INFECTION AFTER FRACTURE FIXATION A N T E K A L S T A D, S T O L A V S H O S P I T A L, N O R W A Y
|
|
|
- Jennifer Mason
- 5 years ago
- Views:
Transcription
1 INFECTION AFTER FRACTURE FIXATION A N T E K A L S T A D, S T O L A V S H O S P I T A L, N O R W A Y
2 INCIDENCE 5% of all osteosynthesis 0.5 2% closed fractures 10 30% open fractures Rabih, N Engl J Med, 2004 McGraw, JBJS, 1988 Obremskey, J.Orth.Trauma, 2003 Perren, JBJS, 2002
3 CLASSIFICATION, IAFF There s been plenty of attempts No consensus yet
4 CLASSIFICATION Early (0-2 weeks) Delayed (2-10 weeks) Late (>10 weeks) Willeneger and Roth classification
5 RISKS Fracture related Patient related Procedure related
6 FRACTURE RELATED Open fractures x Rabih, N Engl J Med, 2004 McGraw, JBJS, 1988 Obremskey, J.Orth.Trauma, 2003 Perren, JBJS, 2002
7 FRACTURE RELATED Open fractures x Gustilo-Andersen Hull, JBJ, 2014
8 FRACTURE RELATED Open fractures x Gustilo-Andersen Contamination x 3 Hull, JBJ, 2014
9 FRACTURE RELATED Open fractures x Gustilo-Andersen Contamination x 3 Tibia fractures x 2.5 Hull, JBJ, 2014
10 PATIENT RELATED Obesity Smoking Low hematocrit Diabetes mellitus Earlier infection in the same region Ortega, Trauma-Ort., 2014
11 PROCEDURE RELATED Handwash technique Sterile technique Preperation of operative field Traffic in the operating room Length of surgery Blood loss > 1L Surgeon unfamiliar with procedure Harrop, J Am Acad Ortop., 2012 Ortega, Trauma-Ort. 2014
12 PROCEDURE RELATED Open fractures time to revision TIME IS OF THE ESSENCE This relationship shows a linear increase of 3% per hour of delay. ll Hull, 2014
13 Procedure related Open fractures time to revision TIME IS OF THE ESSENCE? no evidence of an association between delayed debridement and infection in the treatment of open long-bone fractures Schenker, 2012 Review 16 studies, 3539 patients
14 BACTERIOLOGY
15 BIOFILM Biofilm leads to times increased resistance towards antibiotics
16 OSTEOCLASTAL ACTIVATION Bacteria Immune response triggering of osteoclastal activation - prevents remodelling - osteolysis
17 DEFINITIVE DIAGNOSIS Positive cultures Bacterial swab Aspiration Tissue culture Sonication Histopathology PCR
18 Tissue cultures 5 samples Separate containers Inform the lab: «infected implant»
19 PROVISIONAL DIAGNOSIS Clinical findings X-ray Lab values Key information
20 KEY INFORMATION 1. Onset of symptoms (early-delayed-late) 2. Fracture healed or stable callus formed? 3. Osteosynthetic construct (stable implant? Satisfactory reduction?) 4. Type of implant (plate, nail, ex.fix?) 5. Fracture localization (eg diaphyseal, articular) 6. Condition of soft tissue envelope 7. Local and systemic host physiology 8. History of infection at site of interest 9. Difficult to treat pathogen? (often not known at time of revision)
21 Treatment
22 CENTRAL AIMS WHEN TREATING IAFF 1. Fracture consolidation 2. Eradication of infection (or suppresion) 3. Healing of the soft tissue envelope 4. Prevention of chronic osteomyelitis 5. Restoration of functionability
23 In contrast to PJI: Fixation devices can be removed after healing -thus removing biofilm
24 TWO WAYS TO ACHIEVE AIMS 1. Irrigation, debridement, and retention of the implant Combined with antibiotic therapy 2. Debridement, implant removal or exchange (one or multiple stages) Combined with antibiotic therapy In rare cases (compromised hosts) healing can t be achieved Salvage procedures (amputation, establishing continuous fistula)
25 REMOVE HARDWARE? Rightmire, 2008 Retrospective study n = 69 Managed with harware in place 68% healed with hardware in place Conclusion: remove hardware
26 REMOVE HARDWARE? Berkes, 2010 Retrospective study n = 121 managed with harware in place 71% healed with hardware in place Conclusion: leave hardware until fracture has healed
27 REMOVE HARDWARE?
28 Is suppression possible? YES: NO: o Debridement o Antibiotics o Potential removal when fracture has healed o Debridement o Remove hardware o Re-stabilize fracture o Antibiotics
29 Is suppression possible? YES: NO: o Early infection o Stable fixation o Young patient o Open fracture o Unstable fixation o Nail o Late diagnosis o Smoker
30 LOCAL ANTIBIOTICS?
31 ANTIBIOTICS Tailor according to resistance 2 weeks IV, then per oral Use for 4-6 weeks after implant removal Metsemakers, et al; Injury, 2018
32 A FEW POINTS Do a good debridement Solid coverage No closure under tension May need a flap Get to know your infectious disease specialists
33 65 year old man Infected calcaneus fixation (extraarticular beak fracture 4 weeks earlier) revised x2
34
35
36
37
38
39 TAKE HOME MESSAGES Get cultures Retaining the hardware depends on several factors Must get good coverage Know the infectious disease specialists
Surgical Management of Osteomyelitis & Infected Hardware. Michael L. Sganga, DPM Orthopedics New England Natick, MA
Surgical Management of Osteomyelitis & Infected Hardware Michael L. Sganga, DPM Orthopedics New England Natick, MA Disclosures None relevant to the content of this material Overview Implants Timing Tenants
Fracture Classification
Fracture Classification Lisa K. Cannada MD Updated: 05/2016 18 th & 19 th century History of Fracture History based on clinical appearance of limb alone Classification Colles Fracture Dinner Fork Deformity
Treatment of infection
Clinica Ortopedica e Traumatologica Università degli Studi di Pavia Fondazione IRCCS Policlinico San Matteo Chairman: Prof. F. Benazzo Goals: - Healing of infection - Healing of fracture - Try to keep
Open Fractures. Ria Dindial. Photo courtesy pic2fly.com
Open Fractures Ria Dindial Photo courtesy pic2fly.com CLINICAL PEARL TYPE WOUND DESCRIPTION OTHER CRITERIA I < 1cm (puncture wounds) - II 1-10 cm - IIIA >10 cm, coverage available Segmental fractures,
Principle Management of Wound and Fracture in Emergency Department
Principle Management of Wound and Fracture in Emergency Department Presented in Clinical Update Seminar January 15 th 2011 dr. Tedjo Rukmoyo, SpOT (K) Spine Initial Management ATLS Procedure A : airway
A prospective study of functional outcome of primary intra-medullary nailing in type 3A and 3B open tibial diaphyseal fractures
2017; 3(3): 696-700 ISSN: 2395-1958 IJOS 2017; 3(3): 696-700 2017 IJOS www.orthopaper.com Received: 18-05-2017 Accepted: 20-06-2017 Dr. Deepak Shivanna Professor, Dept. of Orthopaedics, BMCRI, Bengaluru,
Elb-2: Does previous surgery (arthroscopic, fracture fixation, other nonarthroplasty) increase the risk of subsequent elbow PJI?
Elbow ICM 2018 Elb-2: Does previous surgery (arthroscopic, fracture fixation, other nonarthroplasty) increase the risk of subsequent elbow PJI? RESEARCHED BY: Barco Laakso, Raul MD, Spain Antuña, Samuel
Orthopaedica Belgica 2018
POSTTRAUMA WOUND MANAGEMENT PRONTOSAN. Polyhexanide + Betaine: Slows growth of bacteria, Removes the biofilm, Cleans the wound. BVOT Congress Brussels May 3th PRIMARY SOFT TISSUE LESIONS prepatellar bursitis-skin
Tibial Nonunions: Should I Tackle and How
Tibial Nonunions: Should I Tackle and How Frank R. Avilucea, MD Assistant Professor Department of Orthopaedic Surgery University of Cincinnati Medical Center Disclosures Journal Reviewer Journal of Bone
Open Treatment and Internal Fixation of Displaced Intraarticular Calcaneal Fractures in High-Risk Patients Utilizing the Sinus Tarsi Approach
Open Treatment and Internal Fixation of Displaced Intraarticular Calcaneal Fractures in High-Risk Patients Utilizing the Sinus Tarsi Approach W. Bret Smith, DO Steve Steinlauf, MD Greg E. Gaski, MD Disclosure
Open Fractures of the Tibial Diaphysis
Open Fractures of the Tibial Diaphysis Daniel N. Segina, MD Robert V. Cantu, MD David Templeman, MD Created March 2004 Updated May 2010 Incidence Open fractures of the tibia are more common than in any
EXPERT TIBIAL NAIL PROTECT
EXPERT TIBIAL NAIL PROTECT Enhance your first line of defense This publication is not intended for distribution in the USA. CLINICAL EVIDENCE CONTENT AUTHOR TITLE OF CHAPTER PAGE ETN PROtect clinical evidence
Open Fracture. Disclaimer. Some illustrations are from the internet and intended for educational purpose only. 07-Jul-14
Open Fracture นพ. ส หธ ช งามอ โฆษ ภาคว ชา ออร โธป ด กส คณะแพทย ศาสตร จ ฬาลงกรณ มหาว ทยาล ย Disclaimer Some illustrations are from the internet and intended for educational purpose only 1 Scope Open fracture
9/26/2016. Matthew J. Seidel, MD Clinical Assistant Professor of Orthopedic Surgery University of Arizona
Matthew J. Seidel, MD Clinical Assistant Professor of Orthopedic Surgery University of Arizona 572,000 THA in the US in 2030 3.5M TKA in the US in 2030 1 2% infection = 80,000 PJI per year in 2030 Important
BOAST 4 Algorithm. 6th September 2013
BOAST 4 Algorithm 6th September 2013 Background The British Orthopaedic Association and the British Association of Plastic, Reconstructive and Aesthetic Surgeons reviewed their 1997 guidance and published
Update on Prosthetic Joint Infections 2017
Update on Prosthetic Joint Infections 2017 George F. Chimento, MD, FACS Chair, Department of Orthopaedic Surgery Associate Professor, University of Queensland School of Medicine Ochsner Medical Center
Disclosures! Infection & Nonunions. Infection workup. Skip early infection. Culture (+) fractures. Gross Infection
The Infected Nonunion Paul Tornetta III, MD Professor Boston Medical Center Disclosures! Publications: Rockwood and Green, Tornetta and Ricci TIFS, Tornetta and Einhorn; Subspecialty series, Court-Brown,
EAST PRACTICE MANAGEMENT GUIDELINES WORK GROUP: UPDATE TO PRACTICE MANAGEMENT GUIDELINES FOR PROPHYLACTIC ANTIBIOTIC USE IN OPEN FRACTURES
EAST PRACTICE MANAGEMENT GUIDELINES WORK GROUP: UPDATE TO PRACTICE MANAGEMENT GUIDELINES FOR PROPHYLACTIC ANTIBIOTIC USE IN OPEN FRACTURES William S. Hoff, MD, FACS 1, John A. Bonadies, MD, FACS 2, Riad
Open fractures. Reto Babst MD, Prof. of Surg. Head of Trauma Surgery Clinic for Orthopedics and Trauma Luzerner Kantonsspital 6002 Luzern
Open fractures Reto Babst MD, Prof. of Surg. Head of Trauma Surgery Clinic for Orthopedics and Trauma Luzerner Kantonsspital 6002 Luzern Outline Problem list Emercency room treatment + assessment Debridement
CASE REPORT. Bone transport utilizing the PRECICE Intramedullary Nail for an infected nonunion in the distal femur
PRODUCTS CASE REPORT Bone transport utilizing the PRECICE Intramedullary Nail for an infected nonunion in the distal femur Robert D. Fitch, M.D. Duke University Health System 1 1 CONDITION Infected nonunion
Session II 11:30 11:45 am. Wound Complications and How to Prevent Them Mark J. Berkowitz, MD Cleveland, Ohio. Disclosure: (n)
Session II 11:30 11:45 am Wound Complications and How to Prevent Them Mark J. Berkowitz, MD Cleveland, Ohio Disclosure: (n) Wound Complications after ORIF of Calcaneus Fractures and How to Prevent Them
JOURNAL OF INTERNATIONAL ACADEMIC RESEARCH FOR MULTIDISCIPLINARY Impact Factor 2.417, ISSN: , Volume 3, Issue 11, December 2015
MANAGEMENT OF PATHOLOGICAL FRACTURE SHAFT HUMERUS SECONDARY TO BACTERIAL OSTEOMYELITIS: A CASE REPORT DR. NARENDRA SINGH KUSHWAHA* DR.SHAH WALIULLAH** DR.VINEET KUMAR*** DR.VINEET SHARMA**** *Asst. Professor,
Role of irrigation and Debridement in PJI. S.M Kazemi associate professor, orthopedic surgeon SBM University Tehran Iran
Role of irrigation and Debridement in PJI S.M Kazemi associate professor, orthopedic surgeon SBM University Tehran Iran M Kazemi associate professor, orthopedic surgeon SBM University Tehran Iran Role
Assessment of Frequency of Long Bone Osteomyelitis in Traumatic Patients Undergoing Orthopedic Surgery in Imam Reza (AS) Hospital-Tabriz
International Journal of Current Microbiology and Applied Sciences ISSN: 2319-7706 Volume 5 Number 1(2016) pp. 818-825 Journal homepage: http://www.ijcmas.com Original Research Article http://dx.doi.org/10.20546/ijcmas.2016.501.084
97% UNION. Humeral Nonunions: Issues and Strategies? Disclosure. Humeral Shaft Fractures 5/3/2016. Cory Collinge, MD
Humeral Nonunions: Issues and Strategies? Cory Collinge, MD Vanderbilt University Nashville, TN 15 minutes Disclosure Consultant Biomet Smith and Nephew Royalties Biomet Smith & Nephew Advanced Orthopedic
Stage Protocol in the Management of Infection Following Plating of the Tibia
Stage Protocol in the Management of Infection Following Plating of the Tibia Nazri MY a, AS Halim b a Department of Orthopaedics, Traumatology and Rehabilitation, Kulliyyah of Medicine, International Islamic
USE OF ANTIBIOTIC CEMENT SPACERS/BEADS IN TREATMENT OF MUSCULOSKELETAL INFECTIONS AT A.I.C. KIJABE HOSPITAL
Research article USE OF ANTIBIOTIC CEMENT SPACERS/BEADS IN TREATMENT OF MUSCULOSKELETAL INFECTIONS AT A.I.C. KIJABE HOSPITAL G.C. Mwangi, MBChB, COSECSA Resident Orthopaedics, A.I.C. Kijabe Hospital, P.O.
No disclosures relevant to this topic Acknowledgement: some clinical pictures were obtained from the OTA fracture lecture series and AO fracture
CALCANEUS FRACTURES No disclosures relevant to this topic Acknowledgement: some clinical pictures were obtained from the OTA fracture lecture series and AO fracture lecture series INCIDENCE 2% of all fractures
Are you going out to dinner in Philadelphia
Trauma Prevention Are you going out to dinner in Philadelphia tonight? A. Agree B. No C. Abstain T-1 (Former T-46) What is the relationship between smoking and infection in fracture procedures? Is smoking
Multi drug resistant pseudomonas infection in open fractures post definitive fixation leading to limb loss: A report of three cases
IJCRI 2011;2(5):1-6. Doshi et. al. 1 CASE SERIES OPEN ACCESS Multi drug resistant pseudomonas infection in open fractures post definitive fixation leading to limb loss: A report of three cases Hitendra
Vasu Pai FRACS, MCh, MS, Nat Board Ortho Surgeon Gisborne
Vasu Pai FRACS, MCh, MS, Nat Board Ortho Surgeon Gisborne FRACTURE MANAGEMENT I Simple closed fracture : Complete or Incomplete Stable or unstable II Open fracture III Multiple fracture IV Polytrauma Fractures
Ankle Replacement Surgery
Ankle Replacement Surgery Ankle replacement surgery is performed to replace the damaged articular surfaces of the three bones of the ankle joint with artificial implants. This procedure is now being preferred
Using Animal Models to Help Solve Clinical Problems
Using Animal Models to Help Solve Clinical Problems -Overview -Epidemiology -Improving the Standards for Initial Wound Care -Use of dual purpose bone grafts -Developing a more relevant animal model Research
Making strides toward effective diabetic foot treatment. Foot and ankle solutions from smith&nephew
Making strides toward effective diabetic foot treatment Foot and ankle solutions from smith&nephew 11.3% of the US population over the age of 20 has diabetes. 1 (American Diabetes Association) 65,000 diabetics
Osteomyelitis: The Burden of Disease LLRS 2013
Osteomyelitis: The Burden of Disease LLRS 2013 J. Spence Reid MD Division of Orthopedic Trauma Penn State University College of Medicine Milton S. Hershey Medical Center Disclosures Smith and Nephew: Teach
EVOS MINI with IM Nailing
Case Series Dr. John A. Scolaro EVOS MINI with IM Nailing A series of studies Introduction Intramedullary nailing has become the standard for many long bone fractures. Fracture reduction prior to nail
FINGERTIP INJURIES ARE THEY REALLY THAT SIMPLE? SANJAY K SHARMA, MD, FACS INSTITUTE OF RECONSTRUCTIVE PLASTIC SURGERY
FINGERTIP INJURIES ARE THEY REALLY THAT SIMPLE? SANJAY K SHARMA, MD, FACS INSTITUTE OF RECONSTRUCTIVE PLASTIC SURGERY Austin Trauma and Critical Care Conference 2018 May 31-June 1, 2018 Outline 1. Scope
Original Research Article
TREATMENT OF COMPLEX TIBIAL FRACTURES TYPES V AND VI OF SCHATZKER CLASSIFICATION BY DOUBLE PLATE FIXATION WITH SINGLE ANTERIOR INCISION Thoguluva Chandra Sekaran Prem Kumar 1, M. N. Karthi 2 1Senior Assistant
Case Report Bilateral Distal Femoral Nailing in a Rare Symmetrical Periprosthetic Knee Fracture
Case Reports in Orthopedics, Article ID 745083, 4 pages http://dx.doi.org/10.1155/2014/745083 Case Report Bilateral Distal Femoral Nailing in a Rare Symmetrical Periprosthetic Knee Fracture Marcos Carvalho,
PRE-OP and POST-OP SURGICAL CONSIDERATIONS
PRE-OP and POST-OP SURGICAL CONSIDERATIONS Darlene Sorrell, DMD, is not an oral surgeon. AIDC is an out-patient facility. 29 years of experience in IHS. Advanced General Practice Residency. No access
Treatment of open diaphyseal fractures of long bones of the limbs. Biology and Medicine
eissn: 09748369 Treatment of open diaphyseal fractures of long bones of the limbs Biology and Medicine Research Article Volume 7, Issue 1, Article ID: BM-065-15, 2015 Indexed by Scopus (Elsevier) www.biolmedonline.com
Evaluation of the functional outcome in open tibial fractures managed with an Ilizarov fixator as a primary and definitive treatment modality
2017; 3(2): 436-440 ISSN: 2395-1958 IJOS 2017; 3(2): 436-440 2017 IJOS www.orthopaper.com Received: 05-02-2017 Accepted: 06-03-2017 Dr. SK Irfan Ali Assistant Professor, Dr. Sujai S Associate Professor,
The Mangled Extremity: It s NOT Just a Flesh Wound. William Hakeos, MD September 22, 2017
The Mangled Extremity: It s NOT Just a Flesh Wound William Hakeos, MD September 22, 2017 Disclosures: Financial I tried to find somebody to pay me to give this talk, but couldn t Disclosures: Intellectual
Two-Stage Revision Arthroplasty in the Management of Periprosthetic Joint Infections. Can Spacer Be a Source of Reinfection?
Dwuetapowa endoprotezoplastyka rewizyjna w leczeniu zakażeń okołoprotezowych. Czy spacer może stanowić źródło reinfekcji? Two-Stage Revision Arthroplasty in the Management of Periprosthetic Joint Infections.
Types of fracture healing and association with fixation
Types of fracture healing and association with fixation MR ANTHONY J THAYAPARAN SPECIALIST REGISTRAR I N TRAUMA AND ORTHOPAEDICS LONDON NORTH WEST HOSPITALS What are we covering? Types of Fracture Healing
A Clinical Study of Compound Fractures of Both Bone Leg In Patients Attending Assam Medical College Hospital, Dibrugarh. Partha Pratim Das 5
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 16, Issue 8 Ver. V(Aug. 2017), PP 69-73 www.iosrjournals.org A Clinical Study of Compound Fractures of
Osteosynthesis involving a joint Thomas P Rüedi
Osteosynthesis involving a joint Thomas P Rüedi How to use this handout? The left column contains the information given during the lecture. The column at the right gives you space to make personal notes.
.org. Tibia (Shinbone) Shaft Fractures. Anatomy. Types of Tibial Shaft Fractures
Tibia (Shinbone) Shaft Fractures Page ( 1 ) The tibia, or shinbone, is the most common fractured long bone in your body. The long bones include the femur, humerus, tibia, and fibula. A tibial shaft fracture
Elbow Fractures ORIF VS Arthroplasty
Elbow Fractures ORIF VS Arthroplasty Oke Anakwenze, M.D. Olympus Orthopedics No disclosures Disclosures Distal humerus fractures 0.5-0.7% of all fractures 30% of all elbow fractures Bimodal etiology Young
Injuries to the Pelvis and Extremities
Injuries to the Pelvis and Extremities Presley Regional Trauma Center Department of Surgery University of Tennessee Health Science Center Memphis, Tennessee General Common occur in 85% of blunt trauma
Retrospective Study of Surgical Outcomes for Combined Ankle and Subtalar Joint Arthrodesis, Cavovarus Deformity Correction and Ankle Fractures
FOOT/ ANKLE RETROSPECTIVE STUDYIC S Retrospective Study of Surgical Outcomes for Combined Ankle and Subtalar Joint Arthrodesis, Cavovarus Deformity Correction and Ankle Fractures Adult & Pediatric Deformity
System of Gustilo and Anderson At the time of surgical débridement is useful in guiding treatment and predicting outcomes.
Open Fractures Definition Breach in the overlying skin of a fracture. Epidemiology Lower limb: 3.3% Tibia more than 20 folds common than femur. [since tibia is subcutaneous] Gustillo: 25% each in I, II,
ICUC Paper. Infection after internal fixation. Part 1: Biomechanics. S.M. Perren, A. Fernández Dell'Oca, P. Regazzoni.
Infection after internal fixation Part 1: Biomechanics S.M. Perren, A. Fernández Dell'Oca, P. Regazzoni November 2017 When a surgeon faces a postoperative infection the next step of treatment is critical
AO / Synthes Proximal Posterior Medial Tibia Plate. Tibial Plateau Fx. Osteosynthesis
Tibial Plateau Fx. Osteosynthesis Articular Fractures Osteosynthesis Characteristics of the LCP system LCP 3.5 system LCP 4.5 system Many different traditional plates (small, large) Lag screws Rafting
Complication Rate and Pitfalls of Temporary Bridging External Fixator in Periarticular Communited Fractures
Original Article Clinics in Orthopedic Surgery 2011;3:62-68 doi:10.4055/cios.2011.3.1.62 Complication Rate and Pitfalls of Temporary Bridging External Fixator in Periarticular Communited Fractures Jong-Keon
Knee Replacement Complications
Knee Replacement Complications Knee replacements have become a routine surgery in the United States. Nearly 700,000 people each year receive this life-improving surgery and are able to enjoy richer, more
Early Management of Open Tibial Fractures in Benin - City -Result of a Structured Treatment Protocol
JMBR: A Peer-review Journal of Biomedical Sciences December 2006 Vol. 5 No.2 pp-33-39 Early Management of Open Tibial Fractures in Benin - City -Result of a Structured Treatment Protocol Umebese Philip
Outcomes of Internal Fixation in a Combat Environment. Consistent with previous conflicts, the vast majority
Outcomes of Internal Fixation in a Combat Environment CPT Daniel J. Stinner, MD, 1 Lt Col James A. Keeney, MD, 2 MAJ(P) Joseph R. Hsu, MD, 1 CPT Jeremy K. Rush, MD, 3 MAJ Mickey S. Cho, MD, 3 Joseph C.
Calcium Phosphate Cement
Calcium Phosphate Cement Fast-Setting Bone Graft and AutoGraft Extender. * Ossilix is a high performance next generation calcium phosphate cement indicated for filling bony defects in cancellous bone.
continued TABLE E-1 Potential Predictors of Short-Term Complications and Reoperations* Comparison Group OR 95% CI P Value
Page 1 of 7 TABLE E-1 Potential Predictors of Short-Term Complications and Reoperations* Pulmonary embolism Charlson comorbidity index 1.2 1.0 to 1.4 0.06 Hospital volume percentile, 40-79 80-100 0.8 0.4
BRIDGE PLATING OF COMMINUTED SHAFT OF FEMUR FRACTURES
BRIDGE PLATING OF COMMINUTED SHAFT OF FEMUR FRACTURES Mohammad Abul kalam, Pradeep Kumar, Mohammad Afzal Hussain and Iqbal Ahmad Abstract A prospective study of forty comminuted femoral shaft fractures,
Principles of intramedullary nailing. Management for ORP
Principles of intramedullary nailing Eakachit Sikarinklul,MD Basic Principles of Fracture Management for ORP Bangkok Medical Center Bangkok, 22-24 July 2016 Learning outcomes At the end of this lecture
Screw Placement and Types Matter
Screw Placement and Types Matter The Blasted Distal Femur Facture: How to Improve Outcomes Abstract ID#: 1506 Friday October 13, 2017 Kyle Jeray University of South Carolina, Greenville Pinpoint open 59
Stress Fracture Of The Supracondylar Region Of The Femur Induced By The Weight Of The Tibial Ring Fixator
ISPUB.COM The Internet Journal of Orthopedic Surgery Volume 4 Number 1 Stress Fracture Of The Supracondylar Region Of The Femur Induced By The Weight Of The Tibial Ring S Dhar, M Mir Citation S Dhar, M
Young Bones. Characteristics. Klaus Hindsø
Young Bones Characteristics Klaus Hindsø What s so special Periostium Elasticity Growth The envelope Periostium Elasticity Growth Connects displaced fragments building a bridge during healing Interposed
Subtrochanteric Femur Fracture. 70 yo female 7/22/2013
Subtrochanteric Femur Fracture Philip J. Kregor, MD 70 yo female Mild hypertension, Type II Diabetes Fell from 20 feet while at a party when the porch collapsed Mild head injury, Rib fractures Had been
Bladder Trauma Data Collection Sheet
Bladder Trauma Data Collection Sheet If there was no traumatic injury with PENETRATION of the bladder DO NOT proceed Date of injury: / / Time of injury: Date of hospital arrival: / / Time of hospital arrival:
Pilon fractures. Pat Yoon, MD Minneapolis Veterans Affairs Medical Center Associate Professor, University of Minnesota
Pilon fractures Pat Yoon, MD Minneapolis Veterans Affairs Medical Center Associate Professor, University of Minnesota Disclosures Reviewer Foot and Ankle International Journal of the American Academy of
Hardware Related Pain and Hardware Removal after Open Reduction and Internal Fixation of Ankle Fractures
The Foot and Ankle Online Journal Official publication of the International Foot & Ankle Foundation Hardware Related Pain and Hardware Removal after Open Reduction and Internal Fixation of Ankle Fractures
Research Article. Abstract
Research Article Management of Open Tibial Shaft Fractures: Does the Timing of Surgery Affect Outcomes? Oscar A. Duyos, MD David Beaton-Comulada, MD Ariel Davila-Parrilla, MD Jose Carlos Perez-Lopez, MD
pat hways Medtech innovation briefing Published: 14 December 2018 nice.org.uk/guidance/mib166
pat hways Galaxy UNYCO for temporary stabilisation of lower limb fractures Medtech innovation briefing Published: 14 December 2018 nice.org.uk/guidance/mib166 Summary The technology described in this briefing
EWMA Educational Development Programme. Curriculum Development Project. Education Module. Wound Infection
EWMA Educational Development Programme Curriculum Development Project Education Module Wound Infection Latest revision: February 2014 ABOUT THE EWMA EDUCATIONAL DEVELOPMENT PROGRAMME The Programme is designed
Time to Initial Operative Treatment Following Open Fracture Does Not Impact Development of Deep Infection: A Prospective Cohort Study of 736 Subjects
ORIGINAL ARTICLE OTA HIGHLIGHT PAPER Time to Initial Operative Treatment Following Open Fracture Does Not Impact Development of Deep Infection: A Prospective Cohort Study of 736 Subjects Donald Weber,
Segmental tibial fractures treated with unreamed interlocking nail A prospective study
2017; 3(2): 714-719 ISSN: 2395-1958 IJOS 2017; 3(2): 714-719 2017 IJOS www.orthopaper.com Received: 13-02-2017 Accepted: 14-03-2017 Ashok Singhvi Hemant Jain Siddharth Jauhar Kishore Raichandani Segmental
Infection. Arthrocentesis: Cell count Differential Culture. Infection and associated microorganism(s) confirmed
Painful joint History and examination Radiograph of affected joint Erythrocyte sedimentation rate C-reactive protein Infection No infection suspected Arthrocentesis: Cell count Differential Culture Stop
Orthopedics in Motion Tristan Hartzell, MD January 27, 2016
Orthopedics in Motion 2016 Tristan Hartzell, MD January 27, 2016 Humerus fractures Proximal Shaft Distal Objectives 1) Understand the anatomy 2) Epidemiology and mechanisms of injury 3) Types of fractures
ADVANCED BONE GRAFT SYSTEM OVERVIEW
ADVANCED BONE GRAFT SYSTEM OVERVIEW NANOSS BIOACTIVE ADVANCED BONE GRAFT Table Of Contents INTRODUCTION System Overview... 1 NANOSS BIOACTIVE COMPONENTS Comparison of nanoss Bioactive and Human Bone...
Bactisure Wound Lavage. Advancing Biofilm Removal
Wound Lavage Advancing Biofilm Removal Wound Lavage Wound Lavage is used to remove debris, including microorganisms, from wounds using pulsed (jet) lavage. The clear, colorless, low-odor solution is a
CHAPTER 16 LOWER EXTREMITY. Amanda K Silva, MD and Warren Ellsworth, MD, FACS
CHAPTER 16 LOWER EXTREMITY Amanda K Silva, MD and Warren Ellsworth, MD, FACS The plastic and reconstructive surgeon is often called upon to treat many wound problems of the lower extremity. These include
Orthopedic & Sports Medicine, Bay Care Clinic, 501 N. 10th Street, Manitowoc, WI Procedure. Subtalar arthrodesis
OSTEOAMP Allogeneic Morphogenetic Proteins Subtalar Nonunions OSTEOAMP Case Report SUBTALAR NONUNIONS Dr. Jason George DeVries and Dr. Brandon M. Scharer Orthopedic & Sports Medicine, Bay Care Clinic,
Management for Postoperative Infection of Fractures
The Journal of the Korean Society of Fractures Vol12, No2, April, 1999 = Abstract = Management for Postoperative Infection of Fractures Eui-Hwan Ahn, MD, In-Whan Chung, MD, Jeong-Hwan Oh, MD, Seong-Tae
Percutaneous Antibiotic Delivery Technique (PAD-T) New Concepts in Osteomyelitis Treatment with Long-term Outcomes
New Concepts in Osteomyelitis Treatment with Long-term Outcomes Jeffrey C. Karr DPM, CWS, ABLES, FAPWCA, FCCWS Founder, Central Florida Limb Salvage Alliance Chairman, Founder: The Osteomyelitis Center
Management of Nonunion of Tibia by Ilizarov Technique Haque MA 1, Islam SM 2, Chowdhury MR 3
...Original Article Management of Nonunion of Tibia by Ilizarov Technique Haque MA 1, Islam SM 2, Chowdhury MR 3 Abstract This prospective study was carried out during the period of January 2007 to December
Original Research Article. Ayub Ali 1 *, Mizanur Rahman 2, Sajedur Reza Faruquee 3, Tazul Islam 4, Zamil Zaidur Rahim 5, Abdullah Yusuf 6
International Journal of Research in Orthopaedics Ali A et al. Int J Res Orthop. 2017 Sep;3(5):898-903 http://www.ijoro.org Original Research Article DOI: http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20173931
Spartan Medical Research Journal
Spartan Medical Research Journal Research at Michigan State University College of Osteopathic Medicine Volume 3 Number 2 Fall, 2018 Pages 1-14 Title: Implementation of an Antibiotic Therapy Protocol for
The Rule of 2s. Diabetic Ankle Fractures: Surgery or No Surgery The Not-So-Straightforward Ankle Fracture. Disclosures. Diabetic Ankle Fractures
Diabetic Ankle Fractures: Surgery or No Surgery The Not-So-Straightforward Ankle Fracture Trauma 101: Fracture Care for the Community Orthopedist, 2018 Ryan Finnan, MD Disclosures No financial disclosures
CELLPLEX TCP SYNTHETIC CANCELLOUS BONE
CELLPLEX TCP SYNTHETIC CANCELLOUS BONE 129257-9 The following languages are included in this packet: English (en) Deutsch (de) Nederlands (nl) Français (fr) Español (es) Italiano (it) Português (pt) -
Tibia fractures are the third most common long bone
ORIGINAL ARTICLE Elastic Intramedullary Nailing Versus Open Reduction Internal Fixation of Pediatric Tibial Shaft Fractures Andrew T. Pennock, MD,*w Tracey P. Bastrom, MA,w and Vidyadhar V. Upasani, MD*w
Amputations of the digit, ray and midfoot
Amputations of the digit, ray and midfoot Dane K. Wukich M.D. Chief, Division of Foot and Ankle Surgery Medical Director, UPMC Foot and Ankle Center University of Pittsburgh School of Medicine Disclosure
Is Distraction Histiogenesis a Reliable Method to Reconstruct Segmental Bone and Acquired Leg Length Discrepancy in Tibia Fractures and Non Unions?
Is Distraction Histiogenesis a Reliable Method to Reconstruct Segmental Bone and Acquired Leg Length Discrepancy in Tibia Fractures and Non Unions? James J Hutson Jr MD Professor Orthopedic Trauma Ryder
Journal of Science Foundation, January 2013, Vol. 11, No.1 ISSN
www.banglajol.info/index.php/jsf Journal of Science Foundation, January 2013, Vol. 11, No.1 ISSN 1728-7855 CASE REPORT Management of Chronic Osteomyelitis of Femur with Interlocking Intramedullary Nail
Malunion in floating knee injuries An analysis in 30 patients presenting to a tertiary care facility and are surgically treated
2017; 3(1): 700-705 ISSN: 2395-1958 IJOS 2017; 3(1): 700-705 2017 IJOS www.orthopaper.com Received: 11-11-2016 Accepted: 12-12-2016 Dr. R Ezhilmaran Assistant Professor, Department of Orthopaedics, Chengalpattu
Tibial plateau fractures: four years review at B&B Hospital
Kathmandu University Medical Journal (2004) Vol. 2, No. 4, Issue 8, 315-323 Original Article Tibial plateau fractures: four years review at B&B Hospital Shrestha BK 1, Bijukachhe B 2, Rajbhandary T 2,
A Clinical Study For Evaluation Of Results Of Closed Interlocking Nailing Of Fractures Of The Shaft Of The Tibia
ISPUB.COM The Internet Journal of Orthopedic Surgery Volume 17 Number 2 A Clinical Study For Evaluation Of Results Of Closed Interlocking Nailing Of Fractures Of The Shaft Of R Gupta, T Motten, N Kalsotra,
Principles Starting Point Trajectory L/A/R Stable Construct. DISCLOSURES Hassan R. Mir, MD, MBA, FACS 5/16/2017
DISCLOSURES Hassan R. Mir, MD, MBA, FACS Medical/Orthopaedic Publications Editorial/Governing Board OTA Newsletter Editor OsteoSynthesis, The JOT Online Discussion Forum Editor JOT Associate Editor JAAOS
Plate vs Nail for Distal Tibia Fxs
Plate vs Nail for Distal Tibia Fxs Frank A. Liporace, MD Associate Professor Dept. of Orthopaedics NYU / HJD Chief Dept. Of Orthopaedics JCMC / RWJBH ??? Controversy??? Nails Minimal invasive Low blood
Infections Amenable to OPAT. (Nabin Shrestha + Ajay Mathur)
3 Infections Amenable to OPAT (Nabin Shrestha + Ajay Mathur) Decisions regarding outpatient treatment of infections vary with the institution, the prescribing physician, the individual patient s condition
Use of Unlocked Intramedullary Nailing in Winquist Type I and II Femoral Isthmus Fracture
Use of Unlocked Intramedullary Nailing in Winquist Type I and II Femoral Isthmus Fracture HT Ling, MBBS (UM), WM Ng, MS Ortho (UM), MK Kwan, MS Ortho (UM), LK Fathi Aizuddeen, MBBS (UM), PCM Tay, MBBS
Advantage and limitations of a minimally-invasive approach and early weight bearing in the treatment of tibial shaft fractures with locking plates
Orthopaedics & Traumatology: Surgery & Research (2012) 98, 564 569 Available online at www.sciencedirect.com ORIGINAL ARTICLE Advantage and limitations of a minimally-invasive approach and early weight