Abstract:
OBJECTIVE:Heterotopic ossification (HO) develops frequently after modern high-energy penetrating war injuries. The purpose of this prospective study was to identify and characterize the unique cytokine and chemokine profile associated with the development of HO as it pertained to the systemic inflammatory response after penetrating combat-related trauma. METHODS:Patients with high-energy penetrating extremity wounds were prospectively enrolled. Surgical debridement along with the use of a pulse lavage and vacuum-assisted-closure device was performed every 48-72 hours until definitive wound closure. Wound bed tissue biopsy, wound effluent, and serum were collected before each debridement. Effluent and serum were analyzed for 22 relevant cytokines and chemokines. Tissue was analyzed quantitatively for bacterial colonization. Correlations between specific wound and patient characteristics were also analyzed. The primary clinical outcome measure was the formation of HO as confirmed by radiographs at a minimum of 2 months of follow-up. RESULTS:Thirty-six penetrating extremity war wounds in 24 patients were investigated. The observed rate of HO in the study population was 38%. Of the 36 wounds, 13 (36%) demonstrated HO at a minimum follow-up of 2 months. An elevated injury severity score was associated with the development of HO (P = 0.006). Wound characteristics that correlated with the development of HO included impaired healing (P = 0.005) and bacterial colonization (P < 0.001). Both serum (interleukin-6, interleukin-10, and MCP-1) and wound effluent (IP-10 and MIP-1α) cytokine and chemokine bioprofiles were individually associated and suggestive of the development of HO (P < 0.05). CONCLUSIONS:A severe systemic and wound-specific inflammatory state as evident by elevated levels of inflammatory cytokines, elevated injury severity score, and bacterial wound colonization is associated with the development of HO. These findings suggest that the development of HO in traumatic combat-related wounds is associated with a hyper-inflammatory systemic response to injury. LEVEL OF EVIDENCE:Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Evans KN,Forsberg JA,Potter BK,Hawksworth JS,Brown TS,Andersen R,Dunne JR,Tadaki D,Elster EAdoi
10.1097/BOT.0b013e31825d60a5subject
Has Abstractpub_date
2012-11-01 00:00:00pages
e204-13issue
11eissn
0890-5339issn
1531-2291journal_volume
26pub_type
杂志文章abstract:OBJECTIVES:To determine preoperative factors predictive of improvement in pain and function following elective implant removal. We hypothesized that patients undergoing orthopaedic implant removal to relieve pain would have significant improvements in both pain and function. DESIGN:Prospective Cohort Study SETTING:: L...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001920
更新日期:2020-10-13 00:00:00
abstract:OBJECTIVES:To determine whether opioid use disorders (OUDs) are associated with adverse perioperative outcomes in patients undergoing surgical fixation for proximal femur fractures. METHODS:The National Hospital Discharge Survey was queried to identify patients surgically treated for proximal femur fractures between 1...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001118
更新日期:2018-05-01 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: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::Orthopaedic surgery and biomechanics are intimately partnered topics in medicine. Biomechanical principles are used to design implants and fashion treatment protocols. Although it would seem that biomechanical principles in the design of fixation devices and fracture repair constructs have been already finalized, ther...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000001126
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVES:Iliosacral screw pathways in the first (S1) and second (S2) sacral segments are commonly used for adult pelvic ring stabilization. We hypothesize that radiographically "safe" pathways exist in pediatric patients. SETTING:Academic level I Trauma Center. PATIENTS:All patients between ages 2 and 16 years with...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0000000000000421
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVES:Far cortical locking (FCL) constructs have been shown to increase axial interfragmentary displacement while limiting shear and have been specifically recommended in the treatment of distal femur fractures. However, there is no available data regarding their mechanical behavior within the range of bridge span...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001341
更新日期:2019-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to compare the relative stiffness of four common external fixation (XF) configurations used to span and stabilize the knee after knee dislocation. METHODS:Synthetic composite femora and tibiae connected with cords were used to simulate a knee. Four configurations of external fix...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181e3cd4b
更新日期:2010-11-01 00:00:00
abstract::Anterior approaches to the pelvis for acetabular surgery require an intimate knowledge of pelvic anatomy. The utilitarian anterior approach is the ilioinguinal approach. This article will describe a technique for modifying the medial window of the ilioinguinal approach to facilitate intrapelvic visualization and instr...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000266
更新日期:2015-02-01 00:00:00
abstract:PURPOSE:Radial head fractures are some of the most common elbow fractures. Fractures with 3 or more fracture fragments have been shown to have worse outcomes when treated with open reduction and internal fixation (ORIF). Radial head replacement offers an alternative treatment for those more comminuted radial head fract...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001537
更新日期:2019-08-01 00:00:00
abstract:PURPOSE:The purpose of this video is to demonstrate the surgical technique of a shoulder arthrodesis for a patient with multidirectional instability and multiple failed previous surgeries. METHODS:A 25-year-old woman with a long history of left shoulder multidirectional instability in the setting of Ehlers-Danlos synd...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001212
更新日期:2018-08-01 00:00:00
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
更新日期:1988-01-01 00:00:00
abstract::Bone healing after fracture occurs in a well-organized manner and involves a multitude of cell types, inflammatory cytokines, growth factors, prostaglandins, and certain vitamins. Some of the means by which alterations in these essential components affect bone repair are understood, whereas others still need to be del...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e318274da8b
更新日期:2012-12-01 00:00:00
abstract::Segmental defects of the tibia present a challenging problem. This report demonstrates the use of an ipsilateral vascularized fibula transfer (IVFT) in a patient with a 15 cm tibial bone defect following tumor resection. Bone union was achieved within 6 months, and 8 years after the surgery the patient has full knee f...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3180330927
更新日期:2007-03-01 00:00:00
abstract:OBJECTIVES:To investigate whether rotational malalignment of tibia, after fracture management with minimally invasive plate osteosynthesis technique (MIPO), leads to impaired results in knee and ankle joint functional scores. DESIGN:Prospectively collected data was retrospectively analyzed for this study. SETTING:Lev...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000002053
更新日期:2020-12-31 00:00:00
abstract:OBJECTIVE:To evaluate the functional outcomes and pain in patients with unilateral posterior pelvic ring injuries treated with transiliac-transsacral screw fixation compared with unilateral iliosacral screw fixation. DESIGN:Retrospective comparative study. SETTING:Three academic level 1 trauma centers. PATIENTS/PART...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000000622
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:Increasing evidence suggests long-term alendronate use may overly suppress bone metabolism, limiting repair of microdamage and creating risk for insufficiency fractures. The purpose of this study is to demonstrate an association between alendronate use and a specific pattern of low-energy femoral shaft fractu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318172841c
更新日期:2008-05-01 00:00:00
abstract:OBJECTIVES:To determine the rates of infection in low-energy gunshot wounds (GSWs) to the extremity. DESIGN:Retrospective review. SETTING:Level I trauma center. PATIENTS/PARTICIPANTS:Patients (N = 140) with at least 90-day follow-up for extremity-only low-energy GSW injuries from 2010-2014 were retrospectively revie...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000827
更新日期:2017-06-01 00:00:00
abstract:OBJECTIVES:Controversy exists regarding optimum management of lateral compression type 1 (LC1) pelvic ring injuries (OTA type 61-B2.1), particularly in patients with complete sacral fractures. We hypothesized that nonoperative treatment would result in acceptable functional outcomes. DESIGN:Database review. SETTING:L...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000130
更新日期:2014-12-01 00:00:00
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
更新日期:2011-05-01 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:OBJECTIVE:To determine if a dual-purpose bone graft can regenerate bone and reduce infection in highly contaminated bone critical size defects in rats. METHODS:Biodegradable polyurethane (PUR) scaffolds were loaded with recombinant human bone morphogenetic protein-2 (BMP-2) and vancomycin (Vanc). The release kinetics ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31821f624c
更新日期:2011-08-01 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::Long-bone deformity may be significantly symptomatic. A uniplanar corrective osteotomy uses a single cut to correct coronal, sagittal, and axial plane deformity simultaneously. Careful preoperative planning is required in addition to a comprehensive understanding of the magnitude and plane of the true deformity of the...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001519
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVES:To report on the radiographic and clinical outcome of symphyseal plating techniques, with specific attention to the incidence of implant failure, reoperation secondary to implant complication, and ability to maintain reduction of the pelvic ring. DESIGN:Retrospective chart and radiographic review. SETTING:...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31817e49ee
更新日期:2008-07-01 00:00:00
abstract:OBJECTIVES:To investigate the clinical and functional outcome in an elderly population with acetabular fractures after low-energy trauma treated acutely with a total hip arthroplasty supported by a reinforcement ring (Burch-Schneider antiprotrusion cage) and autologous bone grafting of the acetabulum. SETTING:Universi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200303000-00007
更新日期:2003-03-01 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::Leg length discrepancies can occur despite successful union of femur fractures after intramedullary nailing (IMN). Often, the leg length discrepancy can result in significant disability to the patient, altered gait biomechanics, pelvic obliquity, and pain. Therefore, a successful clinical result for such deformities a...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181f92d6e
更新日期:2011-11-01 00:00:00
abstract::Periprosthetic fractures after shoulder arthroplasty occur in up to 2% of patients. In patients with stable components who fail or cannot undergo nonoperative management, stable fixation is required. We present a new technique to obtain proximal fixation around the humeral component using a 4.5-mm large fragment plate...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000935
更新日期:2017-12-01 00:00:00
abstract:OBJECTIVE:To report the results from functional bracing of isolated ulnar shaft fractures. DESIGN:Retrospective review. SETTING:Two university hospitals. PATIENTS:Isolated ulnar shaft fractures in 444 patients were stabilized in functional braces that permitted full range of motion of all joints. INTERVENTION:Prefa...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199808000-00009
更新日期:1998-08-01 00:00:00