The treatment of comminuted, intra-articular distal femoral fractures (Orthopaedic Trauma Association [OTA] classification1 33-C3) is challenging. Many these injuries are the result high-energy trauma, which generates severe soft-tissue damage and articular metaphyseal comminution. Bone loss resulting from open fracture poor bone quality may decrease stability fixation. Traditional devices for internal fixation have included 95° condylar blade-plate, dynamic screw with a side-plate,...

Background: The purposes of this study were to evaluate the clinical and radiographic results functional outcomes after operative treatment tibial plafond fractures treated with internal or external fixation. Methods: A retrospective review identified 76 patients 79 (OTA 43-B 43-C) plafond. Their average age was 45 years. Twenty-one (27%) open, 43 (54%) type 43-C3. Five 43-B1, four 43-B2, two 43-B3, 15 43-C1, 10 43-C2. Patients open reduction fixation (ORIF) ( n = 63) limited articular wire...

Objectives: To report on pin-related complications in patients who underwent temporary staging external fixation using a self-drilling pin insertion technique. Design: Retrospective cohort study Setting: Single tertiary referral level one trauma center Patient Selection Criteria: Adult were included spanning of the lower extremity (AO/OTA 32, 33, 41, 42, 43, 44, 81, 82, 83, 84, and 85 fractures) self-tapping pins placed technique (Stryker Hoffman External Fixation System, Kalamazoo, MI, USA)...

OBJECTIVES: To describe outcomes in patients with periprosthetic distal femur fractures (PPDFF) who underwent retrograde intramedullary nailing (rIMN), including subsequent revision total knee arthroplasty (TKA) and subjective and/or objective evidence of flexion instability (FI). The hypothesis this study is can occur following rIMN cruciate-retaining (CR-TKA), possibly due to iatrogenic PCL damage. METHODS: Design : Retrospective review Setting: Single academic Level-I trauma center...

A nonunion is a reconstructive challenge that may have devastating effect on patient's quality of life. To develop an individualized treatment plan, surgeons must carefully assess several factors related to the nonunion, including involved bone, existing implants, presence infection, soft-tissue envelope, and function extremity, as well status patient. Essential components plan for patient with include management infection (if present); optimization systemic local biologic environment via...

Salvage of acute and chronic tibial osseocutaneous defects in the lower extremity poses a formidable problem. Although local, distant, free tissue transfer or bone grafting alone may be adequate for repair small wounds osseous defects, large complicated necessitate different approach. The authors describe their experience with combination distraction osteogenesis complex composite osteocutaneous defects.The reviewed consecutive series 28 patients who underwent treatment over an 8-year...

To analyze long-term functional outcomes in patients with posttraumatic infected tibial nonunions having undergone bone transport hexapod external fixator.Retrospective cohort study.Level 1 trauma center.Thirty-eight of the tibia.Resection nonunion application stacked fixator for transport.Functional outcome was measured using short Musculoskeletal Functional Assessment (sMFA). Parameters included age, sex, presence diabetes, smoking, use a free flap, defect size, length frame, fixation...

Objective: To assess clinical, radiographic, and functional outcomes after intramedullary nail (IMN) fixation of tibia fractures with an infrapatellar approach compared to a suprapatellar approach. Design: Retrospective chart review. Setting: Level 1 trauma center. Patients/Participants: Two hundred four patients 208 treated nailing between 2008 2018. Methods: A retrospective review was conducted. The clinical IMN were groups versus Multivariate models created control for confounding...

Objectives Acute blood flow to the femoral head has been postulated be affected negatively by traumatic acetabular fracture or dislocation. To best of our knowledge, a prospective study that examined acute changes in with respect timing reduction and effect open internal fixation after dislocations not performed. Design Setting From June 1994 February 1996, fifty-four consecutive patients hip without fractures acetabulum were entered into this investigation. The categorized three groups:...

The purpose of this study was to evaluate the clinical and radiographic outcomes patients who underwent tibiotalar arthrodesis between 1997 2003 for arthritis. cause predominantly posttraumatic arthritis secondary tibial plafond fracture (n = 15) or talar body 2).We retrospectively evaluated a consecutive series 20 with 21 arthritic joints. Radiographs, notes, scheduled visits, telephone interviews were used obtain outcome data after using custom blade plate. American Orthopedic Foot Ankle...

Case: Posttraumatic limb-length discrepancies secondary to femoral malunion can be treated with a variety of external or internal lengthening systems. The PRECICE nail is an intramedullary device featuring remote control activate magnetically driven distraction mechanism. While this system avoids the soft-tissue complications common lengthening, it has unique mechanisms failure that are difficult diagnose and require systematic approach. Conclusion: In case report, we describe lengthen...

The purpose of this study was to define the utility CT scans for detecting articular extension in tibial shaft fractures and determine whether radiographic parameters can predict presence operative distal (DTAFs).

The stacked hexapod bone transport technique is an effective treatment for infected tibial nonunions with loss. purpose of this study was to evaluate the patients' risk factors and timing requiring adjunctive stabilization.Retrospective cohort study.Level 1 trauma center.Seventy-five patients posttraumatic tibia.Resection nonunion application frame transport.Parameters measured included age, sex, diabetes, smoking, use a free flap, defect size, length in frame, external fixation index,...

A conventional transtibial amputation may not be possible when the zone of injury involves proximal part tibia, or in cases massive tibial bone and/or soft-tissue loss. The purpose this study was to examine outcomes salvage a level with rotational osteocutaneous pedicle flap from ipsilateral hindfoot.Fourteen patients who had an foot were included study. Twelve followed for more than twenty-four months (mean, 60.2 months) and evaluated use Sickness Impact Profile (SIP), Musculoskeletal...

To analyze the correlation between surgical timing and outcomes for calcaneus fractures treated using a sinus tarsi approach (STA).Single Level-1 trauma center.Retrospective.Seventy consecutive intra-articular (OTA/AO 82C; Sanders II-IV) operatively STA with minimum of 1-year follow-up.Open management STA.Surgery timing, wound complications, American Orthopaedic Foot Ankle Society ankle hindfoot Patient-reported Outcomes Measurement System scores.Patients were primarily men (68.6%) averaging...

Abstract Objectives: To compare the number of patients with gunshot wounds presenting to our level 1 trauma center before and during COVID-19 pandemic a focus on volume trends after lifting stay-at-home directives through August 2020. Design: Retrospective. Setting: Level center. Patients/Participants: Seven hundred six wound between 2016 2020 (months March September only). Intervention: resultant stay at home directives. Main Outcome Measurements: Number per time period. Results: The...

Patterson, Brendan M. MD; Smith, Anthony A. Holdren, Amy RN; Sontich, John K. MD Author Information

The case of a patient who sustained an avulsion fracture the femoral head (Pipkin Type I) that was unrecognized is described. referred to authors' institution four months after injury, and radiographic studies showed malunited acetabulum. subsequently went on excellent result surgical debridement. authors recommend additional in cases exclude fractures where possible hip subluxation may have occurred.