Journal of orthopaedic trauma
-
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.
-
To quantify the obliquity and dimensions of the upper and second sacral segment iliosacral screw safe zones and to determine the differences between normal and dysmorphic sacral morphology. ⋯ Sacral dysmorphism occurred in 44% of patients in this consecutive series. Many anatomic differences were consistently found between the two morphologies with clinical relevance to iliosacral screw placement. Specifically, the dysmorphic upper sacral segment safe zone is significantly smaller and more obliquely oriented but is still large enough to accommodate an iliosacral screw in nearly all patients. The second sacral segment safe zone is approximately transversely oriented in both sacral types but is more than twice as large in dysmorphic sacra. This segment may be a primary fixation opportunity in patients with sacral dysmorphism.