Cases reported "Fractures, Comminuted"

Filter by keywords:



Filtering documents. Please wait...

1/22. Combined talar body and tibial plafond fracture: a case report.

    We report a case of a crush fracture of the body of the talus associated with an anterior tibial plafond fracture. This injury is a rare variant of talar body fracture which merits special attention. The bony injury in this type of fracture is associated with multiple loose fragments involving both weightbearing surfaces of the ankle joint. After appropriate imaging to allow preoperative planning, we utilized a two-incision approach which was necessary to achieve adequate exposure and fixation. We used basic fracture management principles to deal with a previously undocumented fracture pattern.
- - - - - - - - - -
ranking = 1
keywords = tibia
(Clic here for more details about this article)

2/22. Intraoperative imaging of the tibial plafond fracture: a potential pitfall.

    STUDY DESIGN: Human tibial plafond cadaveric specimens were coronally sectioned and imaged to assess the accuracy of evaluation of ankle joint line congruity using anteroposterior radiography. Two interesting representative clinical cases are discussed. OBJECTIVES: To evaluate the validity of the routine use of anteroposterior radiographs to evaluate intra-operative ankle joint line congruity in circumstances where lateral radiographs are infeasible due to obscuring internal or external hardware. methods: Eleven frozen human cadaveric lower extremity specimens were used in this study. At the level of the tibial plafond, the specimens were sequentially sliced into 0.5cm sections in the coronal plane. True anteroposterior radiographs were taken with the specimen en bloc. Sequentially, the posterior slices were removed one by one, with an image taken after removing each section. The process was then repeated by removing the anterior sections sequentially with intervening radiographs. Each series of anteroposterior radiographs was then evaluated to characterize which portion of the joint line on the whole specimen view had been contributed by each of the sections. This then allowed us to make inferences about the evaluation of the joint line if it had been derived solely by anteroposterior radiography. Two poignant clinical cases demonstrating the clinical relevance of this information are discussed. RESULTS: By sequentially imaging after removing coronal sections of the tibial plafond we were able to accurately characterize the contribution of each portion of the plafond to the overall anteroposterior view. By primarily imaging the anterior portions of the plafond, with the posterior portions removed, the joint line image was virtually unchanged from the en bloc anteroposterior radiograph. However, removal of the anterior coronal sections caused large variation in the joint line image. These observations demonstrate that the anteroposterior radiograph of the tibial plafond characterizes the anterior portion of the joint well, while it represents a poor assessment of the posterior portion of the joint. This was well illustrated in our clinical case presentations. CONCLUSION: In severe fractures of the tibial plafond multiple forms of internal and external devices are frequently used for fixation. In these circumstances hardware may obscure the lateral view making it impossible to obtain adequate lateral radiographs to assess fracture reduction and joint line congruity. In this scenario, the anteroposterior radiograph is frequently relied upon to confirm the anatomic relationship of the displaced fragments. However, this view fails to accurately characterize reduction in the entire joint line and, intra-operatively, may mislead the surgeon to accept a reduction as anatomic when intra-articular incongruity still exists. Strict attention to pre-operative radiographs and the use of additional rotated views may aid the surgeon in this setting to assess fracture reduction and joint line congruence.
- - - - - - - - - -
ranking = 1.8
keywords = tibia
(Clic here for more details about this article)

3/22. Immediate tibiocalcaneal arthrodesis with interposition fibular autograft for salvage after talus fracture: a case report.

    Treatment goals in the operative management of talus fractures include prompt, anatomic, open reduction with rigid internal fixation; functional outcome is measured by degree of arthrosis, pain, range of motion, limb length, cosmesis, and return to premorbid activities. If restoration of the articular surfaces is precluded secondary to comminution, immediate and/or staged reconstructive salvage procedures must be considered. This report describes an immediate reconstructive procedure for salvage after a comminuted talus fracture with an ipsilateral tibia fracture. A standard antegrade tibial nail extending into the calcaneus was selected to stabilize both fracture sites. The technique of tibiocalcaneal arthrodesis using interposition fibular autograft and intramedullary fixation is presented as a unique treatment option.
- - - - - - - - - -
ranking = 0.4
keywords = tibia
(Clic here for more details about this article)

4/22. achilles tendon rupture associated with ankle fracture.

    The case of a 40-year-old man who sustained a medial malleolar fracture with extension of the fracture into the tibial plafond is discussed. Before surgery, the physical examination revealed an achilles tendon rupture. Surgical treatment to repair the bone and tendon injury was performed. achilles tendon rupture is not an uncommon injury, but it is rarely associated with a fracture. When a fracture is present, the achilles tendon injury can be overlooked, which may result in a delay of treatment or residual morbidity.
- - - - - - - - - -
ranking = 0.2
keywords = tibia
(Clic here for more details about this article)

5/22. Coronal split fracture of the proximal tibia epiphysis through a partially closed physis: a new fracture pattern.

    SUMMARY: A comminuted coronal split fracture of the proximal tibial epiphysis is an uncommon injury in children. The authors evaluated and treated two patients who sustained an epiphyseal fracture through a partially closed proximal tibial epiphysis. Plain radiography and computed tomography with three-dimensional reconstruction showed a comminuted coronal split fracture of the proximal tibial epiphysis. Each patient underwent definitive operative fixation of the fracture and was followed at least 1 year after clinical union. A mechanism consisting of three-point bending on the tibial plateau is proposed.
- - - - - - - - - -
ranking = 1.6
keywords = tibia
(Clic here for more details about this article)

6/22. Low-velocity gunshot fractures of the tibia.

    A gunshot-related fracture is a unique type of open fracture. Bullet-induced fractures of the tibia may be encountered in any urban or rural setting as a result of hunting or cleaning mishaps or, perhaps more frequently, of criminal activity. For surgeons with limited experience, there is a bewildering range of apparently contradictory advice concerning their management. This article reports a case of a 53-year-old man with a highly comminuted bullet-induced shaft fracture of the tibia received during hunting activity. The patient was treated with a unilateral external fixator and vascularized flap for skin reconstruction. Six months after surgery, the external fixator was removed at clinical and radiological evidence of healing. At 1 year follow-up, the patient obtained complete healing and returned to normal activity.
- - - - - - - - - -
ranking = 1.2
keywords = tibia
(Clic here for more details about this article)

7/22. Quantifying comminution as a measurement of severity of articular injury.

    The severity of articular injury caused by a fracture of periarticular bone impacts patient prognosis. There currently are not good, objective methods for grading articular injury severity. Quantification of bone comminution from fracture image data, which has been possible in laboratory studies, may be a promising route. We show that tibial pilon fractures can be discriminated on the basis of de novo surface-apparent energy absorption.
- - - - - - - - - -
ranking = 0.2
keywords = tibia
(Clic here for more details about this article)

8/22. Intramedullary nailing in a tibial shaft fracture with distal articular extension.

    Newer-generation intramedullary nails that allow placement of distal locking screws near the end of the nail have helped extend the indications for nailing in different types of tibial fractures.
- - - - - - - - - -
ranking = 1
keywords = tibia
(Clic here for more details about this article)

9/22. A completely shattered tibia.

    Despite advances in reconstructive surgery, salvage of mangled extremities still requires long periods of treatment with many operations that can be taxing both to the surgeon and the patient. Attempts at reconstruction of severely shattered limbs necessitate counselling with regard to the protracted course of treatment and associated morbidity as well as problems which may require abandoning of the procedure and secondary amputation. We report the successful salvage of a severely comminuted and open fracture of the tibia in a 32-year-old man.
- - - - - - - - - -
ranking = 1
keywords = tibia
(Clic here for more details about this article)

10/22. Treatment of the knee stiffness caused by partial patellectomy--technical tricks.

    Partial patellectomy is advised in treating comminuted fractures of patella when accurate reduction and stable fixation cannot be achieved. Usually, after partial patellectomy, the tendon-to-bone junction requires prolonged protection. One of the effects of the prolonged immobilization is lack of knee flexion. Stiffness of the knee was treated with manipulation under anaesthesia. In order to protect patellar ligament insertion to the patella remnant, a Steinmann pin was put through tibial tuberosity, a metal wire was pulled through the patella remnant and tied firmly to the pin. Gentle manipulation was performed and full flexion of the knee was achieved without damaging bone ligament complex.
- - - - - - - - - -
ranking = 0.2
keywords = tibia
(Clic here for more details about this article)
| Next ->


Leave a message about 'Fractures, Comminuted'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.