpenAIRE

    Lo, Cho Yau; Lui, Tun Hing; Sit, Yan Kit

    2014-01-01

    Introduction: Iatrogenic patellar fracture is reported as a complication of patella procedures, such as medial patellofemoral ligament reconstruction, reconstruction of the anterior cruciate ligament of the knee using bone-patellar tendon-bone technique, and resurfacing the patella in total knee arthroplasty. Case Presentation: A 65-year-old lady with right patella fracture was treated with open reduction and cerclage wiring. An iatrogenic split fracture was noted during tension of the cercla...

  17. Combined Tibial Tubercle Avulsion Fracture and Patellar Avulsion Fracture: An Unusual Variant in an Adolescent Patient.

    Science.gov (United States)

    Stepanovich, Matthew T; Slakey, Joseph B

    2016-01-01

    Traumatic extensor dysfunction of the knee in children is a rare injury, with the majority resulting from tibial tubercle avulsion fracture or patellar sleeve fracture. We report a rare case of combined patellar avulsion fracture and tibial tubercle fracture. With open anatomic reduction, both injuries were successfully treated. While many variations of tibial tubercle fracture have been reported, the authors believe this to be the first report in the English-language literature of this particular combined injury to the knee extensor mechanism in an adolescent. Advanced imaging with computed tomography provided vital information to aid with operative planning, especially since the majority of the unossified tubercle was not seen on plain radiographs, and all fracture fragments were originally believed to be from the tibial tubercle. Computed tomography distinguished the patellar fracture from the tibial tubercle fragments, verifying preoperatively the complexity of the injury. PMID:26761925

  18. Dental trauma in association with maxillofacial fractures: an epidemiological study

    OpenAIRE

    Ruslin, Muhammad

    2015-01-01

    The aim of this study was to retrospectively investigate the incidence and associated factors of dental trauma in patients with maxillofacial fractures at the VU Medical Center in Amsterdam. Material and methods: Data from 707 patients who were treated surgically for maxillofacial fractures were evaluated. The data were collected retrospectively from patient files and other available databases. The data collected included date of fracture, age, gender, type of fracture, and ...

  19. Curative Effect Analysis of Treating Thoracolumbar Vertebral Compression Fracture Through Injured Vertebra Nail%经伤椎置钉治疗胸腰椎压缩性骨折的疗效分析

    Institute of Scientific and Technical Information of China (English)

    时代; 顾德毅; 荆鑫

    2014-01-01

    目的:探究经伤椎椎弓根复位固定的对于治疗胸腰椎骨折的可行性及其临床疗效。方法根据随机数字表法将60例单椎体胸腰椎骨折患者分为30例的经伤椎椎弓根固定的6钉固定术(6钉组)和30例的单纯行跨伤椎的4钉固定术(4钉组),对所有的患者随访12~43个月,平均随访(27.65±2.42)个月,通过比较两组的手术时间、术中出血量、术后卧床时间、术后伤口引流量等从而得到围手术期指标及伤椎前后缘高度比值内固定失败率腰背痛评分改善指数及神经功能恢复情况。结果两组围手术期相关指标中术中出血量、手术时间、术后卧床时间比较,差异有统计学意义(P<0.05),4钉组过度撑开致术后螺钉松动率为13.33%,后凸加重发生率为10.00%,这是4钉组的情况,但是6钉组则不存在此情况。4钉组术后1周和术后6个月随访腰背痛评分平均改善率均低于6钉组,差异有统计学意义,但两组术后神经功能恢复情况具有较大的差异无统计学意义。结论经伤椎椎弓根置钉能更直接牢固骨折和固定复位,改善应力分布和固定的强度,比传统跨伤椎固定能更好的维持矫正效果。%Objective The feasibility and clinical curative effect of treating thoracolumbar vertebral fracture through resetting and fixing of injured vertebral pedicle are discussed in the thesis. Methods 60 patients with single-vertebral thoracolumbar fracture are divided into two groups according to the random number table method;the first group has 30 patients who are subjected to 6-nail fixation of injured vertebral pedicle fixation (6-nail group);the second group has 30 patients who are subjected to 4-nail fixa-tion of simple line-cross injured vertebra (4-nail group). The follow-up visit time of all patients is 12 to 43 months; the average time is (27.65±2.42) months. Perioperative indicators such as operation time, the amount of intraoperative blood loss

  20. Case Report: Treatment of Open Femoral Shaft Fracture in a Severely Burned Patient

    OpenAIRE

    Chang, Tai-Li; Spence, Robert J.; Mears, Simon C

    2008-01-01

    Objective: To present a case report of a patient with an open fracture and severe burns and review the literature. Methods: The patient was treated with intubation, intravenous antibiotics, and debridement and intramedullary nailing for the femur fracture. He later underwent multiple burn excision procedures with allograft and autograft skin coverage. The wound over the fracture was treated with dressing changes. The fracture was treated with nail exchange and bone grafting for atrophic nonun...

  1. Seismic attenuation in fractured media

    International Nuclear Information System (INIS)

    The prime objective of this paper is to quantitatively estimate seismic attenuation caused by fractures with different physical parameters. In seismic wave simulation, the fractured media are treated as the anisotropic media and fractures are represented by frequency-dependent elastic constants. Based on numerical experiments with three different parameters, namely viscosity, porosity and the Lamé parameters, this paper has the following observations. First, seismic attenuation is not affected by the viscosity within fractures, although it increases with the increase of porosity and decreases with the increase of the Lamé parameters within fractures. Among the latter two parameters, seismic attenuation is more sensitive to the Lamé parameters than to the porosity. Second, for the attenuation anisotropy, low frequencies have more anisotropic effect than high frequencies. For example, a 50 Hz wavefield has the strongest anisotropy effect if compared to 100 and 150 Hz wavefields. The attenuation anisotropy for low frequency (say 50 Hz) is more sensitive to the viscosity than the porosity and the Lamé parameters have the weakest effect among these three parameters. These observations suggest that low-frequency seismic attenuation, and especially the attenuation anisotropy in low frequency, would have great potential for fluid discrimination within fractured media. (paper)

  2. INCIDENCE, AETIOLOGY AND PATTERN OF MANDIBULAR FRACTURES IN PONDICHERRY

    Directory of Open Access Journals (Sweden)

    Karthik

    2015-12-01

    Full Text Available BACKGROUND The mandible is the second most commonly fractured part of the maxillofacial region after nasal bones. The incidence, etiology and pattern of mandibular fractures vary considerably among the different study population, there is a need to evaluate aspects of mandibular trauma in Pondicherry. This study was undertaken to evaluate the results of mandibular fractures treated in a population of Pondicherry. PATIENT AND METHOD A total of sixty nine patients treated for mandibular fractures at the Department Of Dentistry, Sri Manakula Vinayagar Medical College and Hospital, Pondicherry from January 2011 to December 2014 were retrospectively evaluated. The variables analyzed in the study were gender, age, aetiology, fracture site, method of treatment and complications. RESULTS This study included 106 fractures in 69 patients. The ratio of male to female was 16:1. The highest prevalence of fracture occurred in 21 to 30 years (37.7% and the minimum in patients over 61 years old. The most common cause of fractures were road traffic accident (RTA, 56.5% followed by fall. In our study most commonly reported fracture site was parasymphysis (37.7%, followed by angle (19.8% and condyle (19.8%. Mandibular fractures were generally treated by Open Reduction and Internal Fixation (ORIF in 76.4% of the patients. CONCLUSION The retrospective study of mandibular fractures has shown, road traffic accidents are main cause of fracture and young men in their 20s are predominantly affected.

  3. Distal radius triplane fracture

    OpenAIRE

    Parkar, AAH; Marya, S.; Auplish, S

    2014-01-01

    A triplane fracture is so named because of the three planes traversed by the fracture line. These are physeal fractures that result from injury during the final phase of maturation and cessation of growth. This fracture pattern typically involves the distal tibia. We present a rare case of a triplane fracture involving the distal radius.

  4. Open Calcaneus Fractures and Associated Injuries.

    Science.gov (United States)

    Worsham, Jacob R; Elliott, Mark R; Harris, Anthony M

    2016-01-01

    Open calcaneus fractures are usually the result of high-energy mechanisms and are associated with other orthopedic and whole body system injures. Understanding the difference between open versus closed fractures is essential for the provider, and they must be vigilant for the associated injuries that present with this condition. We performed a retrospective medical record review of 62 patients (64 calcaneus fractures) with open calcaneus fractures from January 2003 to January 2013 presenting at a level 1 trauma center. Sex, age, laterality, mechanism of injury, wound appearance, initial management, and associated injures were recorded. The most common mechanisms were motor vehicle accidents (35 [56.4%]) and falls from >6 ft (15 [24.1%]). Four (6.4%) patients had a posterior tibial artery transection. Eight (12.9%) patients had a femoral shaft fracture, 14 (22.5%) an ipsilateral ankle fracture, 16 (25.8%) a metatarsal fracture, and 11 (17.7%) had associated midfoot fractures. Of the midfoot fractures, 12 (19.3%) patients had a talus fracture and 5 (8.0%) a cuboid fracture. Spinal fractures were present in 9 (14.5%) of the patients, with lumbar fractures occurring in 6 (9.6%) patients. Fifteen (24.1%) patients had associated upper extremity fractures. Thirteen (20.9%) patients had an associated pulmonary injury, including 8 pneumothoraces. Ten (16.1%) patients had a closed head injury and 6 (9.6%) had an abdominal injury. Fifteen (23.4%) patients were treated with percutaneous wire fixation and 7 (10.9%) with open reduction internal fixation. A total of 44 (68.7%) fractures were treated without internal fixation. Overall, 5 (8.0%) patients with an open calcaneus fracture eventually underwent a below-the-knee amputation. Open calcaneus fractures are severe, high-energy injuries with the potential for considerable morbidity to the patient, given the high rate of concomitant orthopedic and whole body system injuries. Type III open injuries have an increased risk of

  5. Stress fracture of the navicular bone. Nine cases in athletes.

    Science.gov (United States)

    Hulkko, A; Orava, S; Peltokallio, P; Tulikoura, I; Walden, M

    1985-12-01

    Nine cases of stress fractures of the tarsal navicular bone were treated in athletes. The diagnosis was made with radiographs and bone scan within 6 months. Only two patients were treated surgically. The only poor result was seen in a patient in whom the fracture was only explored. PMID:4090953

  6. Imaging of fractures of the lateral process of the talus, a frequently missed diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Bonvin, Florent; Montet, Xavier; Copercini, Michele; Martinoli, Carlo; Bianchi, Stefano E-mail: stefano.bianchi@hcuge.ch

    2003-07-01

    Although if fractures of the lateral process of the talus (LPT) have been considered rare the widespread diffusion in snowboard practice has resulted in a dramatic increase in their frequency. If unrecognized they can result in secondary osteoarthritis of the ankle and/or talo-calcaneal joints and chronic pain and stiffness. Due to the complex anatomy of the region, these fractures are difficult to detect by standard radiographs. A high degree of suspicion is then necessary to diagnose them. Once suspected on the basis of physical examination and/or non concluding radiographs, computed tomography (CT) is the best modality to confirm the diagnosis and accurately appreciate the number of the fragments and their position which have therapeutic consequences (medical vs. surgical treatment). A better knowledge of these lesions seems necessary to the general radiologist to allow an early diagnosis in order to avoid chronic sequel. The purpose of this article is to report three additional cases of LPT fractures and discuss their pathogenesis, diagnosis and treatment.

  7. Fresh Body Fracture of Triquetrum Treated with A Hollow Titanium Bold Screw:A Case Report and Literature Review%中空钛质Bold螺钉治疗新鲜腕三角骨体部骨折一例报道并文献复习

    Institute of Scientific and Technical Information of China (English)

    董军峰; 李新志; 卢国强; 黄卫; 徐留海; 陈文瑶

    2014-01-01

    本院利用中空肽质Bold螺钉成功治疗1例新鲜左腕三角骨体部骨折患者,取得满意临床疗效,并结合相关文献对此病例进行分析报道。CT或MRI能提高腕三角骨骨折诊断准确率,利用Bold螺钉治疗新鲜腕三角骨体部骨折创伤小,有利于患者早期康复训练、功能锻炼及术后腕关节功能的恢复。对于新鲜腕三角骨体部骨折患者,Bold螺钉内固定术是一种安全有效的方法之一。%A patient with fresh wrist triquetrum body fracture was treated with a hollow titanium Bold screw in our hos-pital recently and achieved satisfactory results. The clinical case was analyzed and reported by reviewing the related litera-ture. Combining with the case,we hold that the CT or MRI could significantly improve diagnosis precision for wrist triquetrum fracture. It is propitious for early healing of the micro-trauma when treated with a hollow titanium Bold screw to the fresh body fracture of the wrist triquetrum case. It is also beneficial for early functional exercise,so this patient's wrist joint function recov-ered soon after operation. Internal fixation with hollow titanium Bold screw is a safe and effective treatment for the fresh wrist triquetrum body fracture patient.

  8. Finite Element Analysis of Foot and Ankle Impact Injury: Risk Evaluation of Calcaneus and Talus Fracture.

    Directory of Open Access Journals (Sweden)

    Duo Wai-Chi Wong

    Full Text Available Foot and ankle impact injury is common in geriatric trauma and often leads to fracture of rearfoot, including calcaneus and talus. The objective of this study was to assess the influence of foot impact on the risk of calcaneus and talus fracture via finite element analysis.A three-dimensional finite element model of foot and ankle was constructed based on magnetic resonance images of a female aged 28. The foot sustained a 7-kg passive impact through a foot plate. The simulated impact velocities were from 2.0 to 7.0 m/s with 1.0 m/s interval.At 5.0 m/s impact velocity, the maximum von Mises stress of the trabecular calcaneus and talus were 3.21MPa and 2.41MPa respectively, while that of the Tresca stress were 3.46MPa and 2.55MPa. About 94% and 84% of the trabecular calcaneus and talus exceeded the shear yielding stress, while 21.7% and 18.3% yielded the compressive stress. The peak stresses were distributed around the talocalcaneal articulation and the calcaneal tuberosity inferiorly, which corresponded to the common fracture sites.The prediction in this study showed that axial compressive impact at 5.0 m/s could produce considerable yielding of trabecular bone in both calcaneus and talus, dominantly by shear and compounded with compression that predispose the rearfoot in the risk of fracture. This study suggested the injury pattern and fracture mode of high energy trauma that provides insights in injury prevention and fracture management.

  9. Detection of radiographically occult-ankle fractures. Positive predictive value of post-traumatic soft-tissue swelling

    International Nuclear Information System (INIS)

    The objective of this study was to assess the value of soft-tissue swelling on plain radiographs as a predictor of radiographically occult fracture, after acute ankle injury (trauma). Patients with acute ankle trauma and plain radiographic evidence of soft-tissue swelling were included in this study. Patients were excluded if ankle trauma was sustained more than 48 hours previously or if fracture was visible on plain radiographs. All subjects (n=25) underwent computed tomography (CT) of the ankle in sagittal and coronal planes. Size of soft-tissue swelling was measured from initial Antero-posterior (AP) radiographs. The subjects in the study were placed into two groups according to whether a fracture was identified on CT or not. The results identified that those subjects without a fracture demonstrated by CT, had a soft-tissue swelling of less than 12.6 mm, while those with over 17.1mm swelling, showed a fracture on CT. Twelve patients (48 per cent) had radiographically occult fractures identified with CT. Fracture sites included: Talus/Talar Dome (n=9), posterior or lateral malleolos (n=2), distal tibia/fibula (n=1). CT detected significant soft-tissue injuries in six patients (24 per cent), composed of damaged anterior talo-fibular ligament (n=4), torn flexor tendons (n=1), and damaged fibular calcaneal ligament (n=1). One patient also showed gas in the talar dome. This study concludes that presence of a large soft-tissue swelling on plain radiographs after acute ankle trauma suggests an underlying fracture. A soft-tissue swelling of >15 mm is a reasonable threshold to prompt further imaging. Helical computed tomography provides good visualisation of subtle bone injuries and may detect clinically important soft-tissue injuries. While the study has a small sample, there is clear evidence that there is a trend worth investigating. Future research will seek to investigate a larger sample. Copyright (1999) Australian Institute of Radiography

  10. Combined fracture dislocation of the navicular bone along with cuboid, cuneiform and longitudinal split fracture of the lateral malleolus: a rare combination of fractures

    OpenAIRE

    Khatri Chhetri*, Kapil Mani

    2014-01-01

    Fracture dislocation of the navicular bone, fracture of the cuboid, cuneiform, and longitudinal split fracture of the lateral malleolus is a rare combination of fractures. This is a high velocity injury fracture and can be caused by forcible plantar flexion and inversion of the foot at the time of impact onto the ground. Here we reported such a case in a 35-year-old male patient who was treated by open reduction and fixation with a partially threaded screw and two K-wires for the navicular...

  11. Discrete fracture modelling for the Stripa tracer validation experiment predictions

    International Nuclear Information System (INIS)

    Groundwater flow and transport through three-dimensional networks of discrete fractures was modeled to predict the recovery of tracer from tracer injection experiments conducted during phase 3 of the Stripa site characterization and validation protect. Predictions were made on the basis of an updated version of the site scale discrete fracture conceptual model used for flow predictions and preliminary transport modelling. In this model, individual fractures were treated as stochastic features described by probability distributions of geometric and hydrologic properties. Fractures were divided into three populations: Fractures in fracture zones near the drift, non-fracture zone fractures within 31 m of the drift, and fractures in fracture zones over 31 meters from the drift axis. Fractures outside fracture zones are not modelled beyond 31 meters from the drift axis. Transport predictions were produced using the FracMan discrete fracture modelling package for each of five tracer experiments. Output was produced in the seven formats specified by the Stripa task force on fracture flow modelling. (au)

  12. Orbital fractures due to domestic violence: an epidemiologic study.

    Science.gov (United States)

    Goldberg, Stuart H.; McRill, Connie M.; Bruno, Christopher R.; Ten Have, Tom; Lehman, Erik

    2000-09-01

    Domestic violence is an important cause of orbital fractures in women. Physicians who treat patients with orbital fractures may not suspect this mechanism of injury. The purpose of this study was to assess the association between domestic violence and orbital fractures. A medical center-based case-control study with matching on age and site of admission was done. Medical center databases were searched using ICD-9 codes to identify all cases of orbital fractures encountered during a three-year period. Medical records of female patients age 13 and older were reviewed along with those of age, gender and site of admission matched controls. A stratified exact test was employed to test the association between domestic violence and orbital fracture. Among 41 adult female cases with orbital fractures treated at our medical center, three (7.3%) reported domestic violence compared to zero among the matched controls (p = 0.037). We believe that domestic violence may be under-reported in both orbital fracture cases and controls. This may result in an underestimate of the orbital fracture versus domestic violence association. Domestic violence is a serious women's health and societal problem. Domestic violence may have a variety of presentations, including illnesses and injuries. Orbital fracture is an identifiable manifestation of domestic violence. Domestic violence is more likely to be detected in adult female hospital patients with orbital fracture than in matched controls with any other diagnosis. Physicians who treat patients with orbital fractures should be familiar with this mechanism of injury. PMID:12045943

  13. Evaluation of osteoporotic fractures in the group of woman over 50 years of age – Comparison of tools FRAX® BMD versus FRAX® BMI

    Directory of Open Access Journals (Sweden)

    Cezary Strugała

    2013-06-01

    Full Text Available Background: The aim of the project is to identify the risk of osteoporotic fractures in women aged over 50, the evaluation of FRAX® BMD and FRAX® BMI in women with and without osteoporotic fractures and the proposal of therapeutic starting points for treatment of osteoporosis. Material and Methods: A group of 1014 women aged 50-89, living in the Kujawsko-Pomorskie province, was investigated. The analysis was based on the WHO definition of osteoporosis. Calculations of 10-year absolute risk of major osteoporotic fractures (AR-10 MOF Fx and femoral neck fractures (AR-10 FN Fx were done using Polish 3.3 version of FRAX® tool. The analysis of fracture risk employed the logistic regression method. Results: A statistically significant relationship was found between the risk of osteoporotic fractures and age, femoral neck BMD, a history of previous osteoporotic fractures, estimated calcaneal BMD and vertebral column BMD. The differences between 10-year absolute risk of major osteoporotic fractures BMD and BMI was small, which means that FRAX® BMI might be a useful tool for GPs and occupational medicine specialists. Conclusions: A high usefulness of the FRAX® BMI tool for evaluating the risk of major osteoporotic fractures provide a new possibility of identifying women at risk of such events. The mean value of 10-year absolute risk of major osteoporotic fractures for FRAX® BMD and BMI was identified as 10% and 12%, respectively and these values were proposed as therapeutic starting points for treatment of osteoporosis in women living in the Kujawsko-Pomorskie province. Med Pr 2013;64(3:327–333

  14. Stress fracture of the fifth metatarsal in athletes.

    Science.gov (United States)

    Hulkko, A; Orava, S; Nikula, P

    1985-01-01

    Between 1975 and 1984 11 athletes with stress fractures of the fifth metatarsal were treated. There were 6 diaphyseal fractures, all of them in runners, and 5 transverse fractures of the base (Jones' fractures). The diaphyseal fractures healed with rest in 3-4 weeks. One patient with Jones' fracture was treated conservatively with a non-weight-bearing toe-to-knee plaster with good results. Four patients with delayed unions were treated operatively, three with a tension band and two Kirschnerwires, one with drilling and a single, thick Kirschner-wire. The fractures treated operatively progressed to bony union in about 3 months. The tendency of the Jones' fracture to delayed union and non-union in active athletes makes special requirements to the initial therapy of stress fractures. Best results have been obtained with a toe-to-knee cast with non-weight-bearing for 6-7 weeks. In delayed unions we recommend a tension band fixation with two Kirschner-wires. Non-unions should be treated with curettage and bone-grafting. PMID:4083785

  15. Radiologic evaluation of anlke fractures

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Won Wha; Park, Hae Won; Park, In Kyu [Kyung Pook National University College of Medicine, Taegu (Korea, Republic of)

    1983-12-15

    The injuries to the anlke joint complex can cause not only bony fractures but also associated ligament rupture. Understanding of the mechanism of those injuries is important for the radiologist to give more information to the orthopedist to identify ligament injuries and then to fix the fractures. In 1948, Lauge-Hansen devised a classification of anlke fractures based on the position of the foot and direction of injuring force at the time of injury. On the basis of location and appearance of the fibular fracture, 4 type of injuries are identified; pronation-abduction (PA), pronation-external rotation (PER), supination-adduction (SA), and supination-external rotation (SER). 60 cases of anlke fractures treated at Kyung Pook National University Hospital from Jan. 1973 to Dec. 1982 were analyzed and classified. The results are as follows: 1. Male was more frequently affected than female and the sex ratio was 4 : 1. 2. The most commonly affected age group was 20's. 3. Right side was more frequently affected than left. 4. Among 4 types, the most common was SER type (33.3%) and next were PER (30.3%), SA (16.7%), and PA (13.3%) types.

  16. Classification to guide internal fixation for tibial fracture

    Institute of Scientific and Technical Information of China (English)

    ZHANG Wen-xi; ZHENG Zhi-liang; JI Yue-ping; QIAO Zhi-jun

    2008-01-01

    Objective: To explore a classification method which can provide the clinical guidance for internal fixation of tibial fracture. Methods: The different fractures were fixed according to their mechanical classification. Totally, 71 cases of tibial plateau fracture, tibial proximal fracture, tibial distal fracture and Pilon fracture were analyzed to test this selective principle. Results: All 71 patients were followed up for 6-32 months. The displacement was seldomly observed in cases treated acccording to the classification principle, while some cases against the principle had postoperative displacement. The difference was statistically significant (P<0.05). It was proved that there was remarkable correlation between tibial fracture classification, internal fixator and fixation methods. Conclusion: Types IIIa3, IIIbl and IIIb2 fractures without eccentric moment should be fixed with double plates or anglestable materials combined with locking structure, otherwise displacement may occur.

  17. SURGICAL FIXATIION OF TALAR FRACTURES - OUR EXPERIENCE

    Directory of Open Access Journals (Sweden)

    Sreenivasa Reddy

    2015-09-01

    Full Text Available BACKGROUND: Fractures and dislocations of the talus are challenging injuries. The frequent incidence of serious complications, such as osteonecrosis, associated with talus fractures leads to a substantial risk of unsatisfactory results. The results of surgical interv ention in these cases have improved over the years, thanks to the usage newer implants and superior surgical skills. MATERIALS AND METHODS: The present study was undertaken in the department of Orthopedics and Traumatology, Osmania General Hospital, during the period September 12 to September 14, and comprises 30 patients who underwent surgical management of displaced talar fractures . CONCLUSIONS : Most of the fractures of the talus should be treated with reduction and internal fixation to reduce the complic ations. Once the fractures are fixed the joints can be mobilized early so that Post trauamatic stiffness can be prevented. However development of Aseptic necrosis and pain the joint are independent of method of treatment and are dependent on the initial di splacement of the fragments.

  18. Treatment of midfacial fractures; Therapie von Mittelgesichtsfrakturen

    Energy Technology Data Exchange (ETDEWEB)

    Schubert, J. [Universitaetsklinik und Poliklinik fuer Mund-, Kiefer- und Plastische Gesichtschirurgie, Martin-Luther-Univ. Halle-Wittenberg, Halle (Germany). Universitaetsklinikum Kroellwitz

    2007-07-15

    Fractures of the midface constitute half of all traumas involving facial bones. Computed tomography is very useful in primary diagnosis. Isolated fractures of the nasal bone and lateral midfacial structures may be diagnosed sufficiently by conventional X-rays. An exact description of the fracture lines along the midfacial buttresses is essential for treatment planning. For good aesthetics and function these have to be reconstructed accurately, which can be checked with X-rays. The treatment of midfacial fractures has been revolutionized over the last two decades. A stable three-dimensional reconstruction of the facial shape is now possible and the duration of treatment has shortened remarkably. The frequently occurring isolated fractures in the lateral part of the midface may be treated easily and effectively by semisurgical methods such as the Gillies procedure or hook-repositioning. (orig.)

  19. Stress fracture of the medial malleolus.

    Science.gov (United States)

    Orava, S; Karpakka, J; Taimela, S; Hulkko, A; Permi, J; Kujala, U

    1995-03-01

    We studied eight patients who had a stress fracture of the medial malleolus. The main symptom was localized pain on the medial side of the ankle. The initial radiographs revealed the lesion for only three patients; for the other patients, the diagnosis was made with the use of isotope scans and was confirmed with computerized tomography scans, magnetic resonance images, or subsequent plain radiographs. One vertical fracture was treated initially with compression with AO screws. On the basis of our experience with stress fractures in other bones, drilling was performed to enhance the formation of bone in two patients who had delayed healing and who had had symptoms for eight and twelve months. The fractures healed four and five months after the drilling. The five patients who were managed non-operatively had to avoid running and jumping for at least three months (average, four months) so that healing could take place. All five of these fractures healed within five months. PMID:7890784

  20. Fractures and Dislocations of the Tarsal Navicular.

    Science.gov (United States)

    Ramadorai, Maj Uma E; Beuchel, Matthew W; Sangeorzan, Bruce J

    2016-06-01

    Fractures of the tarsal navicular are commonly the result of trauma or chronic overload. Because of its complex anatomy and blood supply, the tarsal navicular is susceptible to osteonecrosis, and injury to this bone can lead to posttraumatic arthrosis of the surrounding joints. Diagnosis of the injury, especially in patients with stress fractures, can require a high index of suspicion and the use of advanced imaging. The treatment of stress fracture is controversial and ranges from immobilization in a non-weight-bearing cast or boot to internal fixation with or without bone grafting. Traumatic fractures are treated with open reduction and internal fixation with or without external fixation for medial and lateral column stabilization. To avoid a poor outcome, concomitant injuries must be recognized and treated. Despite appropriate treatment, patients may ultimately require fusion procedures to address ongoing pain and disability. PMID:27213621

  1. 肌皮瓣移植治疗跟骨慢性骨髓炎并皮肤缺损的护理%Nursing of the Chronic Calcaneal Osteomyelitis Combined with Soft Tissue Defect Repair with Myocutaneous Flaps

    Institute of Scientific and Technical Information of China (English)

    严若芬; 骆渊城; 于德美

    2012-01-01

    目的 探讨肌皮瓣移植治疗跟骨慢性骨髓炎并皮肤缺损的护理方法.方法 经过合理的术前指导,精心术后皮瓣血运观察,及时有效的处理血管危象,并做好持续冲洗引流的护理,观察皮瓣成活及慢性跟骨骨髓炎的愈合情况.结果 肌皮瓣移植治疗跟骨慢性骨髓炎并皮肤缺损的患者,皮瓣完全成活,伤口愈合,骨髓炎治愈无复发,患者术后功能恢复良好.结论 正确的术前指导,严格的术后观察,及时有效的处理,正确的术后持续冲洗,是肌皮瓣移植治疗跟骨慢性骨髓炎并皮肤缺损护理的关键.%Objective:Study on the nursing methods of the chronic calcaneal osteomyelitis combined with soft tissue defect repair with myocutaneous flaps Methods:By reasonable of preoperative instruction, elaborate flap blood revolve postoperative, timely and effective management of vascular crisis, and doing well the nurse of continuous irrigation, observed flap surviving and chronic calcaneal osteomyelitis healing Results:all cases transplanted myocutaneous flaps survived, the wound healed, without recurrence of calcaneal osteomyelitis. The function recovery is satisfactory. Conclusion:The key successful factors for the nursing of myocutaneous flap repairing chronic calcaneal osteomyelitis with soft tissue defect is correct preoperative instruction strict postoperative observation timely and effective management right continuous irrigation.

  2. Bone graft substitutes and bone morphogenetic proteins for osteoporotic fractures: What is the evidence?

    NARCIS (Netherlands)

    E.M.M. van Lieshout (Esther); V. Alt (Volker)

    2016-01-01

    textabstractDespite improvements in implants and surgical techniques, osteoporotic fractures remain challenging to treat. Among other major risk factors, decreased expression of morphogenetic proteins has been identified for impaired fracture healing in osteoporosis. Bone grafts or bone graft substi

  3. Compression fractures of the vertebrae during a "bumpy" boat ride.

    LENUS (Irish Health Repository)

    Chukwunyerenwa, C K

    2012-01-31

    INTRODUCTION: Compression fracture of the vertebrae is common, often the result of falls from height and motor vehicle accidents in the younger age groups. It can occur following minor trauma in the elderly and in those with osteoporosis. MATERIALS AND METHODS: We present an interesting case of compression fracture of the vertebral bodies occurring simultaneously in a couple during a boat ride while on holiday. One individual had fracture of the T8, while the other fractured the L1 vertebrae. Both injuries were treated conservatively with Taylor braces. CONCLUSION: We highlight one of the potential hazards of this recreational activity, and the almost identical fracture pattern in this couple.

  4. Recognizing and reporting vertebral fractures: reducing the risk of future osteoporotic fractures

    International Nuclear Information System (INIS)

    Given the increasing evidence that vertebral fractures are underdiagnosed and not acted on, Osteoporosis Canada and the Canadian Association of Radiologists initiated a project to develop and publish a set of recommendations to promote and facilitate the diagnosis and reporting of vertebral fractures. The identification of spinal fractures is not uniform. More than 65% of vertebral fractures cause no symptoms. It is also apparent that vertebral fractures are inadequately recognized when the opportunity for diagnosis arises fortuitously. It is to patients' benefit that radiologists report vertebral fractures evident on a chest or other radiograph, no matter how incidental to the immediate clinical indication for the examination. The present recommendations can help to close the gap in care in recognizing and treating vertebral fractures, to prevent future fractures and thus reduce the burden of osteoporosis-related morbidity and mortality, as well as fracture-related costs to the health care system. Several studies indicate that a gap exists in regard to the diagnosis of vertebral fractures and the clinical response following such diagnosis. All recommendations presented here are based on consensus. These recommendations were developed by a multidisciplinary working group under the auspices of the Scientific Advisory Council of Osteoporosis Canada and the Canadian Association of Radiologists. Prevalent vertebral fractures have important clinical implications in terms of future fracture risk. Recognizing and reporting fractures incidental to radiologic examinations done for other reasons has the potential to reduce health care costs by initiating further steps in osteoporosis diagnosis and appropriate therapy. Physicians should be aware of the importance of vertebral fracture diagnosis in assessing future osteoporotic fracture risk. Vertebral fractures incidental to radiologic examinations done for other reasons should be identified and reported. Vertebral fractures

  5. Biological plating of comminuted fractures of femur and tibia

    Directory of Open Access Journals (Sweden)

    Mohammad Javdan

    2007-08-01

    Full Text Available

    BACKGROUND: The treatment of comminuted fractures in long bones has continued to be a problem in orthopedic surgery. Recently, fixation without exploration of the fracture site, known as "biologic fixation”, has been introduced. This study was performed to assess the results and complications of this method for the treatment of comminuted fractures of the tibia and femur.
    METHODS: The study included 41 patients with comminuted fractures of the tibia and femur treated with biologic plating from 2003 to 2006 (25 femur fractures and 16 tibial fractures. After biological fixation joint motion was started but weight bearing was avoided until radiographic evidence of union was shown.
    RESULTS: The mean time of union in the tibial fractures was 19 ± 2 weeks and 17 ± 2 weeks for the femur fractures. All patients had fracture union without any infection, non-union or implant failure. In one patient with a femur fracture there was a 10° internal rotation deformity. Two of the femoral fractures had shortening of 1 cm, and one patient had shortening of about 2 cm. Compared to similar studies, all results were statistically significant (P<0.05.
    CONCLUSIONS: The biologic plating method is a safe, simple and effective method of fixation for comminuted fractures of long bones. It has a high rate of union with minimal complications.
    KEY WORDS: Biological fixation, plate, comminuted fracture.

  6. Delayed unions and nonunions of stress fractures in athletes.

    Science.gov (United States)

    Orava, S; Hulkko, A

    1988-01-01

    From 1971 to 1985, 369 athletes presented to us with stress fractures. Of these patients, 10% (37) were treated for development of delayed unions or nonunions. Twenty-seven of the patients were male and 10 were female. Their mean age was 23.1 years (range, 17 to 39). About half of the athletes were involved in endurance sports. The diagnostic criteria for a delayed union or nonunion were clinical and radiological evidence. There was a diagnostic delay of about 3.5 months in the series. Plain radiographs, tomography, and isotope scans were used in the diagnosis. Special radiographic views were also used. In 15 cases (10 hallux sesamoid bone fractures, 1 midtibial shaft fracture, 1 metatarsal V base fracture, 1 tarsal navicular fracture, 1 olecranon fracture, and 1 proximal tibial shaft fracture) nonoperative treatment was used. Operative treatment was used 22 times (5 sesamoid fractures, 5 midtibial fractures, 5 metatarsal V base fractures, 3 tarsal navicular fractures, 3 olecranon fractures, and 1 proximal tibial shaft fracture). Results were good or excellent in 32 cases (86.5%), moderate in 4 cases, and poor in 1 case. PMID:3189662

  7. Minimal Invasive Percutaneous Plate Osteosynthesis for Distal Tibial Fractures: A Prospective Study

    OpenAIRE

    Nitin Samal; Sanjay Deshpande; Vasant Gawande; Romil Rathi

    2014-01-01

    Background: Fractures of distal tibia and pilon fractures are one of the most common fractures and are difficult to treat on account of, absence of muscle tissue attachment on lower ¼ tibia and metaphyseal cancellous comminution. Most of them are compound fractures and result in poor blood supply to the distal tibia. The conventional technique of Open Reduction and Internal Fixation (ORIF) with plating of distal tibia fracture requires wide exposure, extensive soft tis...

  8. Assessment of fracture risk

    Energy Technology Data Exchange (ETDEWEB)

    Kanis, John A. [WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX (United Kingdom)], E-mail: w.j.pontefract@sheffield.ac.uk; Johansson, Helena; Oden, Anders [WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX (United Kingdom); McCloskey, Eugene V. [WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX (United Kingdom); Osteoporosis Centre, Northern General Hospital, Sheffield (United Kingdom)

    2009-09-15

    Fractures are a common complication of osteoporosis. Although osteoporosis is defined by bone mineral density at the femoral neck, other sites and validated techniques can be used for fracture prediction. Several clinical risk factors contribute to fracture risk independently of BMD. These include age, prior fragility fracture, smoking, excess alcohol, family history of hip fracture, rheumatoid arthritis and the use of oral glucocorticoids. These risk factors in conjunction with BMD can be integrated to provide estimates of fracture probability using the FRAX tool. Fracture probability rather than BMD alone can be used to fashion strategies for the assessment and treatment of osteoporosis.

  9. Assessment of fracture risk

    International Nuclear Information System (INIS)

    Fractures are a common complication of osteoporosis. Although osteoporosis is defined by bone mineral density at the femoral neck, other sites and validated techniques can be used for fracture prediction. Several clinical risk factors contribute to fracture risk independently of BMD. These include age, prior fragility fracture, smoking, excess alcohol, family history of hip fracture, rheumatoid arthritis and the use of oral glucocorticoids. These risk factors in conjunction with BMD can be integrated to provide estimates of fracture probability using the FRAX tool. Fracture probability rather than BMD alone can be used to fashion strategies for the assessment and treatment of osteoporosis.

  10. Combined fracture dislocation of the navicular bone along with cuboid, cuneiform and longitudinal split fracture of the lateral malleolus: a rare combination of fractures

    Directory of Open Access Journals (Sweden)

    Khatri Chhetri*, Kapil Mani

    2014-12-01

    Full Text Available Fracture dislocation of the navicular bone, fracture of the cuboid, cuneiform, and longitudinal split fracture of the lateral malleolus is a rare combination of fractures. This is a high velocity injury fracture and can be caused by forcible plantar flexion and inversion of the foot at the time of impact onto the ground. Here we reported such a case in a 35-year-old male patient who was treated by open reduction and fixation with a partially threaded screw and two K-wires for the navicular bone, and two interfragmentary screws with a one third tubular plate for the lateral malleolus. K-wires were removed 6 weeks after surgery followed by partial weight bearing. After 6 months, the patient can walk normally with minimal pain and swelling of the foot. Key words: Arthritis; Navicular fracture dislocation; Split fracture of lateral malleolus

  11. Analysis of 23 cases of avulsion fractures of posterior cruciate ligament of knee joint treated by tension band wire fixation%张力带钢丝固定治疗膝关节后交叉韧带止点撕脱骨折23例分析

    Institute of Scientific and Technical Information of China (English)

    张朝凯; 吴莉; 丁晶; 刘庆波; 李迎辉; 吴明贵; 俞超

    2013-01-01

    目的 探讨张力带钢丝固定治疗膝关节后交叉韧带止点撕脱骨折的效果.方法 23例膝关节后交叉韧带止点撕脱骨折患者,采用张力带钢丝复位固定,并对关节腔进行修整;采用Lysholm膝关节评分法评价疗效.结果 23例患者随访6个月~2年,22例(95.7%)术后膝关节功能恢复良好,1例老年患者术前即有骨性关节炎,关节间隙狭窄,术后仍有慢性疼痛及曲伸功能障碍.结论 张力带钢丝固定治疗膝关节后交叉韧带止点撕脱骨折简单、经济、有效.%Objective To investigate the outcomes of avulsion fractures of posterior cruciate ligament of knee joint treated by tension band wire fixation. Methods Twenty-three patients with avulsion fractures of posterior cruciate ligament of knee joint were treated with tension band wire fixation, and the outcomes were evaluated by Lysholm knee joint scoring. Results All the patients were followed up for 6 months to 2 years. Favorable function recovery was achieved in 22 (95.7%) patients. The other senior patient suffered from osteoarthritis and narrow joint space before operation, and there still existed chronic pain and flexion-extension dysfunction after operation. Conclusion Treatment of avulsion fractures of posterior cruciate ligament of knee joint by tension band wire fixation is simple, economical and effective.

  12. Splinting of Longitudinal Fracture: An Innovative Approach

    Science.gov (United States)

    Bansal, Rashmi; Chowdhary, Priyanka; Gurtu, Anuraag; Mehrotra, Nakul; Kishore, Abhinav

    2016-01-01

    Trauma may result in craze lines on the enamel surface, one or more fractured cusps of posterior teeth, cracked tooth syndrome, splitting of posterior teeth, and vertical fracture of root. Out of these, management of some fractures is of great challenge and such teeth are generally recommended for extraction. Literature search reveals attempts to manage such fractures by full cast crown, orthodontic wires, and so forth, in which consideration was given to extracoronal splinting only. However, due to advancement in materials and technologies, intracoronal splinting can be achieved as well. In this case report, longitudinal fractures in tooth #27, tooth #37, and tooth #46 had occurred. In #27, fracture line was running mesiodistally involving the pulpal floor resulting in a split tooth. In teeth 37 and 46, fractures of the mesiobuccal cusp and mesiolingual cusp were observed, respectively. They were restored with cast gold inlay and full cast crown, respectively. Longitudinal fracture of 27 was treated with an innovative approach using intracanal reinforced composite with Ribbond, external reinforcement with an orthodontic band, and full cast metal crown to splint the split tooth. PMID:27247808

  13. Splinting of Longitudinal Fracture: An Innovative Approach

    Directory of Open Access Journals (Sweden)

    Rashmi Bansal

    2016-01-01

    Full Text Available Trauma may result in craze lines on the enamel surface, one or more fractured cusps of posterior teeth, cracked tooth syndrome, splitting of posterior teeth, and vertical fracture of root. Out of these, management of some fractures is of great challenge and such teeth are generally recommended for extraction. Literature search reveals attempts to manage such fractures by full cast crown, orthodontic wires, and so forth, in which consideration was given to extracoronal splinting only. However, due to advancement in materials and technologies, intracoronal splinting can be achieved as well. In this case report, longitudinal fractures in tooth #27, tooth #37, and tooth #46 had occurred. In #27, fracture line was running mesiodistally involving the pulpal floor resulting in a split tooth. In teeth 37 and 46, fractures of the mesiobuccal cusp and mesiolingual cusp were observed, respectively. They were restored with cast gold inlay and full cast crown, respectively. Longitudinal fracture of 27 was treated with an innovative approach using intracanal reinforced composite with Ribbond, external reinforcement with an orthodontic band, and full cast metal crown to splint the split tooth.

  14. Effect of the Skid Mounted Flotation and Magnetic Separation Device Which Treats Fracturing Fluid Recovery%橇装气浮与磁分离装置处理压裂返排液的效果

    Institute of Scientific and Technical Information of China (English)

    庞焕岩; 赵树君; 许成君; 狄茂; 雷军; 吴越强; 王飞

    2016-01-01

    根据油田"十二五"及"十三五"开发规划, 2014年至2020年,大庆油田每年将增加压裂井次,单井产生的压裂液量将大幅增加.压裂返排液中含有大量对环境有害的物质,不能直接排放,大量的废液存放在废液坑中存在安全隐患.基于此,油田集成了3套橇装式处理装置用以处理废液池压裂返排液和现场直接返排的废液.根据压裂返排液的水质特点及实验研究结果,制定了"调质—气浮—磁分离"的工艺路线.对三种氧化药剂进行了不同投量和氧化时间的优化试验,1#氧化剂在投加量为100 mg/L、氧化40 min时的黏度去除率达到74%.压裂返排液经橇装装置的调质单元、气浮单元、磁分离单元处理后,其悬浮物、含油量都降低到20 mg/L以下,达到进入联合站的要求.%According to the last two years' plan in"the Twelfth Five-year Plan"and"the Thirteenth Five-year Developing Plan"of Daqing Oilfield, from 2014 to 2020, the oilfield will increase the times of fracturing wells each year and the amount of fracturing fluid produced by single well will increase significantly. Fracturing fluid recovery contains large amounts of environmentally harmful substances, so it can not be directly discharged, thus a large amount of waste fluid stored in the waste pit poses a safety hazard. Basing on this situa-tion, the oilfield can process the fracturing fluid recovery in the waste reservoir and the waste fluid directly from the site. The researchers combine 3 sets of processing devices of skid-mounted type and develop a"conditioning, air flotation and magnetic separation"process route according to the water quality characteristics of fracturing fluid recovery and experimen-tal results. The researchers utilize three kinds of oxidation agent;do the optimization of dif-ferent volumes and oxidation time experiments. Three kinds of oxidants all play the role of viscosity reduction, but 1# oxidant is compared with the other two

  15. Capillary fracture of soft gels.

    Science.gov (United States)

    Bostwick, Joshua B; Daniels, Karen E

    2013-10-01

    A liquid droplet resting on a soft gel substrate can deform that substrate to the point of material failure, whereby fractures develop on the gel surface that propagate outwards from the contact line in a starburst pattern. In this paper, we characterize (i) the initiation process, in which the number of arms in the starburst is controlled by the ratio of the surface tension contrast to the gel's elastic modulus, and (ii) the propagation dynamics showing that once fractures are initiated they propagate with a universal power law L[proportional]t(3/4). We develop a model for crack initiation by treating the gel as a linear elastic solid and computing the deformations within the substrate from the liquid-solid wetting forces. The elastic solution shows that both the location and the magnitude of the wetting forces are critical in providing a quantitative prediction for the number of fractures and, hence, an interpretation of the initiation of capillary fractures. This solution also reveals that the depth of the gel is an important factor in the fracture process, as it can help mitigate large surface tractions; this finding is confirmed with experiments. We then develop a model for crack propagation by considering the transport of an inviscid fluid into the fracture tip of an incompressible material and find that a simple energy-conservation argument can explain the observed material-independent power law. We compare predictions for both linear elastic and neo-Hookean solids, finding that the latter better explains the observed exponent. PMID:24229192

  16. 三种固定器械固定胫骨骨折的应力松弛实验%Stress relaxation study of tibial fractures treated by three types of fixation devices

    Institute of Scientific and Technical Information of China (English)

    吴志峰; 李艳玲; 刘光耀; 马洪顺

    2012-01-01

    背景:骨力学是生物力学的分支,研究内外固定器固定骨折后的生物力学特性是评价固定效果的重要方法之一.目的:比较3种内外固定器械固定胫骨骨折后骨的应力松弛特性.方法:模拟胫骨骨折分别以髓内钉,钢板,外固定支架进行固定.在电子万能试验机上对3组标本进行轴向压缩应力松弛实验.结果与结论:从各组内、外固定标本轴向压缩应力松弛曲线可以看出,外固定支架组7 200 s应力松弛量大于钢板和髓内钉组,但差异无显著性意义(P > 0.05).初步表明股骨颈骨折钢板固定、髓内钉固定、外固定支架固定后对骨的应力松弛特性影响基本一致.%BACKGROUND: Bone mechanics is a branch of biomechanics. Biomechanical property research of fractures after internal andexternal fixation is an important method to estimate the fixed-effects.OBJECTIVE: To compare the stress relaxation properties of tibial fractures fixed by three different internal and external fixationdevices.METHODS: The simulated tibial fractures were fixed by the intramedullary nails, plate, and external fixation respectively. Axialcompression stress relaxation experiment was performed in the specimens of the three groups using electronic universal testingmachine.RESULTS AND CONCLUSION: Axial compression stress relaxation curves of the specimens fixed with internal and externalfixation in each group showed that the stress relaxation at 7 200 s in the external fixation group was higher than those of the platefixation group and the intramedullary nail fixation group, but the differences were not significant (P > 0.05). The results preliminaryshowed that the effects of plate fixation, intramedullary nail fixation, and external fixation on stress relaxation property of bone infemoral neck fractures were similar.

  17. PERITROCHANTERIC FRACTURES - SURGICAL MANAGEMENT BY PF - LCP

    Directory of Open Access Journals (Sweden)

    Kiran

    2014-07-01

    Full Text Available : Background and objectives: - Due to increasing life span and sedentary habits of elderly people fractures around hip are common. Among these, peritrochanteric fractures are commonest and they need immediate and stable reconstruction to mobilize the affected patients. METHODS: We studied 20 cases of peritrochanteric fractures treated by PF-LCP at KR hospital, MMCRI from Sep 2013- May 2014. They included 14 male and 6 female patients of age group from 28 yrs. to 75 yrs. the cause of injury was trivial in 80%, RTA in 20% of cases. Follow up was done for 6-8 months and assessed using Boyd and Griffin’s classification and Harris hip score. RESULTS: Among the selected cases we evaluated both clinically and radiologically at the intervals of 6th, 12th, and 6 months we found that the final outcome was better than the cases treated with other type of implants and treated conservatively. The union rate was 40% (8/20 and 85% (17/20 at the 12th week and 6 months follow up respectively. We had 1 case of complication as cut-out of screws from proximal fragment. CONCLUSION: The peritrochanteric fractures when treated with PF-LCP resulted in stable reconstruction of fracture and maintenance of anatomical reduction and bio-mechanical axis. Because of its strong angular fixation by the top three screws PF-LCP is advantageous in all types of bone density.

  18. [Arthroscopic treatment of distal radius fracture].

    Science.gov (United States)

    Lindau, T

    2006-11-01

    The orthopaedic surgeons cannot predict the functional results after a distal intra articular radius fracture. The intra-articular incongruity of more than 1 mm is associated with the development of secondary osteoarthrosis. The wrist arthroscopy became an essential help for the reduction of these fractures. The hand is normally in an upright position with a traction of approximately 4-5 kg which facilitates the reduction of the extra-articular fracture component. It is possible to use a technique of horizontal traction. The arthroscopy allows the reduction and control of the fixing of the various fragments, but also the treatment associated lesions associated. One randomized study, which compared 34 arthroscopically treated fractures with 48 openly treated, concluded that the arthroscopy-treated group had better outcome, better reduction, better grip strength and better range of motion than the openly treated group. The treatment of intra articular distal radius fractures with arthroscopic assistance is thus the guaranteeing of the most anatomical reduction of articular surface. It allows the diagnosis and the treatment of the associated lesions, decreases the peripheral fibrous scars of soft tissues by avoiding initially extensive approaches and finally gives better functional results. PMID:17361885

  19. Scaphoid fracture treated by percutaneous fixation with arthroscope assistance%腕关节镜监视经皮螺钉内固定治疗新鲜腕舟骨骨折的初步临床疗效研究

    Institute of Scientific and Technical Information of China (English)

    魏利成; 雷光华; 易汉文; 胡伟国; 何科; 车国良; 欧阳鹤鹏; 兰昌

    2016-01-01

    Objective To investigate the preliminary clinical results of treating scaphoid fracture by percutaneous fixation with arthroscope assistance. Methods From October 2009 to May 2015, a consecutive series of 12 patients with scaphoid fracture were treated by percutaneous fixation with arthroscope assistance. Meanwhile TFCC was man-aged if necessary. As followed, X-ray was adopted for assessment bone healing at 6-month postoperation, 12-month postoperation. Postoperative evaluations included clinical measurement (grip strength and motion range), radiograph-ic, and functional (modified Mayo wrist score) parameters, Herbert and Fisher scaphoid fracture parameters. Healthy wrist as control group. Results All the scaphoid fracture were healed with an average healing time of 24 weeks. All 12 cases were followed for an average of 18.5 months. The function was rated excellent in 7 cases, good in 5 cases according to the modified Mayo wrist score. There was no difference between the injuried wrist and control group. Conclusion For scaphoid fracture, percutaneous fixation with arthroscope assistance is a reliable and minimally in-vasive method to treat scaphoid fracture.%目的:探讨关节镜监视经皮微创治疗腕舟骨骨折的临床疗效。方法该科2009年10月-2015年5月收治12例腕舟骨骨折患者运用关节镜探查腕关节并在腕关节镜监视下复位腕舟骨经皮微创螺钉固定,如合并三角纤维软骨复合体(TFCC)损伤一期进行处理,术后12例患者均得到随访,并进行回顾性分析。术前常规行三维CT及MRI检查。12例患者均在伤后15d内进行手术治疗。结节部骨折8例,腰部骨折4例。年龄20~58岁,男7例,女5例,慢速车祸外伤6例,运动损伤4例,摔伤2例。应用改良Mayo腕关节评分标准及Her-bert和Fisher腕舟骨骨折评价标准评价手术后随访结果,随访时间12~24个月,平均随访时间18.5个月,患者健侧为对照并进行统计

  20. A clinico-radiologic study of bony remodeling of the fractured condyles in children

    International Nuclear Information System (INIS)

    Bony remodeling pattern of condyle fractures in children are different from in adult for growing of condyle, also might affect treatment and prognosis of the condyle fracture. Subjects of this clinical and radiologic study were 26 temporomandibular joints diagnosed as condyle fracture in 23 patients under 15 years old age, They were treated with conservative method at Dental Hospital of Yonsei University from Jan., 1986 to Oct., 1994. Bony remodeling related with fracture pattern was evaluated. The results obtained are as follows: 1. The ratio of male to female in patients with condyle fracture was 1 : 0.9 and the difference of sex ratio was not noted. Comparing with preschool-age group and school-age group, age frequency was higher in preschool-age group (83%). 2. Fallen down (54%) was the most frequent cause of condyle fractures. Traffic accident and slip down were followed. 3. The most common clinical sign of condyle fractures was tenderness to palpation (19 cases). Mouth opening limitation (17 cases), swelling (7 cases), malocclusion (3 cases) were next in order. 4. According to sites of condyle fractures, unilateral fractures were in 20 patients and bilateral fractures in 3 patients, therefore total 23 patients-26 cases of condyle fracture were observed. According to fracture distribution, condyle fractures were in 10 patients (44%). Condyle fractures with symphysis fracture (9 patients, 39%), condyle fractures with ascending ramus fracture (2 patients, 9%), condyle fracture with mandibular body fracture (1 patient, 4%), and condyle fractures with mandibular angle fracture (1 patient, 4%) were followed. 5. In displacement pattern of fractured fragment of mandibular condyle, displacement (17 cases, 66%) was most common. Dislocation (5 cases, 19%) and deviation (4 cases, 15%) were next in order. 6. During the observation period of fractured condyles, remodeling patterns of fracture sites related with articular fossa were observed with usual congealer shape in 23

  1. A clinico-radiologic study of bony remodeling of the fractured condyles in children

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jeong Shin; Park, Chang Seo [Department of Dentistry, The Graduate School, Yonsei University, Seoul (Korea, Republic of)

    1995-08-15

    Bony remodeling pattern of condyle fractures in children are different from in adult for growing of condyle, also might affect treatment and prognosis of the condyle fracture. Subjects of this clinical and radiologic study were 26 temporomandibular joints diagnosed as condyle fracture in 23 patients under 15 years old age, They were treated with conservative method at Dental Hospital of Yonsei University from Jan., 1986 to Oct., 1994. Bony remodeling related with fracture pattern was evaluated. The results obtained are as follows: 1. The ratio of male to female in patients with condyle fracture was 1 : 0.9 and the difference of sex ratio was not noted. Comparing with preschool-age group and school-age group, age frequency was higher in preschool-age group (83%). 2. Fallen down (54%) was the most frequent cause of condyle fractures. Traffic accident and slip down were followed. 3. The most common clinical sign of condyle fractures was tenderness to palpation (19 cases). Mouth opening limitation (17 cases), swelling (7 cases), malocclusion (3 cases) were next in order. 4. According to sites of condyle fractures, unilateral fractures were in 20 patients and bilateral fractures in 3 patients, therefore total 23 patients-26 cases of condyle fracture were observed. According to fracture distribution, condyle fractures were in 10 patients (44%). Condyle fractures with symphysis fracture (9 patients, 39%), condyle fractures with ascending ramus fracture (2 patients, 9%), condyle fracture with mandibular body fracture (1 patient, 4%), and condyle fractures with mandibular angle fracture (1 patient, 4%) were followed. 5. In displacement pattern of fractured fragment of mandibular condyle, displacement (17 cases, 66%) was most common. Dislocation (5 cases, 19%) and deviation (4 cases, 15%) were next in order. 6. During the observation period of fractured condyles, remodeling patterns of fracture sites related with articular fossa were observed with usual congealer shape in 23

  2. Imaging of vertebral fractures

    Directory of Open Access Journals (Sweden)

    Ananya Panda

    2014-01-01

    Full Text Available Vertebral fracture is a common clinical problem. Osteoporosis is the leading cause of non-traumatic vertebral fracture. Often, vertebral fractures are not clinically suspected due to nonspecific presentation and are overlooked during routine interpretation of radiologic investigations. Moreover, once detected, many a times the radiologist fails to convey to the clinician in a meaningful way. Hence, vertebral fractures are a constant cause of morbidity and mortality. Presence of vertebral fracture increases the chance of fracture in another vertebra and also increases the risk of subsequent hip fracture. Early detection can lead to immediate therapeutic intervention improving further the quality of life. So, in this review, we wish to present a comprehensive overview of vertebral fracture imaging along with an algorithm of evaluation of vertebral fractures.

  3. Trans-Scaphoid Perilunate Fracture Dislocation; A Technical Note

    Science.gov (United States)

    Aslani, Hossein; Bazavar, Mohammad Reza; Sadighi, Ali; Tabrizi, Ali; Elmi, Asghar

    2016-01-01

    Carpal fracture-dislocation is regarded as an unusual orthopedic injury and, thus, orthopedic surgeons are less experienced in dealing with and treating these fractures and dislocations. We report a 20-year-old worker man suffering from an unusual carpal fracture-dislocation. There was trans-scaphoid fracture and lunate dislocation with other carpal proximal bones toward volar of the wrist. Two volar and dorsal approaches were used to treat and stabilize the fracture. It was completely stabilized after open reduction and fixation using several pins. After two days, neural symptoms were completely recovered and the patient was discharged. Postoperative radiographies revealed complete restitution of lesser and greater arcs and normalization of Gilula's line. Scapholunate and lunatocapitate angles reached to less than 60° and 10°, respectively. The combined approach had favorable results for treatment of this unusual type of carpus fracture dislocation. However longer follow up is need to evaluate the arthritis and degenerative changes in wrist. PMID:27331069

  4. Coupled exofixator for comminuted fracture of humeral shaft

    Institute of Scientific and Technical Information of China (English)

    马红如; 马树林; 尹同珍

    2005-01-01

    Objective: To report and assess the efficacy of a coupled exofixator in the treatment of comminuted fracture of the humeral shaft.Methods: From June 1999 to September 2003, 24 patients with comminuted fracture of the humeral shaft were treated in our department, in whom 11 were involved in left humerus fractures and 13 in right humerus fractures. Closed reduction or open reduction with a small incision as well as a coupled exofixator was used to treat these patients. Results: All cases got anatomical reduction after 6-12 months follow-up. The time for fracture union averaged 5.8 months with a good functional recovery of the shoulder-elbow joints. Conclusions: The coupled exofixator is favorable to the treatment of comminuted humeral shaft fractures. It can shorten union time and avoid nonunion occurrence.

  5. Effect of osteoporosis medications on fracture healing.

    Science.gov (United States)

    Hegde, V; Jo, J E; Andreopoulou, P; Lane, J M

    2016-03-01

    Antiosteoporotic medications are often used to concurrently treat a patient's fragility fractures and underlying osteoporosis. This review evaluates the existing literature from animal and clinical models to determine these drugs' effects on fracture healing. The data suggest that these medications may enhance bone healing, yet more thorough prospective studies are warranted. Pharmacologic agents that influence bone remodeling are an essential component of osteoporosis management. Because many patients are first diagnosed with osteoporosis when presenting with a fragility fracture, it is critical to understand how osteoporotic medications influence fracture healing. Vitamin D and its analogs are essential for