Abstract:
INTRODUCTION:An infected non-union is a major complication following bone fracture. While bone union can be obtained in 70% to 100% of cases, treatment of osteomyelitis is less predictable, with reported healing rates ranging from 40% to 100%. The primary aim of this study was to assess the success rate of treating infected non-unions of the tibia and femur by a team specializing in complex bone and joint infections. MATERIAL AND METHODS:This single-center retrospective study included all patients operated between 2002 and 2012 due to an infected non-union of the femur or tibia using standardized surgical methods. The procedure was typically done in two phases: excision of the infected site and stabilization, followed by bone reconstruction after a waiting period. Additional procedures (lavage and/or bone grafting) were performed in some cases. A minimum 6-week course of antibiotic therapy was given. The primary endpoint was successful medical and surgical treatment after a minimum 2 years' follow-up defined as healing of the infection (no local clinical signs of infection, ESR≤20mm and CRP≤10mg/L, no mortality attributed to the infection) and radiological and clinical bone union, with the lower limb spared. RESULTS:Fifty-five patients (39 men, 16 women) were included with an average age of 37±11 years. There were 40 tibial fractures and 15 femur fractures. A polymicrobial infection was present in 47% of cases. Repeat surgery was required in 56.4% of patients. At an average of 4±2 years from the first surgical procedure, the treatment was successful in 49 patients (89%): 36 tibia (90%) and 13 femur (87%). The mean time to union was 9±4 months. There were six failures: 3 amputations at 5, 6 and 16 months; 1 mechanical and infection-related failure; 2 failed union. CONCLUSION:This study found that 89% of patients with an infected tibial or femoral non-union treated by a team specialized in complex bone and joint infections using a standardized surgical protocol had bone union and healing of the infection in an average of 9 months. LEVEL OF EVIDENCE:IV, retrospective study.
journal_name
Orthop Traumatol Surg Resjournal_title
Orthopaedics & traumatology, surgery & research : OTSRauthors
Bauer T,Klouche S,Grimaud O,Lortat-Jacob A,Hardy Pdoi
10.1016/j.otsr.2017.10.014subject
Has Abstractpub_date
2018-02-01 00:00:00pages
137-145issue
1issn
1877-0568pii
S1877-0568(17)30353-5journal_volume
104pub_type
杂志文章abstract:INTRODUCTION:There is no consensus about the necessity of exchanging a stable femoral component during revision total hip arthroplasty (RTHA) when only the acetabular component requires replacement. Sparing the femoral component reduces morbidity, but can make acetabular replacement technically more difficult. Moreover...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.08.014
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate long-term radio-clinical outcome in scapulothoracic fusion using the Letournel technique (where the fourth rib is passed through the wing of the scapula and cerclage wires are tightened to the two ribs below) for patients suffering from facioscapulohumeral muscular dystr...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.12.012
更新日期:2017-05-01 00:00:00
abstract:INTRODUCTION:Among the numerous techniques available, medial patellofemoral ligament (MPFL) reconstruction is increasingly used for the surgical treatment of objective patellar instability. The main objective of the present study was to assess efficacy in preventing recurrence of patellar dislocation and in correcting ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.09.023
更新日期:2015-02-01 00:00:00
abstract:INTRODUCTION:Treatment of the distal radius fracture in elderly remains controversial. The objective was to assess the outcomes of volar locking plate for displaced complete intra-articular distal radius fractures in elderly as compared to younger patients. HYPOTHESIS:The outcomes in elderly patients would be comparab...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2019.12.008
更新日期:2020-04-01 00:00:00
abstract:BACKGROUND:There is no universally accepted approach to the elbow for the fixation of coronoid process fractures. This study aims to introduce a novel anterior surgical approach for the fixation of the ulnar coronoid fracture, with minimal surgical dissection damage and excellent visualization for reduction and interna...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2017.05.020
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:In young active patients with hip dysplasia, choosing between periacetabular osteotomy (PAO) and total hip arthroplasty (THA) is challenging. MATERIALS AND METHODS:We systematically searched Medline, Embase, and Cochrane Library for studies published until October 10, 2019, comparing PAO and THA in patients...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2020.08.012
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Endoscopic piriformis release (EPR) is among the available treatments for piriformis syndrome. This procedure typically involves dividing the muscle near the sciatic nerve in the sub-gluteal space, which contains numerous blood vessels and nerves. The objectives of this prospective cadaver study were: 1) to ...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2018.02.018
更新日期:2018-12-01 00:00:00
abstract:BACKGROUND:Fractures of the distal radius only rarely give rise to complications in the immediate postoperative period. Combined median and ulnar nerve palsy is a complication that can be missed by the surgeon. MATERIALS AND METHODS:Three cases diagnosed early after surgery are reported here. The patients were 15, 16,...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2018.04.026
更新日期:2018-10-01 00:00:00
abstract:INTRODUCTION:Patient information is the requisite first step in securing informed consent ahead of surgery, and is legally mandatory. The study hypothesis was that this information is deficient in a significant proportion of cases. This was tested on a clinical audit. The principal objective was to quantify the rate of...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2012.03.007
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Transiliac-transsacral (TITS) screw fixation might be necessary in some cases involving the vertical shearing injuries with transforaminal fracture and bilateral posterior ring injuries. However, the possibility of S1 TITS screw should be preoperatively assessed because the pelvic ring injuries with sacral d...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.03.023
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND AND HYPOTHESIS:Range of motion (ROM) is a core component of some commonly used measures of disability, such as the American Knee Society Score and Harris Hip Score. However, the relationship between ROM and function is contested. The aim of this cross-sectional analysis was to investigate the relationship be...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2013.09.016
更新日期:2014-04-01 00:00:00
abstract:INTRODUCTION:The reference surgical treatment for unstable posterior pelvic fracture is percutaneous iliosacral screw fixation, isolated or in association with other techniques. As there is a risk of passage outside the bone when performing screw fixation under fluoroscopy, new image-guidance techniques have been devel...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2013.03.002
更新日期:2013-06-01 00:00:00
abstract:INTRODUCTION:There is concern regarding potential non-union of the fibula following distraction osteogenesis and if non-union of the fibula leads to poor outcome. HYPOTHESIS:Assess the incidence of fibula non-union in patients undergoing distraction osteogenesis of the tibia and to report the effects on patient outcom...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2018.09.012
更新日期:2018-12-01 00:00:00
abstract::Burnout corresponds to a state of exhaustion (emotional, physical, mental) that can result in complete psychological and/or physical breakdown. Burnout is a result of how our society has evolved. A recent phenomenon, it affects all strata of society, all corporations, and all countries. Physicians are not immune to it...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2019.04.029
更新日期:2020-02-01 00:00:00
abstract:BACKGROUND:In spinal deformity surgery, iatrogenic spinal cord injury is the most feared complication. Intraoperative monitoring (IOM) of the spinal cord assesses its functional integrity and allows significant reduction of the rate of spinal cord injury. HYPOTHESIS:In case of severe IOM alert, lesional level diagnosi...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.09.021
更新日期:2017-02-01 00:00:00
abstract::Management of lower limb fractures in children involves many approaches, spanning from conservative treatment to open reduction and internal fixation. A number of intermediate treatments have also been shown to be effective, notably skeletal traction. However, each of these techniques has its own advantages and disadv...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.05.016
更新日期:2011-12-01 00:00:00
abstract:PURPOSE:Some reports have noted favorable long-term clinical results with milder postoperative arthritic changes after total meniscectomy in symptomatic patients with torn discoid lateral meniscus (DLM). This meta-analysis was conducted to compare the clinical and radiographic results between partial and total meniscec...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,meta分析
doi:10.1016/j.otsr.2019.02.023
更新日期:2019-06-01 00:00:00
abstract::Our objective was to describe the management and prevention of thoracic aortic injuries caused by a malposition of pedicle screws in corrective surgery of major spine deformities. Positioning pedicle screws in thoracic vertebras by posterior approach exposes to the risk of injury of the elements placed ahead of the th...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2014.03.020
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:The WOSI (Western Ontario Shoulder Instability Index) is a self-administered quality of life questionnaire designed to be used as a primary outcome measure in clinical trials on shoulder instability, as well as to measure the effect of an intervention on any particular patient. It is validated and is reliabl...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究
doi:10.1016/j.otsr.2013.09.007
更新日期:2014-02-01 00:00:00
abstract:UNLABELLED:Extensor digitorum tendon (EDT) tear in the wrist is frequently associated with inflammation (rheumatoid arthritis, chondrocalcinosis) or distal radio-ulnar osteoarthritis. EDT protection and repair is often hampered by poor tissue trophicity and associated procedures. We describe an extensor retinaculum (ER...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2015.03.005
更新日期:2015-06-01 00:00:00
abstract::We report a case of anterior thigh compartment syndrome (TCS), which occurred after a closed femoral fracture internal fixation using an intramedullary rod. A 20 ml ropivacaine hydrochloride single-injection femoral block had preceded general anaesthesia to conduct the surgical procedure. The compartment syndrome diag...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,评审
doi:10.1016/j.otsr.2009.03.014
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Arthroscopic subacromial decompression (acromioplasty) is widely held to be effective, although pain may persist after the procedure. The objective of this study was to evaluate the proportion of patients with residual pain (i.e., the failure rate) after isolated subacromial decompression and to look for pre...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究
doi:10.1016/j.otsr.2014.09.006
更新日期:2014-12-01 00:00:00
abstract:PURPOSE:Patient-reported outcome measures (PROMs) have been gaining in popularity over the last decade. The Oxford Shoulder Score (OSS) is a well-established self-administered questionnaire for shoulder evaluation adapted for the English-speaking population. The aim of the present study was to develop a translation and...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.05.010
更新日期:2016-09-01 00:00:00
abstract:BACKGROUND:The use of an anatomic cementless stem in hemiarthroplasties for femoral intracapsular proximal fracture has been debated, notably because of bone weakness and/or morphological defects related to osteoporosis. We therefore conducted a retrospective study in subjects over 75 years of age who had received an a...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.05.013
更新日期:2016-10-01 00:00:00
abstract:INTRODUCTION:Chronic scapholunate instability can lead to functional deficits and radiocarpal osteoarthritis. A number of procedures, namely scapho-trapezio-trapezoid (STT) fusion, scaphocapitate (SC) fusion or soft tissue reconstruction procedures, aim to improve function while protecting the wrist from osteoarthritis...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2010.11.006
更新日期:2011-04-01 00:00:00
abstract:INTRODUCTION:The aim of this study is to analyze the long-term results and possible complications of the Grammont reverse shoulder prosthesis in the management of recent trauma in the elderly patient. PATIENTS AND METHODS:Two male and 33 female patients of mean age 75 years (range, 58 to 92), operated on for 24 fractu...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2011.03.025
更新日期:2011-10-01 00:00:00
abstract:BACKGROUND:The optimal approach for the fixation of coronoid process fractures is unknown. We present the advantages and the clinical effect of the pronator teres and the flexor carpi radialis interval approach for the treatment of ulna coronoid process fractures. METHODS:The patients, who had operative treatment of c...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2020.04.004
更新日期:2020-05-14 00:00:00
abstract:INTRODUCTION:Burnout is a pathology that can affect care-giving professionals. It associates emotional exhaustion (EE), depersonalization (DP) and impaired personal accomplishment (PA). Surgery entails great responsibility and frequently heavy workloads, incurring risk of burnout. Data, however, are not available for F...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,多中心研究
doi:10.1016/j.otsr.2018.12.009
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:The intrawound application of vancomycin powder in addition to intravenous administration of antibiotics has been reported to be an easy and cost-efficient technique for reducing the deep infection, which is a serious complication of spinal surgeries. The aim of the present meta-analysis was to derive a prel...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.otsr.2014.05.022
更新日期:2014-11-01 00:00:00
abstract:INTRODUCTION:Adipose tissue represents an abundant and accessible source of adult stem cells that can differentiate into cells and tissues of mesodermal origin, including osteogenic cells. METHODS:This paper describes the procedure to obtain a 5-cm3 saline sample, containing the adipose-derived stem cells (ASCs) pelle...
journal_title:Orthopaedics & traumatology, surgery & research : OTSR
pub_type: 杂志文章
doi:10.1016/j.otsr.2016.07.006
更新日期:2016-11-01 00:00:00