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[PMID]:29390346
[Au] Autor:Zhao B; Li H; Yan J; Han LR; Yang XF
[Ad] Endereço:Department of Orthopaedics, Liaocheng People's Hospital and Liaocheng Clinical School of Taishan Medical University, Liaocheng, Shandong, China.
[Ti] Título:Pipkin type III femoral head fracture-dislocation combined with complicated acetabular fracture: A rare case report and literature review.
[So] Source:Medicine (Baltimore);96(50):e9214, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Pipkin III fracture, which is characterized by high risk of avascular necrosis of the femoral head, is extremely rare. It is more difficult to treat and has a worse prognosis when accompanied with severe acetabular fractures. Few studies show that both Pipkin type III femoral head fracture-dislocation and complicated acetabular fracture presented in one patient. PATIENT CONCERNS: A 34-year-old male suffered a terrible traffic accident with a serious damage to the left side when he was sitting in the car's cockpit. Pelvic radiograph and 3-dimensional reconstruction of computed tomography revealed characteristics of fractures before the emergency operation. DIAGNOSIS: Pipkin III fractures combined with complicated acetabular fracture. INTERVENTIONS: Firstly, we used combined anterior and posterior approach for treatment to fix the femoral head fractures. Then, we completed anatomical reduction of fractures with countersunk head screw, hollow screw, and reconstruction plate. OUTCOMES: At the 12-months follow-up, the patient could walk freely and perform activities of daily living without necrosis of femoral head and heterotopic ossification. LESSONS: Although there are serious complications in Pipkin III fractures combined with complicated acetabular fracture, early surgical treatment with appropriate approach and fixation could get satisfactory results.
[Mh] Termos MeSH primário: Fraturas do Colo Femoral/cirurgia
Fratura-Luxação/cirurgia
Fixação Interna de Fraturas/métodos
Fraturas do Quadril/cirurgia
[Mh] Termos MeSH secundário: Acidentes de Trânsito
Adulto
Fraturas do Colo Femoral/classificação
Fraturas do Colo Femoral/diagnóstico por imagem
Fraturas do Colo Femoral/etiologia
Fratura-Luxação/classificação
Fratura-Luxação/diagnóstico por imagem
Fratura-Luxação/etiologia
Fixação Interna de Fraturas/instrumentação
Fraturas do Quadril/diagnóstico por imagem
Fraturas do Quadril/etiologia
Seres Humanos
Fixadores Internos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180203
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009214


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[PMID]:29279933
[Au] Autor:Backes M; Dingemans SA; Dijkgraaf MGW; van den Berg HR; van Dijkman B; Hoogendoorn JM; Joosse P; Ritchie ED; Roerdink WH; Schots JPM; Sosef NL; Spijkerman IJB; Twigt BA; van der Veen AH; van Veen RN; Vermeulen J; Vos DI; Winkelhagen J; Goslings JC; Schepers T; WIFI Collaboration Group
[Ad] Endereço:Trauma Unit, Department of Surgery, Academic Medical Center Amsterdam, the Netherlands.
[Ti] Título:Effect of Antibiotic Prophylaxis on Surgical Site Infections Following Removal of Orthopedic Implants Used for Treatment of Foot, Ankle, and Lower Leg Fractures: A Randomized Clinical Trial.
[So] Source:JAMA;318(24):2438-2445, 2017 12 26.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Importance: Following clean (class I, not contaminated) surgical procedures, the rate of surgical site infection (SSI) should be less than approximately 2%. However, an infection rate of 12.2% has been reported following removal of orthopedic implants used for treatment of fractures below the knee. Objective: To evaluate the effect of a single dose of preoperative antibiotic prophylaxis on the incidence of SSIs following removal of orthopedic implants used for treatment of fractures below the knee. Design, Setting, and Participants: Multicenter, double-blind, randomized clinical trial including 500 patients aged 18 to 75 years with previous surgical treatment for fractures below the knee who were undergoing removal of orthopedic implants from 19 hospitals (17 teaching and 2 academic) in the Netherlands (November 2014-September 2016), with a follow-up of 6 months (final follow-up, March 28, 2017). Exclusion criteria were an active infection or fistula, antibiotic treatment, reimplantation of osteosynthesis material in the same session, allergy for cephalosporins, known kidney disease, immunosuppressant use, or pregnancy. Interventions: A single preoperative intravenous dose of 1000 mg of cefazolin (cefazolin group, n = 228) or sodium chloride (0.9%; saline group, n = 242). Main Outcomes and Measures: Primary outcome was SSI within 30 days as measured by the criteria from the US Centers for Disease Control and Prevention. Secondary outcome measures were functional outcome, health-related quality of life, and patient satisfaction. Results: Among 477 randomized patients (mean age, 44 years [SD, 15]; women, 274 [57%]; median time from orthopedic implant placement, 11 months [interquartile range, 7-16]), 470 patients completed the study. Sixty-six patients developed an SSI (14.0%): 30 patients (13.2%) in the cefazolin group vs 36 in the saline group (14.9%) (absolute risk difference, -1.7 [95% CI, -8.0 to 4.6], P = .60). Conclusions and Relevance: Among patients undergoing surgery for removal of orthopedic implants used for treatment of fractures below the knee, a single preoperative dose of intravenous cefazolin compared with saline did not reduce the risk of surgical site infection within 30 days following implant removal. Trial Registration: clinicaltrials.gov Identifier: NCT02225821.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Antibioticoprofilaxia
Cefazolina/administração & dosagem
Remoção de Dispositivo/efeitos adversos
Fraturas Ósseas/cirurgia
Extremidade Inferior/lesões
Infecção da Ferida Cirúrgica/prevenção & controle
[Mh] Termos MeSH secundário: Adulto
Idoso
Método Duplo-Cego
Feminino
Seres Humanos
Incidência
Infusões Intravenosas
Análise de Intenção de Tratamento
Fixadores Internos
Masculino
Meia-Idade
Próteses e Implantes/efeitos adversos
Qualidade de Vida
Infecção da Ferida Cirúrgica/epidemiologia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); IHS69L0Y4T (Cefazolin)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180228
[Lr] Data última revisão:
180228
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171228
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.19343


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[PMID]:29384883
[Au] Autor:Lu Y; Bao W; Wang Z; Zhou F; Zou J; Jiang W; Yang H; Zhang Z; Zhu X
[Ad] Endereço:Department of Orthopedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou.
[Ti] Título:Comparison of the clinical effects of zero-profile anchored spacer (ROI-C) and conventional cage-plate construct for the treatment of noncontiguous bilevel of cervical degenerative disc disease (CDDD): A minimum 2-year follow-up.
[So] Source:Medicine (Baltimore);97(5):e9808, 2018 Feb.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Comparing the clinical and radiographic outcomes in anterior cervical discectomy and fusion (ACDF) using a zero-profile anchored spacer (ROI-C) or a conventional cage-plate construct (CPC) for treating noncontiguous bilevel of cervical degenerative disc disease (CDDD).Overall, 46 patients with 2 noncontiguous segments of CDDD, treated with ACDF from January 2011 to October 2015, were included in this study. ROI-C was used in 22 patients (group A) and CPC in 24 patients (group B). The clinical and radiographic outcomes and complications were compared pre- and postoperatively. All patients were followed up for at least 24 months after surgery.No significant difference was found in fusion rate, cervical curvature, height of fused segment (FSDH), intraoperative blood loss, and Japanese Orthopaedic Association (JOA), and Neck Disability Index (NDI) scores between the 2 groups. Group A had a shorter operation time and significantly lower incidence of dysphagia (3 and 24 months postoperatively) than group B (P < .001 and P < .05, respectively). Moreover, group A had a higher loss of FSDH than group B, but with no difference between the 2 groups (P > .05). Two cages developed subsidence in group A (4.5%) and 2 adjacent levels developed degeneration in group B (2,8%).ACDF with ROI-C device was superior to CPC for noncontiguous bilevel of CDDD because it avoided postoperative dysphagia and required a shorter operation time. Moreover, the clinical outcomes were comparable. Prospective trials with larger samples and longer follow-up are required to confirm the results.
[Mh] Termos MeSH primário: Vértebras Cervicais
Fixadores Internos
Degeneração do Disco Intervertebral/cirurgia
Fusão Vertebral/instrumentação
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seguimentos
Seres Humanos
Degeneração do Disco Intervertebral/diagnóstico por imagem
Masculino
Meia-Idade
Estudos Retrospectivos
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180222
[Lr] Data última revisão:
180222
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009808


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[PMID]:29252741
[Au] Autor:Wilson J; Riff AJ; Hellman MD; Sethi S; Jacobs JJ; Gitelis S
[Ad] Endereço:Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin.
[Ti] Título:A Novel Complication of the Dall-Miles Cable Grip System Mimicking Recurrent Synovial Chondromatosis: A Case Report and Review of the Literature.
[So] Source:JBJS Case Connect;6(4):e87, 2016 Oct-Dec.
[Is] ISSN:2160-3251
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:CASE: A 25-year-old man with synovial chondromatosis of the hip was treated with a synovectomy through a transtrochanteric approach; the repair was made with use of a Dall-Miles cable. Approximately 13 years later, the patient returned with a massive bursal reaction and a cyst containing "rice bodies." Although the physical examination and imaging were suggestive of recurrent synovial chondromatosis, the bursal reaction actually represented a novel complication of the Dall-Miles system. CONCLUSION: When a patient who has had prior orthopaedic instrumentation presents with pain and imaging that demonstrates formation of a bursal cyst, a cyst containing rice bodies secondary to bursal irritation by the implant should be considered.
[Mh] Termos MeSH primário: Condromatose Sinovial/diagnóstico
Articulação do Quadril/cirurgia
Fixadores Internos/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Condromatose Sinovial/cirurgia
Seres Humanos
Masculino
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180216
[Lr] Data última revisão:
180216
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171219
[St] Status:MEDLINE
[do] DOI:10.2106/JBJS.CC.16.00046


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[PMID]:29201305
[Au] Autor:Kim JS; Cho HK; Young KW; Kim JS; Lee KT
[Ad] Endereço:Surgery of Foot and Ankle, Department of Orthopedic Surgery, CM Chungmu General Hospital, Seoul, Korea.
[Ti] Título:Biomechanical Comparison Study of Three Fixation Methods for Proximal Chevron Osteotomy of the First Metatarsal in Hallux Valgus.
[So] Source:Clin Orthop Surg;9(4):514-520, 2017 Dec.
[Is] ISSN:2005-4408
[Cp] País de publicação:Korea (South)
[La] Idioma:eng
[Ab] Resumo:Background: Fixation of proximal chevron metatarsal osteotomy has been accomplished using K-wires traditionally and with a locking plate recently. However, both methods have many disadvantages. Hence, we developed an intramedullary fixation technique using headless cannulated screws and conducted a biomechanical study to evaluate the superiority of the technique to K-wire and locking plate fixations. Methods: Proximal chevron metatarsal osteotomy was performed on 30 synthetic metatarsal models using three fixation techniques. Specimens in group I were fixated with K-wires (1.6 mm × 2) and in group II with headless cannulated screws (3.0 mm × 2) distally through the intramedullary canal. Specimens in group III were fixated with a locking X-shaped plate (1.3-mm thick) and screws (2.5 mm × 4). Eight metatarsal specimens were selected from each group for walking fatigue test. Bending stiffness and dorsal angulation were measured by 1,000 repetitions of a cantilever bending protocol in a plantar to dorsal direction. The remaining two samples from each group were subjected to 5 mm per minute axial loading to assess the maximal loading tolerance. Results: All samples in group I failed walking fatigue test while group II and group III tolerated the walking fatigue test. Group II showed greater resistance to bending force and smaller dorsal angulation than group III ( = 0.001). On the axial loading test, group I and group II demonstrated superior maximum tolerance to group III (54.8 N vs. 47.2 N vs. 28.3 N). Conclusions: Authors have demonstrated proximal chevron metatarsal osteotomy with intramedullary screw fixation provides superior biomechanical stability to locking plate and K-wire fixations. The new technique using intramedullary screw fixation can offer robust fixation and may lead to better outcomes in surgical treatment of hallux valgus.
[Mh] Termos MeSH primário: Fixação Intramedular de Fraturas/métodos
Hallux Valgus/cirurgia
Fixadores Internos
Ossos do Metatarso/cirurgia
Osteotomia/métodos
[Mh] Termos MeSH secundário: Fenômenos Biomecânicos
Placas Ósseas
Parafusos Ósseos
Fios Ortopédicos
Fixação Intramedular de Fraturas/instrumentação
Seres Humanos
Teste de Materiais
Modelos Anatômicos
Falha de Prótese
Estresse Mecânico
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180207
[Lr] Data última revisão:
180207
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171205
[St] Status:MEDLINE
[do] DOI:10.4055/cios.2017.9.4.514


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[PMID]:29310377
[Au] Autor:Lin YN; Chuang CH; Huang SH; Huang SH; Lin TM; Lin IW; Lin SD; Kuo YR
[Ad] Endereço:Division of Plastic and Reconstructive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University.
[Ti] Título:Fat grafting for resurfacing an exposed implant in lower extremity: A case report.
[So] Source:Medicine (Baltimore);96(48):e8901, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Although numerous reconstruction protocols have been reported for lower leg trauma, those for distal leg trauma remain few. We present the case of a woman with an implant exposure wound, who was successfully treated through fat grafting, without major flap surgery. PATIENT CONCERNS: An 83-year-old woman with an exposed implant in lower extremity received reconstruction surgery once and the surgery failed. She refused additional major surgery and negative pressure wound therapy. DIAGNOSES: The diagnosis of a tibia and fibula shaft open fracture (type IIIA) complicated with an exposed implant was made. INTERVENTIONS: The procedure was performed by deploying purified and emulsified fat with a Micro-Autologous Fat Transplantation gun. The required lipoaspirate amount was grossly estimated using a standard formula: 0.5 cc of a lipoaspirate per square centimeter of wound. We prepared the lipoaspirate simply through centrifugation followed by physical emulsification. The endpoint of fat grafting was when lipoaspirate began to flow out of the wound. The initial dressing after the procedure included the topical usage of biomycin ointment with AQUACEL Foam (ConvaTec Inc., NC, USA) coverage, which was later changed to INTRASITE gel (Smith & Nephew, London, UK) with a gauze dressing for 4 weeks. After 4 weeks, dressing components were changed to Mepilex (Mölnlycke Health Care, Gothenburg, Sweden) alone. OUTCOMES: The wound healed completely without requiring major flap surgery by 18 weeks after surgery. LESSONS: Fat grafting is one kind of cell therapy and potentially has regenerative effects during wound healing. Fat grafting is critical in the healing processes of complicated wounds and might be considered a step in reconstruction surgery.
[Mh] Termos MeSH primário: Tecido Adiposo/transplante
Fíbula/lesões
Fíbula/cirurgia
Fixação Interna de Fraturas/instrumentação
Fixadores Internos
Traumatismos da Perna/cirurgia
Procedimentos Cirúrgicos Reconstrutivos
Fraturas da Tíbia/cirurgia
[Mh] Termos MeSH secundário: Acidentes de Trânsito
Idoso de 80 Anos ou mais
Feminino
Seres Humanos
Traumatismos da Perna/etiologia
Retalhos Cirúrgicos
Cicatrização
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008901


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[PMID]:29310362
[Au] Autor:Yan A; Mei HB; Liu K; Wu JY; Tang J; Zhu GH; Ye WH
[Ad] Endereço:Department of Pediatric Orthopaedics, Hunan Children's Hospital, The Pediatric Academy of University of South China, Changsha, Hunan Province, P.R. China.
[Ti] Título:Wrapping grafting for congenital pseudarthrosis of the tibia: A preliminary report.
[So] Source:Medicine (Baltimore);96(48):e8835, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Treatment of congenital pseudarthrosis of the tibia (CPT) remains a challenge. The autogenic iliac bone graft is important consistent of treatment for CPT. The purpose of this study was to investigate the role of wrapping autogenic iliac bone graft in improvement of the curing opportunities of CPT. METHODS: We combined Ilizarov fixator with intramedullary rodding of the tibia and wrapping autogenic iliac bone graft for treatment 51 cases of CPT between 2007 and 2010. The mean age is 3.2 years at index operation, of which 31 patients (61%) were below 3 years old. According to Crawford classification, 5 tibia had type-II morphology; 3, type-III; 43, type-IV. RESULTS: In the postoperative follow-up of 3.5 months (range from 3 to 4.5 months), all cases were found that the bone graft sites of pseudarthrosis of the tibia showed a significant augmentation and spindle-shaped expansion as obvious change. All cases of this series have been followed-up, average followed-up time were 1.6 years (range from 7 to 3.1 years), of which 19 cases were more than 2 years. The average time of removed the Ilizarov ring fixator was 3.5 months (range from 3 to 4.5 months). According to Johnston Clinical evaluation system, 26 cases had grade I, 21 cases, grade II, 4 cases, grade III. Following the Ohnishi X-ray evaluation criteria, union of pseudarthrosis of the tibia were 42 cases, delayed union 5 cases, nonunion 4 cases. CONCLUSION: Autogenic iliac bone graft is able to offer the activity of osteoblasts and osteogenesis induced by bone morphogenetic protein (BMP) and glycoprotein, meanwhile enclosing bone graft could help keep cancellous bone fragments in close contact around pseudarthrosis of the tibia, allowing the formation of high concentration of glycoprotein and BMP induced by chemical factors because of established the sealing environment in location, all of which could enhance the healing of pseudarthrosis of the tibia.
[Mh] Termos MeSH primário: Transplante Ósseo/métodos
Pseudoartrose/congênito
Tíbia/cirurgia
[Mh] Termos MeSH secundário: Pré-Escolar
Feminino
Seres Humanos
Técnica de Ilizarov
Fixadores Internos
Masculino
Pseudoartrose/cirurgia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180115
[Lr] Data última revisão:
180115
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180110
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008835


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[PMID]:27770632
[Au] Autor:Zhao D; Witte F; Lu F; Wang J; Li J; Qin L
[Ad] Endereço:Department of Orthopaedics, Affiliated Zhongshan Hospital of Dalian University, Dalian, China. Electronic address: zhaodewei2000@163.com.
[Ti] Título:Current status on clinical applications of magnesium-based orthopaedic implants: A review from clinical translational perspective.
[So] Source:Biomaterials;112:287-302, 2017 01.
[Is] ISSN:1878-5905
[Cp] País de publicação:Netherlands
[La] Idioma:eng
[Ab] Resumo:As a new generation of medical metallic material, magnesium (Mg) and its alloys with or without surface coating have attracted a great deal of attention due to its biodegradability and potential for avoiding a removal operation after the implant has fulfilled its function for surgical fixation of injured musculoskeletal tissues. Although a few clinical cases on Mg-based orthopaedic implants were reported more than a century ago, it was not until recently that clinical trials using these implants with improved physicochemical properties were carried out in Germany, China and Korea for bone fracture fixation. The promising results so far suggest a bright future for biodegradable Mg-based orthopaedic implants and would warrant large scale phase II/III studies. Given the increasing interest on this emerging biomaterials and intense effort to improve its properties for various clinical applications, this review covers the evolution, current strategies, and future perspectives in the development of Mg-based orthopaedic implants. We also highlight a few clinical cases performed in China that may be unfamiliar to the general orthopaedic community.
[Mh] Termos MeSH primário: Materiais Biocompatíveis/química
Fixadores Internos/tendências
Prótese Articular/tendências
Magnésio/química
[Mh] Termos MeSH secundário: Animais
Análise de Falha de Equipamento
Seres Humanos
Desenho de Prótese/tendências
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (Biocompatible Materials); I38ZP9992A (Magnesium)
[Em] Mês de entrada:1712
[Cu] Atualização por classe:180106
[Lr] Data última revisão:
180106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161023
[St] Status:MEDLINE


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[PMID]:27770774
[Au] Autor:Zhu GH; Mei HB; He RG; Liu YX; Liu K; Tang J; Wu JY
[Ad] Endereço:Department of Orthopedics, Hunan Children's Hospital, 86 Ziyuan road, Changsha, Hunan, People's Republic of China.
[Ti] Título:Combination of intramedullary rod, wrapping bone grafting and Ilizarov's fixator for the treatment of Crawford type IV congenital pseudarthrosis of the tibia: mid-term follow up of 56 cases.
[So] Source:BMC Musculoskelet Disord;17(1):443, 2016 10 22.
[Is] ISSN:1471-2474
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: The purpose of this study was to investigate the initial union rate, refracture rate and residual deformities of congenital pseudarthrosis of the tibia (CPT), using combined surgery including pseudarthrosis resection, intramedullary rodding, autogenous iliac bone grafting and Ilizarov's fixator, with a mean 5.2 years follow-up. METHODS: We retrospectively reviewed the records and diagrams of patients with Crawford type IV congenital pseudarthrosis of the tibia between February 2007 and March 2010. Patients managed by pseudarthrosis resection, intramedullary rod of the tibia, wrapping autogenous iliac bone grafting and Ilizarov's fixator were enrolled. We evaluated the bone union rate, tibial alignment, limb length discrepancy (LLD), valgus deformity of the ankle and the frequencies of refracture during period of follow-up. RESULTS: There were 56 cases enrolled in the study, with a mean follow-up 5.2 years (range, 3 to 6.7 years). The mean age of the patients at surgery was 3.5 years (range, 1.5 to 12.4 years). Fifty (89.2 %) of the 56 patients had primary bone union at site of pseudarthrosis, while 5 obtained union after second surgery and 1 failed. The average time spent to obtain pseudarthrosis initial union was 4.5 months (range, 3.0 to 10.0 months) and mean duration of Ilizarov treatment was 4.7 months (range, 3.2 to 10.4 months). Eleven (19.6 %) patients had proximal tibial valgus with a mean angle of 9.5° (range, 5 to 24°), while 10 (17.9 %) patients had ankle valgus deformities with a mean of 12.3° (range, 6 to 21°). Sixteen (28.6 %) patients had an average 2.2 cm LLD (range, 1.5-4.2 cm). Of the 50 cases who obtained initial bone union of pseudarthrosis, 13 (26.0 %) had refracture which need cast immobilization or secondary surgery. CONCLUSIONS: This combined surgery obtained initial union rate of 89.2 % at primary surgery while the refracture rate is 26.0 %. However, residual deformities such as proximal tibial valgus, LLD and ankle valgus were also existed which should be pay more attention to and dealt with. TRIAL REGISTRATION: This study was registered in ClinicalTrials.gov under the name "The Effect of Combined Surgery in Management of Congenital Pseudarthrosis of Tibia" ( NCT02640040 ), which was released on August 31, 2015.
[Mh] Termos MeSH primário: Transplante Ósseo/métodos
Fixação Intramedular de Fraturas/métodos
Técnica de Ilizarov
Pseudoartrose/congênito
Fraturas da Tíbia/cirurgia
[Mh] Termos MeSH secundário: Moldes Cirúrgicos
Criança
Pré-Escolar
Feminino
Seguimentos
Fixação Intramedular de Fraturas/instrumentação
Seres Humanos
Ílio/transplante
Lactente
Fixadores Internos
Masculino
Pseudoartrose/diagnóstico por imagem
Pseudoartrose/cirurgia
Radiografia
Reoperação/estatística & dados numéricos
Estudos Retrospectivos
Fraturas da Tíbia/diagnóstico por imagem
Transplante Autólogo/métodos
[Pt] Tipo de publicação:CLINICAL TRIAL; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171209
[Lr] Data última revisão:
171209
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161025
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE


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[PMID]:29145983
[Au] Autor:Barcak EA; Beebe MJ; Weinlein JC
[Ad] Endereço:Department of Orthopaedic Surgery, University of Tennessee-Campbell Clinic, Regional One Health, Memphis, TN, USA. Electronic address: ericbarcak@gmail.com.
[Ti] Título:The Role of Implant Removal in Orthopedic Trauma.
[So] Source:Orthop Clin North Am;49(1):45-53, 2018 Jan.
[Is] ISSN:1558-1373
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Although implant removal is common after orthopedic trauma, indications for removal remain controversial. There are few data in the literature to allow evidence-based decision-making. The risk of complications from implant removal must be weighed against the possible benefits and the likelihood of improving the patient's symptoms.
[Mh] Termos MeSH primário: Remoção de Dispositivo
Fixação Interna de Fraturas/efeitos adversos
Fixação Interna de Fraturas/instrumentação
Fraturas Ósseas/cirurgia
Fixadores Internos
Complicações Pós-Operatórias/cirurgia
[Mh] Termos MeSH secundário: Seres Humanos
Complicações Pós-Operatórias/etiologia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1712
[Cu] Atualização por classe:171204
[Lr] Data última revisão:
171204
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171118
[St] Status:MEDLINE



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