Abstract:
OBJECTIVE:To observe and report the clinical results of indirect reduction and plating in the treatment of distal femoral nonunions. DESIGN:Prospective consecutive study. SETTING:Regional trauma center. PATIENTS:A consecutive series of twenty patients with nonunion of the distal femur, nineteen of whom had undergone operative initial fracture care. INTERVENTION:Surgical treatment with indirect reduction techniques using the 95-degree condylar blade-plate, condylar buttress plate, or locking condylar plate with autologous cancellous bone grafting in 45 percent of patients. Emphasis was placed on preoperative planning, intraoperative attention to soft tissue sparing, and selection of the appropriately applied implant to correct deformity, when present, and obtain union. MAIN OUTCOME MEASUREMENTS:Healing rate and time, operative blood loss and time, incidence of complications including instrumentation failure, loss of fixation, infection, and postoperative malalignment. Both the Böstman and Hospital for Special Surgery knee scores were used to quantify postoperative clinical results at an average follow-up of twenty-three months (range 12 to 60 months). RESULTS:All twenty nonunions healed without further intervention at an average of fourteen weeks (range 12 to 20 weeks) postoperatively. There were no intraoperative complications. Average operative time was 154 minutes (range 90 to 240 minutes), and blood loss was 245 milliliter (range 100 to 400 milliliters). Average Böstman knee score improved from eighteen to twenty-five points, and average Hospital for Special Surgery score improved from fifty-eight to eighty points. Average arc of knee motion improved from 92 to 110 degrees. There was no patient with significant postoperative axial or rotational malalignment (>5 degrees) or limb length discrepancy (more than one centimeter). One patient with a history of osteomyelitis became infected postoperatively and healed without consequence after a debridement procedure. CONCLUSIONS:Contemporary plating techniques are effective in the treatment of distal femoral nonunions. Union occurred reliably with few complications, resulting in a majority of good or excellent clinical results.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Bellabarba C,Ricci WM,Bolhofner BRdoi
10.1097/00005131-200205000-00001subject
Has Abstractpub_date
2002-05-01 00:00:00pages
287-96issue
5eissn
0890-5339issn
1531-2291journal_volume
16pub_type
杂志文章abstract::Salvage of limb length following oblique proximal foot amputations is presented. The technique, results, and follow-up of this procedure are described and compared with other standard procedures. A prospective study was done on 3 adolescents who presented consecutively during years 1999 and 2000. The salvage procedure...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000164168.94365.49
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVES:To assess the treatment preferences of orthopaedic surgeons for displaced three- and four-part proximal humerus fractures. DESIGN:Cross-sectional survey. SETTING:Academic and nonacademic institutions across Canada. PATIENTS/PARTICIPANTS:Members of the Canadian Orthopedic Trauma Society and the Joint Ortho...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181bdc46a
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVES:To determine the effects of tubular resorbable polymer membranes on the healing of a segmental diaphyseal bone defect. DESIGN:A randomized prospective study using the minipig model. Animals were evaluated with in vivo roentgenograms on a biweekly basis until explanted at twelve weeks. SETTING:After surgery...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199711000-00002
更新日期:1997-11-01 00:00:00
abstract:OBJECTIVES:To identify associated injuries that occur in varus posteromedial rotatory instability (VPMRI) of the elbow and present their surgical management. DESIGN:Level II retrospective study. SETTING:Tertiary referral center. PATIENT/PARTICIPANTS:Twenty-seven patients with VPMRI injuries treated surgically over a...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001313
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVES:We studied the safety of immediate weight bearing as tolerated (IWBAT) and immediate range of motion (IROM) following open reduction internal fixation (ORIF) of selected malleolar ankle fractures (defined as involving bony or ligamentous disruption of two or more of the malleoli or syndesmosis without articu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000002003
更新日期:2020-11-09 00:00:00
abstract:OBJECTIVES:To compare the static and dynamic mechanical properties of a modified crossed cannulated screw (CS) configuration, the inverted triangle (IT) cannulated screw configuration, and a compression hip screw (CHS) with derotation screw in Pauwels type III femoral neck fractures. METHODS:Thirty synthetic femora we...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000836
更新日期:2017-07-01 00:00:00
abstract:OBJECTIVE:To identify the fracture characteristics that can be reliably assessed by analysis of plain radiographs of tibial plateau fractures. DESIGN:Radiographic review study. PARTICIPANTS:Five orthopaedic traumatologists served as observers. INTERVENTION:Observers made assessments based on the radiographs of fifty...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200008000-00001
更新日期:2000-08-01 00:00:00
abstract:OBJECTIVES:To investigate whether a conventional fracture hematoma block (FHB) or an ultrasound-guided peripheral nerve block has more superior analgesic effect during nonoperative management of distal radius fractures in an emergency department setting. Two peripheral nerve block types were investigated, one at the le...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/BOT.0000000000001388
更新日期:2019-04-01 00:00:00
abstract::A simulation study of distal interlocking of an intramedullary nail was performed using newly devised, portable stereo fluoroscopy. Two intramedullary nails in which ten holes were drilled perpendicular to the long axis and at various angles to the diameter were inserted into a femoral and a tibial bone model. Ten dri...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199705000-00014
更新日期:1997-05-01 00:00:00
abstract::Traumatic spinal cord injuries have a tremendous impact on individuals, families, and society as a whole. Substantial heterogeneity in the patient population, their presentation and underlying pathophysiology has sparked debates along the care spectrum from initial assessment to definitive treatment. This article revi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000943
更新日期:2017-09-01 00:00:00
abstract:OBJECTIVES:To determine whether severe open tibial fractures in children behave like similar fractures in adults. DESIGN AND SETTING:A combined retrospective and prospective review evaluated treatment protocol for type II and type III open tibial fractures in children over a ten-year period from 1984 to 1993. PATIENT...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199707000-00010
更新日期:1997-07-01 00:00:00
abstract::Although opioids are widely used for the management of pain in patients with hip fracture, these medications are known to have a wide range of adverse effects that can result in suboptimal outcomes or serious life-threatening complications. Common opioid-related adverse events include gastrointestinal effects, central...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000563
更新日期:2016-05-01 00:00:00
abstract::Minifragment implants provide several advantages for the stabilization of distal humerus fractures. Compared with small fragment implants, minifragment implants may provide enhanced fracture fixation because a greater number of screws can be placed into the distal fragments. In addition, minifragment plates are easier...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000157908.45939.d7
更新日期:2005-08-01 00:00:00
abstract::Healing patterns were compared between transverse and 60 degrees oblique osteotomies in canine tibiae stabilized under external fixation. Under similar in vitro testing conditions (osteotomy ends in contact), the axial stiffness of the oblique osteotomy under external fixation was 45% of the paired transverse osteotom...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199109000-00016
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVES:Prophylaxis against thromboembolic complications has become routine after major orthopedic surgery. In contrast, it remains an issue for debate whether prophylaxis after minor surgery and immobilization is necessary, even though these treatments are well-known risk factors for deep-vein thrombosis (DVT). The...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/01.bot.0000250741.65003.14
更新日期:2007-01-01 00:00:00
abstract::Our purpose was to determine the incidence of deep-vein thrombosis (DVT) in patients who have had early operative fixation of fractures of the lower extremity distal to the hip. There is a high incidence of distal thrombosis in patients who have undergone early operative fixation of lower-extremity fractures. The inci...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199605000-00002
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Combined rupture of the anterior cruciate ligament (ACL) and patellar tendon (PT) is a rare injury pattern. Currently, little evidence exists to help guide management decisions for these patients. METHODS:A systematic literature search was conducted using PubMed (MEDLINE) and Scopus (EMBASE and MEDLINE) for...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001219
更新日期:2018-08-01 00:00:00
abstract::A modified freehand method using a cannulated drill bit for the insertion of distal locking screws for interlocking intramedullary nails is described. It should be useful to introduce surgeons to interlocking and to aid those who are not comfortable with the freehand method. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199306000-00009
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:To describe in utero radiation exposures in pregnant patients undergoing acetabular fracture repair. DESIGN:Retrospective case series. SETTING:University-affiliated regional trauma center. PATIENT/PARTICIPANTS:Eight pregnant patients with acetabular fractures treated over a 6-year period. There were an add...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181847a42
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:The treatment of some pelvic injuries has evolved recently to include the use of a subcutaneous anterior pelvic fixator (INFIX). We present 8 cases of femoral nerve palsy in 6 patients after application of an INFIX to highlight this potentially devastating complication to pelvic surgeons using this technique ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000193
更新日期:2015-03-01 00:00:00
abstract::Fractures of the femur have long been a major cause of morbidity and mortality in developing countries and are most frequently caused by road traffic accidents. Intramedullary nail fixation has become the gold standard of care for diaphyseal fractures of the femur. However, modern techniques require proper implants, a...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000001407
更新日期:2019-05-01 00:00:00
abstract::Rotational ankle fractures are incredibly common, resulting in a wide spectrum of bony and ligamentous injury patterns. After open reduction of an ankle fracture, the treating surgeon must always evaluate syndesmotic stability. If the syndesmosis is determined to be unstable, a reduction of the distal tibiofibular joi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000588
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVES:To compare the results between a new intramedullary Gamma nail and a compression hip screw in the treatment of trochanteric fractures. DESIGN:Prospective randomized. SETTING:Level 1 trauma center. PATIENTS:Two hundred ten consecutive patients older than 65 years with trochanteric femoral fractures. INTER...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.bot.0000151819.95075.ad
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVES:To describe the technique and to determine the outcome of operatively treated displaced scapular body or glenoid neck fractures using minifragment fixation through a modified Judet approach. DESIGN:Retrospective review of scapular or glenoid fractures. SETTING:Level 1 teaching trauma center. PATIENTS:All ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181a18216
更新日期:2009-09-01 00:00:00
abstract:OBJECTIVE:To study the activity and incidence of knee pain after sustaining an isolated tibia fracture treated with an infrapatellar intramedullary nail at 1 year. DESIGN:Retrospective review of prospective cohort. SETTING:Multicenter Academic and Community hospitals. PATIENTS:Four hundred thirty-seven patients with...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000000475
更新日期:2016-03-01 00:00:00
abstract:OBJECTIVES:Retrospective evaluation of the long-term outcomes after surgical treatment of traumatic patellar dislocations in adolescents and identification of possible predictive factors of poor outcomes. DESIGN:Retrospective clinical study. SETTING:University Clinic, Level I Trauma Center. PATIENTS:All 33 adolescen...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318299cb50
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to analyze the appropriateness of transfer of patients with orthopaedic injuries to a Level I trauma center from surrounding Level II to IV centers. DESIGN:A prospective study was conducted over a 5-month period by collecting data on all orthopaedic patients being transferred ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181b18b89
更新日期:2010-06-01 00:00:00
abstract::Fractures and dislocations of the sternum may be associated with flexion-compression injuries of the thoracic spine. Sternal injuries most commonly occur at or near the sternomanubrial joint. We present a patient with a known thoracic spine fracture who developed a subsequent late-onset, symptomatic sternomanubrial di...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199509040-00014
更新日期:1995-01-01 00:00:00
abstract:INTRODUCTION:External rotation and gravity stress radiographs have been described to distinguish stable supination-external rotation-II (SER-II) ankle fractures from unstable SER-IV fractures. It has been previously shown that both external rotation and gravity stress views are equivalent in their ability to diagnose d...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000817
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of exchange reamed nails for treatment of aseptic femoral delayed unions and nonunions. DESIGN:Retrospective chart review. PATIENTS:Nineteen patients admitted to the Carolinas Medical Center Level I trauma center from 1990 to 1996 for repair of femoral shaft fracture nonunion ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200006000-00005
更新日期:2000-06-01 00:00:00