scholarly journals Intra-articular Calcaneus Fractures: Current Concepts Review

2020 ◽  
Vol 5 (3) ◽  
pp. 247301142092733
Author(s):  
Paul R. Allegra ◽  
Sebastian Rivera ◽  
Sohil S. Desai ◽  
Amiethab Aiyer ◽  
Jonathan Kaplan ◽  
...  
Keyword(s):  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Treatment Strategies ◽  
Late Complications ◽  
Classification Systems ◽  
Surgical Approaches ◽  
Calcaneal Fractures ◽  
Level Of Evidence ◽  
Tarsal Bones ◽  
Calcaneus Fractures

Calcaneal fractures are the most common fracture of the tarsal bones and represent 1% to 2% of all fractures. Roughly 75% of these fractures include intra-articular involvement of the posterior facet of the calcaneus. Intra-articular calcaneal fractures are challenging injuries to manage for both patients and surgeons given their association with both early and late complications. This article aims to review the management, classification systems, surgical approaches, and care regarding intra-articular calcaneal fractures. A review of the current literature yielded treatment strategies that aim to reduce complications such as soft tissue injury or loss of articular reduction while maintaining satisfactory clinical outcomes. The purpose of this article is to review these current concepts in the management of intra-articular calcaneal fractures. Level of Evidence: Level V, expert opinion.

Pattern of Injuries and Treatment Given to Victims of Rana Plaza Tragedy in a Level II Armed Forces Medical Facility in Bangladesh

2016 ◽  
Vol 11 (1) ◽  
pp. 21-24
Author(s):  
Shafiul Alam ◽  
Rabiul Alam ◽  
Manirul Islam ◽  
Amin Salek
Keyword(s):  
Soft Tissue ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Armed Forces ◽  
Military Hospital ◽  
Surgical Approaches ◽  
Rescue Operation ◽  
Cross Sectional ◽  
Building Collapse ◽  
Industrial Disaster

AbstractBackgroundRana Plaza building collapse is the worst industrial disaster of Bangladesh so far. The 9-storied structure collapsed suddenly on April 24, 2013, with more than 4000 people inside. Bangladesh Armed Forces played a key role in the massive rescue operations.MethodsWe conducted a cross-sectional study with 423 victims who were treated at a Combined Military Hospital to review the pattern of injuries and management provided.ResultsMiddle-aged (35±12.75 years) females (68.32%) were the majority of the victims. Among the injured, 42.35% had soft tissue injury, 22.55% had abrasions, 18.79% had fractures, 3.75% had facial injuries, and 2.5% each had head and abdominal injuries. We treated the injured with various surgical approaches, such as soft tissue debridement (38.84%), fasciotomy (18.79%), amputation (3.75%), and other procedures. We had to refer 8.27% of the patients to different advanced centers. The mortality rate was 5.91%, including 1 volunteer rescuer.ConclusionPattern of injuries and modalities of management needed in an industrial disaster is a valuable experience which can be utilized in preparing to face disasters in the future and beyond. Death of a voluntary rescuer once again warrants the necessity of using a helmet and safety gear during any rescue operation. (Disaster Med Public Health Preparedness. 2017;11:21–24)

scholarly journals Staged Subtalar Fusion for Severe Calcaneus Fractures with Bone Loss

2013 ◽  
Vol 7 (1) ◽  
pp. 614-618 ◽  
Author(s):  
Chad G. Williams ◽  
Michael J. Coffey ◽  
Peter Shorten ◽  
James D. Lyions ◽  
Richard T. Laughlin
Keyword(s):  
Soft Tissue ◽  
Bone Loss ◽  
Soft Tissues ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
High Energy ◽  
Fusion Procedure ◽  
Subtalar Fusion ◽  
Thorough Debridement ◽  
Calcaneus Fractures

Background: With high energy fractures to the calcaneus there is the potential for significant bone loss. The loss of bone can make it difficult to fully regain calcaneal alignment. In addition these fractures are often associated with significant soft tissue injury. These two factors make it difficult to address this injury in a single stage, and can have significant complications. To address these issues our initial goal in treatment has been restoration of calcaneal alignment and stabilization of the surrounding soft tissue, followed by delayed/staged subtalar arthrodesis. Methods: Patients with calcaneus fractures treated by a single surgeon from 2002 to 2012 were reviewed. Injuries which were found to have medial extrusion of the posterior facet and bone loss, and subsequently underwent a staged protocol involving early provisional fixation and late subtalar fusion were included. Results: We treated 6 calcaneus fractures with bone loss. All patients were treated with staged subtalar fusion after initial irrigation and debridement and provisional fixation. No soft-tissue complications were noted after the fusion procedure in any of the six cases. Fusion occurred in all six patients at an average of 20.6 weeks (range, 13-23 weeks). All patients were able to ambulate and wear a regular shoe by one year following the initial injury. Conclusion: It is important in the high energy calcaneus fracture to assess for both soft tissue integrity and bone loss. A thorough debridement of both the soft tissues and any devitalized bone should be performed as well as provisional fixation which attempts to restore near normal calcaneal anatomy. Definitive fusion should not be performed until the soft tissues have fully recovered.

scholarly journals Titel Treatment of Hand and Wrist Fractures with the Stryker Hand Plating System

2021 ◽  
Author(s):  
Christoph Biehl ◽  
Sabine Stötzel ◽  
Lydia Schock ◽  
Gabor Szalay ◽  
Christian Heiss
Keyword(s):  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Early Mobilization ◽  
Fracture Treatment ◽  
Outcome Study ◽  
Inclusion Criteria ◽  
Level Of Evidence ◽  
Wrist Fractures ◽  
Hand Fractures ◽  
The Mean

Abstract Background: 10% of all fractures occur in the fingers and metacarpal region. Early mobilization with preservation of grip function is the goal of any therapy for these injuries. Osteosyntheses with plates are used in complex fractures that do not allow any other treatment. The aim of this retrospective study was to evaluate the performance and safety of the Stryker Hand System.Patients and Methods: Between 2010 and 2019, 190 patients underwent surgical treatment with plates for fractures of the fingers and metacarpal region. Of these, 140 operations could be analyzed according to the inclusion criteria based on clinical and radiological parameters.Results: Three-quarters of the patients were male. The mean age at the time of surgery was 39.3 ± 15.97 years. Falling was the leading cause for hand fractures, and the commonest were fractures of the shaft (>52%). More than 15% were complex hand injuries with more than one fractured finger. The majority of patients were healthy non-smokers without systemic diseases and relevant medical history. Conclusion: The Stryker Finger Plates are safe implants with good results that are consistent with those reported in the literature. The trend is also toward stable-angle implants for fracture treatment of the finger, in order to enable the earliest possible functional, safe mobilization. The maxim that the extent of the soft tissue injury is responsible for the result continues to apply.Level of Evidence Level: IV; Outcome-study, retrospective

scholarly journals “Fixator-assisted Nailing” Technique for Closed Segmental Tibia Shaft Fracture with Extensive Soft Tissue Injury – A Case Report

2021 ◽  
Vol 11 (8) ◽  
Author(s):  
Vivek M Sodhai ◽  
Chetan V Pradhan ◽  
Parag K Sancheti ◽  
Ashok K Shyam
Keyword(s):  
Case Report ◽  
Soft Tissue ◽  
Internal Fixation ◽  
External Fixator ◽  
Road Traffic ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Treatment Strategies ◽  
Soft Tissue Injuries ◽  
Definitive Treatment

Introduction: Segmental tibia fractures with extensive soft tissue injuries are rare and surgical intervention is challenging with no definitive treatment strategies. Case Report: A 52-year-old man presented with closed right segmental tibia and fibula fracture with extensive blistering of skin caused due to road traffic accident. Distal pulses were palpable and there were no signs of compartment syndrome and other systemic injuries. In the presence of extensive blistering, a monoplanar external fixator was applied within 24 h of injury. 3 weeks later, skin condition was conducive for internal fixation, and closed intramedullary multi-locking nailing was performed using the external fixator for reduction. Fracture healed at 15 months and patient had an excellent functional outcome with full knee range of motion at 2-years follow-up without any complications. Conclusion: Fixator-assisted nailing is a simple, minimally invasive, and easily reproducible technique that is useful in reducing the fracture and preventing axial rotation of the intercalary segment minimizing the damage to the periosteal blood supply. Our case also highlights the importance of temporary external fixator in soft tissue healing and making the skin conducive for internal fixation. Keywords: Devascularization, fixator-assisted nailing, intercalary segment, rotational displacement, segmental tibial fracture.

scholarly journals Correlation between the quality of calcaneal fracture reduction and time to return to work

2018 ◽  
Vol 12 (4) ◽  
pp. 304-09
Author(s):  
Fabielle Patrícia Zanardini Motizuki ◽  
Juliano Rodrigo Martynetz ◽  
Mário Fábio Polati ◽  
Sidney Silva de Paula ◽  
Afonso Klein Júnior ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Return To Work ◽  
Functional Limitation ◽  
Calcaneal Fracture ◽  
Late Complications ◽  
Fracture Reduction ◽  
Joint Involvement ◽  
Calcaneal Fractures ◽  
Level Of Evidence

Objective: The aim of this study is to test the hypothesis that patients with calcaneal fractures who are surgically treated and have Böhler and Gissane angles restored to normal have a faster return to work than patients without restoration of these angles. Calcaneal fractures represent 1-2% of all fractures, and approximately 75% of these are articular, indicating surgical treatment. Joint involvement results in functional limitation and can lead to late complications such as chronic pain, subtalar arthrosis, difficulty walking, and deformities. Methods: Lateral radiographs of the calcaneus of 44 patients who underwent surgical treatment for calcaneal fracture during the period from 2014 to 2016 were analysed to measure the Böhler and Gissane angles and to evaluate the association of their restoration to normal with the time to return to work. Results: Among the patients, 70.2% presented restoration of the Böhler angle and 44.7% presented restoration of the Gissane angle with surgery. The mean time away from work was 8.38 months. A total of 76.6% of patients returned to the same function. Patients who had good fracture reduction had a shorter time to return to work, but this result was not statistically significant. Conclusion: Surgical restoration of angles can positively influence the functional outcomes of patients, but this is not the only variable and thus should not be exclusively used to analyse the functional outcome and time to return to work of patients. Level of Evidence III; Therapeutic Studies; Cases Series.

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 Current concepts in anterior glenohumeral instability: diagnosis and treatment

SICOT-J ◽  
2021 ◽  
Vol 7 ◽  
pp. 48
Author(s):  
Daniel Moya ◽  
Nuri Aydin ◽  
Nobuyuki Yamamoto ◽  
Juan Pablo Simone ◽  
Paul Patiño Robles ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Tissue Injury ◽  
Treatment Plan ◽  
Soft Tissue Injury ◽  
Classification Systems ◽  
Surgical Instruments ◽  
Patient Specific ◽  
Glenohumeral Instability ◽  
Joint Dislocations ◽  
Glenoid Track

The glenohumeral joint is the most dislocated articulation, accounting for more than 50% of all joint dislocations. The reason behind shoulder instability should be investigated in detail for successful management, and the treatment plan should be individualized for all patients. Several classification systems have been proposed for glenohumeral instability. A physical exam is mandatory no matter what classification system is used. When treating patients with anterior shoulder instability, surgeons need to be aware of the critical size of the bone loss, which is commonly seen. The glenoid track concept was clinically adopted, and the measurement of the glenoid track for surgical decision-making is recommended. Detailed assessment of existing soft tissue injury to the labrum, capsule, glenohumeral ligaments, and rotator cuff is also mandatory as their presence influences the surgical outcome. Rehabilitation, arthroscopic repair techniques, open Bankart procedure, capsular plication, remplissage, Latarjet technique, iliac crest, and other bone grafts offer the surgeon different treatment options according to the type of patient and the lesions to be treated. Three-dimensional (3D) technologies can help to evaluate glenoid and humeral defects. Patient-specific guides are low-cost surgical instruments and can be used in shoulder instability surgery. 3D printing will undoubtedly become an essential tool to achieve the best results in glenohumeral instability surgery.

Plantar Medial Avulsion Fragment Associated With Tongue-Type Calcaneus Fractures

2019 ◽  
Vol 40 (6) ◽  
pp. 634-640 ◽  
Author(s):  
Mark R. Adams ◽  
Kenneth L. Koury ◽  
Jaydev B. Mistry ◽  
William Braaksma ◽  
John S. Hwang ◽  
...  
Keyword(s):  
Retrospective Chart Review ◽  
Plantar Fascia ◽  
Calcaneal Fractures ◽  
Level Of Evidence ◽  
Fracture Fragment ◽  
Avulsion Fractures ◽  
Distinct Level ◽  
Level I ◽  
Calcaneus Fractures ◽  
Essex Lopresti

Background: The plantar fascia attaches to the tuberosity of the calcaneus, which produces a distinct plantar medial avulsion (PMA) fracture fragment in certain calcaneal fractures. We hypothesized that tongue-type fractures, as described by the Essex-Lopresti classification, were more likely to be associated with this PMA fracture than joint depression fractures. Methods: A retrospective chart review was performed at 2 distinct Level I trauma centers to identify patients sustaining calcaneal fractures. Radiographs were then reviewed to determine the Essex-Lopresti classification, OTA classification, and presence of a PMA fracture. Results: The review yielded 271 total patients with 121 (44.6%) tongue-type (TT), 110 (40.6%) joint depression (JD), and 40 (14.8%) fractures not classifiable by the Essex-Lopresti classification. In the TT group, 73.6% of the patients had the PMA fracture whereas only 8.2% of JD and 15.0% of nonclassifiable fractures demonstrated a PMA fragment ( P < .001). Conclusion: Plantar medial avulsion fractures occurred in 38.4% of the calcaneal fractures reviewed with a significantly greater proportion occurring in TT (73.6%) as opposed to JD (8.2%). Given the plantar fascia attachment to the PMA fragment, there may be clinical significance to identifying this fracture and changing treatment management; however, this requires further investigation. Level of Evidence: Level III, comparative study.

scholarly journals CHARACTERISTICS AND PREVENTION OF SPORTS INJURIES IN TAEKWONDO TRAINING

2022 ◽  
Vol 28 (1) ◽  
pp. 37-39
Author(s):  
Shupeng Xiao
Keyword(s):  
Sports Injuries ◽  
Tissue Injury ◽  
Soft Tissue Injury ◽  
Young Athletes ◽  
Level Of Evidence ◽  
Acute Injuries ◽  
Level Of Training ◽  
Serious Injuries ◽  
Preventive Methods ◽  
Timely Treatment

ABSTRACT Introduction: With the extensive and in-depth development of Taekwondo in China, more and more people participate in Taekwondo training. Due to the lack of experience of some coaches and the misunderstanding of scientific sports training by young athletes, injuries occur from time to time. This has a bad effect on Taekwond itself, and it can also damage the health of athletes. Objective: This article discusses joint injuries in Taekwondo and analyzes the characteristics of Taekwondo sports injuries and preventive methods. Methods: This article uses a questionnaire applied to young athletes to gain an understanding of the sports injuries situation. Results: The most common injury sites were feet and joints. The nature of the injuries is mostly soft tissue injury, ligament laceration, and muscle strain. The most serious injuries are kidney and perineal damage. Conclusion: Improving the level of training, strengthening medical supervision, and paying attention to the timely treatment of acute injuries are important ways to reduce the occurrence of trauma. Level of evidence II; Therapeutic studies - investigation of treatment results.

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