Journal of orthopaedic trauma
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To present the treatment outcome for patients with displaced inferior pole patella fractures treated with anterior tension band wiring through cannulated screws. ⋯ Anterior tension band wiring through cannulated screws for displaced inferior pole patella fractures is a safe, simple, and reliable alternative treatment with minimal soft tissue irritation. Good functional results and recovery can be expected.
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Osteoporotic fractures present a number of significant challenges for surgical management, including high degrees of fracture comminution, poor implant fixation secondary to inferior bone quality, and compromised capacity for fracture healing. Osteobiologics are materials/agents that can promote fracture healing and enhance fracture stability. ⋯ Despite this, limited clinical investigation into the use of osteobiologics in the management of osteoporotic fractures has been performed. This article reviews a select number of osteobiologic products and the evidence for their use in osteoporotic fractures.
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Periprosthetic fractures are fractures that occur in association with an orthopaedic implant, most often used for joint arthroplasty or fracture fixation. They are associated with significant morbidity and increased mortality in some cases. ⋯ Implant, surgeon, and patient factors all contribute to the risk of periprosthetic fracture. In this review, we intend to discuss current trends in periprosthetic fractures and risk factors associated with their development in the joint arthroplasty and fracture patient.
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Multiple trauma in the elderly is increasing with the aging population. In contrast to their younger counterparts, elderly patients experience significantly higher mortality rates and complications after major trauma. Diminished physiological reserve and the existence of multiple medical comorbidities present additional challenges to management. As such, a different approach is required to care for the elderly trauma patient.
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Case Reports
Avulsion fracture of the iliac crest apophysis treated with open reduction and internal fixation.
We report a case involving an avulsion fracture of the iliac crest apophysis in a 16-year-old boy. Occasionally, apophyseal avulsion fractures of the pelvis occur; however, those that occur at the iliac crest are rare. As a result of the large size of the fracture fragment and marked displacement (more than 3 cm), the fracture was managed operatively with open reduction and internal fixation. The patient returned to preinjury physical activity levels 2 months after surgery without complication.