Abstract:
OBJECTIVES:The stacked hexapod bone transport technique is an effective treatment for infected tibial nonunions with bone loss. The purpose of this study was to evaluate the patients' risk factors and timing for requiring adjunctive stabilization. DESIGN:Retrospective cohort study. SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS:Seventy-five patients with infected posttraumatic nonunions of the tibia. INTERVENTION:Resection of nonunion with application of stacked hexapod frame for bone transport. MAIN OUTCOME MEASUREMENTS:Parameters measured included age, sex, diabetes, smoking, use of a free flap, bone defect size, length in frame, external fixation index, and direction of lengthening. Outcomes recorded: removal of frame, below knee amputation, or adjunctive stability. Further analysis evaluated location of nonunion, timing of adjunctive stabilization, and type of fixation. RESULTS:The average patient age was 45.7 ± 12.5 years, 76% patients were men, 11% were diabetic, and 44% were smokers. Forty two percent had soft tissue defects that required a free flap. Thirty-eight patients had removal of frame, whereas 36 patients required adjunctive stability of the hexapod frame. Patient receiving adjunctive stabilization had a longer length of time in the hexapod frame (P = 0.026) and were more likely to require a free flap (P = 0.053). Ninety-three percent docking site nonunions occurred after the removal of the frame (P = 0.032); whereas 79% regenerate nonunions occurred before the hexapod frame was removed (P = 0.029). CONCLUSIONS:The use of a hexapod frame for the infected tibial nonunions with bone loss is an effective method for achieving union and eradicating infection in a difficult orthopaedic patient population. Use of adjunctive stabilization is a reasonable technique to address delayed regenerate and docking site nonunions. LEVEL OF EVIDENCE:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Napora JK,Weinberg DS,Eagle BA,Kaufman BR,Sontich JKdoi
10.1097/BOT.0000000000000840subject
Has Abstractpub_date
2017-07-01 00:00:00pages
393-399issue
7eissn
0890-5339issn
1531-2291pii
00005131-201707000-00010journal_volume
31pub_type
杂志文章abstract::We used a mathematical model to determine whether the approach to derotation of the malrotated femur can be improved for use in corrective osteotomy of the femur. Rotational corrective osteotomy of the femur (RCOF) is a procedure performed by orthopedic surgeons to correct congenital femoral torsion deformities and po...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199806000-00012
更新日期:1998-06-01 00:00:00
abstract:OBJECTIVES:To determine the angular rotation that maximizes screw tension without sacrificing screw pullout force yet minimizing loss of screw purchase. METHODS:Three pairs of human humeri in each of the 3 groups (osteopenic, osteoporotic, and normal) underwent screw tension and pullout protocols. For screw tension, 3...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000435631.71393.60
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:To determine whether stimulation with low-intensity ultrasound will reduce the radiologic healing time of fresh tibial shaft fractures fixed with a reamed and statically locked intramedullary rod. DESIGN:Prospective, randomized, double blinded, and placebo controlled. PATIENTS AND METHODS:Thirty-two adult p...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199905000-00005
更新日期:1999-05-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the loss of strength in the distal humerus that resulted from the creation of two different entry portals used for retrograde humeral nailing. DESIGN:Nine pairs, treated as blocks of size two, of fresh frozen humeri from individuals free of musculoskeletal disease w...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200002000-00005
更新日期:2000-02-01 00:00:00
abstract::A study was undertaken to review the results of donor site morbidity of cancellous bone grafts obtained from the proximal tibial metaphysis. Two hundred six patients who underwent 230 proximal tibial bone graft harvestings were reviewed. Patients with lower-extremity fractures or nonunions who required cancellous bone...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199112000-00014
更新日期:1991-01-01 00:00:00
abstract::Osteochondromas are one of the most commonly observed benign bone tumors. Although there have been a number of experimental studies carried out to determine the origin of osteochondromas, their etiology remains a controversial issue. A well-documented case is presented in which a displaced Salter-Harris type II physea...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199410000-00013
更新日期:1994-10-01 00:00:00
abstract::A modified anterior approach to the distal femur is presented. The approach allows surgical exposure of the entire articular surface of the distal femur. The quadriceps muscle bellies are spared during the approach. The skin incision used will not interfere with subsequent total knee arthroplasty, if posttraumatic art...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199902000-00012
更新日期:1999-02-01 00:00:00
abstract:OBJECTIVE:To review our series of open calcaneal fractures compared with other series. DESIGN:Retrospective review. SETTING:All patients were treated at a single Level 1 trauma center. PATIENTS/PARTICIPANTS:We reviewed 19 consecutive patients, each with an open fracture of the calcaneus. Fracture morphology ranged f...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200401000-00002
更新日期:2004-01-01 00:00:00
abstract::A mechanically improved design of bone plate and screw was compared in vivo with conventional plate fixation. This method was investigated biologically in a standardized osteotomy model on sheep tibiae. It was found that maintenance of reduction of an osteotomy was facilitated and there was no adverse effect of this f...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199109000-00006
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVES:The objective of this study was to evaluate donor site morbidity associated with anterior iliac crest bone graft harvesting for orthopaedic trauma reconstructions. DESIGN:Retrospective case series. SETTING:Level 1 trauma center. PATIENTS:Forty-Six consecutive patients who had undergone anterior iliac cres...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000551
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:To determine whether the cost of nonoperative treatment, including those who require delayed operative treatment, is less than those receiving initial operative management. METHODS:We identified 4 recent randomized controlled trials comparing operative and nonoperative treatment of displaced midshaft clavic...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,meta分析,评审
doi:10.1097/BOT.0000000000000225
更新日期:2015-04-01 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::Transverse fractures at the distal tip of a well-fixed femoral prosthesis are difficult to stabilize using plates and screws due to the presence of the underlying intramedullary stem. The attachment of plates using cerclage wires obviates the need for screws, but the stability provided by cerclage plating is a clinica...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199505000-00004
更新日期:1995-01-01 00:00:00
abstract:OBJECTIVES:To evaluate the relationship between mechanism of injury and mortality in geriatric trauma patients and the ability of existing injury severity indices (ISIs) to assess mortality. DESIGN:Retrospective review. SETTING:Urban level 1 trauma center. PARTICIPANTS:Four thousand five hundred forty-five trauma pa...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000281
更新日期:2015-07-01 00:00:00
abstract::A modified freehand method using a cannulated drill bit for the insertion of distal locking screws for interlocking intramedullary nails is described. It should be useful to introduce surgeons to interlocking and to aid those who are not comfortable with the freehand method. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199306000-00009
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to determine if proximity of cannulated lag screws to the articular surface of the patella combined with the tension band technique affects resistance to fracture gap opening, and if an alternative locking nut and bolt device without a tension band behaves in a biomechanically si...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31826f5985
更新日期:2012-12-01 00:00:00
abstract:OBJECTIVES:The increasing number of fractures of the proximal humerus, especially in the elderly, carries with it the unsolved problem of the optimal treatment for the displaced or unstable fractures. The authors' goal was to analyze whether fixation with a bent valgus angled blade plate could improve the outcomes repo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200604000-00004
更新日期:2006-04-01 00:00:00
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
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:To determine whether operating on "major" vertebral fractures leads to premature abortion of surgery and/or other acute cardiopulmonary complications. DESIGN:Retrospective review. CLINICAL SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS AND INTERVENTION:We retrospectively queried our institutional Tra...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001316
更新日期:2019-01-01 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:Comparison of the effect of stainless steel and titanium low-contact dynamic compression plate application on the vascularity and mechanical properties of cortical bone after fracture. DESIGN:Randomized, prospective. SETTING:Orthopaedic research laboratory. ANIMALS:Ten large (greater than twenty-five kilo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199710000-00006
更新日期:1997-10-01 00:00:00
abstract::Successful treatment of periprosthetic femur fractures, like all fractures, requires careful attention to understand the fracture pattern nuances, identifying and executing a rational treatment approach, and providing an appropriate postoperative recovery protocol. Unlike most other fractures, modification of standard...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000282
更新日期:2015-03-01 00:00:00
abstract:OBJECTIVE:To examine the impact of number and position of locking screws in the diaphyseal portion of an osteoporotic distal femoral fracture model with hybrid fixation. METHODS:Four groups containing 5 osteoporotic bone models were used with varying combinations of diaphyseal screw fixation: 4 nonlocking screws (cont...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318238c086
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVE:Syndesmotic instability may coexist with unstable Weber B supination-external rotation (SE) lateral malleolar fractures. Current recommendations suggest that Weber B injuries should not have associated syndesmotic instability after open reduction and internal fixation of the lateral malleolus. The purpose of ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318157a63a
更新日期:2007-10-01 00:00:00
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::In patients who are candidates for a total knee arthroplasty and suffer a periarticular fracture of the femur, the arthroplasty may be performed after bony union of the fracture or immediately, in conjunction with the fracture repair. Herein we present the case of a sixty-year-old female with rheumatoid arthritis and ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199906000-00014
更新日期:1999-06-01 00:00:00
abstract:OBJECTIVES:To determine the current published patterns of computed tomography (CT) use postoperatively in peri-articular fractures and identify those populations whereby postoperative CT changes management or results in better clinical outcomes. DATA SOURCES:Systematic review of MEDLINE and Cochrane using a combinatio...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,meta分析,多中心研究
doi:10.1097/BOT.0000000000000660
更新日期:2017-01-01 00:00:00
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::Thirty-five patients with four-part displaced proximal humeral fractures and fracture-dislocations were retrospectively reviewed from the years 1977-1990. Thirty-three patients were available for study. All fractures were treated by open reduction and internal fixation allowing early motion. Surgical technique was as ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199312000-00002
更新日期:1993-01-01 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