Abstract：
UNLABELLED:Information on the microbiology of infections after operative ankle fractures, on the details of a treatment protocol used when the ankle joint is preserved, and on the outcome of this protocol will be helpful for the physicians managing patients with this complex problem. We therefore determined the most common pathogen of these infections, the infection recurrence rate, and the amputation rate. We retrospectively reviewed 26 patients of a mean age of 43 years with infections following operative treatment of ankle fractures. Twenty-one of 26 patients (81%) were compromised hosts according to the Cierny-Mader classification. Patients presenting up to 10 weeks postoperatively were treated by débridement and either hardware retention (if implants were judged stable) or hardware removal (if implants were loose). All patients presenting more than 10 weeks postoperatively underwent débridement and hardware removal, with the exception of one patient who underwent below knee amputation. Staphylococcus aureus was identified in 17 patients (65%) and was oxacillin-resistant in six (23%). The infection recurred in five of 18 patients who were followed up for 8 months on average. Three recurrent infections were controlled with repeat débridement. The remaining two patients underwent below-knee amputation, resulting in amputations in 3 of 18 patients. Infection after operative treatment of ankle fractures is a limb-threatening complication, especially in patients with comorbidities, such as diabetes mellitus. Treatment is challenging with high infection recurrence and amputation rates. LEVEL OF EVIDENCE:Level IV, therapeutic study case series.
journal_name
Clin Orthop Relat Resjournal_title
Clinical orthopaedics and related researchauthors
Zalavras CG,Christensen T,Rigopoulos N,Holtom P,Patzakis MJdoi
10.1007/s11999-009-0743-8subject
Has Abstractpub_date
2009-07-01 00:00:00pages
1715-20issue
7eissn
0009-921Xissn
1528-1132journal_volume
467pub_type
杂志文章abstract：:Trauma remains a significant and persistent public health problem, accounting for 90,000 deaths and 20 million people disabled annually. Current concepts of appropriate triage and emergency treatment of gunshot wounds are addressed from a trauma surgeon's perspective. Recent studies regarding prehospital transport pol...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200303000-00006
更新日期：2003-03-01 00:00:00
abstract：BACKGROUND:Metal-on-metal (MOM) THA bearing technology has focused on improving the arc of motion and stability and minimizing wear compared with traditional metal-on-polyethylene (MOP) bearing couples. It is unclear whether this more costly technology adds value in terms of improved implant survival. QUESTIONS/PURPOS...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-013-2821-1
更新日期：2013-06-01 00:00:00
abstract：:In 63 anatomic specimens of the shoulder, the coracohumeral ligament was found to be a clear, well-developed structure in 59 and absent or vestigial in four. The origin of the coracohumeral ligament was consistently found at the base of the coracoid process. The insertion was more variable, between the rotator interva...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1992-07-01 00:00:00
abstract：BACKGROUND:Grip strength reflects functional status of the upper extremity and has been used in many of the clinical studies regarding upper extremity disease or fracture. However, the smallest difference in grip strength that a patient would notice as an improvement resulting from treatment (defined as the minimum cli...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-014-3666-y
更新日期：2014-08-01 00:00:00
abstract：:Mechanical evaluation of healing fractures in rabbits suggests that tensile testing both minimizes artifacts and permits direct intrinsic determinations of tissue quality. In healing osteotomies in the rabbit fibula, there is a rapid return of stiffness at 16 days, correlating with callus maturation. The failure mode ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-01-01 00:00:00
abstract：:Lead markers were placed on various osseous structures of the talus and calcaneus in fresh amputation specimens to analyze the radiographic anatomy of the hindfoot. Analysis of the talocalcaneal articulations revealed that only the central one-third of the posterior subtalar joint can be visualized on the lateral proj...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-07-01 00:00:00
abstract：:In a series of children's hip fracture seen over a 27-year-period, there were 39 patients (40 fractures) with a mean age of 8.9 years followed for an average 7 years. After an initial period of traction, 50% of the fractures were treated in a spica cast, 40% by internal fixation, and 10% by bed rest. Overall, there we...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1980-06-01 00:00:00
abstract：:Onset of firing for the quadriceps, hamstrings, and gastroc soleus groups during running, both on a treadmill and over ground, was determined in seven normal adult male subjects. Surface and wire electrode data were collected simultaneously from 959 individual gait cycles. The mean velocity over ground was 274 +/- 38 ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1983-06-01 00:00:00
abstract：:The success of a total hip arthroplasty (THA) is dependent on many more parameters than simply the prosthesis used. This study has demonstrated that a randomized controlled clinical trial of 250 patients comparing two types of hip prostheses (cemented versus cementless) with virtually complete follow-up examination is...
journal_title：Clinical orthopaedics and related research
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1994-01-01 00:00:00
abstract：:Five patients treated with gentamicin-polymethylmethacrylate (PMMA) beads were monitored during the treatment of nine to 14 days. Kinetic data of the gentamicin delivery were gathered constantly by multiple samples of blood and urine. The treatment with 48-360 beads caused a gentamicin serum concentration of 0.03-0.4 ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1986-04-01 00:00:00
abstract：:A follow-up study was carried out on 20 patients with a Hitchcock type of biceps tenodesis performed during the past seven years at the Hospital for Special Surgery. Thirteen cases were diagnosed as biceps tendinitis and seven as biceps instability. At follow-up, there was a 30% failure rate; the failures were related...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1982-04-01 00:00:00
abstract：:In this series of 62 free flap transfers, 48 (80%) have been successful. There have been a significant number of vascular complications, 39% of which the majority were arterial thrombosis. Fifty per cent of those which thrombosed were salvaged on exploration and revision of the vessels. The frequency of complications ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1978-06-01 00:00:00
abstract：:Despite the clinical success of total knee arthroplasty, little information can be found in the literature about the relationship between certain postoperative physical findings and the outcome. Specifically, is the range of motion related to patient perception of outcome? We performed a cohort prospective study on 48...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/BLO.0b013e318046ccb7
更新日期：2007-07-01 00:00:00
abstract：:The etiology of aseptic loosening of prosthetic joint replacement components is unclear. Implant materials have been considered biologically inert, but recently studies indicate that inflammatory reactions directed against the implanted materials may contribute to aseptic loosening. Data suggesting a progression from ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199605000-00008
更新日期：1996-05-01 00:00:00
abstract：:Tibial articular cartilage and the knee meniscus from cast-immobilized rabbits whose quadriceps were electrically stimulated for 17 days were compared with those from cast-immobilized rabbits without muscle stimulation. Cartilage from non-stimulated rabbits showed evidence of deep fibrillation and loss of Safranin O m...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1984-10-01 00:00:00
abstract：:The results of a dome-shaped osteotomy of the proximal third of the fifth metatarsal in patients with symptomatic bunionette deformity were reviewed. The series was comprised of eight patients (10 feet; mean age of patients, 21 years). The average followup was 30 months. All patients were free from pain at the fifth m...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200203000-00026
更新日期：2002-03-01 00:00:00
abstract：:Two untreated completely dislocated hips were examined pathologically in a 74-year-old male dissecting room cadaver. The femoral heads bilaterally were 9 cm above the acetabular fossae. They lay adjacent to each ilium with no secondary acetabulum formation. A thickened and markedly elongated fibrous capsule appeared t...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1976-09-01 00:00:00
abstract：BACKGROUND:Arthroplasty for shoulder fractures is a technically challenging and unpredictable procedure and its use is controversial. QUESTIONS/PURPOSES:We therefore asked (1) to what degree function would be restored, (2) whether tuberosity healing would reliably occur, and (3) whether stem design would influence fun...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-011-1919-6
更新日期：2011-12-01 00:00:00
abstract：:Local antibiotic delivery is an emerging area of study designed to provide alternative methods of treatment to clinicians for compromised wound sites where avascular zones can prevent the delivery of antibiotics to the infected tissue. Antibiotic-loaded bone cement is the gold standard for drug-eluting local delivery ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-008-0228-1
更新日期：2008-06-01 00:00:00
abstract：:One hundred twenty-six primary total hip arthroplasties composed of a hybrid cemented femoral component and a cementless acetabular component were followed for a minimum of two years (mean, 42 months). The average patient age was 63 years. The most common diagnosis was osteoarthritis (85 hips), although 13 of the case...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-12-01 00:00:00
abstract：:Pulled elbow and hypermobility of joints are frequently seen in young children, the latter occurring in 5% of the general population. A group of 100 children with pulled elbows, composed of 64 girls and 36 boys with a mean age of 25.5 months, and their parents were checked for joint hypermobility in a prospective stud...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1990-08-01 00:00:00
abstract：:Of 36 fractures of the talar neck without comminution of the body, eight were undisplaced, treated closed, and 28 were displaced and treated by open reduction. Twenty of the operations were less than 12 hours after injury. Nineteen of 20 were performed through a medial approach, six with a medial malleolar osteotomy. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1985-10-01 00:00:00
abstract：:Although hemiarthroplasties are an important treatment for femoral neck fractures, the literature does not provide a clear approach for selecting the implant fixation method. Therefore, we performed a systematic search of the medical literature and identified 11 prospective and retrospective studies that compared resu...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s11999-008-0368-3
更新日期：2008-10-01 00:00:00
abstract：BACKGROUND:T1ρ MRI has been shown feasible to detect the biochemical status of hip cartilage, but various region-of-interest strategies have been used, compromising the reproducibility and comparability between different institutions and studies. QUESTIONS/PURPOSES:The purposes of this study were (1) to determine repr...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1007/s11999-016-5011-0
更新日期：2017-04-01 00:00:00
abstract：:Palsies of the lower cranial nerves occurred in association with traumatic atlantoaxial dissociations in two patients. The fracture-dislocations sustained were rare injuries and the neurologic complications contributed greatly to their morbidity and mortality. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1991-05-01 00:00:00
abstract：:The Exeter stem and impacted, morselized allograft bone and cement were used in the revisions of 18 consecutive femoral components (17 patients). The primary arthroplasty had been done because of osteoarthritis. All of the femoral components were revised for the first time because of aseptic loosening. The migration p...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-200108000-00018
更新日期：2001-08-01 00:00:00
abstract：:Forty-six patients with 48 operatively fixed unstable posterior pelvic ring disruptions were observed for an average of 44 months. Two thirds of the patients returned to their original jobs and 16% changed jobs because of an associated injury. Sixty-three percent of the patients had no pain or pain only on strenuous a...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199608000-00022
更新日期：1996-08-01 00:00:00
abstract：:Rupture of the peroneus longus tendon with an associated fracture of the os peroneum is an uncommon injury, which may present as chronic lateral ankle instability. There have been only seven cases documented in the literature since 1966. A case of chronic peroneus longus tendon rupture with os peroneum fracture is pre...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章,评审
doi：10.1097/00003086-199908000-00021
更新日期：1999-08-01 00:00:00
abstract：:The objective of lower extremity amputation surgery is to create a viable, functional residual limb to maximize patient mobility and independence. When part or all of the forefoot is lost to trauma, infection or gangrene, and the hindfoot is viable, every attempt should be made to preserve as much foot function as pos...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：10.1097/00003086-199904000-00012
更新日期：1999-04-01 00:00:00
abstract：:Fifteen patients with spondylolysis have received compression screw and bone graft treatment for repair of this defect. In all but one case, solid fusion of the pars defect was achieved within six months after surgery. After one year, 13 of the 15 patients were able to participate fully in sports activities. ...
journal_title：Clinical orthopaedics and related research
pub_type： 杂志文章
doi：
更新日期：1989-09-01 00:00:00
