Aims. Fracture-Related Infection (FRI) is a severe complication caused by microbial infection of bone. It is imperative to gain more insight into the potentials and limitations of Debridement, Antibiotics and Implant Retention (DAIR) to improve future FRI treatment. The aims of this study were to: 1) determine how time to surgery affects the success rate of DAIR procedures of the
Compartment pressures have not previously been studied in healthy children. We compared the pressures in the four
Reimplantation is a well-established procedure in reconstructive surgery. This is especially so after amputation of the upper limb since prostheses provide limited function. In unilateral amputation of the
Background and Objectives. There are various classifications to assess the degree of open fracture and each has it’s own advantages and disadvantages. We proposed a new system since we couldn’t find any which was simple, objective, reliable, reproducible and applicable in an emergency setting. We set five variables namely, skin break, bone damage, muscle injury, neurovascular impairment and the degree of contamination to make scoring. We needed to know if the proposed classification had a better reliability, was simple, objective and applicable. Design and Setting. A proposed diagnostic testing was set to better classifying the degree and severity open fractures. Every patient with open
Aim. Soft tissue defects of the
Introduction. Lower limb immobilisation with full casts is commonly used to manage fractures. There may be the need to split casts in an emergency, such as compartment syndrome, with no current consensus as to which technique is most effective in reducing pressure quickly. Our study aims to compare the reduction in pressure across
Aims: Our purpose was to evaluate þnal results of the fasciotomy of the
Aim. Since surgical site infections (SSIs) remain among the most common complications of orthopedic (trauma) surgery, there has been unwavering attention for potential predictors of a SSI. Specifically in surgical fields with a high complication rate, such as foot/ankle surgery, risk factor identification is of great importance. Recently, some studies have suggested environmental factors such as season to be of influence on the number of SSI. Specifically patients operated on in the summer are reported to have a higher incidence of SSIs, compared to other seasons. The aim of this study is to identify if “seasonality” is a significant predictor for SSI in a cohort of (trauma) surgical foot and ankle procedures. Method. This retrospective cohort study included all patients undergoing trauma related surgery (fracture fixation, arthrodesis, implant removal and tendon repair) of the
Ulceration of the
The aetiology of pain in the
Aims: Only gangrene of the entire foot and life-threatening sepsis with severe infection require a high amputation. Method: Between 1984 and 1999, 188 amputations in the area of the lower extremity were carried out at Bad Düben specialist hospital for orthopaedics. In 31 cases, partial amputation (so-called amputation of border zones) was required in the area of the foot owing to diabetic foot syndrome. The medical records were analysed and the patients who were still living underwent a follow-up examination; 8 patients had died. Results: Of the 31 patients, 20 were men and 11 were women. From 1982 to 1987 there were 4 partial amputations of the foot, from 1988 to 1993 there were 12 and from 1994 to 1999 there were 11. The average age was 69.1 years. In 11 cases, amputation of the
Complex joint fractures of the lower extremity are often accompanied by soft-tissue swelling and are associated with prolonged hospitalization and soft-tissue complications. The aim of the study was to evaluate the effect of vascular impulse technology (VIT) on soft-tissue conditioning in comparison with conventional elevation. A total of 100 patients were included in this prospective, randomized, controlled monocentre study allocated to the three subgroups of dislocated ankle fracture (n = 40), pilon fracture (n = 20), and intra-articular calcaneal fracture (n = 40). Patients were randomized to the two study groups in a 1:1 ratio. The effectiveness of VIT (intervention) compared with elevation (control) was analyzed separately for the whole study population and for the three subgroups. The primary endpoint was the time from admission until operability (in days).Aims
Methods
The aim of this study was to evaluate the functional outcome in patients undergoing implant removal (IR) after fracture fixation below the level of the knee. All adult patients (18 to 75 years) undergoing IR after fracture fixation below the level of the knee between November 2014 and September 2016 were included as part of the WIFI (Wound Infections Following Implant Removal Below the Knee) trial, performed in 17 teaching hospitals and two university hospitals in The Netherlands. In this multicentre prospective cohort, the primary outcome was the difference in functional status before and after IR, measured by the Lower Extremity Functional Scale (LEFS), with a minimal clinically important difference of nine points.Aims
Patients and Methods
Vacuum orthoses are being applied in the care of patients with foot and
Introduction. Fully implantable distraction nails are frequently used for lengthening of the
Aim. Fracture-related infection (FRI) is a severe post-traumatic complication which can be accompanied with a soft-tissue defect or an avital soft-tissue envelope. In these cases, a thoroughly planned orthoplastic approach is imperative since a vital soft-tissue envelope is mandatory to achieve fracture union and infection eradication. The aim of our study was to analyse plastic surgical aspects in the management of FRIs, including the type and outcome of soft-tissue reconstruction (STR), and to investigate the long-term outcome of FRI after STR. Method. Patients with a
Aims. Understanding of open fracture management is skewed due to reliance on small-number lower limb, specialist unit reports and large, unfocused registry data collections. To address this, we carried out the Open Fracture Patient Evaluation Nationwide (OPEN) study, and report the demographic details and the initial steps of care for patients admitted with open fractures in the UK. Methods. Any patient admitted to hospital with an open fracture between 1 June 2021 and 30 September 2021 was included, excluding phalanges and isolated hand injuries. Institutional information governance approval was obtained at the lead site and all data entered using Research Electronic Data Capture. Demographic details, injury, fracture classification, and patient dispersal were detailed. Results. In total, 1,175 patients (median age 47 years (interquartile range (IQR) 29 to 65), 61.0% male (n = 717)) were admitted across 51 sites. A total of 546 patients (47.1%) were employed, 5.4% (n = 63) were diabetic, and 28.8% (n = 335) were smokers. In total, 29.0% of patients (n = 341) had more than one injury and 4.8% (n = 56) had two or more open fractures, while 51.3% of fractures (n = 637) occurred in the
The aim of this study was to investigate the effect of different loading scenarios and foot positions on the configuration of the distal tibiofibular joint (DTFJ). Fourteen paired human cadaveric
Gait analysis is an indispensable tool for scientific assessment and treatment of individuals whose ability to walk is impaired. The high cost of installation and operation are a major limitation for wide-spread use in clinical routine. Advances in Artificial Intelligence (AI) could significantly reduce the required instrumentation. A mobile phone could be all equipment necessary for 3D gait analysis. MediaPipe Pose provided by Google Research is such a Machine Learning approach for human body tracking from monocular RGB video frames that is detecting 3D-landmarks of the human body. Aim of this study was to analyze the accuracy of gait phase detection based on the joint landmarks identified by the AI system. Motion data from 10 healthy volunteers walking on a treadmill with a fixed speed of 4.5km/h (Callis, Sprintex, Germany) was sampled with a mobile phone (iPhone SE 2nd Generation, Apple). The video was processed with Mediapipe Pose (Version 0.9.1.0) using custom python software. Gait phases (Initial Contact - IC and Toe Off - TO) were detected from the angular velocities of the