The use of a biodegradable, load-bearing scaffold as a carrier for antibiotics in an infected open fracture model.

Abstract:

OBJECTIVES:Open fractures with bone loss are common, disabling injuries. Biodegradable, load-bearing scaffolds able to carry high concentrations of local antibiotics are an emerging technology to address these injuries. This study investigates the use of such scaffolds with gentamicin (along with bone morphogenetic protein) in an infected rat open fracture model to decrease osteomyelitis and promote fracture healing. METHODS:A contaminated open fracture was created in 32 Brown Norway rats. A comminuted femoral fracture was created, followed by crushing, and the 5-mm bone defect was inoculated with Staphylococcus aureus (10 colony-forming units/mL) and Escherichia coli (10 colony-forming units/mL). The scaffold was stabilized in the defect with an intramedullary Kirschner wire. Gentamicin was loaded onto the scaffolds at two doses, either 10 mg (n = 12) or 20 mg (n = 10). Controls (n = 10) received no antibiotics. All three groups had 10 microg bone morphogenetic protein loaded on the scaffold. Serial radiographs were obtained. Microbiologic analysis, microcomputed tomography, and histology were performed. RESULTS:There was a statistically significant difference in the radiographic evidence of osteomyelitis (P = 0.004) and callus formation (P = 0.021) between the treated and control groups. Bone culture analysis results were not significant for S. aureus (P = 0.29) or E. coli (P = 0.25). There was no difference in the mean scaffold volume or density of the three treatment groups. CONCLUSIONS:Our results suggest that gentamicin applied to a biodegradable scaffold is effective at decreasing radiographically defined osteomyelitis in an infected open fracture.

journal_name

J Orthop Trauma

authors

Stewart RL,Cox JT,Volgas D,Stannard J,Duffy L,Waites KB,Chu TM

doi

10.1097/BOT.0b013e3181ed1349

subject

Has Abstract

pub_date

2010-09-01 00:00:00

pages

587-91

issue

9

eissn

0890-5339

issn

1531-2291

pii

00005131-201009000-00016

journal_volume

24

pub_type

杂志文章
  • Predictors of reoperation following operative management of fractures of the tibial shaft.

    abstract:BACKGROUND:Accurate prediction of likelihood of reoperation in patients with tibial shaft fractures would facilitate optimal management. Previous studies were limited by small sample sizes and noncomprehensive examination of possible risk factors. OBJECTIVE:We conducted an observational study to determine which progno...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-200305000-00006

    authors: Bhandari M,Tornetta P 3rd,Sprague S,Najibi S,Petrisor B,Griffith L,Guyatt GH

    更新日期:2003-05-01 00:00:00

  • Do locking screws work in plates bent at holes?

    abstract:OBJECTIVES:To assess whether plate bending at a hole significantly changes the biomechanical properties of a locked screw. METHODS:Coronal plane bends of 5-, 15-, or 45-degree angles were placed in 3.5-mm locking compression plates with the apex at a locking hole. An additional 45-degree angle test group was created i...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3182a73a77

    authors: Boulton CL,Kim H,Shah SB,Ryan SP,Metzger TA,Hsieh AH,O'Toole RV

    更新日期:2014-04-01 00:00:00

  • Biomechanical Stability of Volar Plate Only Versus Addition of Dorsal Ulnar Pin Plate: A Dorsal Ulnar Fragment, C-3-Type, Distal Radius, Cadaver Fracture Model.

    abstract:OBJECTIVE:To determine if the addition of a dorsal ulnar pin plate provides improved stability characteristics in the management of intra-articular distal radius fractures with an associated dorsal ulnar fragment. METHODS:OTA/AO type C3 fractures, with a dorsal ulnar fragment of one-third or one-half the width of the ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001776

    authors: Patrick NC,Lewis GS,Roush EP,Black SS,Henderson SR,Taylor KF

    更新日期:2020-09-01 00:00:00

  • Getting organized in your job.

    abstract::The benefits of being organized when starting one's career are countless and worth the time and effort in developing an effective and efficient practice. Established protocols, good habits, and methodical communication that include all members of the team will help create a system that keeps all components of one's pr...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3182a52344

    authors: Siegel J

    更新日期:2013-10-01 00:00:00

  • Use of Nonopioid Analgesics and the Impact on Patient Outcomes.

    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

    authors: Sanzone AG

    更新日期:2016-05-01 00:00:00

  • Volar radiocarpal dislocation with ulnar translocation.

    abstract::The first known reported case of volar radiocarpal dislocation with ulnar translocation is described with a review of previous literature on the isolated components of these injuries. Radiographic criteria for their diagnosis are presented with recommendations for early operative intervention to minimize the risk of s...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/00005131-198802040-00009

    authors: Penny WH 3rd,Green TL

    更新日期:1988-01-01 00:00:00

  • A biomechanical analysis of internal fixation of complex tibial plateau fractures.

    abstract:OBJECTIVE:To compare the mechanical stability of fixation of an unstable bicondylar tibial plateau fracture with several different fixation techniques in a cadaveric model. DESIGN:Randomized laboratory investigation using a simulated bicondylar tibial plateau fracture with metaphyseal-diaphyseal dissociation. SETTING...

    journal_title:Journal of orthopaedic trauma

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1097/00005131-199911000-00005

    authors: Horwitz DS,Bachus KN,Craig MA,Peters CL

    更新日期:1999-11-01 00:00:00

  • Modified Judet approach and minifragment fixation of scapular body and glenoid neck fractures.

    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

    authors: Jones CB,Cornelius JP,Sietsema DL,Ringler JR,Endres TJ

    更新日期:2009-09-01 00:00:00

  • A new ankle spanning fixator construct for distal tibia fractures: optimizing visualization, minimizing pin problems, and protecting the heel.

    abstract::Pilon and ankle fractures and ligamentous injuries about the ankle often require external fixation to allow for soft tissue stabilization before definitive surgery. Often used external fixator constructs can cause obscuring of the site of injury on radiographs, pin tract infections, loosening of calcaenal pin fixation...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3182604639

    authors: Ziran BH,Morrison T,Little J,Hileman B

    更新日期:2013-02-01 00:00:00

  • Femoral and cruciate blood flow after retrograde femoral reaming: a canine study using laser Doppler flowmetry.

    abstract:OBJECTIVE:To determine the effect of retrograde femoral reaming on the blood flow of the distal femur and the cruciate ligaments. DESIGN:Canine experimental study. SETTING:Tertiary referral and teaching hospital in Toronto, Canada. PARTICIPANTS:Thirteen skeletally mature, cross-bred dogs. MAIN OUTCOME MEASURE:Red c...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199805000-00007

    authors: ElMaraghy AW,Schemitsch EH,Richards RR

    更新日期:1998-05-01 00:00:00

  • Efficacy of popliteal block in postoperative pain control after ankle fracture fixation: a prospective randomized study.

    abstract:OBJECTIVES:To compare postoperative pain control in patients treated surgically for ankle fractures who receive popliteal blocks with those who received general anesthesia alone. DESIGN:Institutional Review Board approved prospective randomized study. SETTING:Metropolitan tertiary-care referral center. PATIENTS:All ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/BOT.0b013e3182638b25

    authors: Goldstein RY,Montero N,Jain SK,Egol KA,Tejwani NC

    更新日期:2012-10-01 00:00:00

  • Metaphyseal screw augmentation of the LISS-PLT plate with polymethylmethacrylate improves angular stability in osteoporotic proximal third tibial fractures: a biomechanical study in human cadaveric tibiae.

    abstract:OBJECTIVES:The incidence of osteoporotic proximal tibial fractures has increased during the last 2 decades. A promising approach in osteoporotic fracture fixation is polymethylmethacrylate-based cement augmentation of implants to gain better implant purchase in the bone. This study investigates the biomechanical benefi...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000004

    authors: Goetzen M,Nicolino T,Hofmann-Fliri L,Blauth M,Windolf M

    更新日期:2014-05-01 00:00:00

  • Can We Estimate the Amount of Malrotation in Supracondylar Humerus Fractures After CRPP?

    abstract:BACKGROUND:Acceptable amounts of malrotation after CRPP for pediatric supracondylar humerus fracture (SCHFx) have yet to be defined. This is an attempt to correlate radiographic parameters of a malrotated SCHFx with degrees of rotational malalignment to assist intraoperative assessment of reduction. METHODS:3D models ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001735

    authors: Prabhakar P,Pierce WA,Standefer KD,Ho CA

    更新日期:2020-07-01 00:00:00

  • Posterior tibial tendon tear after 4-cortex syndesmotic screw fixation: a case report and literature review.

    abstract::We describe a previously unreported problem of a patient who underwent errant 4-cortex syndesmotic screw fixation with resultant posterior tibial tendon tear necessitating removal of hardware and repair of a tendon tear. ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/BOT.0b013e31821e127f

    authors: Kwon JY,Campbell JT,Myerson MS

    更新日期:2012-06-01 00:00:00

  • Mechanical effects of off-axis insertion of locking screws: should we do it?

    abstract:OBJECTIVES:The purposes of this study were to evaluate the cantilevered bending strength and failure modes of locking screws inserted at various angles in a plate with fully circumferential threaded holes. As an additional measure, the amount of screw head prominence at these angles was also assessed. METHODS:Standard...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000000066

    authors: Cartner JL,Petteys T,Tornetta P 3rd

    更新日期:2014-01-01 00:00:00

  • Nonunion of capital femoral physeal fracture with a large metaphyseal fragment.

    abstract::This report presents a case demonstrating the nonunion of a capital femoral physeal fracture with a large metaphyseal fragment in a 10-year-old boy. To our knowledge, there is no previously reported case of this type of nonunion. The treatment of this nonunion presented a potential risk of premature physeal closure an...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3181c83a3b

    authors: Yukata K,Kubo T,Matsui Y,Koizumi T,Takata S,Yasui N

    更新日期:2010-08-01 00:00:00

  • Anteroinferior 2.7-mm versus 3.5-mm plating for AO/OTA type B clavicle fractures: a comparative cohort clinical outcomes study.

    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

    authors: Galdi B,Yoon RS,Choung EW,Reilly MC,Sirkin M,Smith WR,Liporace FA

    更新日期:2013-03-01 00:00:00

  • Midshaft clavicle nonunions treated with intramedullary Steinman pin fixation and onlay bone graft.

    abstract::The current literature tends to favor rigid internal fixation with plates for symptomatic midclavicular nonunions. From 1985 to 1992, 14 patients with clavicular nonunions were treated by open reduction and intramedullary Steinman pin fixation with onlay iliac crest bone grafting. The average age of patients was 36 ye...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199404000-00002

    authors: Capicotto PN,Heiple KG,Wilbur JH

    更新日期:1994-01-01 00:00:00

  • Multiplanar Fixation for Patella Fractures Using a Low-Profile Mesh Plate.

    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

    authors: Lorich DG,Warner SJ,Schottel PC,Shaffer AD,Lazaro LE,Helfet DL

    更新日期:2015-12-01 00:00:00

  • The Clinical Utility of Additional Axillary and Velpeau Radiographs in the Evaluation of Suspected Shoulder Trauma.

    abstract:OBJECTIVES:To investigate the clinical utility of additional axillary or Velpeau views in evaluating potential shoulder trauma after a standard radiograph series of anteroposterior, Grashey, and/or trans-scapular views. DESIGN:Retrospective study. SETTING:Level I academic medical center. PATIENTS:All patients in a 1...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001760

    authors: Cruz SA,Castillo H,Chintapalli RTV,Adams OE,Morgan VK,Koh JL,Lee MJ,Shi LL

    更新日期:2020-08-01 00:00:00

  • Immediate interlocking nailing of fractures of the femur caused by low- to mid-velocity gunshots.

    abstract::A retrospective review of 39 fractures of the femur in 37 patients caused by low- and mid-velocity handgun missiles treated with static interlocking nailing within 18 h of injury was conducted to evaluate the efficacy, safety, and cost savings of immediate intramedullary nailing in these injuries. Patients were follow...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199404000-00010

    authors: Nowotarski P,Brumback RJ

    更新日期:1994-01-01 00:00:00

  • Greenstick fracture of the scapula: a cause of scapular winging.

    abstract::A case of an angulated, greenstick fracture of the scapula mimicking scapular winging in a skeletally immature 12-year-old boy is described. The bony deformity was visualized with plain radiography. CT was helpful in exclusion of a thoracic injury or an underlying neoplasm. Closed reduction yielded satisfactory result...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/01.bot.0000174707.10980.f4

    authors: Bowen TR,Miller F

    更新日期:2006-02-01 00:00:00

  • Physical Performance Limitations After Severe Lower Extremity Trauma in Military Service Members.

    abstract:OBJECTIVES:To characterize the type and magnitude of lower extremity physical performance deficits in military service members who have undergone rehabilitation after limb salvage or transtibial amputation. DESIGN:Cross-sectional prospective. SETTING:Level I trauma military medical and rehabilitation center. PATIENT...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001103

    authors: Wilken JM,Roy CW,Shaffer SW,Patzkowski JC,Blanck RV,Owens JG,Hsu JR

    更新日期:2018-04-01 00:00:00

  • Induced Membrane Technique: Pearls and Pitfalls.

    abstract::The induced membrane technique for reconstruction of bone defects has proved its effectiveness and is now widely accepted. The 2 stages procedure, implying a cement spacer in the first stage and a huge bone graft in the second stage, responds to rigorous technical details involving each phase of the procedure. Prerequ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/BOT.0000000000000979

    authors: Masquelet AC

    更新日期:2017-10-01 00:00:00

  • Three-dimensional computerized tomographic demonstration of bilateral atlantoaxial rotatory dislocation in an adult: report of a case and review of the literature.

    abstract::A rare case of bilateral atlantoaxial rotatory dislocation (Fielding type V) in an adult is presented. The diagnosis was rapidly made by computed axial tomography. Prior reports of this entity have not clearly defined the pathoanatomy, which in our case was confirmed by three-dimensional tomographic reconstruction. We...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,评审

    doi:10.1097/00005131-199402000-00015

    authors: Born CT,Mure AJ,Iannacone WM,DeLong WG Jr

    更新日期:1994-01-01 00:00:00

  • Reverse shoulder prosthesis for acute four-part fracture: tuberosity fixation using a horseshoe graft.

    abstract::Results of hemiarthroplasty for complex four-part proximal humerus fractures in the elderly have been unreliable. Although patients often achieve pain relief, return of above-shoulder level function can be challenging, because tuberosity nonunion, malunion, and/or resorption is quite common. The reverse shoulder repla...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e3181f22088

    authors: Levy JC,Badman B

    更新日期:2011-05-01 00:00:00

  • Late salvage of failed open reduction and internal fixation of posterior wall fractures of the acetabulum.

    abstract:OBJECTIVES:The purpose of this study was to review the outcome of late revision surgery in a series of patients with posterior wall fractures having recurrent hip instability after failed initial open reduction and internal fixation. DESIGN:Retrospective analysis of consecutive patients. SETTING:Level 1 trauma center...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0b013e31819a07cf

    authors: Dean DB,Moed BR

    更新日期:2009-03-01 00:00:00

  • Assessment of Open Syndesmosis Reduction Techniques in an Unbroken Fibula Model: Visualization Versus Palpation.

    abstract:OBJECTIVES:This cadaveric study sought to evaluate the accuracy of syndesmotic reduction using direct visualization via an anterolateral approach compared with palpation of the syndesmosis through a laterally based incision. METHODS:Ten cadaveric specimens were obtained and underwent baseline computed tomography (CT) ...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/BOT.0000000000001322

    authors: Pang EQ,Coughlan M,Bonaretti S,Finlay A,Bellino M,Bishop JA,Gardner MJ

    更新日期:2019-01-01 00:00:00

  • Computed tomographic scanning of cervical spine fractures: does it influence treatment?

    abstract:OBJECTIVE:To determine whether the superior sensitivity of computed tomography (CT) results in changes in treatment plans for cervical spine fractures that have been diagnosed on plain films alone. DESIGN:Retrospective review of radiographic studies for cervical spine trauma. SETTING/PARTICIPANTS:An orthopaedic spine...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章

    doi:10.1097/00005131-199906000-00003

    authors: Katz MA,Beredjiklian PK,Vresilovic EJ,Tahernia AD,Gabriel JP,Chan PS,Heppenstall RB

    更新日期:1999-06-01 00:00:00

  • Calcaneal Avulsion Fractures: A Multicenter Analysis of Soft-Tissue Compromise and Early Fixation Failure.

    abstract:OBJECTIVE:To characterize the presentation and outcomes of calcaneal avulsion fractures. DESIGN:Case series. SETTING:Two ACS Level I trauma centers. PATIENTS/PARTICIPANTS:Forty-seven calcaneal avulsion fractures isolated from a cohort of 1365 calcaneus fractures treated over a 17-year period. MAIN OUTCOME MEASUREME...

    journal_title:Journal of orthopaedic trauma

    pub_type: 杂志文章,多中心研究

    doi:10.1097/BOT.0000000000001582

    authors: Mitchell PM,OʼNeill DE,Branch E,Mir HR,Sanders RW,Collinge CA

    更新日期:2019-11-01 00:00:00