Treatment of tibial plateau fractures by limited internal fixation.

Abstract:

:Seventy-five adults who sustained 76 tibial plateau fractures were treated according to a prospective protocol using instability in extension as the principal indication for operative fixation. Patients showing instability underwent closed manipulative reduction under fluoroscopic guidance. If significant joint depression persisted after reduction, elevation of the fracture was performed either from below using bone punches through a cortical window or via limited arthrotomy. Iliac crest bone graft was used to buttress depressed fractures. Fixation was then secured using 7-mm cannulated screws with washers or buttress plates and screws. Postoperatively, 58 of 76 knees were managed in a hinged knee brace, allowing the patient early range of motion and protected weightbearing for 8 weeks. Patients who were found to have a stable knee were treated with Bledsoe braces according to the postoperative protocol. In the 75 patients, 18 of the 76 knees were unsuitable for percutaneous screw fixation because of fracture complexity requiring plates, severe open injuries, or inadequate reductions with limited fixation had been done. A minimum followup of 12 months was obtained in 55 patients (range, 12-59 months). All fractures had healed at the time of followup. Eighty-seven percent of the patients at followup had a successful outcome using Rasmussen's criteria. Fourteen of these patients had arthroscopic assisted reduction or evaluation. All seven patients who had poor outcomes had AO Type C3 fracture patterns. Severely depressed or comminuted fractures or fractures with significant metaphyseal diaphyseal extension may not be suitable for this technique and require the addition of an external fixation device or buttress plate to maintain the reduction and allow for early range of motion.

journal_name

Clin Orthop Relat Res

authors

Duwelius PJ,Rangitsch MR,Colville MR,Woll TS

doi

10.1097/00003086-199706000-00007

subject

Has Abstract

pub_date

1997-06-01 00:00:00

pages

47-57

issue

339

eissn

0009-921X

issn

1528-1132

pub_type

杂志文章
  • Computer-assisted tumor surgery in malignant bone tumors.

    abstract:BACKGROUND:Small recent case series using CT-based navigation suggest such approaches may aid in surgical planning and improve accuracy of intended resections, but the accuracy and clinical use have not been confirmed. QUESTIONS/PURPOSES:We therefore evaluated (1) the accuracy; (2) recurrences; and (3) function in pat...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1007/s11999-012-2557-3

    authors: Wong KC,Kumta SM

    更新日期:2013-03-01 00:00:00

  • Case report: Rhodococcus erythropolis osteomyelitis in the toe.

    abstract::The Rhodococcus species rarely cause musculoskeletal infections, with only two cases reported in the literature. We report the case of a 53-year-old woman who had an infection develop after first metatarsophalangeal joint fusion. A year after surgery, she continued to have pain and swelling with nonunion. She underwen...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1007/s11999-009-0901-z

    authors: Roy M,Sidhom S,Kerr KG,Conroy JL

    更新日期:2009-11-01 00:00:00

  • Delayed fracture healing in primary hyperparathyroidism.

    abstract::The incidence of fractures in primary hyperparathyroidism is highly variable. The possibility that there might be an increased susceptibility to fracture is discussed. Healing in most is without delay. Three cases of delayed or nonunion following fracture are presented. In all three, healing accelerated dramatically a...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Lancourt JE,Hochberg F

    更新日期:1977-05-01 00:00:00

  • Treatment and outcomes of pelvic malunions and nonunions: a systematic review.

    abstract:UNLABELLED:Although acute management of pelvic fractures and their long-term functional outcome have been widely documented, important information regarding malunion and nonunion of these fractures is sparse. Despite their relative rarity, malunions and nonunions cause disabling symptoms and have major socioeconomic im...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章,评审

    doi:10.1007/s11999-009-0712-2

    authors: Kanakaris NK,Angoules AG,Nikolaou VS,Kontakis G,Giannoudis PV

    更新日期:2009-08-01 00:00:00

  • Soft tissue attachments of the ulnar coronoid process. An anatomic study with radiographic correlation.

    abstract::Regan and Morrey proposed a 3-type coronoid fracture classification observing that the incidence of concommitant elbow dislocation was proportional to fragment size. Elbow instability associated with coronoid fractures presumably is related to disrupted bony architecture and ineffective stabilizers attached to the fre...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Cage DJ,Abrams RA,Callahan JJ,Botte MJ

    更新日期:1995-11-01 00:00:00

  • Incidence of contralateral THA after index THA for osteoarthritis.

    abstract:BACKGROUND:Currently more than 200,000 THAs are performed annually in the United States. In patients with bilateral disease, the chance of subsequent contralateral THA reportedly ranges from 16% to 85%. Factors influencing contralateral THA are not completely understood. QUESTIONS/PURPOSES:We therefore determined (1) ...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1007/s11999-011-2110-9

    authors: Sayeed SA,Johnson AJ,Jaffe DE,Mont MA

    更新日期:2012-02-01 00:00:00

  • Arthroscopic treatment of lateral epicondylitis: clinical and cadaveric studies.

    abstract::Clinical and cadaveric studies were done to investigate the role of a degenerative fringe of the radiocapitellar complex subluxating in the radiocapitellar joint in patients with lateral epicondylitis. In the clinical study, arthroscopic resection of this capsular complex was done. Thirty patients with recalcitrant sy...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1097/01.blo.0000176143.08886.fe

    authors: Mullett H,Sprague M,Brown G,Hausman M

    更新日期:2005-10-01 00:00:00

  • Outcomes after scarf osteotomy for treatment of adult hallux valgus deformity.

    abstract:BACKGROUND:Many procedures have been developed to correct hallux valgus deformity using distal soft tissue realignment, metatarsal osteotomy, and periodically, a proximal phalanx osteotomy (Akin). The ideal metatarsal osteotomy allows for varying degrees of correction with reliable improvement in deformity and patient ...

    journal_title:Clinical orthopaedics and related research

    pub_type: 临床试验,杂志文章

    doi:10.1007/s11999-010-1510-6

    authors: Adam SP,Choung SC,Gu Y,O'Malley MJ

    更新日期:2011-03-01 00:00:00

  • The relationship of the accessory navicular to the development of the flat foot.

    abstract::The Kidner procedure has been the most frequently recommended form of surgical treatment for the painful accessory navicular. This formal relocation of the posterior tibial tendon is said to restore the dynamic balance to the foot which is lost when the posterior tibial tendon gives an abnormal insertion into the acce...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Sullivan JA,Miller WA

    更新日期:1979-10-01 00:00:00

  • A special guide for insertion of multiple pins for fracture of the hip: experience with 200 cases.

    abstract::Two hundred cases of intracapsular femoral neck fractures have been treated with a multiple parallel pin technique similar to that originated by Austin Moore. The technique employs a personally designed guide which facilitates insertion of multiple parallel pins. The fixation obtained satisfactorily resists shear stre...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Modny MT,Kaiser AJ

    更新日期:1978-11-01 00:00:00

  • Early pathogenesis of hemophilic arthropathy. Evolution of the subchondral cyst.

    abstract::Observations of the knee joint made at surgical synovectomy in young children with the chronic synovitis stage of hemophilic arthropathy permitted description of the evolution of the subchondral cyst in this disease. Beginning as a subchondral hematoma beneath the load-bearing surfaces of the joint, the subchondral cy...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Speer DP

    更新日期:1984-05-01 00:00:00

  • Surgical treatment of the tibia in osteogenesis imperfecta.

    abstract::Segmentation and intramedullary rod fixation of the tibia have been found to be safe and effective procedures in osteogenesis imperfecta. An extensible rod is more difficult to insert than a solid rod due to the problem of obtaining an adequate fit distally, so the practical advantage of one type over the other is not...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Niemann KM

    更新日期:1981-09-01 00:00:00

  • The Otto Aufranc Award. Strut allograft healing to the femur with recombinant human osteogenic protein-1.

    abstract::Allograft struts are used to reinforce the deficient proximal femur in hip arthroplasty or for fixation of a periprosthetic fracture. Although the use of strut grafts wired or cabled to the proximal femur generally has been successful, the time for healing is slow. The purpose of the current study was to determine whe...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1097/00003086-200012000-00006

    authors: Cook SD,Barrack RL,Santman M,Patron LP,Salkeld SL,Whitecloud TS 3rd

    更新日期:2000-12-01 00:00:00

  • Do External Supports Improve Dynamic Balance in Patients with Chronic Ankle Instability? A Network Meta-analysis.

    abstract:BACKGROUND:To improve ankle stability in patients who have experienced an ankle sprain with residual symptoms of instability and/or objective joint laxity, external supports (such as taping, bracing, and orthotic insoles) are used sometimes. However, available randomized trials have disagreed on whether restraints impr...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章,meta分析

    doi:10.1097/CORR.0000000000000946

    authors: Tsikopoulos K,Sidiropoulos K,Kitridis D,Cain Atc SM,Metaxiotis D,Ali A

    更新日期:2020-02-01 00:00:00

  • Indications for surgical treatment of localized Ewing's sarcoma of bone.

    abstract::There has been considerable improvement in recent years i the prognosis for patients with localized Ewing's sarcoma of bone. This improvement largely stems from the use of radiation therapy to the primary lesion accompanied by aggressive adjuvant chemotherapy. With patients surviving longer, it has become evident that...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Pritchard DJ

    更新日期:1980-11-01 00:00:00

  • Controversies in the treatment of fingertip amputations. Conservative versus surgical reconstruction.

    abstract::Fingertip amputations are the most common type of amputation injury in the upper extremity. These injuries are either seen in the emergency room or in an office setting. These lesions are very frequent and require precise wound care for optimal results. The longer finger and the thumb, being the most distal and indepe...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章,评审

    doi:10.1097/00003086-199808000-00008

    authors: Martin C,González del Pino J

    更新日期:1998-08-01 00:00:00

  • Total hip arthroplasty for avascular necrosis of the femur in systemic lupus erythematosus.

    abstract::Six patients with systemic lupus erythematosus and avascular necrosis of the femoral head were treated by total hip arthroplasty (THA). The primary indication for surgery was persistent hip pain despite conservative therapy. Postoperatively, pain was relieved with corresponding improvement in range of motion in all si...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Prupas HM,Patzakis M,Quismorio FP Jr

    更新日期:1981-11-01 00:00:00

  • Stabilization and prosthetic replacement in difficult fractures and bone tumors.

    abstract::Comminuted fractures of the femoral shaft, especially when combined with fractures of the hip, may be difficult to treat. A four-sided titanium alloy locking nail with transfixing screws was designed in 1967 and allows compression of the fracture site. If necessary, the nail may be inserted without intraoperative roen...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Huckstep RL

    更新日期:1987-11-01 00:00:00

  • Depression and Non-modifiable Patient Factors Associated with Patient Satisfaction in an Academic Orthopaedic Outpatient Clinic: Is it More Than a Provider Issue?

    abstract:BACKGROUND:Patient satisfaction surveys play an increasingly important role in United States healthcare policy and serve as a marker of provided physician services. In attempts to improve the patient's clinical experience, focus is often placed on components of the healthcare system such as provider interaction and oth...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1097/CORR.0000000000000927

    authors: Tisano BK,Nakonezny PA,Gross BS,Martinez JR,Wells JE

    更新日期:2019-12-01 00:00:00

  • A comparison of intramedullary and juxtacortical low-grade osteogenic sarcoma.

    abstract:UNLABELLED:While low-grade juxtacortical and low-grade intramedullary osteogenic sarcomas are histologically indistinguishable, they have been studied as separate entities. We retrospectively reviewed the clinical, radiographic, histologic features and treatment of 59 patients treated surgically to compare the rate of ...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1007/s11999-008-0251-2

    authors: Schwab JH,Antonescu CR,Athanasian EA,Boland PJ,Healey JH,Morris CD

    更新日期:2008-06-01 00:00:00

  • Can Dislocation of a Constrained Liner Be Salvaged With Dual-mobility Constructs in Revision THA?

    abstract:BACKGROUND:Revision THA to treat recurrent instability can itself be complicated by recurrent instability, and when this occurs, this problem is difficult to treat. Some patients' THAs will continue to dislocate despite use of a constrained liner. One option in this difficult-to-treat group is conversion to a dual-mobi...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1007/s11999.0000000000000026

    authors: Chalmers BP,Pallante GD,Taunton MJ,Sierra RJ,Trousdale RT

    更新日期:2018-02-01 00:00:00

  • Alignments and clinical results in conventional and navigated total knee arthroplasty.

    abstract::In this prospective, randomized, controlled study, we compared the performance of conventional and navigated total knee arthroplasties. Component alignment was measured in 60 patients operated on using navigation and in 60 patients operated on using the conventional technique. The groups then were divided into a subpo...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章,随机对照试验

    doi:10.1097/BLO.0b013e3180316c92

    authors: Ensini A,Catani F,Leardini A,Romagnoli M,Giannini S

    更新日期:2007-04-01 00:00:00

  • Bacterial contamination of the surgical knife.

    abstract::Two hundred and eight skin knives and 374 deep knives were evaluated in 153 clean orthopedic cases with and without a horizontal wall-less laminar air-flow system. There was no statistical difference in contamination frequency between the skin and the deep knives with and without the laminar air-flow. However, the kni...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1097/00003086-197505000-00024

    authors: Ritter MA,French ML,Eitzen HE

    更新日期:1975-05-01 00:00:00

  • Complete knee dislocation. A follow-up study of operative treatment.

    abstract::Twenty knee dislocations in 19 patients (one bilateral) occurred over a period of 20 years. The age range was 21 to 65 years, with an average age of 40.8 years. There were two popliteal artery and eight peroneal nerve injuries in the group. All patients were managed by early closed reduction at the scene of the accide...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Sisto DJ,Warren RF

    更新日期:1985-09-01 00:00:00

  • What are the Functional Results, Complications, and Outcomes of Using a Custom Unipolar Wrist Hemiarthroplasty for Treatment of Grade III Giant Cell Tumors of the Distal Radius?

    abstract:PURPOSE:A giant cell tumor (GCT) of bone presenting in the distal radius is rare, however, when they occur, Campanacci Grade III tumors can present formidable reconstructive challenges. They are associated with a high local recurrence rate with intralesional treatment, therefore approaches to reconstruct the wrist afte...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1007/s11999-016-4975-0

    authors: Wang B,Wu Q,Liu J,Chen S,Zhang Z,Shao Z

    更新日期:2016-12-01 00:00:00

  • Epiperineurium-fascial stitches along the stumps of a transected nerve. An additional method for closing the gap in the nerve trunk.

    abstract::Following peripheral nerve repair, tension on the suture line is regarded as an important factor in producing scar tissue. In some cases, one or more microsurgical epiperineurium-fascial stitches (EPFS) along the proximal and distal stumps of a transected nerve permit their firm approximation, shifting tensile forces ...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Fernandez E,Pallini R

    更新日期:1987-03-01 00:00:00

  • Thirty-day Postoperative Complications After Surgery For Metastatic Long Bone Disease Are Associated With Higher Mortality at 1 Year.

    abstract:BACKGROUND:The benefits of surgical treatment of a metastasis of the extremities may be offset by drawbacks such as potential postoperative complications. For this group of patients, the primary goal of surgery is to improve quality of life in a palliative setting. A better comprehension of factors associated with comp...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:10.1097/CORR.0000000000001036

    authors: Bindels BJJ,Thio QCBS,Raskin KA,Ferrone ML,Lozano Calderón SA,Schwab JH

    更新日期:2020-02-01 00:00:00

  • An internal fixator for posterior application to short segments of the thoracic, lumbar, or lumbosacral spine. Design and testing.

    abstract::A new spinal implant has been designed and biomechanical testing completed, intended for application to "short-segment" spinal defects such as disc degeneration, fracture, spondylolisthesis, or tumor. Major improvements over currently available devices include: only 2-3 vertebrae are spanned, not 5-7 as with Harringto...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Krag MH,Beynnon BD,Pope MH,Frymoyer JW,Haugh LD,Weaver DL

    更新日期:1986-02-01 00:00:00

  • Effects of polymethylmethacrylate on rabbit articular chondrocytes in monolayer culture.

    abstract::The effects of polymethylmethacrylate (PMMA) on DNA, protein, and sulfated-proteoglycan synthesis by rabbit articular chondrocytes were observed in monolayer cultures. PMMA pellets in ratios of 1:1 and 1:2 (liquid monomer:powder) significantly reduced [3H]thymidine incorporation into DNA during the first 24 h of cultu...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Boyd AD Jr,Goldberg VM,Miller LM,Malemud CJ

    更新日期:1984-10-01 00:00:00

  • Delayed primary wound closure in upper extremity soft tissue infections.

    abstract::Health care costs for inpatient care have been escalating. Homeless and indigent patients may be unable to have access to clean toilet facilities to perform adequate wound care. Evaluation of delayed primary closure of upper extremity soft tissue infections after incision and drainage in 34 patients was done. Patients...

    journal_title:Clinical orthopaedics and related research

    pub_type: 杂志文章

    doi:

    authors: Schnall SB,Thommen VD,Allari T,Holtom PD

    更新日期:1997-02-01 00:00:00