Genesis and Symptom Interval of Osteosarcoma Following High-Energy Trauma

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.

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

N.N. Priorov Journal of Traumatology and Orthopedics ◽

10.17116/vto201902114 ◽

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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Factors Influencing Functional Outcomes of Subtalar Fusion for Posttraumatic Arthritis After Calcaneal Fracture

Foot & Ankle International ◽

10.1177/1071100718777492 ◽

2018 ◽

Vol 39 (9) ◽

pp. 1062-1069 ◽

Cited By ~ 8

Author(s):

Quirine M.J. van der Vliet ◽

Falco Hietbrink ◽

Fabio Casari ◽

Luke P.H. Leenen ◽

Marilyn Heng

Keyword(s):

Quality Of Life ◽

Functional Outcomes ◽

Calcaneal Fracture ◽

High Energy ◽

Posttraumatic Arthritis ◽

High Energy Trauma ◽

Subtalar Arthrodesis ◽

Subtalar Fusion ◽

Subtalar Arthritis

Background: Subtalar arthrodesis is a common salvage operation for posttraumatic subtalar arthritis. This study aimed to identify factors associated with functional outcomes and quality of life after subtalar fusion for posttraumatic subtalar arthritis after calcaneal fracture. Methods: This is a retrospective study with follow-up by questionnaire in two level 1 trauma centers. Patients who underwent subtalar arthrodesis for posttraumatic arthritis after a calcaneal fracture between 2001 and 2016 were identified and contacted for completion of a survey consisting of the Foot and Ankle Ability Measure (FAAM), Maryland Foot Score (MFS), Patient-Reported Outcomes Measurement System Physical Function (PROMIS PF, Short Form 10a) questionnaire, EuroQol 5-dimensional (EQ-5D) questionnaire, and EuroQol visual analog scale (EQ-VAS). Exclusion criteria were initial subtalar arthrodesis at an outside facility, primary arthrodesis for fracture, initial arthrodesis earlier than 2001, amputation of the fused foot or leg, younger than 18 years at time of fusion, and inability to communicate in English. A total of 159 patients met our inclusion criteria. Eighty-four patients completed the questionnaires, resulting in a response rate of 59%. Results: Median FAAM score was 79 (interquartile range [IQR], 48-90), median MFS was 74 (IQR, 56-86), and median PROMIS PF was 45 (IQR, 38-51). Quality of life was significantly lower when compared to a reference population ( P = .001). Smoking was independently associated with worse outcomes. Complications after fusion (such as nonunion, implant failure, and infectious complications), high-energy trauma, and ipsilateral injury were also predictors for poorer outcomes. Conclusion: Acceptable functional outcomes and quality of life were observed after subtalar fusion. Smoking, complications after subtalar fusion, high-energy trauma, and presence of ipsilateral injuries were independently associated with worse functionality and quality of life. Level of Evidence: Prognostic level III, comparative series.

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Intra-articular Transcalcaneal Fracture-Dislocation Associated With Ipsilateral Transtalar Fracture: A Report of a Rare Combination

Foot & Ankle Specialist ◽

10.1177/1938640020913177 ◽

2020 ◽

Vol 13 (4) ◽

pp. 335-340

Author(s):

Danilo Ryuko Cândido Nishikawa ◽

Bruno Rodrigues de Miranda ◽

Fernando Aires Duarte ◽

Guilherme Honda Saito ◽

Rogério Carneiro Bitar ◽

...

Keyword(s):

Case Report ◽

High Energy ◽

Fracture Dislocation ◽

Calcaneal Fractures ◽

Short Term ◽

High Energy Trauma ◽

Rare Combination ◽

Severe Bone Loss ◽

Neck Fracture

The association of ipsilateral talar and calcaneal fractures is an uncommon combination and is typically the result of a high-energy trauma. It is often associated with comminution, marked fracture displacement, and soft-tissue compromise. Obtaining satisfactory clinical and radiographic results is very challenging. Residual deformities, multiple procedures, and limitations are usually the norm. Therefore, studies have suggested that primary arthrodesis may represent the best option of surgical treatment. In this study, we report a case of a 30-year-old male patient with a rare combination of a highly comminuted transcalcaneal fracture-dislocation associated with a talar neck fracture successfully treated with open reduction and internal fixation (ORIF) with an 18-month follow-up. This case demonstrates that even when there are associated fractures of the talus and calcaneus with severe bone loss, ORIF may provide satisfactory outcomes in the short-term postoperative period. Levels of Evidence: Level V: Case report

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P216 An evaluation of articular cartilage and subchondral bone architecture (Articulone) in bovine cadaver knees after high energy trauma

Osteoarthritis and Cartilage ◽

10.1016/s1063-4584(07)61571-4 ◽

2007 ◽

Vol 15 ◽

pp. B142

Author(s):

M.J. Langworthy

Keyword(s):

Articular Cartilage ◽

Subchondral Bone ◽

High Energy ◽

Bone Architecture ◽

High Energy Trauma

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Distal femur and knee

10.1093/med/9780198813170.003.0014 ◽

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.

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