Journal of orthopaedic trauma
-
1) To introduce a computed tomography-based "three-column fixation" concept; and 2) to evaluate clinical outcomes (by using a column-specific fixation technique) for complex tibial plateau fractures (Schatzker classification Types V and VI). ⋯ Three-column fixation is a new fixation concept in treating complex tibial plateau fractures, which is especially useful for multiplanar fractures involving the posterior column. The combination of posterior and anterior-lateral approaches is a safe and effective way to have direct reduction and satisfactory fixation for such difficult tibial plateau fractures.
-
Case Reports
Extruded osteoarticular distal tibia: success at 18-month follow-up with reimplantation.
Extruded bone is a rare complication of open fractures associated with high energy. We describe a case of bony extrusion involving an osteoarticular segment of distal tibial treated with reimplantation and internal fixation with 18-month follow-up.
-
To quantify patellofemoral contact pressures and forces during infrapatellar (IP) and suprapatellar (SP) intramedullary tibial nail insertion. ⋯ It is known that structural integrity of articular cartilage is compromised at impact loads exceeding 25 MPa, and chondrocyte apoptosis can occur at sustained loads of as little as 4.5 MPa in immature bovine cartilage. The results of this study indicate that although the patellofemoral contact pressures are higher with SP nail insertion, they remain below the values reported to be detrimental to articular cartilage. Based on these data, we do not believe that the SP entry portal poses a significant risk to the viability or structural integrity of the articular cartilage of the patellofemoral joint. Clinical correlation is needed.
-
Modified judet quadricepsplasty and Ilizarov frame application for stiff knee after femur fractures.
Limited knee range of motion caused by posttraumatic arthrofibrosis after periarticular fracture remains a challenging problem. Traditionally, Judet or Thompson quadricepsplasty has been performed for severe stiff knee after distal femoral fracture. ⋯ This technique was applied in 10 patients over a 7-year period by one surgeon. The treatment resulted in improved knee range of motion without rebound phenomenon, which is a frequent problem when using either the Ilizarov frame or quadricepsplasty alone.