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Results for “TIBIAL FRACTURES”

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At least 19 recordsLinked to original sources
PubMed1989

Fluoroscopy of rotation in tibial fractures.

Tibial torsion was assessed fluoroscopically in 38 patients with unilateral tibial fractures. Measurements were performed bilaterally after fracture reduction and stabilization. The difference in torsion between the respective tibias of each subject was calculated, and the result was compared with the values obtained from measurements in 100 normal adults with the same fluoroscopic method. A tibial torsion difference exceeding the normal mean +/- SD was found in 26 patients. The maximum difference was 49 degrees, as compared with 15 degrees in normal adults. In order to reduce the risk of disabling malrotation, measurement of tibial torsion in the operating room is recommended.

Fluoroscopy↗
PubMed1998

[The effect of treatment method for tibial fracture on tibial bone mineral density].

Bone mineral density (BMD) has been measured above malleolar fracture site and within femoral neck in 17 patients treated conservatively and in 17 patients treated surgically. The BMD was taken 3 months after injury. BMD at the fracture site decreased in patients treated conservatively by 20 +/- 3% and by 17 +/- 4% in those operated on. BMD within the femoral neck of the extremity involved decreased by 5% regardless of the mode of treatment. The results achieved indicate no significant difference in BMD in both groups of patients.

Adult↗
PubMed2000

Treatment of periprosthetic tibial fractures.

Periprosthetic fractures of the tibia are less commonly encountered and have received less attention than periprosthetic fractures of the patella and distal femur. In contrast with distal femoral fractures, tibial fractures frequently are encountered with loose implants and treatment often requires simultaneous revision knee surgery to address the loose prosthesis, the fracture, and any associated bone deficiencies. In some instances, fractures associated with well-fixed and satisfactorily positioned knee components may be treated by traditional methods of operative or nonoperative fracture management. A classification system, which accounts for the anatomic location of the fracture, the status of prosthesis fixation, and timing of the fracture is helpful in description of the various fracture patterns and direction of the appropriate treatment approach.

Arthroplasty, Replacement, Knee↗
PubMed1996

Surgical treatment of patients with open tibial fractures.

Open tibial fractures are true surgical emergencies because of the risk of extensive infection to bone and devitalized soft tissue. The most serious consequence of open tibial fractures is osteomyelitis, which usually can be prevented by prompt surgical intervention within six to eight hours after injuries occur. Open tibial fractures often are the result of trauma from motor vehicle collisions, farm accidents, falls from heights, or gunshot wounds. Initial management of patients with multiple trauma injuries focuses on their life-threatening injuries before or during orthopedic surgical intervention for open tibial fractures. Orthopedic surgeons often work in collaboration with general, vascular, and plastic surgeons and perform multiple surgical procedures (eg, fasciotomy procedures for compartment syndromes, irrigation and debridement of wounds, application of external fixation devices, placement of intramedullary nails, possible limb amputations). The type and extent of open tibial fractures and soft tissue injuries determine the best treatment options for patients. Perioperative nurses should help patients focus on treatment choices for their open tibial fractures that ensure optimal surgical outcomes and maintain their quality of life.

Accidents↗
PubMed2002

The treatment of open tibial fractures and of tibial non-union with a novel external fixator.

We report the results of external fixation in 29 patients treated for tibial fractures and tibial non-union using a novel multi axial external fixator (MAXX) followed prospectively until bony union. The results of treatment were classified according to the Association for the Study and Application of the Method of Ilizarov (ASAMI). Overall, 13 patients had excellent bone results; 13 had good bone results; two had fair bone results, and 1 patient had poor bone results. Regarding functional results, 21 patients had excellent results; 6 obtained good results; none had fair results, and two had poor results. Acute patients did better functionally than chronic patients. This fixator is safe and versatile, although the indications for its use are very specific.

Adolescent↗
PubMed1995

Modified fracture brace for tibial fracture with varus angulation: a case report.

Sarmiento introduced the functional fracture brace for the management of tibial shaft fracture in 1963. However, tibial angulation with varus deformity cannot be prevented or corrected by such a device. In this paper, a case of tibial shaft fracture with varus angulation treated with a modified below-knee fracture brace was reported.

Adult↗
PubMed2003

Fracture stabilization of proximal tibial fractures with the proximal tibial LISS: early experience in Birmingham, Alabama (USA).

This study is a prospective evaluation of the Less Invasive Stabilization System (LTSS) for the treatment of high-energy tibial plateau and proximal tibial fractures treated between November, 1998 and June, 2000. Thirty-two patients sustained thirty-five acute fractures of the tibial plateau (25) or proximal tibia (10). These patients were injured primarily in blunt trauma accidents, with eighteen having multiple fractures, fifteen having ipsilateral extremity fractures, and eleven having major knee ligament injuries. Seventeen patients had open fractures. Thirty-four patients healed their fractures, with one developing a nonunion. Two patients developed infections, both following Type III open fractures. Final range of motion averaged 2 to 116 degrees. Alignment was well maintained, with no patient losing the alignment that was obtained in the operating room. The tibial LISS system worked well at stabilizing difficult fractures of the tibial plateau and proximal tibia with a low incidence of complications in this preliminary study with short-term follow-up.

Adult↗
PubMed1990

[One- or two-step management (with external fixator) of severe pilon-tibial fractures].

Pilon tibiale fractures with significant joint involvement (AO-classification B2/3 and C2/3) are considered one of the most unfavourable injuries of the lower extremity. It was possible for follow-up examinations to be performed on 50 patients with this injury pattern from the years 1984 to 1988. Primary plate osteosynthesis is primary blamed for causing a high infection rate. Remaining functional losses, uneven joints, defective positionings and early arthrosis are not avoidable with either a one step or a two step approach. The infection rate could be significantly lowered through a two step approach with primary stabilization through an external fixator, without having to accept further disadvantages. An early change of procedure in suitable cases between the second and third week guarantees an internal osteosynthesis with the best possible anatomic reposition of articular surface and axes. In chosen cases an end treatment is possible with an external fixator. The road is open for a primary arthrodesis of irreparably damaged articular surfaces.

Ankle Injuries↗
PubMed1995

Significance of fracture gap in open tibial fracture.

The healing pattern of medial and lateral cortical gap in open transverse or short oblique tibial fractures were retrospectively reviewed in 2 groups; In group A, 16 patients were treated by Judet external fixator in rigid mode. In group B, 6 patients were treated in biocompressive mode, which allowed predominantly longitudinal axial motion. The characteristic healing pattern in group A was gap healing without or with minimal periosteal callus. The healing time and time for consolidation per 1mm gap were significantly longer in medial cortices than lateral ones (p < 0.036, p < 0.024 respectively). In group B, the fractures were healed with periosteal callus. There was no difference in the healing time and the time for consolidation per 1mm gap between the two cortices. The consolidation time per 1mm gap in the medial cortices was significantly longer in group A than group B (p < 0.020). The longitudinal axial motion in open transverse tibial fractures seems to shorten the healing time effectively in the medial cortex.

Adolescent↗
PubMed1994

The treatment of open and/or unstable tibial fractures with an unreamed double-locked tibial nail.

A multicenter, prospective study was conducted to assess the efficacy of an unreamed, double-locked tibial nail for the acute management of open and/or unstable tibial fractures. Seventy-seven acute unstable and/or open tibial fractures in 74 patients were treated from December 1986 to February 1989. Forty fractures were closed and 37 were open; 25% occurred in polytraumatized patients and 39% of the patients had additional fractures. All closed tibial fractures healed at an average of 14.2 weeks; 94.6% of the open tibial fractures healed at an average of 20.1 weeks. There were no infections in the closed tibial fracture group. There were 4 infections among the 37 patients (11%) in the open tibial fracture group, 2 superficial and 2 deep. There were 7 problems intraoperatively (8.4%) with fin deployment: 2 fins bent during nail insertion, 4 fins penetrated the cortex, while 1 set of fins only partially deployed. Difficulty was encountered with proximal screw insertion in one third of the cases. Considering the high energy of these injuries, the treatment of open and/or unstable tibial fractures with an unreamed, double-locked tibial nail can offer the surgeon a high rate of union (97%) with minimal complications. The low infection rate found in this series indicates that this nail may be of particular benefit in the treatment of closed and select open tibial fractures.

Adolescent↗
PubMed2003

Treatment of closed tibial fractures.

Closed tibial shaft fractures are common injuries that remain challenging to treat because of the wide spectrum of fracture patterns and soft-tissue injuries. Understanding the indications for surgical and nonsurgical treatment of these fractures is essential for good outcomes. Although cast treatment of stable tibial shaft fractures has traditionally been successful and continues to be widely used, recent clinical studies have shown that intramedullary nails may be more advantageous for fracture healing and function than casting. Surgical treatment (intramedullary nailing, plate fixation, or external fixation) of closed tibial shaft fractures varies depending on multiple factors. Metaphyseal fractures are well suited for plates, although newer intramedullary nail designs provide the option of intramedullary nailing of proximal or distal metaphyseal tibia-fibula fractures. External fixators are well suited for skeletally immature patients with unstable fracture patterns or for patients with unacceptably small intramedullary canals. Interlocking intramedullary nails are the treatment of choice for most unstable tibia-fibula shaft fractures.

Bone Plates↗
PubMed1989

Intramedullary devices for tibial fracture stabilization.

Reamed tibial nails that allow interlocking have been the most significant recent advance in the management of tibial fractures. Interlocking nails have expanded the indications for intramedullary fixation to include most nonarticular tibial fractures. Regardless of the amount of comminution, tibial fractures extending from just distal to the tibial tuberosity to 5 cm above the ankle joint may now be safely stabilized with interlocking nail devices.

Adult↗
PubMed1996

A comparison of one versus two distal locking screws in tibial fractures treated with unreamed tibial nails: a prospective randomized clinical trial.

The objective was to determine whether the number of interlocking screws have an impact on hardware failure. In a clinical prospective randomized study of skeletally mature patients with diaphyseal tibial fractures, 44 were randomized pre-operatively into the two treatment arms over a two-year period. Two patients, one from each group, were excluded later. Of eligible patients, 22 had one distal locking screw and 20 had two distal locking screws. One distal screw failed (59.1 per cent) significantly more often than two distal screws (5 per cent). Screw failure occurred more often in heavier patients and usually between six and 12 weeks. Proximal screw failure was seen in 17 per cent of patients. There was no significant difference between groups with respect to fracture union.

Adolescent↗
PubMed1990

Experimental tibial fractures in rabbits simulating proximal tibial metaphyseal fractures in children.

The etiology of valgus deformity after a seemingly innocuous fracture of the proximal tibial metaphysis in children is unknown. The purpose of this work was to identify the etiology of this deformity using a rabbit model. Twenty-two eight-week-old rabbits were divided into two groups. In Group I, the medial periosteum was excised from the left proximal tibial metaphysis. A partial osteotomy was created 5 mm distal to the epiphyseal plate, involving the medial one-half of the tibial metaphysis. Two 0.7-mm Kirschner wires were placed as markers on each side of the osteotomy. In Group II, the identical procedure was performed from the lateral side. Standard roentgenograms were obtained postoperatively and weekly until death by sodium pentobarbital overdose at six weeks. The angular deformity, medial growth, and lateral growth were calculated from the markers on the roentgenograms. All tibias were decalcified and analyzed under light microscopy. In Group I, all 11 rabbits developed valgus deformity averaging 12.2 degrees; asymmetric growth was statistically significant. In Group II, ten of 11 rabbits developed varus deformity averaging 9.8 degrees; asymmetric growth was not statistically significant. Despite obvious asymmetric growth in both groups, light microscopy failed to reveal any asymmetry of the physis. Valgus and varus deformities are secondary to asymmetric growth, which is not demonstrable by light microscopy.

Animals↗