Journal of orthopaedic trauma
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The objective of this study was to compare the effect of tourniquet-induced ischemia/reperfusion (I/R) injury on the recovery of muscle function with and without prior hemorrhage. ⋯ The functional loss resulting from tourniquet application is exacerbated by the superimposition of hemorrhage in the predominantly fast-twitch plantaris but not the predominantly slow-twitch soleus. This was likely a result of metabolic derangement resulting from the combination of hemorrhage and tourniquet application. The development of interventions designed to attenuate the loss of muscle mass and function following complex trauma is necessary for optimal patient recovery.
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Clinical Trial
A prospective functional outcome and motion analysis evaluation of the hip abductors after femur fracture and antegrade nailing.
To determine if dynamic hip abductor weakness during gait, evaluated through component measures of hip kinematics and hip kinetics, demonstrate longitudinal improvement after antegrade intramedullary nailing of femoral shaft fractures and if these improvements correlate with patient reported functional outcomes. ⋯ After isolated femur fracture, patients treated with antegrade intramedullary nailing demonstrated a significant negative effect on hip kinematics and kinetics, and this effect was time-dependent. Early postsurgical ipsilateral trunk lean correlated with long-term functional outcome scores; therefore, excessive frontal plane movement during gait in the early postoperative stages may be indicative of a poorer self-reported longer-term functional outcome.
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Biomechanical study on cadaveric bones using physiological loading conditions to quantify interfragmentary movements in a tibial shaft fracture model fixed by intramedullary nailing. ⋯ Clearance of the implant within the medullary canal, the flexibility of the implant itself, and the compliance of the implant (nail and locking screws) within the bone determine the extent of movement. The implant flexibility and the clearance are strongly dependent on the thickness of the intramedullary nail.
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To evaluate the functional outcomes and long-term effects on muscle strength of femoral shaft fractures treated with intramedullary (IM) antegrade nailing using a standard piriformis start point. ⋯ Antegrade reamed interlocking IM nailing of femoral shaft fractures using a standard trochanteric fossa starting point is associated with a mild hip abductor muscle-strength deficit. Gait pattern returns to normal following femoral shaft fracture treated with this technique, and functional outcomes are good.
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To determine rates of major limb amputation in U.S. military casualties in the current conflicts in Afghanistan and Iraq, to correlate these with mechanism of injury, and compare the rate with that seen in U.S. casualties from the Vietnam War. ⋯ Overall, major limb amputation rates for the current U.S. engagement in Afghanistan and Iraq are similar to those of previous conflicts.