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The refractory post-operative diaphyseal femur fracture (DFF) non-union is extremely difficult to treat and remains severe challenges for orthopedists. Although several traditional internal fixations and novel biomedical techniques have been used in managing this complication, its treatment is still fraught with severe challenges.Starting from 1999, 5 patients after three previous internal fixation...
Anterior humeral line (AHL) location is commonly used to evaluate sagittal alignment after fracture reduction in children with supracondylar humeral fractures. However, the position of the AHL for acceptable fracture reduction has not been validated by clinical outcome. The purpose of this study was to investigate the relationship between the location of AHL and range of elbow motion.We retrospectively...
The purpose of this study was to determine if the triceps-reflecting anconeus pedicle (TRAP) approach combined with the precontoured locking plate can provide acceptable clinical outcomes in the treatment of comminuted distal humerus fracture.Between August 2008 and June 2014, 48 patients with Orthopaedic Trauma Association type C (21 with C2, 27 with C3) distal humerus fractures underwent open reduction...
Fragility femoral fractures occur in a similar group of patients to hip fractures but they are not routinely managed along standardised guidelines. This study looked specifically at whether delay to surgery has an impact on mortality and morbidity.An international, multi-centre retrospective review was carried including all patients over 60 years with fragility femoral fractures, including most periprosthetic...
The majority of paediatric forearm fractures are treated using a circumferential splint, with prior manipulation as necessary. Plaster of Paris is often chosen for its ease of application, cost and proven reliability.Softcast is an alternative, providing a comfortable and water-resistant splint that can be removed without a plaster saw, and is in widespread use for immobilising buckle fractures. Softcast...
The goal of this study was to evaluate the ability of a novel computer assisted surgery system to guide ideal placement of a lag screw during cephalomedullary nailing and then accurately measure the tip-apex distance (TAD) measurement intraoperatively.Retrospective case review.Level II trauma hospital.The initial 98 consecutive clinical cases treated with a cephalomedullary nail in conjunction with...
To report the perioperative results and surgical outcomes of patients with vertical unstable sacral fractures who underwent lumbopelvic fixation through a modified subcutaneous route for iliac screw fixation.Treating vertical unstable sacral fractures is still challenging for orthopedic surgeons. Among various methods for treating these fractures, lumbopelvic fixation provides a high reduction quality...
The Russel-Taylor type 2B fractures compromised the trochanteric region and medial buttress of proximal femur. This fracture pattern limits the choice of implants and raises the risk of adverse outcomes. We aimed to (i) determine the outcome of Russel-Taylor type 2B fractures treated using reverse less invasive stabilization system plates (LISS-DF) and to (ii) learn what factors affected outcomes...
We describe the step-by-step process of a corrective osteotomy using 3D printed patient specific guides. Before surgery, bilateral computed tomography (CT) scans are made to plan correction in the affected limb. The digital pre-planning defines the location of the K-wires, drill holes, and the osteotomy site(s). Subsequently, a 3D printed patient specific guide is applied, which indicates the exact...
To quantify and compare the incidence of lower extremity injuries in skiers and snowboarders who present to emergency rooms in the United States.Cross-sectional study of lower extremity injuries in skiers and snowboarders that were evaluated in emergency rooms in the United States. The National Electric Injury Surveillance System (NEISS) database was queried from January 1st, 2014 and December 31st,...
Hip fractures are common in the elderly and have a high risk of early mortality. Identification of patients at high risk of early mortality could contribute to enhanced quality of care. A simple scoring system is essential for preoperative identification of patients at high risk of early mortality in clinical practice. Of risk models published, The Nottingham Hip Fracture Score (NHFS) shows the most...
The treatment of tibial plateau fractures involving the lateral and posterolateral column is a demanding and fine surgical challenge. The purpose of this study was to evaluate the safety and clinical efficacy of combined approach for the treatment of lateral and posterolateral tibial plateau fractures.A prospective study was performed in 17 patients with lateral and posterolateral tibial plateau fractures...
To determine the difference in infection rate between 24h versus five days of prophylactic antibiotic use in management of Gustilo II open tibia fractures.Unblinded randomized control trial.Accident and Emergency, orthopedic wards and outpatient clinics at Kenyatta National Hospital (KNH).The study involved patients aged 18–80 years admitted through accident and emergency department with Gustilo II...
Previous reports have questioned whether an orthogonal or parallel configuration is superior for distal humeral articular fractures. In previous clinical and biomechanical studies, implant failure of the posterolateral plate has been reported with orthogonal configurations; however, the reason for screw loosening in the posterolateral plate is unclear. The purpose of this study was to evaluate biomechanical...
We hypothesize that inserting a curved intramedullary internal fixation device which follows curved osseous fixation paths (OFPs) would be more versatile and mechanically stronger than straight screws for fixation of pelvic ring and acetabular injuries. This study characterizes the dimensions of curved OFPs of the pelvic ring and acetabulum and suggests design parameters for such a curved device.CT...
Femoral neck fractures in young individuals are typically vertical shear fractures. These injuries are difficult to stabilize due to a significant varus displacement force across the hip with weight bearing. The purpose of this study was to evaluate the biomechanical stability offered by the addition of an augmented wire to conventional inverted triangle triple screw fixation for stabilizing vertical...
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