Injury
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Distal tibial nonunion is usually due to severe open distal tibial fractures with high energy injury. The best surgical treatment is not well established because of the poor soft tissue condition. We retrospectively analyzed a series of patients with distal tibial nonunion after severe open distal tibial fractures; our purpose was to introduce a treatment using a contralateral anterior L-shaped locking compression plate through a posterior-lateral approach with Iliac crest bone graft and evaluate the outcomes of patients. ⋯ Using a contralateral anterior L-shaped locking compression plate fixation through a posterior-lateral approach with Iliac crest bone graft to reconstruct the distal tibial nonunion is a safe and reliable method that can successfully treat patients with poor soft tissue condition of anterior portion of leg because of its adequate exposure, both tibia and fibula rigid fixation and plenty of bone graft. We believe the application of this method resulting in a high union and low complication rate.
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Failure of bone healing after intramedullary nailing of a diaphyseal long bone fracture is a severe complication that requires an effective management to ensure the best chances for successful bone-union and termination of a long period of incapacity and morbidity for the sufferers. Traditional procedures require removal of the existing nail and re-fixation with wider nail, plate or external fixation constructs. The concept that bone union can be obtained with the existing nail in situ is gaining popularity as its removal adds trauma and potential complications and prolongs the operating time. This article reviews all techniques that have been proposed for the management of aseptic diaphyseal long bone non-unions that stimulate bone healing without removing the existing nail.
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Comparative Study
Infection after fracture fixation of the tibia: Analysis of healthcare utilization and related costs.
One of the most challenging complications in musculoskeletal trauma surgery is the development of infection after fracture fixation (IAFF). It can delay healing, lead to permanent functional loss, or even amputation of the affected limb. The main goal of this study was to investigate the total healthcare costs and length-of-stay (LOS) related to the surgical treatment of tibia fractures and furthermore identify the subset of clinical variables driving these costs within the Belgian healthcare system. The hypothesis was that deep infection would be the most important driver for total healthcare costs. ⋯ This study shows the enormous hospital-related healthcare costs associated with IAFF of the tibia. Treatment costs for patients with deep infection are higher than previously mentioned in the literature. Therefore, future research should focus more on prevention rather than treatment strategies, not only to reduce patient morbidity but also to reduce the socio-economic impact.
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The hoverboard, a self-balancing powered scooter, was introduced to the market in 2015 and quickly became one of the most popular purchases of the year. As with similar products, this scooter brought a host of concerns surrounding injuries. The purpose of this study is to determine the incidence of injuries that coincided with the popularity of hoverboard. ⋯ Given the number of injuries caused by these products, safety equipment, such as wrist guards and helmets, should be worn in an attempt to reduce the number of injuries. Additionally, this study highlights the importance of physicians keeping up to date with current trends to best advise their patients on safe practices.
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Intra-articular tibial plafond fractures are a challenge for the surgeon with generally poor functional outcomes. The purpose was to assess the impact of this injury on patient quality of life (QOL), as well as analyzed the predictor factors. ⋯ Intra-articular tibial plafond fracture had a dramatic impact on QOL. Among the predictors of unsuccessful outcome, the reduction quality was the only modifiable factor by the surgeon. The OMAS had a predictive value on the prognosis of QOL.