scholarly journals A case of fracture talus with medial malleolus treated with headless screws and cancellous cannulated screws using single anteromedial approach

2022 ◽  
Author(s):  
Shubham N. Katti ◽  
Prithviraj A. Paigude ◽  
Praful A. Ingale ◽  
Sushilkumar R. Mane
Keyword(s):  
Wound Healing ◽  
Joint Stiffness ◽  
Skin Condition ◽  
Fracture Site ◽  
Medial Malleolus ◽  
Cannulated Screws ◽  
Management Options ◽  
Talar Fractures ◽  
Medial Malleolus Fracture ◽  
Complex Injuries

<p>Talar fractures are complex injuries with an array of management options and complications. We present a case of talar fracture with medial malleolus fracture fixed via common anteromedial approach through the fracture site. The incidence of associated malleolar injury has ranged from 19% to 28% in prior studies. The skin condition is often poor and prone to swelling in such cases which makes the management challenging. Along with poor wound healing, joint stiffness, osteonecrosis and osteoarthritis of the ankle are complications affecting the outcome of the patient.</p>

Wound With Diabetes: Present Scenario And Future

2020 ◽  
Vol 16 ◽  
Author(s):  
Kuldeep B. Pawar ◽  
Shivani Desai ◽  
Ramesh R. Bhonde ◽  
Ritesh P. Bhole ◽  
Atul A. Deshmukh
Keyword(s):  
Wound Healing ◽  
Blood Flow ◽  
Healing Process ◽  
Endocrine System ◽  
Healing Time ◽  
Special Focus ◽  
Diabetic Wound ◽  
Management Options ◽  
And Migration ◽  
Proliferation And Migration

: Diabetes is a chronic metabolic disorder of endocrine system characterized by increase in blood glucose level. Several factors such as pancreatic damage, oxidative stress, infection, genetic factor, obesity, liver dysfunction play a vital role in pathogenesis of diabetes which further lead to serious diabetic complications. Diabetic wound is one such complication where the wound formation occurs, especially due to pressure and its healing process is disrupted due to factors such as hyperglycemia, neuropathy, nephropathy, peripheral vascular disease, reduction of blood flow, atherosclerosis, impaired fibroblast. Process of wound healing is delayed due to different abnormalities like alteration in nitric oxide level, increase in aldose reductase, sorbitol and fructose. Therefore, diabetic wound requires more time to heal as compare to normal wound. Healing time is delayed in diabetic wound due to many factors such as stress, decreased oxygenation supply, infection, decreased blood flow, impaired proliferation and migration rate, impaired growth factor production, impaired keratinocytes proliferation and migration, and altered vascular endothelial mediators. The current treatment for diabetic wound includes wound patches, oxygenation therapy, hydrogel patches, gene therapy, laser therapy, and stem cell therapy. Medications with phytoconstituents is also one way to manage diabetic wound, but it is not more effective for quick healing. The objective of this review is to understand the potential of various management options which are available for diabetic wound, with a special focus on biological cells.

scholarly journals The Surgical Outcomes of Unstable Ankle Fractures in Patients Aged >65 Years

2021 ◽  
Vol 12 ◽  
pp. 215145932199776
Author(s):  
Adem Sahin ◽  
Anıl Agar ◽  
Deniz Gulabi ◽  
Cemil Erturk
Keyword(s):  
Surgical Outcomes ◽  
External Rotation ◽  
High Energy ◽  
Ankle Fractures ◽  
Medial Malleolus ◽  
Aofas Score ◽  
Non Union ◽  
The Mean ◽  
Medial Malleolus Fracture ◽  
Mechanism Of Trauma

Aim: To evaluate the surgical outcomes and complications of patients over 65 years of age, with unstable ankle fractures. Material and Method: The study included 111 patients (73F/38 M) operated on between January 2015 and February 2019 and followed up for a mean of 21.2 months (range, 6-62 months).Demographic characteristics, comorbidities, fracture type, and mechanisms of injury were evaluated. Relationships between postoperative complications and comorbidities were examined. In the postoperative functional evaluations, the AOFAS score was used and pre and postoperative mobilization (eg, use of assistive devices) was assessed. Results: The mean age of the patients was 70.5 ± 6.1 years (range, 65-90 years). The mechanism of trauma was low-energy trauma in 90.1% of the fractures and high-energy trauma in 9.9%. The fractures were formed with a SER injury (supination external rotation) in 83.7% of cases and bimalleolar fractures were seen most frequently (85/111, 76%).Complications developed in 16 (14.4%) patients and a second operation was performed in 11 (9.9%) patients with complications. Plate was removed and debridement was performed in 5 of 6 patients due to wound problems. Nonunion was developed in the medial malleolus in 4 patients. Revision surgery was performed because of implant irritation in 2 patients and early fixation loss in the medial malleolus fracture in one patient. Calcaneotibial arthrodesis was performed in 3 patients because of implant failure and ankle luxation associated with non-union. A correlation was determined between ASA score and DM and complications, but not with osteoporosis. The mean follow-up AOFAS score was 86.7 ± 12.5 (range, 36-100).A total of 94 (84.7%) patients could walk without assistance postoperatively and 92 (82.9%) were able to regain the preoperative level of mobilization. Conclusion: Although surgery can be considered an appropriate treatment option for ankle fractures in patients aged >65 years, care must be taken to prevent potential complications and the necessary precautions must be taken against correctable comorbidities.

Current Advances in Hypertrophic Scar and Keloid Management

2021 ◽  
Author(s):  
Natasha Barone ◽  
Tyler Safran ◽  
Joshua Vorstenbosch ◽  
Peter Davison ◽  
Sabrina Cugno ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Wound Healing ◽  
Psychological Health ◽  
Hypertrophic Scar ◽  
Tissue Response ◽  
Fibroblast Proliferation ◽  
Hypertrophic Scars ◽  
Physical Status ◽  
Management Options

AbstractHypertrophic scars and keloids are caused by excessive tissue response to dermal injury due to local fibroblast proliferation and collagen overproduction. This response occurs because of pathologic wound healing due to dysregulation in the inflammatory, proliferative, and/or remodeling phase. Patients with hypertrophic scars or keloids report reduced quality of life, physical status, and psychological health. Hypertrophic scars or keloids will develop in 30 to 90% of individuals, and despite their prevalence, treatment remains a challenge. Of the treatments currently available for hypertrophic scars and keloids few have been adequately supported by studies with appropriate experimental design. Here, we aim to review the available literature to provide up-to-date information on the etiology, epidemiology, histology, pathophysiology, prevention, and management options available for the treatment of hypertrophic scars and keloids and highlight areas where further research is required.

Wound-Healing Issues Following Rotational Ankle Fracture Surgery: Predictors and Local Management Options

2018 ◽  
Vol 12 (5) ◽  
pp. 409-417 ◽  
Author(s):  
Hesham Saleh ◽  
Sanjit Konda ◽  
Adam Driesman ◽  
John Stranix ◽  
Catherine Ly ◽  
...  
Keyword(s):  
Wound Healing ◽  
Ankle Fracture ◽  
Wound Complications ◽  
Management Options ◽  
Original Cohort ◽  
Surgical Interventions ◽  
Postoperative Wound ◽  
Trimalleolar Fractures ◽  
Medical Histories ◽  
Fracture Surgery

Background. The incidence and risk factors of wound-healing complications following rotational ankle fracture surgery are well documented in the literature. However, there is a paucity regarding management options following these complications. The goal of this study was to provide a descriptive analysis of one surgeon’s experience managing wound complications in patients who have undergone ankle fracture surgery. Methods. A total of 215 patients who were operatively treated for an unstable ankle were retrospectively identified. Patient demographics, medical histories, initial injury characteristics, surgical interventions, and clinical follow-up were collected. Twenty-five of these patients developed postoperative wound problems. Results. Of the original cohort of 215 patients, 25 (11.6%) developed wound-healing complications. Their average age was 53.6 ± 18.0 years; there were 12 males (48.0%). Connective tissue/inflammatory disease (odds ratio [OR] 3.9), cardiovascular disease (OR 3.6), and active smoking (OR 3.3) were associated with an increased likelihood of developing postoperative wound complications. With regard to injuries, open fractures (OR 17.9) had the highest likelihood of developing postoperative complications, followed by type 44-C (OR 2.8) and trimalleolar fractures (OR 2.0). Conclusion. Wound complications following open treatment of ankle fractures occurred with an incidence of 11.6% in this series, of which only about half required operative intervention. A third of wounds were managed by orthopaedics in conjunction with plastic surgery. Levels of Evidence: Level III: Retrospective comparative study

scholarly journals A Study To Determine The Effect Of Egg Albumin Dressing On Peristomal Wound Healing of the Colostomy Patients In A Selected Hospital, Kolkata, West Bengal

2021 ◽  
Vol 4 (04) ◽  
Author(s):  
Ms. Rimi Chakraborty ◽  
Dr Arpan Dutta Roy ◽  
Dr Sayantan Ghosh ◽  
Dr Pankaj Kumar Singh ◽  
Dr. Prolay Paul
Keyword(s):  
Wound Healing ◽  
Sample Selection ◽  
Skin Condition ◽  
Control Group ◽  
Egg Albumin ◽  
Final Study ◽  
Reduction Of Pain ◽  
Quasi Experimental ◽  
Peristomal Skin ◽  
And Control

The researcher conducted a quasi experimental study to evaluate the effect of egg albumin dressing on peristomal wound healing in a selected hospital, Kolkata, with the objectives to assess the peristomal skin condition of colostomy patients before treatment, to evaluate the effect of egg albumin dressing on healing of peristomal area and reduction of pain, to find out the association between the peristomal wound healing and selected variables. The final study was conducted at Curzon ward, Victoria ward of SSKM hospital, Kolkata. Ethical permission was sought out from Ethical Committee of SSKM hospital, Kolkata. Informed consent was taken from all respondents. The sample was selected according to their selected criteria. The sample selection was done by purposive sampling. They were randomly assigned into two groups (experimental and control group) in 1:1 ratio. The study concluded with its limitations, implications and recommendations for conducting a study may be conducted for a longer duration of observation with the treatment.

Symphyseal fracture in a three-month-old infant

2021 ◽  
Vol 14 (12) ◽  
pp. e245661
Author(s):  
Amir Labib ◽  
Amir Samir Elbarbary
Keyword(s):  
Conservative Management ◽  
Male Infant ◽  
Fracture Site ◽  
Mandibular Fractures ◽  
Management Options ◽  
Mandibular Growth ◽  
Long Term Follow Up ◽  
High Index Of Suspicion ◽  
Displaced Fracture

Mandibular fractures are rare in infants, and diagnosis can be easily missed due to the difficulty in obtaining an adequate history and the subtle signs. A high index of suspicion and detailed history taking from the caregiver are mandatory to pick up these cases.There are a plethora of management options that have been reported in dealing with such fractures. They range from conservative management to internal fixation by absorbable plates. While conservative management does not interfere with mandibular growth and teeth development, any surgical intervention can carry this risk. Nevertheless, a severely displaced fracture may need anatomical reduction and fixation to allow early nutrition.This study reports a 3-month-old male infant with a fracture in the mandibular symphysis who underwent reduction of the fracture and circummandibular fixation using immobilisation by an acrylic splint for 4 weeks. His long-term follow-up after 20 months showed adequate dentition with proper healing of the fracture site.

scholarly journals The 12-HHT/BLT2/NO Axis Is Associated to the Wound Healing and Skin Condition in Different Glycaemic States

2019 ◽  
Vol 7 (4) ◽  
pp. 65
Author(s):  
Leguina-Ruzzi ◽  
Ortiz Diban ◽  
Velarde
Keyword(s):  
Nitric Oxide ◽  
Wound Healing ◽  
Tight Junction ◽  
Skin Condition ◽  
Inos Mrna ◽  
Nitric Oxide Production ◽  
Mrna Levels ◽  
Oxide Production

Type 2 diabetes affects over 340 million people worldwide. This condition can go unnoticed and undiagnosed for years, leading to a late stage where high glycaemia produces complications such as delayed wound healing. Studies have shown that 12-HHT through BLT2, accelerates keratinocyte migration and wound healing. Additionally, evidence has shown the role of nitric oxide as a pro-regenerative mediator, which is decreased in diabetes. Our main goal was to study the association between the 12-HHT/BLT2 axis and the nitric oxide production in wound healing under different glycaemia conditions. For that purpose, we used in vivo and in vitro models. Our results show that the skin from diabetic mice showed reduced BLT2 and iNOS mRNA, TEER, 12-HHT, nitrites, and tight junction levels, accompanied by higher MMP9 mRNA levels. Furthermore, a positive correlation between BLT2 mRNA and nitrites was observed. In vitro, HaCaT-BLT2 cells showed higher nitric oxide and tight junction levels, and reduced MMP9 mRNA levels, compared to mock-keratinocytes under low and high glucose condition. The wound healing capacity was associated with higher nitric oxide production and was affected by the NOS inhibition. We suggest that the BLT2 expression improves the keratinocyte response to hyperglycaemia, associated with the production of nitric oxide.

scholarly journals Association of Bosworth, Pilon, and Open Talus Fractures: A Very Unusual Ankle Trauma

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Kevin Moerenhout ◽  
Georgios Gkagkalis ◽  
Rayan Baalbaki ◽  
Xavier Crevoisier
Keyword(s):  
Case Report ◽  
Fracture Dislocation ◽  
Tibial Tubercle ◽  
Medial Malleolus ◽  
Distal Fibula ◽  
Rare Lesion ◽  
Ankle Trauma ◽  
One Year ◽  
Medial Malleolus Fracture ◽  
Hindfoot Arthrodesis

Introduction. A Bosworth fracture-dislocation is a rare lesion resulting in a fixed dislocation of the distal fibula behind the posterior tibial tubercle. Only few cases have been reported showing an associated consequent fracture, namely, a pilon or a medial malleolus fracture. Case Report. We present a case report of a patient with an unusual combination of a Bosworth injury with a pilon fracture and an open multifragmentary talus fracture and our approach for open reduction and internal fixation. At one year postoperative, the patient developed an invalidating tibiotalar and subtalar arthrosis that eventually required an ankle-hindfoot arthrodesis. A Bosworth injury is an infrequent entity and is even rarer when associated with other fractures. Careful preoperative planning is necessary, as the combination of these fractures is a surgical challenge. Special care must be taken to preserve the neurovascular bundle. Discussion. The present case highlights a Bosworth injury involving a severity that has never been described before and suggests adding an eighth stage to the classification presented by Perry et al.

Clinical Outcomes of Total Ankle Arthroplasty With Total Talar Prosthesis

2019 ◽  
Vol 40 (8) ◽  
pp. 948-954
Author(s):  
Noriyuki Kanzaki ◽  
Nobuaki Chinzei ◽  
Tetsuya Yamamoto ◽  
Takahiro Yamashita ◽  
Kazuyuki Ibaraki ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Case Series ◽  
Total Ankle Arthroplasty ◽  
Medial Malleolus ◽  
Level Of Evidence ◽  
Ankle Arthroplasty ◽  
The Mean ◽  
End Stage ◽  
Medial Malleolus Fracture

Background: Total ankle arthroplasty (TAA) has been developed to treat patients with end-stage ankle osteoarthritis (OA). However, there is often difficulty in treating complicated pathologies such as ankle OA with subtalar joint OA and severe talar collapse. Therefore, this study aimed to explore the short-term results and complications of TAA with total talar prosthesis, known as combined TAA, as the new techniques to treat such complicated pathology. Methods: We examined postoperative results including ankle range of motion, Japanese Society for Surgery of the Foot (JSSF) scale, and complications. There were 22 patients (15 women), with mean follow-up of 34.9 (range, 24–53 months), and the mean age was 72 (range, 62–80) years. The main indications for combined TAA included osteoarthritis (18 patients), rheumatoid arthritis (3 patients), and talar osteonecrosis with osteoarthritis (one patient). Results: The mean range of motion improved from 4.0 to 14.4 degrees in dorsiflexion and from 23.8 to 32.0 degrees in plantarflexion. The JSSF scale improved from 50.5 to 91.5 points. Prolonged wound healing occurred in 3 patients, and medial malleolus fracture occurred in 4 patients. Conclusion: Combined TAA was a reliable procedure for the treatment of not only ankle OA following avascular necrosis of talus but also of degeneration of both ankle and subtalar joints. Level of Evidence: Level IV, case series.

Sign in / Sign up

Export Citation Format

Share Document