From 1997 to 2003 (7 years follow-up) we treated 33 complex traumas of the upper limbs with the use of external fixation: forearm or humeral complete amputation, complex crash, sometimes with hand crash associated. Often a revascularisation was necessary like as a secondary skin coverage for soft tissue loss or following ischaemic necrosis. Three patients were reluctant to agree to a secondary amputation for large soft tissue necrosis and infection. A high percentage of cases need a successive operation because of bone non-union. Revision of our casistic helps us answer the following: how complex and long is the prognosis of this kind of patient, which are the most important choices we have to make, how important is the length of time taken to make a decision and what are the weak spots in the treatment of these traumas.
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http://dx.doi.org/10.1007/s12306-007-0001-8 | DOI Listing |
JMIR Med Educ
January 2025
Department of Orthopedics, First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
Background: Teaching severe pelvic trauma poses a significant challenge in orthopedic surgery education due to the necessity of both clinical reasoning and procedural operational skills for mastery. Traditional methods of instruction, including theoretical teaching and mannequin practice, face limitations due to the complexity, the unpredictability of treatment scenarios, the scarcity of typical cases, and the abstract nature of traditional teaching, all of which impede students' knowledge acquisition.
Objective: This study aims to introduce a novel experimental teaching methodology for severe pelvic trauma, integrating virtual reality (VR) technology as a potent adjunct to existing teaching practices.
Cureus
December 2024
Internal Medicine, O'Connor Hospital, Santa Clara, USA.
Osteomyelitis is commonly caused by pathogens like , but rare organisms such as , typically associated with superficial skin infections, can also be implicated. Recognizing these atypical pathogens presents diagnostic and therapeutic challenges, especially in the presence of orthopedic hardware. We conducted a literature review yielding 25 studies and encompassing 797 patient cases, which highlights the emerging role of species in osteomyelitis, particularly following trauma or surgical interventions.
View Article and Find Full Text PDFCureus
December 2024
Orthopedics, Queensland Health, Toowoomba, AUS.
Open ankle fractures in the elderly are increasingly common, with significant morbidity and mortality. Management is challenging due to poor soft tissue conditions, comorbidities, and limited functional independence. While traditional surgical options include external fixation or open reduction and internal fixation (ORIF), hindfoot nail (HFN) fixation may offer advantages, including immediate weight-bearing and reduced immobilisation complications.
View Article and Find Full Text PDFPLoS One
January 2025
Department of Orthopedic Surgery, Chonnam National University Hospital, Dong-gu, Gwangju, Republic of Korea.
Background: Ankle fractures are among the most common types of fractures in the orthopaedic field, and the Lauge-Hansen classification is commonly used to categorize rotational ankle fractures. This study evaluated and compared the clinical and radiological outcomes of surgically treated supination external rotation (SER) and pronation external rotation (PER) injuries of grades III or IV.
Methods: We retrospectively reviewed and enrolled 104 patients who underwent open reduction and internal fixation for SER or PER injuries classified as Grades III or IV between January 2016 and December 2021, all performed at a single center.
JBJS Case Connect
January 2025
Department of Surgery, Plastic and Reconstructive Surgical Service, Memorial Sloan Kettering Cancer Center, New York, New York.
Case: Wide resection of a synovial sarcoma of the anteromedial distal leg involving the dimetaphyseal tibia and posterior tibial tendon produced an 8.5-cm osseous defect. To keep the free flap from invaginating into the defect and prevent kinking of the anastomosis, six 1.
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