Early peri-implant fractures after distal femur fracture locked plating?

Purpose: To report the peri-implant fracture rates after locked plating of distal femur fractures and examine risk factors.

Methods: Over a 7 year period, 89 AO/OTA 33A/C distal femur fractures were identified and reviewed. After excluding treatment with intramedullary nails, age under 50, those with the proximal femur protected, or those without 6 months of follow-up, 42 distal femur fractures in 41 patients, mean age 72.

Irreducible Traumatic Fracture-Dislocation of the Hip with Impalement onto the Ischial Spine: A Case Report.

Case: A 45-year-old man appeared to have a central (protrusio) hip dislocation but actually had a transverse posterior wall acetabulum fracture with irreducible posterior dislocation due to impalement of the femoral head on the ischial spine. He underwent urgent open reduction on presentation and subsequent internal fixation in a staged manner. He developed avascular necrosis at 18 months postoperatively.

High-risk ankle fractures in high-risk older patients: to fix or nail?

Introduction: Optimal treatment of high-risk ankle fractures in older, comorbid patients is unknown. Results of open reduction internal fixation (ORIF) versus tibiotalocalcaneal (TTC) fusion nailing for the treatment of high-risk geriatric ankle fractures were investigated.

Materials And Methods: Results of ORIF versus TTC fusion nailing were evaluated via retrospective case-control cohort study of 60 patients over age 50 with an open ankle fracture or one with at least 50% talar subluxation and at least 1 high-risk comorbidity: diabetes mellitus (DM), peripheral vascular disease, immunosuppression, active smoking, or a BMI > 35.

Supine Posterior Hoop Plating of Bicondylar Posterior Coronal Shear Tibial Plateau Fractures Without Fibular Osteotomy.

Tibial plateau posterolateral fragments, especially those associated with articular depression, are difficult to capture and support with anteriorly or lateral based implants. Applying implants to the posterior plateau has traditionally involved a prone approach or fibular osteotomy, especially when access to both the medial and lateral sides is necessary, such as a bicondylar posterior coronal shear fracture pattern. By combining two previously described techniques for posterolateral rim plating and bicondylar hoop plating, we describe a novel technique to apply a posterior bicondylar hoop implant in the supine position without fibular osteotomy for bicondylar posterior coronal shear injuries.

Interobserver Variability in the Measurement of Lower Leg Compartment Pressures.

Objectives: To determine whether interobserver technical variations and errors in the measurement of compartment pressures may affect measurement accuracy.

Methods: Four above-knee cadaveric specimens were used to create a consistent model of lower leg compartment syndrome. Thirty-eight physicians examined the limbs and measured 4 compartment pressures using the Intra-Compartmental Pressure Monitor (Stryker Orthopaedics).

Does perioperative systemic infection or fever increase surgical infection risks after internal fixation of femur and tibia fractures in an intensive care polytrauma unit?

Background: We hypothesized that internal fixation procedures performed on trauma intensive care unit (ICU) patients with systemic infections, some also febrile, would be at increased risk for deep infection.

Methods: A total of 128 patients (mean age, 37.4 years; mean Injury Severity Score [ISS], 34.

Internal fixation in a combat theater hospital.

Limited data are available on the use of internal fixation in combat zone hospitals. The authors performed a retrospective review of 713 surgical cases during 2 Operation Enduring Freedom deployments to a Level III theater hospital in 2007 and 2009 to 2010. The epidemiology and short- to intermediate-term outcomes of patients treated with internal fixation devices were studied.

Effect of negative pressure wound therapy on the elution of antibiotics from polymethylmethacrylate beads in a porcine simulated open femur fracture model.

Objectives: To determine whether negative pressure wound therapy (NPWT) affects antibiotic elution in simulated femur fractures treated with antibiotic impregnated polymethylmethacrylate (PMMA) beads and whether fascial closure between beads and sponge affects the outcome.

Methods: PMMA beads containing vancomycin and tobramycin were placed adjacent to bilateral corticotomies created in 20 anesthetized pigs. In 1 leg, NPWT was applied with the sponge either in direct contact with the beads or superficial to reapproximated fascia lata.

Locked plating of supracondylar periprosthetic femur fractures.

Fifty periprosthetic supracondylar femur fractures above a total knee arthroplasty were reviewed. Fractures were closed Lewis and Rorabeck type II with a stable prosthesis. Twenty-nine patients (group I), were treated with locked condylar plating.

A biomechanical comparison of 2 ulnar collateral ligament reconstruction techniques.

Purpose: To biomechanically compare the Jobe transosseous ulnar collateral ligament (UCL) reconstruction procedure and an interference screw reconstruction (ISR) technique versus the intact elbow UCL.

Methods: Intact stiffness of 10 matched cadaveric elbow pairs was tested via submaximal valgus loading at 4 flexion angles. From each pair, a metal ISR and a traditional transosseous Jobe reconstruction was performed with the use of matched hamstring tendon grafts.