CLINICO – RADIOLOGICAL OUTCOME OF FEMUR DIAPHYSEAL FRACTURES TREATED WITH INTRAMEDULLARY INTERLOCKING NAILING

2021 ◽  
pp. 46-47
Author(s):  
Phani Teja Villa ◽  
P Sadhana ◽  
K Thulasi Ram
Keyword(s):  
Lower Extremity ◽  
High Energy ◽  
Radiological Outcome ◽  
Internal Organs ◽  
Load Bearing ◽  
Mortality And Morbidity ◽  
High Energy Trauma ◽  
Male Predominance ◽  
Orthopedic Surgeon ◽  
Diaphyseal Fractures

Background: Fracture diaphysis of a femur is one of the most common fractures that an orthopedic surgeon comes across. Since femur is one of the principal load bearing bones in the lower extremity, femur diaphyseal fractures resulting from high energy trauma, and are often associated with concomitant injury of internal organs. Thus these fractures are associated with considerable mortality and morbidity. Results: In the present study, we used WINQUEST AND HANSENS CLASSIFICATION to classify the fractures , 14 (46.66%) cases were type 0 fractures; type1 fractures were 6 (21.33%). The age of the patients ranges from 18-70 years, with a mean age of 37.6 yrs. Male predominance was seen; about 76.66% (23 cases) were males and the rest females, i.e., 23.33% (7 cases). Eighteen cases (18) were right-sided, and twelve cases (12) were left-sided fracture diaphysis of the femur

Distal femur and knee

2018 ◽  
Author(s):  
Jim Hughes
Keyword(s):  
Distal Femur ◽  
High Energy ◽  
The Body ◽  
Long Bones ◽  
Surgical Equipment ◽  
Load Bearing ◽  
High Energy Trauma ◽  
Articular Surfaces ◽  
Cerclage Wiring ◽  
Selection Of

The knee is one of the main load-bearing joints of the body, and injuries to it can involve damage to the joint or articular surfaces, or fractures to the long bones in case of high-energy trauma. The position of the contralateral leg can cause difficulty in positioning for imaging, but good positioning and technique should allow demonstration of the region for intervention. This chapter covers a selection of orthopaedic procedures involving the distal femur and knee, covering distal femoral plating and LISS plates, tension band wiring of the patella, and cerclage wiring of the patella. Each procedure includes images that demonstrate the position of the C-arm, patient, and surgical equipment, with accompanying radiographs demonstrating the resulting images.

scholarly journals Free Tissue Transfer Optimizes Stump Length and Functionality Following High-Energy Trauma

2019 ◽  
Vol 04 (02) ◽  
pp. e96-e101
Author(s):  
Merisa L. Piper ◽  
Dominic Amara ◽  
Sarosh N. Zafar ◽  
Charles Lee ◽  
Hani Sbitany ◽  
...  
Keyword(s):  
Lower Extremity ◽  
San Francisco ◽  
Free Flap ◽  
Free Tissue Transfer ◽  
High Energy ◽  
Limb Length ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
High Energy Trauma ◽  
Tissue Transfer

Abstract Background Advances in medicine and surgery have allowed patients, who in the past would have required more aggressive amputations, to maintain longer stump lengths. Microvascular free tissue transfer has become increasingly popular to preserve limb length and optimize functionality. We present our experience using microvascular free flap reconstruction to preserve lower extremity limb length in the setting of high-energy trauma. Methods We conducted an Institutional Review Board-approved retrospective review of patients at three San Francisco hospitals who underwent free flap reconstruction after high-energy trauma between 2003 and 2015. We included all patients who underwent free flap reconstruction for lower extremity limb length preservation. We reviewed patient demographics, preoperative variables, intraoperative details, and postoperative outcomes, including complications, functional status, reoperation rates, and need for revision amputation. Results Twelve patients underwent microvascular free tissue transfer for limb length preservation. Overall, the patients had similar preoperative comorbidities and a mean age of 44. Six patients had postoperative complications: three minor complications and three major complications. Seven patients had additional surgeries to improve the contour of the flap. One patient required revision amputation, while the remaining 11 patients preserved their original limb length. The majority of patients were fully ambulatory, and four used a prosthesis. Conclusion Microvascular free tissue transfer can be used to effectively maintain lower extremity stump length following trauma. Although these patients often require multiple surgeries and face lengthy hospital courses, this technique enables preservation of a functional extremity that would otherwise require a more proximal amputation.

scholarly journals Management of tibial plateau fractures with compromised soft tissue using hybrid external fixator

2020 ◽  
Vol 6 (6) ◽  
pp. 1297
Author(s):  
Mahesh K. Sharma ◽  
Mukul Jain ◽  
Harish K. Jain ◽  
Sukhveer Khichar ◽  
Rahul Jadoo
Keyword(s):  
Soft Tissue ◽  
External Fixator ◽  
Tibial Plateau ◽  
High Energy ◽  
Tibial Plateau Fractures ◽  
Neurovascular Compression ◽  
Radiological Outcome ◽  
High Energy Trauma ◽  
Soft Tissue Envelope ◽  
Hybrid External Fixator

<p class="abstract">Tibial plateau fractures with high energy trauma are complex injury due to its precarious soft tissue envelope. High energy trauma has high incidence of open fractures, articular depression, fracture comminution and displacement, soft tissue injury, and neurovascular compression. It is often difficult to achieve and maintain reduction and commonly predisposes to secondary arthritis. Hybrid external fixator minimizes the iatrogenic soft tissue damage, provides adequate fixation of the fracture, permits early range of motion, easy wound care and leave no large implant in subcutaneous position. This study was performed to evaluate the functional and radiological outcome with this procedure. In this case series, prospective study of 15 cases of tibial plateau fractures were treated with hybrid external fixator at tertiary care teaching hospital in southern Rajasthan from July 2018 to June 2019. The functional and radiological outcome was assessed by Rasmussen functional and radiological score. The mean interval between surgery and union was 16 weeks (range 13 to 18 weeks). Rasmussen functional results were acceptable in 13 cases (86.66%) comprising excellent in 9 (60%), good in 4 (26.66%), and fair in 2 (13.33%). Rasmussen radiological results were acceptable in 13 cases (86.66%) comprising excellent in 9 (60%), good in 4 (26.66%), and fair in 2 (13.33%). Minimal internal and hybrid external fixation for management of tibial plateau fracture with compromised soft tissue is more biological, require less surgical time, less hospital stay, very effective in compromised soft tissue, highly cost effective and has minimal complications with good functional outcome.</p>

Clinical and economic effects of selective radiological evaluation of high-energy trauma patients: a prospective experience of a level 1 busy trauma centre

2014 ◽  
Vol 32 (7) ◽  
pp. 535-538 ◽  
Author(s):  
Shahram Paydar ◽  
Armin Ahmadi ◽  
Behnam Dalfardi ◽  
Alireza Shakibafard ◽  
Hamidreza Abbasi ◽  
...  
Keyword(s):  
High Energy ◽  
Trauma Centre ◽  
Economic Effects ◽  
Trauma Patients ◽  
Radiological Evaluation ◽  
High Energy Trauma ◽  
Level 1

Angiography in patients with pelvic fractures and contrast extravasation on CT following high-energy trauma

2021 ◽  
Author(s):  
Jonathan Hammerschlag ◽  
Yehuda Hershkovitz ◽  
Itamar Ashkenazi ◽  
Zahar Shapira ◽  
Igor Jeroukhimov
Keyword(s):  
High Energy ◽  
Pelvic Fractures ◽  
Contrast Extravasation ◽  
High Energy Trauma

scholarly journals Changing presentation of knee dislocation and vascular injury from high-energy trauma to low-energy falls in the morbidly obese

2013 ◽  
Vol 57 (5) ◽  
pp. 1196-1203 ◽  
Author(s):  
Andrew G. Georgiadis ◽  
Farah H. Mohammad ◽  
Kristin T. Mizerik ◽  
Timothy J. Nypaver ◽  
Alexander D. Shepard
Keyword(s):  
Vascular Injury ◽  
Knee Dislocation ◽  
High Energy ◽  
Low Energy ◽  
Morbidly Obese ◽  
High Energy Trauma

scholarly journals Scapulothoracic dissociation

2019 ◽  
Vol 92 (1101) ◽  
pp. 20190090
Author(s):  
Kimia Khalatbari Kani ◽  
Felix S Chew
Keyword(s):  
Differential Diagnosis ◽  
Shoulder Girdle ◽  
High Energy ◽  
Imaging Evaluation ◽  
Acute Setting ◽  
High Energy Trauma ◽  
Diagnosis And Management ◽  
Life Threatening ◽  
Spectrum Imaging ◽  
Scapulothoracic Dissociation

Scapulothoracic dissociation is a rare and potentially limb- and life-threatening injury, that results from high-energy trauma. Scapulothoracic dissociation has the potential to be overlooked in the acute setting, especially in the setting of polytrauma. Therefore, a careful search for this condition should be performed in all patients with high-energy shoulder girdle injuries. The goals of this article are to review the anatomy of the scapulothoracic articulation as well as the spectrum, imaging evaluation, differential diagnosis and management of scapulothoracic dissociations.

scholarly journals Features of surgical treatment of intra- and periarticular fractures of the lower third of the femur in patients with polytrauma

2019 ◽  
Vol 26 (2) ◽  
pp. 14-18
Author(s):  
E. I Solod ◽  
N. V Zagorodni ◽  
A. F Lazarev ◽  
M. A Abdulkhabirov ◽  
Ya. M Alsmadi ◽  
...  
Keyword(s):  
Distal Part ◽  
Distal Femur ◽  
Traumatic Shock ◽  
High Energy ◽  
Optimal Time ◽  
Prospective Analysis ◽  
Severity Scale ◽  
Duration Of Treatment ◽  
High Energy Trauma ◽  
Results Of Treatment

Treatment of patients with fractures of femur has a particular relevance in modern traumatology, especially in patients with polytrauma. The treatment of such fractures is complicated by the fact that it depends not only on the nature of the fracture, but also on the general condition of the patient. These fractures are caused by high-energy trauma, they have the tendency to be splintered or fragmented, and often accompanied by neurovascular complications, especially in the distal part. Such fractures are often accompanied by soft tissue damage. Purpose: improving the results of treatment of intra-and periarticular fractures of the distal femur in patients with polytrauma. Material and methods. In the present study, a prospective analysis of using conversion osteosynthesis in the treatment of 72 patients with intra-and periarticular fractures of the lower third of the femur patients with polytrauma, according to the ISS severity scale (ISS 17-40) was performed in a multidisciplinary hospital. Results. The most optimal time for conversion osteosynthesis to patients with polytrauma was 5-7 days, which prevented the occurrence of traumatic shock and prevented the occurrence of inflammatory complications in the postoperative period. Conclusion. The study confirmed the feasibility of conversion osteosynthesis in the treatment of patients with intra-and periarticular fractures of the lower third of the femur. The use of the technique of transferring the fixation of fragments by the external fixation to the internal osteosynthesis (conversion) contributed to a reduction in the duration of treatment of patients in the hospital with fractures of the long bones.

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