Fractures of the Central Metatarsal

1996 ◽  
Vol 17 (4) ◽  
pp. 200-203 ◽  
Author(s):  
E. Sánchez Alepuz ◽  
V. Vicent Carsi ◽  
P. Alcántara ◽  
A. J. Llabrés
Keyword(s):  
Traffic Accidents ◽  
Sagittal Plane ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Functional Results ◽  
Work Related ◽  
Metatarsal Fractures ◽  
Plane Displacement ◽  
Anatomic Localization

We reviewed the evolution and final results of 57 patients with central metatarsal fractures treated in Hospital “La Fe” in Valencia between 1982 and 1993. The treatments were nonsurgical in 36 cases and surgical in 21 cases. The most frequent etiologies were traffic accidents, followed by work-related accidents. The fractures were classified according to their anatomic localization and whether they were closed (44 cases) or open (13 cases). Poor functional results manifested by metatarsalgia were present most often when one or two of the following were present: comminution, sagittal plane displacement, open fracture, or severe soft tissue injury. The mean follow-up was 5 years.

Acute Compartment Syndrome of Upper Extremities with Tendon Ruptures

2017 ◽  
Vol 22 (04) ◽  
pp. 411-415
Author(s):  
Taku Suzuki ◽  
Eiko Yamabe ◽  
Takuji Iwamoto ◽  
Katsuji Suzuki ◽  
Harumoto Yamada ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Compartment Syndrome ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Skin Grafting ◽  
High Energy ◽  
Acute Compartment Syndrome ◽  
Mechanism Of Injury ◽  
Sensory Disturbances

Background: It is well known that acute compartment syndrome is associated with fracture of the forearm, while involvement of soft tissue injury including musculotendinous injury remains unclear. The purpose of this study was to evaluate the soft tissue involvement, including musculotendinous ruptures, in acute compartment syndrome of the upper limb. Methods: We retrospectively enrolled 16 patients who underwent surgical treatment for acute compartment syndrome of the upper extremity. The average age of the patients was 47 years (range, 14 to 79) and the mean follow-up period after the surgery was 15 months (range, 12 to 29). Complications included at least one presentation at the final follow up of sensory disturbances or motor disturbances. We examined the presence of musculotendinous injury mechanism of injury, presence of fracture, the performance of skin grafting, and complications. Results: Mechanism of injury of “caught in a machine” was found in six cases. Three of these patients had musculotendinous ruptures and all muscle tears were revealed by intraoperative findings. No patients had muscle ruptures with other injury mechanisms. Seven out of 16 patients (44%) developed complications at final follow-up. Skin grafting was performed in six patients, and five of these patients developed complications. Only one of the nine patients without complications underwent skin grafting. Conclusions: In cases of high-energy injuries, the surgeon should suspect the presence of a musculotendinous injury prior to surgery.

A Medicolegal Analysis of Worker Appeals for Fibromyalgia as a Compensable Condition Following Workplace Soft-tissue Injury

2013 ◽  
Vol 40 (3) ◽  
pp. 323-328 ◽  
Author(s):  
MARY-ANN FITZCHARLES ◽  
PETER A. STE-MARIE ◽  
YORAM SHIR
Keyword(s):  
Health Status ◽  
Soft Tissue ◽  
Tissue Injury ◽  
Traumatic Event ◽  
Soft Tissue Injury ◽  
Tissue Type ◽  
Work Related ◽  
Physical Findings ◽  
Time From Injury ◽  
New Onset

Objective.Workplace injuries may be implicated in the causation of fibromyalgia (FM), hence linking FM to compensation. We examined the appeals by workers directed to an appeals tribunal for causation of FM following soft-tissue injury sustained in the workplace.Methods.One hundred fifty tribunal decisions relevant to FM were examined using a predetermined protocol. New-onset FM was appealed in 123, and aggravation of preexisting FM in 15.Results.All injuries were of a soft-tissue type, without persistent physical findings to explain continued symptoms. The tribunal accepted 67% of appeals for aggravation of FM, and 59% for new-onset FM. Time from injury to FM diagnosis was 4.3 ± 4.1 years, with 6.3 ± 2.8 physicians cited for each worker, and with previous health status not reported for 26%. Injuries were a single event in 68%, with location in low back for 44%, and shoulder/upper limb in 40%. The FM diagnosis was based on a rheumatologist report in 74%.Conclusion.Over half of appeals for aggravation or causation of FM following a work-related soft-tissue injury were accepted by the tribunal, with importance ascribed to a rheumatologist diagnosis. Concerns are raised regarding lengthy duration from injury to diagnosis, claimants’ high healthcare use, and neglect of mention of previous health status. The attribution of causation of FM to a soft-tissue workplace traumatic event is contentious and requires further examination.

scholarly journals Prospective Evaluation of Role of Limb Reconstruction System (Rail External Fixator) in Open Fractures and Infected Non-union of Femur

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hemant Singh Chahar ◽  
Mayur Gupta ◽  
Vinod Kumar ◽  
Rohit Yadav ◽  
Jaydeep Patel ◽  
...  
Keyword(s):  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Case Series ◽  
Functional Results ◽  
Open Fractures ◽  
Long Bone ◽  
Limb Reconstruction ◽  
Non Union ◽  
Femur Fractures

Introduction: Severe open fractures continue to be a nightmare for orthopedicians even with use of more accepted line of treatment. Open fractures and infected non-union of femur bone are not infrequently seen in orthopedic wards as femur is the most common long bone injured. We present a case series of 14 such patients treated successfully with limb reconstruction system enabling recovery to pre-injury status and activities. Case Series: The present study was done to access the role of limb reconstruction system in the management of open femur fractures and in infected non-union with modifications to meet the requirements of each case. We viewed the results of treatment of 14 cases of late presentation with complicated open femur fractures and infected non-unions. Average time of fixator removal was 4 months–24 months. Average follow-up duration was 18 months (range 6?36 months). Evaluation of results was based on ASAMI criteria. The excellent bone results were obtained in 85.72% of cases while 7.14% showed good and 7.14% were poor results. Excellent functional results were observed in 71.43% of cases and 28.57% of cases shows good and fair results. Conclusion: The use of limb reconstruction system is based on compression and distraction technique. It was found to be a simple and effective modality for open injuries in terms of enhanced union rate, rapid rehabilitation, and easy care of soft-tissue injury along with bone loss, thus avoiding multiple surgeries. Keywords: Open fracture, non-union, femur, limb reconstruction system, ASAMI criteria.

scholarly journals Comparitive Study of Reamed vs Unreamed Interlocking Intra Medullary Nailing for Fracture Shaft of Tibia

2021 ◽  
pp. 417-422
Author(s):  
N. Mathivanan ◽  
S. V. Satyanarayana
Keyword(s):  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Medullary Canal ◽  
Open Fractures ◽  
Tibial Shaft ◽  
Advantages And Disadvantages ◽  
Interlocking Nailing ◽  
Open Injury ◽  
Radiological Union

Tibia is the commonest bone to sustain open injury because of subcutaneous position. Treatment of open fractures requires simultaneous management of both skeletal and soft tissue injury. Intramedullary nailing with reaming is generally considered to be contraindicated for open fractures tibia, because it damages the endosteal blood supply which will lead to non-union, deep infection. However, recent studies with or without reaming in open fracture tibia shows no influence in healing of fracture. Purpose: To compare the clinical and radiological results of intramedullary interlocking nailing of open fractures of the tibial shaft after reaming versus unreamed medullary canal. The aim and objective is a comparative study on the technique, outcome and time taken for clinical and radiological union in either of the reamed or unreamed interlocking nailing in tibial shaft fractures. The operative technique, advantages and disadvantages, follow up, time taken for bony and radiological union and complications if any and overall functional outcome will be evaluated in patients. The follow up of patients will be done in the immediate post operative period and  subsequently  at periodic intervals both clinically and radiologically and the result so obtained will be compared.

A STUDY ON OUTCOME OF SURGICAL TREATMENT OF COMPOUND TIBIA FRACTURES BY INTRAMEDULLARY NAILING AFTER PRELIMINARY EXTERNAL FIXATION – SHORT TERM RETROSPECTIVE AND PROSPECTIVE ANALYSIS

2021 ◽  
pp. 19-21
Author(s):  
Suresh Kumar Thirugnanam ◽  
Sudhakar Ramasamy
Keyword(s):  
Surgical Treatment ◽  
Functional Outcome ◽  
Intramedullary Nailing ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Prospective Analysis ◽  
Short Term ◽  
Tibia Fractures ◽  
Grade Iii

About 23% of all tibial fractures are open and most of these are Gustilo grade III. This study was done to evaluate the functional outcome of surgical treatment of compound tibia fractures by intramedullary nailing after preliminary external xation as a short term retrospective and prospective analysis. From February 2012 to November 2013, a short term retrospective and prospective analysis was done in The Institute of Orthopedics & Traumatology, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai. We did secondary interlocking nailing after preliminary external xation for grade II to grade III B open tibia fractures in 31 patients for 31 fractures (Box 1 shows the inclusion and exclusion criteria). Out of these 31 patients, we lost follow-up of 4 patients and analyzed the results with the average follow-up of 12 months and minimum follow up of 5 months. Data was tabulated and analysed using Microsoft excel 2003. Functional outcome of secondary intra medullary nailing after external xation was far better than in primary interlocking with primary closure in our institution. Although the supercial infection is there and there is delay in denitive procedure in the management of compound fractures, this can be improved by early surgical intervention, timely secondary procedures and accurate assessment of soft tissue injury. The nal outcome is mainly depends on the age of the patient, time of admission since injury, type of injury.

scholarly journals Utility of MRI in the Evaluation of Acute Greater Tuberosity Proximal Humeral Fractures

2019 ◽  
Vol 7 (6) ◽  
pp. 232596711985147
Author(s):  
Austin Pitcher ◽  
Christopher Langhammer ◽  
Brian T. Feeley
Keyword(s):  
Rotator Cuff ◽  
Tissue Injury ◽  
Biceps Tendon ◽  
Soft Tissue Injury ◽  
Rotator Cuff Tears ◽  
Mri Findings ◽  
Partial Thickness ◽  
High Incidence ◽  
Delayed Recovery

Background: Understanding soft tissue injury patterns associated with greater tuberosity (GT) fractures may help clinicians provide guidance to patients. Hypothesis: Evaluating magnetic resonance imaging (MRI) findings in patients with suspected isolated GT fractures will help elucidate the role of MRI in the diagnosis and treatment of these patients. Study Design: Case series; Level of evidence, 4. Methods: We performed a retrospective review of medical records from 2010 to 2014 for patients presenting with acute isolated GT fractures and MRI. Uncomplicated and delayed recovery groups were established according to the need for delayed procedural intervention or persistent symptoms past last recorded follow-up. Multivariate regression analysis was used to analyze the relationships between MRI findings and delayed recovery. Results: A total of 32 patients met the inclusion criteria (mean age, 47 years [range, 24-88 years]; mean follow-up, 30 weeks [range, 33 days–4 years]). There was no significant difference in the estimation of fracture displacement as measured on radiography and compared with MRI (radiography, 2.8 mm; MRI, 3.5 mm; P = .16). There was a high incidence of full-thickness rotator cuff tears (9%), partial-thickness rotator cuff tears (72%), partial biceps tendon tears (41%), and labral tears (50%). Presence of biceps pathology or partial-thickness rotator cuff tear was predictive of delayed recovery in a multivariate model. Conclusion: There is a high incidence of soft tissue injury found by MRI following GT fracture. MRI did not appreciably change the measure of displacement of the fracture fragment. In the multivariate analysis, presence of a partial-thickness rotator cuff tear or biceps tendon injury was associated with delayed recovery.

Os Centrale Carpi Simulating a Scaphoid Waist Fracture

1994 ◽  
Vol 19 (6) ◽  
pp. 754-756 ◽  
Author(s):  
Z. Y. YANG ◽  
L. A. GILULA ◽  
K. JONSSON
Keyword(s):  
Soft Tissue ◽  
Sagittal Plane ◽  
Tissue Injury ◽  
Incidental Finding ◽  
Scaphoid Fracture ◽  
Soft Tissue Injury ◽  
Carpal Bone ◽  
X Ray

The os centrale carpi is a relatively rare accessory carpal bone, and its presence may be confused with a scaphoid fracture. A case is presented which simulated an un-united scaphoid fracture on the plain X-ray film. However, CT in the sagittal plane showed two rounded fragments on the dorsum of the scaphoid with smooth, regular cortical margins differing from an acute scaphoid fracture. Their volume combined with the volume of the scaphoid is more than that of a completely normal scaphoid. There is no evidence of degeneration in the two rounded fragments and scaphoid. Because of these features, the diagnosis of soft tissue injury with an incidental finding of an os centrale carpi was suggested.

scholarly journals Large Autologous Ilium with Periosteum for Tibiotalar Joint Reconstruction in Rüedi-Allgöwer III Pilon Fractures

2020 ◽  
Author(s):  
Dong Li ◽  
Jiao Jiao Li ◽  
Yuanyuan Zhu ◽  
Fushan Hou ◽  
Yuan Li ◽  
...  
Keyword(s):  
Tissue Injury ◽  
Donor Site ◽  
Soft Tissue Injury ◽  
Outcome Analysis ◽  
Pilon Fracture ◽  
Level Of Evidence ◽  
Tibiotalar Joint ◽  
Joint Reconstruction ◽  
Pilon Fractures

Abstract Background: Management of Rüedi-Allgöwer III or AO type C3 pilon fracture present numerous challenges to the orthopaedic surgeon. A joint preservation technique using a large autologous ilium with periosteum in combination with internal implant fixation was reported to improve the outcome of reconstruction. Methods: Twenty-five patients with soft tissue injury of Tscherne-Gotzen I-II after Rüedi-Allgöwer III pilon fracture received a large autologous ilium with periosteum for tibiotalar joint reconstruction and open reduction and internal fixation (ORIF), between March 2015 and September 2018. The visual analog scale (VAS), American Orthopaedic Foot & Ankle Society (AOFAS) score, and Burwell and Charnley criteria were used for outcome analysis.Results: Twenty patients with an average age of 45.2 years were followed for an average of 18.3 months. The VAS and AOFAS scores, and Burwell and Charnley ratings were recorded at the last follow-up after reconstructive surgery. Two patients developed redness and swelling at the wound site, but recovered after local care and dressing changes. No patient displayed deep surgical site infection, donor site complication, non-union or local complication during the final follow-up. The average bone union time was 18.3 months (range 3-36).Conclusions: Large autologous ilium with periosteum in combination with ORIF can be safely performed for tibiotalar joint reconstruction. This method greatly reduces the risk of post-operative complications following articular reconstruction for Rüedi-Allgöwer III pilon fractures.Level of Evidence: Level III, retrospective cohort study

scholarly journals What should we be careful of ankle arthroscopy?

2019 ◽  
Vol 27 (3) ◽  
pp. 230949901986250 ◽  
Author(s):  
Jae Hoon Ahn ◽  
Dojoon Park ◽  
Yong Taek Park ◽  
Joonyoung Park ◽  
Yoon-Chung Kim
Keyword(s):  
Soft Tissue ◽  
Skin Necrosis ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Total Duration ◽  
Osteochondral Lesion ◽  
Ankle Arthroscopy ◽  
Tourniquet Time ◽  
Posterior Thigh

Purpose: Ankle arthroscopy has been used as a standard tool by foot and ankle surgeons. To overcome the narrowness of ankle joint, a noninvasive distraction technique is used for the successful visualization in ankle arthroscopy. The aim of this study was to investigate the incidence and type of complications associated with ankle arthroscopy using a noninvasive distraction technique and to report a troublesome complication. Methods: We reviewed 514 patients’ charts from 2003 to 2011. The same noninvasive distraction technique was used. Patients’ demography, duration of follow-up, diagnoses, procedures, and complications related to ankle arthroscopy were analyzed. Results: There were 388 male and 126 female; mean age was 37.2 years; mean follow-up duration was 33 months. The diagnoses were osteochondral lesion of talus, chronic ankle instability, anterolateral soft tissue impingement syndrome, and anterior bony impingement. We performed arthroscopic synovectomy, osteochondral procedure, bony spur excision, and loose body removal. The mean time of arthroscopic procedure was 47 min. There were neurologic complications (eight cases), skin necrosis of posterior thigh (three cases), instrument breakage (two cases), and superficial wound infection (one case). All complications were well resolved. The total duration of distraction plus tourniquet inflation exceeded 120 min in the three cases of skin necrosis. Skin necrosis was deemed to be resulted from the long tourniquet time. Conclusion: The noninvasive distraction technique is safe and effective for ankle arthroscopy. However, the distraction plus tourniquet requires attention because it can cause high pressure on posterior thigh resulting in soft tissue injury.

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