Abstract:
OBJECTIVE:The purpose of this study was to examine the results of computed tomography angiography (CTA) obtained in patients with high-energy tibial plafond fractures and assess if the information gleaned from CTA could be useful to the treating orthopedic surgeon. DESIGN:Consecutive patient series. SETTING:Level 2 trauma center. PATIENTS:Consecutive patients treated between October 1, 2004 and June 31, 2006 for high-energy injury of the tibial plafond according to a protocol of early temporizing external fixation, CT, and elevation, followed by delayed reconstruction of the tibial plafond. INTERVENTION:Addition of angiography to CT scan (CTA) in treatment protocol. MAIN OUTCOME MEASUREMENTS:CTA abnormalities were identified and categorized to define the pattern of arterial lesions present. Characteristics of patients, injuries, treatments, and complications were evaluated and related to CTA findings. RESULTS:CTA was performed at an average of 3 days postinjury in 25 consecutive patients treated for high-energy tibial plafond fractures. Abnormalities of the arterial tree of the leg were seen in 13 of 25 (52%) patients. One patient had 2 of 3 vessels notably injured. Fourteen arteries showed acute changes at the level of injury and 1 showed significant chronic atherosclerotic disease at the trifurcation. Acute arterial abnormalities included 7 arteries with complete occlusion, 2 with partial occlusion/diminished flow, and 5 with normal flow but with anatomic disturbances (4 tenting over and 1 entrapped by fracture fragments). Open fractures were associated with arterial abnormalities (P<0.05), but no other characteristics correlated with arterial injury. No patients had dye reactions or other problems relating to CTA. Patients with CTA-diagnosed vascular abnormalities were treated with more minimally invasive surgery than those without at the discretion of the surgeon, and no patients with vascular abnormalities had wound problems or infection. CONCLUSIONS:In more than half of high-energy tibial plafond fractures, CTA identified significant abnormalities to the arterial tree of the distal leg. These injuries most commonly involved the anterior tibial artery and included a variety of lesions. CTA appears to be a safe and potentially useful tool for the assessment and preoperative planning of high-energy tibial plafond fractures.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
LeBus GF,Collinge Cdoi
10.1097/BOT.0b013e31815cf6e9subject
Has Abstractpub_date
2008-01-01 00:00:00pages
16-22issue
1eissn
0890-5339issn
1531-2291pii
00005131-200801000-00005journal_volume
22pub_type
杂志文章abstract::Forty-three patients with 43 comminuted femoral shaft fractures treated with the Brooker-Wills interlocking nail were followed through bony union to determine the device's ability to maintain length and rotational control of these difficult injuries. Only severely comminuted fractures, types III and IV, were included....
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198702010-00002
更新日期:1987-01-01 00:00:00
abstract:OBJECTIVE:To analyze the mechanical stability of locked plating in comparison with tension-band wiring for the fixation of fractures of the patella. METHODS:Biomechanical tests were performed on artificial foam patella specimens comparing an angular stable plate and monocortical screws with tension-band wiring. Tests ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000309
更新日期:2015-09-01 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::The best results following fractures of the distal humerus are provided by anatomic reduction and rigid internal fixation. Plates of two designs placed in five different fixation configurations were used to determine the construct that would maximize rigidity of fixation of the distal humerus. Using a cadaver distal h...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract::Operative management of patella fractures continues to be associated with poor outcomes and high reoperation rates. Traditionally, tension band fixation has been used for more simple fracture patterns; however, fixation remains a challenge particularly for comminuted fractures. More recently, various types of plate fi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000908
更新日期:2017-08-01 00:00:00
abstract::Patella fractures are challenging orthopaedic injuries. Many commonly used fixation techniques can be ineffective and lead to poor clinical outcomes even with satisfactory reductions and fracture healing. In this investigation, we present the technique of cage plate fixation of patella fractures and the clinical outco...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0000000000000415
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVES:To document the high failure rate of a specific implant: the Synthes Variable Angle (VA) Locking Distal Femur Plate. DESIGN:Retrospective. SETTING:Urban University Level I Trauma Center. PATIENT/PARTICIPANTS:All distal femur fractures (OTA/AO 33-A, B, C) treated from March 2011 through August 2013 were re...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000391
更新日期:2016-01-01 00:00:00
abstract:BACKGROUND:Because embalming has been demonstrated to decrease the mechanical integrity of bone, most investigators favor fresh-frozen specimens for biomechanical evaluation. However, little is known about how the integrity of fresh--frozen specimens may change during biomechanical testing or may be affected by standar...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318225b875
更新日期:2011-08-01 00:00:00
abstract::Theoretically, fissures and minor fractures of the pelvis sustained by the elderly after low-energy trauma may lead to thromboembolic complications. Few studies exist, but clinically, these injuries had been considered to have an excellent prognosis until a recent study reported a 10% fatality rate from pulmonary embo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-198906000-00005
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVES:We developed a protocol to determine the timing of definitive fracture care based on the adequacy of resuscitation. Inception of this project required a multidisciplinary group, including physicians from anesthesiology, general trauma and critical care, neurosurgery, orthopaedic spine, and orthopaedic trauma...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000383
更新日期:2015-11-01 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:OBJECTIVES:To compare the Disability of the Arm, Shoulder, and Hand (DASH) and Constant scores, time to union, rate of union, patient cosmetic satisfaction rate, and the need for secondary procedures between 2.7- and 3.5-mm anteroinferior plating for Arbeitsgemeinschaft für Osteosynthesefragen (AO)/Orthopaedic Trauma A...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182693f32
更新日期:2013-03-01 00:00:00
abstract::The application of a pelvic clamp for provisional stability of unstable pelvic fractures has been advocated in the orthopaedic literature. Although the technique has gained some supporters, problems with placement and associated complications have prevented widespread acceptance. We have modified the pelvic clamp (ACE...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000175156.92743.db
更新日期:2006-01-01 00:00:00
abstract::This paper presents a modified surgical technique for interlocked intramedullary stabilization of tibia fractures. An external distractor is used to achieve an indirect fracture reduction on a fluoroscopy table. This method avoids the potential traction complications associated with conventional fracture tables. The f...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:1992-01-01 00:00:00
abstract:OBJECTIVES:To determine the most commonly associated injuries, complications, and healing rates of patients sustaining segmental tibial shaft fractures. DESIGN:Retrospective review. SETTING:Two Level I trauma centers. PATIENTS:A total of 108 patients with segmental tibial shaft fractures were identified between 2005...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000001132
更新日期:2018-06-01 00:00:00
abstract:OBJECTIVE:To determine if cancellous screw (CS) and sliding hip screw (SHS) technical factors during low-energy femoral neck fracture fixation affects a 24-month revision surgery rate and health-related quality of life (HRQL). DESIGN:Prospective randomized controlled study. SETTING:International, multicenter. PATIEN...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001891
更新日期:2021-02-01 00:00:00
abstract::Seat belt legislation has resulted in increased restraint use by passengers in automobiles in Washington State. At Harborview Medical Center in Seattle, we have observed an increased incidence of seat belt-related injuries. Twenty cases of Chance-type thoracolumbar flexion-distraction fractures were reviewed retrospec...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199105020-00006
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVES:To evaluate the role of a modified Pauwels' intertrochanteric osteotomy (MPIO) in neglected femoral neck fractures in children. DESIGN:Prospective study with retrospective analysis. SETTING:Tertiary care Postgraduate Institute of Medical Sciences. PATIENTS:Ten children (8 males, 2 females) with an average...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31804cfdad
更新日期:2007-04-01 00:00:00
abstract::A case of a complex distal humeral fracture is presented. The patient lacked sufficient bony architecture to allow for conventional reconstruction. A technique is described using an intramedullary plate to obtain bony stabilization and permit early range of motion exercises. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200205000-00011
更新日期:2002-05-01 00:00:00
abstract::A rare case of a complete fracture-separation of the proximal radial epiphysis is described in a pediatric patient. A further complicating factor is the delay in diagnosis that may worsen prognosis. An emphasis on early detection by physical examination and imaging studies, as well as consideration of treatment option...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-199506000-00013
更新日期:1995-06-01 00:00:00
abstract::The difficulty in assessing femoral rotation during intramedullary nailing is well-established. Navigation systems allow the surgeon to detect and set the version of the injured leg at the desired angle. We report the first cases of navigated femoral nailing using noninvasive registration of the contralateral uninjure...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31812f69a9
更新日期:2007-11-01 00:00:00
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 evaluate the effect of negative pressure wound therapy (NPWT) on deep infection rate in open tibial fractures. DESIGN:Retrospective cohort study. Data was collected from medical records and radiographs. SETTING:Two level-1 trauma centers. PATIENTS/PARTICIPANTS:Patients who sustained an open tibial frac...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31824133e3
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVES:To identify factors affecting the outcomes of surgery for acetabular fracture in patients over the age of 60 years. DESIGN:Retrospective review of records and radiographs; current examination, radiographs and outcome surveys when possible. SETTING:Academic, Level 1 trauma center. PATIENTS/PARTICIPANTS:For...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200310000-00005
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVES:This study aimed to evaluate the incidence and morphologic features of posterolateral fragments in lateral and bicondylar tibial plateau fractures. DESIGN:This study used retrospective chart and computed tomography (CT) reviews. SETTING:The study was conducted in a university hospital. PATIENTS:All patien...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000170
更新日期:2015-02-01 00:00:00
abstract::Fifteen patients with fractures of the extremities and associated arterial injuries treated from 1976 to 1987 were retrospectively analyzed. Complete ischemia was present in only two cases; in four cases with partial ischemia, the vascular injury presented late after 12 h-14 days. All limbs could be preserved, but com...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199103000-00005
更新日期:1991-01-01 00:00:00
abstract::In our search for an osteosynthesis device that would tolerate the surgical errors of the inexperienced surgeon, we tested in vitro femoral stiffness in 75 human osteoporotic femora after internal fixation of a cervical neck osteotomy using three commonly used devices: two von Bahr screws (A. Ericsson AB, Sweden), two...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199608000-00009
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVES:We evaluated the economic aspects of an orthopaedic trauma section at a regional Level I, semi-academic community hospital. This study analyzes the economics of a dedicated hospital-based orthopaedic trauma program. METHODS:Institutional financial reports were analyzed for 2 time periods. In the pre-program...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31816bae67
更新日期:2008-04-01 00:00:00
abstract::Not all fractures heal well or rapidly in the adult skeleton, and basic scientists and clinicians continue to search for ways to make fractures heal more predictably. It is a fundamental tenet of orthopaedics that skeletal injury is followed by inflammation and that this inflammatory response is the first stage in a s...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e3181f17b33
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVES:Because locked plates as a neutralization device for lag screw fracture fixation have different biomechanics than that of unlocked plates, we investigated how this would affect lag screw load at the fracture site. The purpose of this study was to assess the load at a fracture site compressed with a lag screw...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31823b3dd1
更新日期:2012-09-01 00:00:00