Objective: To assess the capability of CT in assessing stability of tibial shaft fractures with planimetry.
Materials And Methods: Eighteen patients with fracture of the tibial shaft were treated by external fixator. All patients underwent CT 1, 6, 12, and 18 weeks postoperatively to assess the fracture healing. The callus formation and compacta were determined with planimetry. Fractometry, a noninvasive method to measure stability, was used as the gold standard to determine the stability of the fracture.
Results: The patients were divided into three groups according to different periods of time for removal of external fixation. Twelve patients with stable fractures showed a steady increase of callus, which was 50% higher after 12 weeks. Three patients with delayed fracture healing demonstrated an increase of callus of > 50% after 18 weeks. Three patients with unstable fractures obtained only callus formation of < 20% after 15-18 weeks. The external fixator was removed and endomedullary nails were used for stabilization.
Conclusion: The CT data allow quantification of callus and compacta formation and are able to determine the stability of tibial shaft fractures.
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Purpose: Previous studies have shown that subtrochanteric femoral fractures treated with intramedullary nails might lead to varus-procurvatum malalignment. Similar results have been reported when using antegrade intramedullary lengthening nails (ILNs). The purpose of our study is to examine if antegrade telescoping intramedullary lengthening nails lead to varus-procurvatum malalignment of the proximal femur and what are possible predictors of that shift.
View Article and Find Full Text PDFJBJS Case Connect
January 2025
Northeast Health Wangaratta, VIC Australia.
Case: A 49-year-old gentleman sustained a closed, right tibia peri-implant fracture with a bent intramedullary nail. This resulted in a 17° valgus and 5° recurvatum deformity with fracture at the distal third of the tibial shaft. The patient underwent closed manipulation with an F-Tool and was reviewed by our unit over the following year.
View Article and Find Full Text PDFJ Orthop Case Rep
January 2025
Department of Orthopaedics, SN Medical College, Agra, Uttar Pradesh, India.
Introduction: Posterior cruciate ligament (PCL) avulsion fractures of the tibia with ipsilateral tibial shaft represent a rare but challenging orthopedic injury, necessitating careful consideration of surgical interventions for optimal outcomes. This case report presents the successful management of tibial shaft fracture (proximal 1/3rd junction) along with ipsilateral PCL avulsion fracture of tibia using a novel approach using open reduction internal fixation (ORIF) of tibial shaft with Locking compression plate (LCP) with cannulated cancellous screw and spiked washer fixation of PCL avulsion. There are no case reports or research articles available for the management of PCL avulsion fracture of tibia associated with ipsilateral tibial shaft fracture.
View Article and Find Full Text PDFInjury
January 2025
Institute for Biomechanics, Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria; Department of Trauma Surgery, BG Unfallklinik Murnau, Professor-Küntscher-Str. 8, 82418 Murnau am Staffelsee, Germany.
Treatment algorithms for fracture nonunion depend on the presence or absence of bacterial infection. However, it is often impossible to identify infection preoperatively. While some infections may present with clinical signs of infection, low-grade infections lack infection signs and have a clinical presentation similar to aseptic nonunion.
View Article and Find Full Text PDFMil Med
January 2025
Department of Orthopaedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA.
Introduction: As illustrated by the "Walker Dip," there is growing concern regarding the lack of combat casualty care during peacetime. Surgical volume and case complexity are paramount for training and skill sustainment. We sought to quantify the recent orthopedic trauma surgical case load of all military orthopedic surgeons across the Military Health System (MHS).
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