The Iowa orthopaedic journal
-
Open fractures of the pelvis remain a devastating injury with a high mortality and morbidity. Such injuries require an aggressive treatment plan and the coordination of trauma and orthopaedic surgeons to achieve the best outcomes. We report our experience at the University of Tennessee Medical Center at Knoxville with open pelvic fractures over the last ten years. ⋯ Open pelvic fractures are usually the result of a high energy transfer, and convey a high morbidity and mortality. A defined resuscitation and fixation strategy improves outcome from historical reports. Injuries from penetrating mechanisms are associated with less morbidity and lower mortality.
-
The purpose of this study was to examine the demographic and hospitalization characteristics of children hospitalized with lower extremity fractures in the United States in 2006. ⋯ This study provides an understanding of the demographic and hospitalization characteristics of children with lower extremity fractures in the United States in 2006. This information may be useful in implementing measures to help prevent similar injuries in the future. Further research is required to determine causality of the associations found including increased mortality risk for this population at rural and non-teaching hospitals.
-
Injury to the saphenous nerve at the ankle has been described as a complication resulting from incision and dissection over the distal tibia and medial malleolus. However, the exact course and location of the distal saphenous nerve is not well described in the literature. The purpose of this study was to determine the distal limit of the saphenous nerve and its anatomic relationship to commonly identified orthopaedic landmarks and surgical incisions. ⋯ This study highlights the proximity of the distal saphenous nerve to common landmarks in orthopaedic surgery. This has important clinical implications in ankle arthroscopy, tarsal tunnel syndrome, fixation of distal tibia medial malleolar fractures, and other procedures centered about the medial malleolus. While the distal course of the saphenous nerve is generally predictable, variations exist and thus the orthopaedic surgeon must operate cautiously to prevent iatrogenic injury. To avoid saphenous nerve injury, incisions should stay distal to the tip of the medial malleolus. The medial arthroscopic portal should be more than one centimeter from the anterior aspect of the medial malleolus which will also avoid the greater saphenous vein. Incision over the anterior tibialis tendon should stay within one centimeter of the medial edge of the tendon.