Abstract:
PURPOSE:Treatment of open fractures is complex and controversial. The purpose of the present study is to add evidence to the management of open tibial fractures, where tissue loss necessitates cover with a free flap. We identified factors that increase the risk of complications. We questioned whether early flap coverage improved the clinical outcome and whether we could improve our antibiotic treatment of open fractures. METHODS:From 2002 to 2013 we treated 56 patients with an open tibial fracture covered with a free flap. We reviewed patient records and databases for type of trauma, smoking, time to tissue cover, infection, amputations, flap loss and union of fracture. We identified factors that increase the risk of complications. We analysed the organisms cultured from open fractures to propose the optimal antibiotic prophylaxis. Follow-up was a minimum of one year. Primary outcome was infection, bacterial sensitivity pattern, amputation, flap failure and union of the fracture. RESULTS:When soft tissue cover was delayed beyond seven days, infection rate increased from 27 to 60 % (p < 0.04). High-energy trauma patients had a higher risk of amputation, infection, flap failure and non-union. Smokers had a higher risk of non-union and flap failure. The bacteria found were often resistant to Cefuroxime, aminoglycosides or amoxicillin, but sensitive to vancomycin or meropenem. CONCLUSION:Flap cover within one week is essential to avoid infection. High-energy trauma and smoking are important predictors of complications. We suggest antibiotic prophylaxis with vancomycin and meropenem until the wound is covered in these complex injuries.
journal_name
Int Orthopjournal_title
International orthopaedicsauthors
Olesen UK,Juul R,Bonde CT,Moser C,McNally M,Jensen LT,Elberg JJ,Eckardt Hdoi
10.1007/s00264-015-2712-zsubject
Has Abstractpub_date
2015-06-01 00:00:00pages
1159-66issue
6eissn
0341-2695issn
1432-5195journal_volume
39pub_type
杂志文章abstract:PURPOSE:Femoroacetabular impingement is a new disease concept for hip disorders in young adults suggested as a major cause of primary hip osteoarthritis in Western countries. However, significant controversy exists regarding the prevalence and contribution of impingement deformities to osteoarthritis in Japan, owing to...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-014-2393-z
更新日期:2014-08-01 00:00:00
abstract:INTRODUCTION:Dual-mobility cups (DMC) are gaining popularity mainly for their reduced rate of dislocation following total hip arthroplasty (THA). Currently, indication for DMC use extends beyond patients with high risk of dislocation or revision THA cases. Many authors reported DMC outcomes in primary THA for all aetio...
journal_title:International orthopaedics
pub_type: 杂志文章,评审
doi:10.1007/s00264-020-04791-8
更新日期:2020-09-19 00:00:00
abstract:PURPOSE:The aim of the study was to investigate risk factors for metastasis at diagnosis. METHODS:We collected patients diagnosed with conventional chondrosarcoma between 1983 and 2014 from the Surveillance, Epidemiology, and End Results (SEER) database. Each patient was classified as having metastatic or localized di...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-018-3942-7
更新日期:2018-12-01 00:00:00
abstract::Between 1971 and 1987, we treated 26 patients with congenital absence of the radius which had produced a club hand; 37 hands were affected. Treatment before the age of 8 months was by gentle manipulation and serial plasters. If a functional position was not obtained, and in patients over 8 months, surgical reduction w...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00194186
更新日期:1993-01-01 00:00:00
abstract::Lower lumbar spinal fusion was carried out in 72 patients by a technique which involved screw fixation of the facet joints. Stability was achieved and mobilisation was allowed immediately. Radiographs after operation showed bony fusion in 94.5%. Pain was diminished and 76% of the patients would undergo the same treatm...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00182698
更新日期:1992-01-01 00:00:00
abstract::We evaluated the pre- and postoperative neurological state of 3 patients with lumbar intradural lipoma. Total resection of the lipoma in the cauda equina was impossible, and partial resection and expansive laminoplasty was carried out. Subsequent neural involvement may depend on the duration of symptoms rather than th...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s002640050147
更新日期:1997-01-01 00:00:00
abstract::This paper reports the long term results of 3 patients with lumbosacral spondyloptosis who were treated by closed reduction, followed by 6 to 12 weeks plaster cast immobilisation, posterior fusion and finally anterior fusion after a further 3 to 6 months. The follow up was from 7.5 to 10.5 years. Spondyloptosis was di...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00180118
更新日期:1990-01-01 00:00:00
abstract:PURPOSE:It is an established fact that post-operative (p.o.) soft-tissue swelling and lymphoedema after total knee arthroplasty (TKA) have a major influence on the p.o. early functional outcome. Kinesio taping has a proven clinical effect in increasing lymph drainage. Despite the decades of experience gained and the as...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-016-3295-z
更新日期:2017-02-01 00:00:00
abstract:PURPOSES:We performed a retrospective, cohort study to compare uncemented tibial fixation with cemented tibial fixation in distal femoral replacement (DFR). METHODS:Sixty-two cases with uncemented tibial fixation and 58 cases with cemented tibial fixation were included. Inter-group comparisons were performed for basel...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-018-3847-5
更新日期:2018-09-01 00:00:00
abstract:PURPOSE:The anterior cruciate ligament (ACL) is known to have a poor healing ability, especially in comparison with the medial collateral ligament (MCL) which can heal relatively well. Interleukin-1beta (IL-1β) is considered to be an important chemical mediator in the acute inflammatory phase of ligament injury. The ro...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-012-1549-y
更新日期:2013-03-01 00:00:00
abstract:INTRODUCTION:The restoration of acetabular bone stock during revision hip arthroplasty remains a challenge. There have been no clinical series reporting the efficacy of bone morphogenic protein-2 (rhBMP-2) in the revision hip setting. METHODS:We retrospectively reviewed the radiographs and records of 15 patients who r...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-017-3671-3
更新日期:2018-04-01 00:00:00
abstract:PURPOSE:The purpose of this study was to determine if a new titanium cup with increased porosity resulted in different periacetabular bone loss and migration compared to a porous coated cup. METHODS:Fifty-one patients with primary hip osteoarthritis were randomized to either a cup with porous titanium construct backsi...
journal_title:International orthopaedics
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00264-014-2571-z
更新日期:2015-05-01 00:00:00
abstract::Two techniques are presented for atraumatic handling of tendon ends during repair of flexor and extensor tendons. If the tendon is cleanly transected, the suture is carried out by holding the tendon in nerve holding forceps. If debridement is needed, a slice is partly cut and used to handle the tendon; the slice is th...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s002640050080
更新日期:1996-01-01 00:00:00
abstract::Reverse total shoulder arthroplasty (RTSA) has been reported to be associated with a complication rate that is four times that of conventional total shoulder arthroplasty. It is the purpose of this article to identify and understand the most common and most serious complications of RTSA and to review current methods o...
journal_title:International orthopaedics
pub_type: 杂志文章,评审
doi:10.1007/s00264-010-1125-2
更新日期:2010-12-01 00:00:00
abstract:PURPOSE:Tibial fractures are the most common lower limb fractures. Some criteria such as open fractures and increasing open stage are known to be associated with high delayed union and pseudarthrosis rate. In cases of delayed or nonunion, classical treatment is autologous cancelous bone graft which is associated with h...
journal_title:International orthopaedics
pub_type: 杂志文章,评审
doi:10.1007/s00264-014-2342-x
更新日期:2014-09-01 00:00:00
abstract:INTRODUCTION:Since 1962, the low friction arthroplasty developed by Sir John Charnley has given us very good long terms results at more than 40 years follow up, but dislocation remains a major complication. The dislocation rate is a permanent risk during the life of the patient and the prosthesis, defined by J. Caton a...
journal_title:International orthopaedics
pub_type: 古典文章,历史文章,杂志文章
doi:10.1007/s00264-016-3361-6
更新日期:2017-03-01 00:00:00
abstract:PURPOSE:Loosening of implants occurs mainly for two reasons: bacterial infection of the implant or "aseptic loosening" presumably due to wear particles derived from the implant. To gain further insight into the pathomechanism, we analysed activation of the T cell response in these patients. METHODS:Activation of perip...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-014-2310-5
更新日期:2014-06-01 00:00:00
abstract:INTRODUCTION:We hypothesised that the use of a polyaxial locking plate design offers the same clinical benefits as a monoaxial locking plate system following distal femoral osteoporotic/periprosthetic fracture fixation. METHOD:A multicentre prospective randomised pilot trial was conducted. Inclusion criteria were pati...
journal_title:International orthopaedics
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s00264-018-4061-1
更新日期:2019-05-01 00:00:00
abstract::Twenty three patients with lumbar spondylolisthesis (6 Grade I, 14 Grade II and 3 Grade III) with low back pain, and radicular pain in 14, were treated surgically when they failed to respond to conservative treatment. Their average age was 33.2 years. Bilateral posterolateral spinal fusions with autologous iliac bone ...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s002640050249
更新日期:1998-01-01 00:00:00
abstract::A randomized, double blind study of low level laser treatment of chondromalacia of the patella in 40 patients has been undertaken. Chondromalacia was established by arthroscopy and was related to subjective symptoms. Eight treatments were given during five weeks by a physiotherapist with the use of a GAAS pulsed laser...
journal_title:International orthopaedics
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF00186879
更新日期:1991-01-01 00:00:00
abstract::This paper is based on an invited lecture given at the SICOT 87 meeting in Munich. The topics discussed include: selective spinal arteriography in the management of tumours, which enables definition of the vascular supply of the cord and of the tumour and may facilitate preoperative embolisation; MRI, which allows vis...
journal_title:International orthopaedics
pub_type: 杂志文章,评审
doi:10.1007/BF00266367
更新日期:1989-01-01 00:00:00
abstract:PURPOSE:Occult intra-operative periprosthetic acetabular fracture is a seldom-reported complication of primary total hip arthroplasty (THA). It may potentially be associated with cup instability and implant loosening. The present study aimed to investigate clinical consequences of this complication. METHODS:Between 20...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-018-4084-7
更新日期:2019-07-01 00:00:00
abstract::Human immunodeficiency virus (HIV) infection has radically changed African orthopaedic practice within a decade. In Lusaka, a third of adults are infected, but most have no physical signs of the disease. Early experience showed that closed fractures healed normally, the risk of sepsis during osteosynthesis was increas...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s002640050074
更新日期:1996-01-01 00:00:00
abstract:PURPOSES:We investigated sequential levels of C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) in uncomplicated ACDF (anterior cervical discectomy and fusion) using allograft and DBM (demineralised bone matrix) for primary cervical spondylosis and/or disc herniation. To our knowledge, there has been no...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-012-1645-z
更新日期:2012-11-01 00:00:00
abstract:AIM OF THE STUDY:The aim of the study was to investigate functional and patient-rated outcome parameters after endoscopic assisted release of the ulnar nerve for cubital tunnel syndrome. METHODS:One hundred of 204 consecutive patients between 2006 and 2011 met the inclusion/exclusion criteria. Fifty-one of these patie...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-018-3760-y
更新日期:2018-06-01 00:00:00
abstract::Discoid meniscus is uncommon and usually affects the lateral meniscus. We present 16 patients (8 male and 6 female) with tears of a discoid lateral meniscus occurring in 1800 arthroscopies. We carried out an arthroscopic partial meniscectomy leaving an intact peripheral rim. This is biomechanically satisfactory and th...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00179715
更新日期:1991-01-01 00:00:00
abstract:PURPOSE:The study aims to analyze the incidence of 30-day mortality in elderly patients who underwent surgery for hip fractures and its associated factors. METHODS:A prospective multicentric study was performed. All patients aged ≥ 65 years, with fragility hip fractures, consecutively admitted in two Italian hospitals...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/s00264-018-4057-x
更新日期:2019-02-01 00:00:00
abstract::A case of bilateral habitual dislocation of the patella associated with cleft lip and palate, and short metatarsals, metacarpals and phalanges is reported. The possible cause of habitual dislocation is discussed in the light of 20 cases which have been seen by the author. ...
journal_title:International orthopaedics
pub_type: 杂志文章
doi:10.1007/BF00183358
更新日期:1990-01-01 00:00:00
abstract:PURPOSE:The mortality rate in patients with haemodynamically unstable pelvic fractures is as high as 40-60%. Despite the new advances in trauma care which are in phase in trauma centres in Hong Kong, the management of haemodynamically unstable pelvic fracture is still heterogeneous. The aim of this study is to review t...
journal_title:International orthopaedics
pub_type: 杂志文章,多中心研究
doi:10.1007/s00264-018-3842-x
更新日期:2018-10-01 00:00:00
abstract:PURPOSE:Controversy still surrounds the optimal treatment for patients with displaced intra-articular calcaneal fractures (DIACF). An up-to-date meta-analysis was performed to evaluate clinical effectiveness of surgical treatment for DIACF compared with nonsurgical treatment. METHODS:We systematically searched four el...
journal_title:International orthopaedics
pub_type: 杂志文章,meta分析,评审
doi:10.1007/s00264-012-1563-0
更新日期:2012-08-01 00:00:00