Soft tissue problems with and without complicated diabetes after surgery for distal fibula fracture

2016 ◽  
Vol 22 (2) ◽  
pp. 84
Author(s):  
C.-A. Shih ◽  
P.-T. Wu ◽  
C.-L. Li Li ◽  
Y.-F. Liu ◽  
P.-C. Cheng ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Distal Fibula ◽  
Fibula Fracture ◽  
Soft Tissue Problems

scholarly journals Non-locking buttress plate in distal tibial metaphyseal fractures

2018 ◽  
Vol 1 (2) ◽  
pp. 87-91
Author(s):  
Norman Lamichhane ◽  
Bhogendra Bahadur KC ◽  
Chandra Bahadur Mishra ◽  
Sabita Dhakal
Keyword(s):  
Soft Tissue ◽  
Weight Bearing ◽  
Delayed Union ◽  
Full Weight Bearing ◽  
Distal Fibula ◽  
Fibula Fracture ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Metaphyseal Fractures

Background: Treatment of distal tibial metaphyseal fractures is often challenging and no single technique has been unanimously advocated. Open reduction and internal fixation with plates and screws allows better restoration of anatomical alignment but with more soft tissue complication. Simultaneous fixation of the fibula is not universally carried out. This study aims at evaluation of the outcome of plating technique and the effect of fixation of fibula fracture in treatment of distal tibial metaphyseal fractures. Material and methods: Thirty-one cases (14 cases in Group A with concomitant distal fibula fracture and 17 cases in Group B without distal fibula fracture) were analyzed retrospectively for the mean duration of full weight bearing, mean union time and complications, and compared. Results: The mean time for full weight bearing and radiological union in our study was 14.2 weeks (15.9 in Group A and 13.1 in Group B) and 23.8 weeks (26.6 in Group A and 21.5 in Group B) respectively. 16.1% of cases had post-operative complications including one case of deep infection and malalignment of 6 degree varus (following delayed union) was seen in one case of Group A. Range of motion (ROM) at ankle was not problem in any of the cases except the one delayed union which had 5 degrees of dorsiflexion and 15 degrees of plantiflexion. Conclusion: Open reduction and internal fixation with plate and screws in distal tibial metaphyseal fracture is more economic means of treatment modality with comparable incidence of post-union malalignment and union time,though more soft tissue complications compared to other modalities. Fixation of fibula fracture aids in reducing the incidence of malalignment.

scholarly journals Extra-articular distal tibia fibula fracture managed with single posterolateral approach: a case report

2021 ◽  
Vol 7 (3) ◽  
pp. 683
Author(s):  
Neetin P. Mahajan ◽  
Prasanna Kumar G. S. ◽  
Tushar C. Patil ◽  
Kartik P. Pande ◽  
Harish Pawar
Keyword(s):  
Distal Tibia ◽  
Posterolateral Approach ◽  
Anterolateral Approach ◽  
Ankle Motion ◽  
Fibula Fracture ◽  
Left Ankle ◽  
Alternative Approach ◽  
Soft Tissue Problems ◽  
Tibia Fractures ◽  
Distal Tibia Fractures

<p class="abstract">Extra-articular distal tibia fractures involve distal tibia approximately 4 cm within tibia plafond with no articular extension. The proper preoperative care, planning and selection of surgical approach is very essential to prevent postoperative wound-related complications. We present a case of a 29 year female patient, presented with left ankle pain and swelling with a wound over the medial aspect of the ankle. X-ray of the left ankle showed extra-articular distal tibia fibula fracture with no neurovascular deficit. We managed both the fractures with open reduction and internal fixation using a single posterolateral approach. At present 1 year follow-up, the patient is having a good range of ankle motion with radiological union with no implant failure and wound-related complications. Extra-articular distal tibia fibula fracture fixation using single posterolateral approach is a viable alternative approach to medial or anterolateral approach in cases of medial or anterior soft tissue problems. It helps in getting a better functional outcome, early mobilisation with less wound-related complications.</p>

Treatment of the Diabetic Foot with Exposed Os Calcis

Foot & Ankle ◽  
1980 ◽  
Vol 1 (3) ◽  
pp. 173-178 ◽  
Author(s):  
Richard L. Jacobs ◽  
Allastair M. Karmody
Keyword(s):  
Soft Tissue ◽  
Medical Care ◽  
Diabetic Foot ◽  
Survival Rates ◽  
Soft Tissue Defects ◽  
Os Calcis ◽  
Soft Tissue Problems ◽  
Improved Methods ◽  
Tissue Defects

With improved methods of medical care, the survival rates in all types of diabetes are improving. There are increasing numbers of older diabetics with complicated soft tissue problems. This is a report of our experiences in treating 15 consecutive patients with soft tissue defects involving the hindfoot. Each of these patients had an intact forefoot.

scholarly journals Do weight bearing radiographs estimate the stability of an isolated distal fibula fracture?

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0052
Author(s):  
Sohail Yousaf ◽  
Daniel Hay
Keyword(s):  
Systematic Review ◽  
External Rotation ◽  
Weight Bearing ◽  
Ankle Fractures ◽  
Controlled Trials ◽  
Distal Fibula ◽  
Fibula Fracture ◽  
Stress Radiographs ◽  
The Stability ◽  
Supination External Rotation

Category: Trauma Introduction/Purpose: Differentiating stable isolated fibula fractures consistent with supination external rotation (SER) II ankle fractures from unstable SER IV fractures is essential in determining the need for surgical stabilisation. Stress radiographs are usually required to assess stability including gravity stress views (GSV) and external rotation views (ER). There is no clear consensus as to which modality is most useful to determine stability in a fracture clinic or emergency setting. In last, few years clinical uncertainty about the reliability has led researcher to focus on weight bearing radiographs (WB) .We aim to review recent literature regarding reliability of WB radiographs to estimate the stability of supination external rotation ankle fractures. Methods: A systematic review of the literature relating to radiological assessment of stability of supination external rotation ankle fractures was conducted according to PRISMA guidelines. The systematic review was prospectively registered with PROSPERO. It involved the following steps: Researching the question-Do weight bearing radiographs estimate the stability of an isolated distal fibula fracture? Setting inclusion and exclusion criteria-All English language articles published in the including any Randomised controlled trials (RCT’s) and cohort studies. Data collection)– A literature search of Medline (PubMed), the Cochrane Bone, Joint, and Muscle Trauma Group trial register, the Cochrane central register of controlled trials, Embase and CINAHL was undertaken. The grey literature was searched. Key terms ‘supination external rotation fracture’, ‘stability’. Other variations to the key words were ‘weight bearing’, “axial load”, ‘stress x-rays’, ‘systematic reviews’ and ‘meta-analysis’. Results: A total of six studies met the inclusion criteria including 601 patients. No previous systematic review on stress radiographs including weight bearing was published. All studies concluded weight bearing radiographs is an easy, pain-free, safe and reliable method to estimate stability of isolated distal fibula fractures. No serious concerns or complications were reported. Conclusion: The evidence base contained many methodological limitations and most of the evidence was either level III or IV, and so any conclusion drawn from the research must be done so with caution. The studies suggest that GSV overestimates the instability which should be assessed with studies should focus on randomized controlled trials with narrow range of clinically useful outcome measures.

scholarly journals New Persistent Opioid Use Following Operative Treatment of Ankle Fractures Compared to Nonoperatively Treated Fractures

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0005 ◽  
Author(s):  
Timothy Gossett ◽  
Fred Finney ◽  
Paul Talusan ◽  
James Holmes
Keyword(s):  
Public Health ◽  
Household Income ◽  
Ankle Fractures ◽  
Patient Specific ◽  
Opioid Use ◽  
Distal Fibula ◽  
Opioid Prescription ◽  
Fibula Fracture ◽  
Closed Treatment ◽  
Chronic Opioid Use

Category: Trauma Introduction/Purpose: Chronic opioid use is a major public health concern in the United States. Orthopaedic surgeons prescribe 8% of narcotics in the U.S. while only comprising 2.5% of U.S. physicians. Understanding that neither the amount nor duration of opioid prescription correlates with patient satisfaction, orthopaedic surgeons have a unique opportunity to play a prominent role in the solution. In order to address and mitigate this epidemic, it is important to first understand rates of new persistent opioid use following specific orthopaedic procedures and to identify patient-specific risk factors. Methods: Using a widely accepted insurance claims database, we identified patients who underwent surgical treatment of common ankle fractures patterns (bimalleolar, trimalleolar, and isolated distal fibula) between January 2008 and December 2016. None had an opioid prescription filled in the period of 12 months to 15 days prior to treatment (defined as “opioid naïve”). Opioid naïve patients who underwent closed treatment of a distal fibula fracture served as a comparative group. We evaluated peri-treatment and post-treatment opioid prescription fulfillment. The primary outcome, new persistent opioid use, was defined as opioid prescription fulfillment between 91 and 180 days after the procedure. Logistic regression was used to evaluate the effect of patient factors, including surgery type, age, gender, median household income, mental health and pain disorders on the likelihood of new persistent use. Results: There was no significant difference in new persistent opioid use rates overall following surgical treatment of ankle fractures (8.4%) compared to closed fibula fracture treatment (7.4%), and all treatment groups demonstrated high rates of new persistent use. Two surgically treated fracture subtypes, treatment of bimalleolar ankle fractures and treatment of trimalleolar ankle fractures with fixation of posterior lip, demonstrated significantly higher new persistent opioid use rates (Figure). Rates were significantly increased among patients who received an opioid dose prescribed in the peri-treatment period that was in the top 25th percentile of total oral morphine equivalents. Patient-specific factors which were associated with new persistent opioid use included certain mental health disorders, comorbid conditions, arthritis, tobacco use, female gender, and household income greater than $100,000. Conclusion: Chronic opioid use, even in opioid naïve patients, is a major problem following orthopaedic procedures. To decrease the rate of chronic opioid use, it is important to first understand and define the rate of persistent use following these procedures. The overall new persistent opioid use following surgical fixation of ankle fractures was similar to the rate of persistent use in patients who underwent closed treatment of a fibula fracture. Understanding these high persistent use rates and the risk factors that may play a role in this problem provides a foundation upon which to address this sometimes lethal public health problem.

Thirteen Pancarpal Arthrodeses Using 2.7/3.5 mm Hybrid Dynamic Compression Plates

1999 ◽  
Vol 12 (03) ◽  
pp. 102-107 ◽  
Author(s):  
N. Gibson ◽  
S. Carmichael ◽  
D. Bennett ◽  
A. Li
Keyword(s):  
Soft Tissue ◽  
Dynamic Compression ◽  
Soft Tissue Trauma ◽  
Custom Made ◽  
Soft Tissue Problems ◽  
Veterinary School ◽  
Hybrid Plate ◽  
Tissue Trauma ◽  
The University

SummaryThirteen pancarpal arthrodeses were performed in eleven dogs at the University of Glasgow Veterinary School. All of the animals were presented as referral patients. Two of the eleven dogs had the procedure carried out in both carpi. The arthrodeses were carried out using a 2.7/3.5 mm hybrid dynamic compression platea. The animals were between 1 year and 11 years of age. Their weight ranged from 15 kg to 38 kg. Two cases had associated soft tissue trauma/infection prior to the surgery; these two dogs together with one other developed post-operative soft tissue problems. The soft tissue problems had resolved by the time of radiographic arthrodesis. The plate was removed in three cases due to persistent lameness. The animals were followed up for a period of at least eight weeks postoperatively; the maximum follow-up time was fourteen months. Arthrodesis occurred in all thirteen antebrachio-carpal joints. The hybrid plate can thus be recommended for carpal arthrodesis in the dog and has many advantages over a conventional dynamic compression plate.Pancarpal arthrodeses were performed in dogs using custom made 2.7/3.5 mm Hybrid Dynamic Compression Plates instead of conventional AO/ASIF Dynamic Compression Plates (DCP). The implantation of the plates was facilitated by their profile and the usage of smaller 2.7 mm screws in the metacarpal regions. All of the carpi went on to full arthrodesis within the follow-up period. The rate of complications associated with the use of this plate compares favourably against previous similar studies using the conventional DCP.

Case series: Laser treatments for soft tissue problems in children

2011 ◽  
Vol 12 (2) ◽  
pp. 113-117 ◽  
Author(s):  
Juan R. Boj ◽  
C. Poirier ◽  
M. Hernandez ◽  
E. Espasa ◽  
A. Espanya
Keyword(s):  
Soft Tissue ◽  
Case Series ◽  
Laser Treatments ◽  
Soft Tissue Problems
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