Objective: To evaluate clinical effects of minimal invasive stabilization system (LISS) for the treatment of comminuted distal tibial fractures.
Methods: From February 2006 to February 2010, 48 patients with comminuted distal tibial fractures were treated with LISS. There were 30 males and 18 females, ranging in age from 18 to 78 years. According to AO classification, there were 13 cases of A3, 19 cases of B1, 10 cases of C1 and 6 cases of C2. All the patients were treated with indirect reduction, small incision and followed up at the 1st, 3rd and 6 months, 1 year after operation.
Results: All the patients were followed up, and the duration ranged from 6 to 15 months (averaged, 12.5 months). Active and passive exercises started at the first day after surgery without casting. The average time of full weight loading were 12.3 weeks (ranged, 11 to 16 weeks). No complications, such as nonunion, breakage of plate and screw or deep infection, occurred in all patients. The mean operation time was 50 minutes (ranged, 45 to 60 min) and the average length of incision was 6 cm (ranged, 5 to 7 cm). According to Helfer criterion for clinical result, excellent results were obtained in 37 patients, good in 7, and fair in 4.
Conclusion: Since LISS combined with indirect reduction and minimal invasion provides solid fixation, promotes bone heeling and permits early functional rehabilitation, which is well suited for the treatment of severe distal tibial fractures.
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Purpose: Anterior tibial closing wedge osteotomy (ATCWO) has been shown to significantly reduce failure rates of revision anterior cruciate ligament (ACL) reconstructions in patients with a posterior tibial slope (PTS) ≥12°. Recent findings suggest a slight but significant reduction of the medial proximal tibial angle (MPTA) resulting in a varus knee where the sagittal osteotomy plane is based on a total of two guide wires defining the osteotomy wedge without respecting the frontal plane. We hypothesize that the placement of a total of four guide wires intraoperatively can reduce the influence on the MPTA.
View Article and Find Full Text PDFBone Rep
March 2025
Weldon School of Biomedical Engineering, Purdue University, West Lafayette, IN, United States of America.
High resolution peripheral quantitative computed tomography (HRpQCT) offers detailed bone geometry and microarchitecture assessment, including cortical porosity, but assessing chronic kidney disease (CKD) bone images remains challenging. This proof-of-concept study merges deep learning and machine learning to 1) improve automatic segmentation, particularly in cases with severe cortical porosity and trabeculated endosteal surfaces, and 2) maximize image information using machine learning feature extraction to classify CKD-related skeletal abnormalities, surpassing conventional DXA and CT measures. We included 30 individuals (20 non-CKD, 10 stage 3 to 5D CKD) who underwent HRpQCT of the distal and diaphyseal radius and tibia and contributed data to develop and validate four different AI models for each anatomical site.
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January 2025
Department of Radiology, Keio University School of Medicine, Shinjuku, Tokyo, Japan.
Background: Long-leg alignment and joint line obliquity have traditionally been assessed using two-dimensional (2D) radiography, but the accuracy of this measurement has remained unclear. This study aimed to evaluate the accuracy of 2D measurements of lateral distal femoral angle (LDFA) and medial proximal tibial angle (MPTA) using upright three-dimensional (3D) computed tomography (CT).
Methods: This study involved 66 knees from 38 patients (34 women, four men) with knee osteoarthritis (OA), categorized by Kellgren-Lawrence (KL) grade.
J Foot Ankle Surg
January 2025
The Ruth and Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel; Orthopedic Department, Rambam Medical Center, Haifa, Israel.
The combination of high energy fractures, extensive soft tissue trauma, and high infection rates in pilon fractures of the distal tibia have long challenged surgeons. Despite the ample evidence, there is no consensus regarding the factors that may influence postoperative infections following surgical management of these fractures. This study aimed to investigate the risk factors for postoperative infections in patients undergoing surgical management for pilon fractures.
View Article and Find Full Text PDFInjury
January 2025
Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Denmark; Department of Orthopaedic Surgery and Traumatology, Lillebaelt Hospital - University Hospital of Southern Denmark, Denmark; Department of Clinical Research, University of Southern Denmark, Denmark.
Background: Proximal femoral fractures has been associated with high mortality risk, while little is known about more distal lower extremity fractures. The aim was to report 30- and 365-days mortality in surgically treated lower extremity fractures in individuals above 65 years.
Materials And Methods: We extracted data from the Danish National Patient Register on all surgically treated lower extremity fracture in the period 1998-2017.
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