Abstract:
OBJECTIVE:To describe a novel approach for the treatment of nonunions of diaphyseal femur fractures. DESIGN:Retrospective review. SETTING:University hospital. PATIENTS:Seven patients (six men, one woman, average age 42.5 years) with diaphyseal femoral fracture nonunions treated between November 2006 and November 2007 were reviewed. The injuries included two open and five closed fractures. All were treated initially with intramedullary nail fixation (two antegrade, five retrograde) and went on to develop a symptomatic nonunion by radiographic and clinical criteria. INTERVENTION:Nonunions were treated with operative débridement of the nonunion with plate fixation and autogenous bone grafting without removal or exchange of the intramedullary nail. MAIN OUTCOME MEASURES:Clinical criteria of decreased pain and return to function as well as radiographic evidence of fracture consolidation. RESULTS:All patients demonstrated radiographic evidence of fracture consolidation with an average follow-up time of 17.9 months (range 12-26 months). All were allowed immediate weightbearing and reported decreased pain with improved function. Six patients reported absolutely no pain with ambulation as related to the fracture site, whereas one noted discomfort about the distal femoral compression plate. Independent ambulation was observed in six subjects. None of the patients required additional operations for implant removal or bone grafting procedures. CONCLUSION:Treatment of diaphyseal femoral fracture nonunion after intramedullary nail fixation with large fragmentary compression plating and bone grafting is a reasonable option, especially for complex fractures about the metadiaphyseal region. The procedure appears to be successful in reducing pain, improving function, and predictably leads to radiographic consolidation of the nonunion.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Hakeos WM,Richards JE,Obremskey WTdoi
10.1097/BOT.0b013e3181dfbb33subject
Has Abstractpub_date
2011-02-01 00:00:00pages
84-9issue
2eissn
0890-5339issn
1531-2291pii
00005131-201102000-00004journal_volume
25pub_type
杂志文章abstract:OBJECTIVE:Lateral cortical stress reactions have been documented to precede femoral insufficiency fractures after long-term bisphosphonate therapy. We studied the natural history of femoral stress lesions associated with long-term bisphosphonate therapy. DESIGN AND SETTING:A retrospective clinical and radiologic revie...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181b6499b
更新日期:2010-02-01 00:00:00
abstract:OBJECTIVES:The aim of the current study was to analyze distraction osteogenesis histomorphometrically to investigate the amount of enchondral ossification adjacent to intramembranous ossification. STUDY DESIGN:Species-specific, longitudinal time study. METHODS Lengthening of 25% of the right tibia was performed in 24 ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200302000-00006
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVE:To evaluate objectively the effectiveness of current surgical management of displaced acetabular fractures. To provide insight into how these evaluation methods can be used to identify areas in which improvements in surgery and rehabilitation can be pursued to improve patient outcomes. DESIGN:Consecutive cas...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200202000-00001
更新日期:2002-02-01 00:00:00
abstract::To evaluate the use of a two-prong splint for displaced, proximal, humerus, epiphyseal fractures, seven children with Neer-Horwitz Classification Type 3-4 fractures of the proximal humerus were retrospectively investigated. After closed reduction, fracture stabilization was accomplished with the use of a two-prong spl...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200309000-00007
更新日期:2003-09-01 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: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 t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31815cf6e9
更新日期:2008-01-01 00:00:00
abstract:OBJECTIVES:To explore the effect of intramedullary pin size on the biology of a healing fracture, specifically endochondral angiogenesis. We hypothesized that fracture fixation with a smaller pin would permit greater interfragmentary strain resulting in increased total amount of vascular endothelial growth factor withi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001555
更新日期:2019-10-01 00:00:00
abstract::The effect of ultrasound (US) on the rate of fibula osteotomy healing in 139 mature New Zealand white rabbits was assessed in this study. Bilateral midshaft fibular osteotomies were made using a 1-mm Gigli saw. US was noninvasively applied to one limb for 20 minutes daily, while the contralateral limb served as a cont...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199004030-00002
更新日期:1990-01-01 00:00:00
abstract::Percutaneous iliosacral screw (IS) fixation for pelvic ring injuries with the use of an O-arm imaging system has been associated with decreased procedure time and improved accuracy of IS screw placement compared with the use of fluoroscopic guidance. Specifically, patients with sacral dysmorphism require identificatio...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001213
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:To compare single versus multiple procedures in the same surgical setting. We hypothesized that complication rates would not be different and length of stay would be shorter in patients undergoing multiple procedures. DESIGN:Prospective, cohort. SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS:A total...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000556
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To determine the relative stability achieved in unstable supracondylar femur fractures treated with long (36 cm) and short (20 cm) retrograde intramedullary nails using 1 or 2 proximal locking bolts. We hypothesized that longer nails would reduce fracture site motion compared with short nails and that 2 proxi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200407000-00004
更新日期:2004-07-01 00:00:00
abstract::Two unusual cases of symptomatic partial rupture of the extensor carpi ulnaris tendon associated with ulnar-styloid nonunion are described. Intraoperative findings suggested that the jagged surface of the distal ulna was the cause of flaying. In one case, debridement of the frayed extensor carpi ulnaris tendon and fix...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-200210000-00011
更新日期:2002-10-01 00:00:00
abstract:OBJECTIVES:To determine factors associated with angular malalignment of femoral shaft fractures treated with intramedullary nails and to determine differences in the incidence of angular malalignment based on fracture location, fracture comminution, and method of treatment (i.e., antegrade or retrograde). DESIGN:Retro...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200102000-00003
更新日期:2001-02-01 00:00:00
abstract:OBJECTIVES:Hospitals and providers that accept transfer patients risk lower ratings on publically reported quality measures that are inadequately adjusted for infirmity and complexity. We compared the outcomes of transferred patients and nontransferred patients after treatment of a hip fracture and sought to determine ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31821146b1
更新日期:2011-11-01 00:00:00
abstract:OBJECTIVE:Risk for bleeding complications during and after early hip fracture surgery for patients taking clopidogrel and other anticoagulants have not been defined. The purpose of this study is to assess the perioperative bleeding risks and clinical outcome after early hip fracture surgery performed on patients taking...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318240d70f
更新日期:2012-10-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the most appropriate positioning of anatomical locking plates on the distal tibia. METHODS:We positioned 4 types of locking plates (3 straight and 1 bayonet) at anterior, middle, and posterior positions on the medial malleolus on both lower limbs of 15 cadavers. We ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31827cd67d
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVES:To relate the incidence of implant failure after internal anterior fixation of the pelvic ring to functional outcome and the health-related quality of life in patients. DESIGN:Retrospective chart and radiographic review. SETTING:Level I Trauma center. METHODS:We retrospectively identified all patients who...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000501
更新日期:2016-06-01 00:00:00
abstract::Understanding complex acetabular fractures is difficult and may require three-dimensional reformatted computed tomographic (CT) images. This paper evaluates a technique, digital rotational imaging (DRI), that displays multiple oblique images of the pelvis and acetabulum. When viewed statically, DRI provides optimal il...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199801000-00011
更新日期:1998-01-01 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:Malalignment has been frequently reported after intramedullary stabilization of distal tibia fractures. Nails have also been associated with knee pain in several studies. Historically, plate fixation has resulted in increased risks of infection and nonunion. Our purposes were to compare plate and nail stabil...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/BOT.0b013e318213f709
更新日期:2011-12-01 00:00:00
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
更新日期:2020-09-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine the extent to which the Mangled Extremity Severity Score (MESS) predicted outcomes for soldiers sustaining combat-related Gustilo-Anderson type III open tibia fractures. DESIGN:Retrospective cohort study. SETTING:Tertiary trauma center. PATIENTS:Service Members w...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000054
更新日期:2014-09-01 00:00:00
abstract:OBJECTIVE:To investigate whether a long bone cortex of well-defined thickness can be regenerated by using an anatomically designed membranous resorbable "tube-in-tube" implant and to establish the functions of membranes in the healing of segmental diaphyseal bone defects larger than the "critical size." DESIGN:Bone he...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199903000-00006
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVES:To evaluate use of intraoperative fluoroscopy during acetabular surgery to determine fracture reduction and accurate placement of screws. DESIGN:Retrospective. SETTING:Level I trauma center. PARTICIPANTS:Thirty patients with thirty-two acetabular fractures. INTERVENTION:Patients were evaluated with fluor...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199908000-00004
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVES:To compare radiographic and clinical outcomes of supination external rotation type IV equivalent (SER IV E) ankle fractures (AO/OTA classification 44-B2.1) treated with transsyndesmotic screw fixation with those treated with deltoid and posterior inferior tibiofibular ligament (PITFL) repair. DESIGN:Case se...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000318
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:To compare the strength of fixation obtained using two unicortical 4.0 mm diameter cancellous screws versus two bicortical 3.5 mm diameter cortical screws in the fixation of intra-articular calcaneus fractures. DESIGN:In eight paired fresh frozen cadaver feet, the subtalar joint complex, consisting of the ta...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199701000-00008
更新日期:1997-01-01 00:00:00
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
更新日期:2020-07-01 00:00:00
abstract::In March 2016, North American academic leaders with an interest in and commitment to the field of global orthopaedics met in Orlando, Florida, to gauge each institution's clinical, research, and educational programs in developing countries, establish the main limitations to participating in global health efforts, and ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001288
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVES:For intramedullary nailing of tibial shaft fractures, a recent study has determined that the entry site should be just medial to the lateral tibial spine at the anterior margin of the articular surface. Gaining access to this site is often through a medial parapatellar or transpatellar approach. Several stud...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200211000-00001
更新日期:2002-11-01 00:00:00
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
更新日期:1994-01-01 00:00:00