Aims. To compare results of institutional preferences with regard to treatment of soft tissues in the setting of open
We analysed the results of 93
All
One hundred patients who had sustained a fracture of the tibial shaft and had been treated by internal fixation were reviewed to obtain information on residual ankle and subtalar disability. This study reinforces the belief that early mobilisation of patients with
The stability of union following the conservative treatment of
We performed a prospective randomised trial on matched groups of patients with displaced
A prospective study of 141 patients with 143
We have reviewed our recent results with functional bracing of
One hundred consecutive closed fractures of the adult tibial shaft treated by closed methods were surveyed prospectively in order to observe their natural history. The fractures were analysed with regards to speed of healing and the influence of age, sex, causal force, radiological morphology and concurrent fibular fracture. At 20 weeks 19 fractures had not yet united, but 15 of these had united by 30 weeks with conservative treatment alone. The remaining four cases were operated upon because no further progress in healing was anticipated. These findings suggest that, with regard to healing, open reduction and internal fixation is rarely justified in closed adult
Aims. Posterior malleolar (PM) fractures are commonly associated with ankle fractures, pilon fractures, and to a lesser extent
We measured pressures in the anterior and deep posterior compartments continuously for up to 72 hours in 20 patients with closed fractures of the tibial shaft treated primarily in plaster casts. All were examined independently after periods of three to 14 months. Pressures above 40 mmHg occurred in seven (35%) and above 30 mmHg in 14 (70%). No patient had the symptoms of compartment syndrome during monitoring. Abnormalities at review did not correlate with the maximum consecutive time periods during which the compartment pressures were raised. Thus, in the absence of symptoms the monitored pressures did not relate to outcome. Routine monitoring in this type of patient is therefore of doubtful benefit.
Aims. The aim of this study was to establish a reliable method for producing 3D reconstruction of sonographic callus. Methods. A cohort of ten closed
Aims. Using
The December 2022 Trauma Roundup. 360. looks at: Anterior approach for acetabular fractures using anatomical plates; Masquelet–Ilizarov for the management of bone loss post debridement of infected tibial nonunion; Total hip arthroplasty – better results after low-energy displaced femoral neck fracture in young patients; Unreamed intramedullary nailing versus external fixation for the treatment of open
Aims. The study objective was to prospectively assess clinical outcomes for a pilot cohort of
Aims. Type IIIB open tibial fractures are devastating high-energy injuries. At initial debridement, the surgeon will often be faced with large bone fragments with tenuous, if any, soft-tissue attachments. Conventionally these are discarded to avoid infection. We aimed to determine if orthoplastic reconstruction using mechanically relevant devitalized bone (ORDB) was associated with an increased infection rate in type IIIB open
We report on the use of the Ilizarov method to
treat 40 consecutive fractures of the tibial shaft (35 AO 42C fractures and
five AO 42B3 fractures) in adults. There were 28 men and
12 women with a mean age of 43 years (19 to 81). The series included
19 open fractures (six Gustilo grade 3A and 13 grade 3B) and 21
closed injuries. The mean time from injury to application of definitive
Ilizarov frame was eight days (0 to 35) with 36 fractures successfully
uniting without the need for any bone-stimulating procedure. The
four remaining patients with nonunion healed with a second frame.
There were no amputations and no deep infections. None required
intervention for malunion. The total time to healing was calculated
from date of injury to removal of the frame, with a median of 166
days (mean 187, (87 to 370)). Minor complications included snapped
wires in two patients and minor pin-site infections treated with
oral antibiotics in nine patients (23%). Clinical scores were available
for 32 of the 40 patients at a median of 55 months (mean 62, (26
to 99)) post-injury, with ‘good’ Olerud and Molander ankle scores
(median 80, mean 75, (10 to 100)), ‘excellent’ Lysholm knee scores
(median 97, mean 88, (29 to 100)), a median Tegner activity score
of 4 (mean 4, (0 to 9)) (comparable to ‘moderately heavy labour
/ cycling and jogging’) and Short Form-12 scores that exceeded the
mean of the population as a whole (median physical component score
55 (mean 51, (20 to 64)), median mental component score 57 (mean
53, (21 to 62)). In conclusion, the Ilizarov method is a safe and
reliable way of treating complex
Objectives. The radiographic union score for tibial (RUST) fractures was developed by Whelan et al to assess the healing of tibial fractures following intramedullary nailing. In the current study, the repeatability and reliability of the RUST score was evaluated in an independent centre (a) using the original description, (b) after further interpretation of the description of the score, and (c) with the immediate post-operative radiograph available for comparison. Methods. A total of 15 radiographs of