Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2012
Case ReportsTreatment of an open distal tibia fracture with segmental bone loss in combination with a closed proximal tibia fracture: a case report.
The treatment of open distal tibia fractures remains challenging, particularly when the fracture is infected and involves segmental bone loss. We report the case of a 38-year-old man who sustained an open distal tibiofibular fracture with segmental bone loss and a closed proximal tibial fracture. The fractures were initially fixed with a temporary external fixator. ⋯ Bone graft was also used to the distal tibiofibular space to achieve distal tibiofibular synostosis. We describe one treatment option for an infected open fracture of the distal tibia with segmental bone loss that is accompanied by a closed fracture of the proximal tibia. This method can treat two fractures simultaneously.
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Arch Orthop Trauma Surg · Aug 2012
Platelets rich plasma for treatment of chronic plantar fasciitis.
Plantar fasciitis is a common cause of heel pain in adults. Many treatment options exist. Platelets rich plasma (PRP) is derived from autologous blood and contains high concentration of growth factors necessary for tissue healing. The use of PRP in the treatment of plantar fasciitis is a fairly recent and evolving concept. The purpose of our work was to study the effectiveness of PRP treatment for chronic plantar fasciitis. ⋯ Injection of PRP is safe and doesn't affect the biomechanical function of the foot. Our successful early findings with injection of PRP indicate that this may become a very commonly used modality in treating this difficult condition.
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Tuberculous tenosynovitis is a rare manifestation of extrapulmonary tuberculosis (Tb), especially if solely the dorsal hand compartment is affected. In this report, we present the medical history of an immuno-competent 32-year-old man presented with a painful swelling of the right dorsal wrist. Initial inflammation onset had occurred 6 months before he consulted our service, resulting in consultation of several physicians and extensive diagnostic procedures without gaining a specific diagnosis. ⋯ The diagnosis was established by positive histology, repeated specific PCR and T-SPOT. TB. Tuberculous tenosynovitis can easily be overlooked as a cause of chronic tenosynovitis particularly in immunocompetent young people lacking any risk factors.
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Arch Orthop Trauma Surg · Aug 2012
Anti-inflammatory treatment increases angiogenesis during early fracture healing.
Both inflammation and angiogenesis are crucial for normal fracture healing. The goal of this work was to determine how anti-inflammatory treatment affects angiogenesis during early stages of fracture repair. ⋯ Anti-inflammatory treatments using indomethacin impair bone and cartilage formation and increase tissue vascularization in the callus during early fracture healing.
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Arch Orthop Trauma Surg · Aug 2012
Core decompression combined with implantation of a demineralised bone matrix for non-traumatic osteonecrosis of the femoral head.
Core decompression is the standard surgical procedure in the treatment of early stage non-traumatic osteonecrosis of the femoral head (ONFH). However, there is still a debate whether decompression in combination with supplementary augmentation by bone grafts, growth factors, or cell implementation is superior to conventional decompression alone. This study evaluated patients after core decompression combined with an augmentation by a demineralised bone matrix, and particularly aimed to report long-term conversion rates to total hip replacement (THR). ⋯ In patients with early- stage femoral head osteonecrosis core decompression combined with the implantation of a demineralised bone matrix leads to a limited, temporary pain relief as seen in core decompression alone. However, long-term results were not encouraging with a high rate of conversion to arthroplasty. Therefore, core decompression with implantation of a demineralised bone matrix may be not appropriate to avoid THR in the long term.