Strategies in Trauma and Limb Reconstruction最新文献

{"title":"Invited Commentary: The Incidence of Deep Infection Following Lower Leg Circular Frame with Minimum of 1-year Follow-up from Frame Removal.","authors":"Stephen Quinnan","doi":"10.5005/jp-journals-10080-1563","DOIUrl":"https://doi.org/10.5005/jp-journals-10080-1563","url":null,"abstract":"<p><p><b>How to cite this article:</b>Quinnan S. Invited Commentary: The Incidence of Deep Infection Following Lower Leg Circular Frame with Minimum of 1-year Follow-up from Frame Removal. Strategies Trauma Limb Reconstr 2022;17(2):92.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"17 2","pages":"92"},"PeriodicalIF":0.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/d9/02/stlr-17-92.PMC9357790.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40713924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An MRI-based Study to Investigate If the Patella is Truly Centred between the Femoral Condyles in the Coronal Plane.","authors":"Nihar S Shah,&nbsp;James C Kyriakedes,&nbsp;Raymond W Liu","doi":"10.5005/jp-journals-10080-1561","DOIUrl":"https://doi.org/10.5005/jp-journals-10080-1561","url":null,"abstract":"<p><strong>Background: </strong>An AP knee radiograph is considered adequate if the patella is centred between the femoral condyles. Our previous studies demonstrated a tendency for lateral patellar deviation on an AP view orthogonal to the posterior femoral condyles. However, findings were based on cadaveric samples limited by the lack of soft tissue effects on patellar positioning.</p><p><strong>Materials and methods: </strong>After excluding those with deformity or damage to osseous or ligamentous structures, 106 knee MRI scans were randomly selected. Patellar centring was calculated as a percentage of total distal femoral intercondylar width and represented how lateral the centre of the patella is located with respect to the midpoint of the femoral condyles. Multiple regression analysis was performed to determine the relationship between patellar centring and age, gender, anatomic lateral distal femoral angle (aLDFA), medial proximal tibial angle (MPTA) and tibial tuberosity to trochlear groove (TT-TG) distance.</p><p><strong>Results: </strong>There were 35 males and 71 females included in the study with a mean age of 29 ± 14 years. Mean patellar centring was 8 ± 4%. There was a statistically significant correlation between TT-TG distance and positive (lateral) patellar centring (standardised <i>β</i> = 0.36, <i>p</i> <0.01). There were no associations between aLDFA and MPTA with patellar centring.</p><p><strong>Conclusion: </strong>This study demonstrates that the patella is rarely perfectly centred and is usually positioned slightly laterally within the femoral condyles in an AP view orthogonal to the posterior aspect of the femoral condyles. The use of supine MRI scans makes this data relevant to a patient on the operating room table.</p><p><strong>How to cite this article: </strong>Shah NS, Kyriakedes JC, Liu RW. An MRI-based Study to Investigate If the Patella is Truly Centred between the Femoral Condyles in the Coronal Plane. Strategies Trauma Limb Reconstr 2022;17(2):63-67.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"17 2","pages":"63-67"},"PeriodicalIF":0.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/4e/stlr-17-63.PMC9357791.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40712751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment of Unstable Elbow Injuries with a Hinged Elbow Fixator: Subjective and Objective Results.","authors":"Luigi Meccariello,&nbsp;Vincenzo Caiaffa,&nbsp;Konrad Mader,&nbsp;Ante Prkic,&nbsp;Denise Eygendaal,&nbsp;Michele Bisaccia,&nbsp;Giuseppe Pica,&nbsp;Sonia Utrilla-Hernando,&nbsp;Roberta Pica,&nbsp;Giuseppe Rollo","doi":"10.5005/jp-journals-10080-1553","DOIUrl":"https://doi.org/10.5005/jp-journals-10080-1553","url":null,"abstract":"<p><strong>Introduction: </strong>Injuries around the elbow pose a challenging problem for orthopaedic surgeons. The complex bony architecture of the joint should be restored and the thin soft tissue envelope needs to be handled with meticulous care. Elbow instability is a complication seen after dislocations and fractures of the elbow and remains a treatment challenge. The purpose of this study was to provide subjective and objective results following the surgical treatment of unstable elbow dislocations with an external hinged fixation technique.</p><p><strong>Methods: </strong>Forty-six consecutive patients with complex trauma of the elbow with instability after ligament reconstruction were enrolled between January 2017 and December 2019. The parameters used to quantify the subjective and objective functional results were the Mayo Elbow Score (MES, objective) and Oxford Elbow Score (OES, subjective), and clinical stability of the elbow joint. We also performed a radiological follow-up of the fractures.</p><p><strong>Results: </strong>The mean MES and OES scores were good at the 12-month follow-up. We had 38 patients with stable joints and 8 patients with minor instability. Using the stress test, we saw a significant difference in the affected joint under varus stress (6.7 ± 1.8 mm) compared to the healthy joint (5.8 ± 1.2 mm) laterally. Furthermore, medially the gap was significantly larger (5.8 ± 0.8 mm, treated elbow) than the contralateral gap under valgus stress (4.3 ± 0.8 mm) (<i>p</i> <0.001). Twenty-one complications occurred in 46 patients (46%): Seven patients had a clinical change of elbow axis: Three valgus (6%), four varus (9%); Superficial wound infection occurred in one case (2%) and ulnar nerve dysfunction in two (4%). The most common medium-term complication was post-traumatic osteoarthritis in eight cases (17%). Heterotopic ossification occurred in five patients (11%) and elbow stiffness in five cases (11%).</p><p><strong>Conclusion: </strong>The use of the hinged elbow external fixator in the treatment of complex elbow trauma is a valid therapeutic adjunct to ligamentous reconstruction showing encouraging results with acceptable complications.</p><p><strong>How to cite this article: </strong>Meccariello L, Caiaffa V, Mader K, <i>et al</i>. Treatment of Unstable Elbow Injuries with a Hinged Elbow Fixator: Subjective and Objective Results. Strategies Trauma Limb Reconstr 2022;17(2):68-73.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"17 2","pages":"68-73"},"PeriodicalIF":0.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/2c/stlr-17-68.PMC9357797.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40712756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Incidence of Deep Infection Following Lower Leg Circular Frame Fixation with Minimum of 1-year Follow-up from Frame Removal.","authors":"Jason Ting,&nbsp;Elizabeth Moulder,&nbsp;Ross Muir,&nbsp;Elizabeth Barron,&nbsp;Yvonne Hadland,&nbsp;Hemant Sharma","doi":"10.5005/jp-journals-10080-1558","DOIUrl":"https://doi.org/10.5005/jp-journals-10080-1558","url":null,"abstract":"<p><strong>Aim: </strong>Superficial pin site infection is a common problem associated with external fixation, which has been extensively reported. However, the incidence and risk factors with regard to deep infection are rarely reported in the literature. In this study, we investigate and explore the incidence and risk factors of deep infection following circular frame surgery. For the purpose of this study, deep infection was defined as persistent discharge or collection for which surgical intervention was recommended.</p><p><strong>Materials and methods: </strong>This study is retrospective review of all patients who underwent frame surgery between April 1, 2015 and April 1, 2019 in our unit with a minimum of 1 year follow-up following frame removal. We recorded patient demographics, patient risk factors, trauma or elective procedure, number of days the frame was <i>in situ</i>, location of infection and fracture pattern.</p><p><strong>Results: </strong>Three-hundred and four patients were identified. Twenty-seven patients were excluded as they were lost to follow-up or had their primary frame surgery as a treatment for infection. This provided us with 277 patients for analysis. The mean age was 47 years (range: 9-89 years), the male to female ratio was 1.5:1, and 80% were trauma frames. Thirteen patients (4.69%) developed deep infection, and all occurred in trauma patients. Of the 13 patients who developed deep infection, 4 had infection before frame removal, and infection occurred in 9 after frame removal. Deep infections occurred in 8 patients within a year of frame removal and in one patient between 1 and 2 years of frame removal.Within the 13 frame procedures for trauma, 12 were periarticular multi-fragmentary fractures, 3 of which were open, and the remaining were an open diaphyseal fracture. The periarticular fractures were more likely to develop deep infection than diaphyseal fractures (p = 0.033). Twelve patients (out of 13) also had concurrent minimally invasive internal fixation with screws in very close proximity of the wires.</p><p><strong>Conclusion: </strong>The rate of deep infection following circular frame surgery appears to be low. Pooled, multi-centre data would be required to analyse risk factors; however, multi-fragmentary, periarticular fracture and the requirement for additional internal fixation appear to be an associated factor.</p><p><strong>How to cite this article: </strong>Ting J, Moulder E, Muir R, <i>et al</i>. The Incidence of Deep Infection Following Lower Leg Circular Frame Fixation with Minimum of 1-year Follow-up from Frame Removal. Strategies Trauma Limb Reconstr 2022;17(2):88-91.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"17 2","pages":"88-91"},"PeriodicalIF":0.8,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/43/0b/stlr-17-88.PMC9357788.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40713928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Surgical Technique for Extraction of a Firmly Integrated Broken Intramedullary Nail.","authors":"Charlotte Mb Somerville,&nbsp;Helena Hanschell,&nbsp;Mehdi Tofighi,&nbsp;Om Lahoti","doi":"10.5005/jp-journals-10080-1550","DOIUrl":"https://doi.org/10.5005/jp-journals-10080-1550","url":null,"abstract":"<p><strong>Aim: </strong>To present a novel technique developed in our institution to remove incarcerated and broken intramedullary (IM) tibial and femoral nails.</p><p><strong>Background: </strong>IM nails are commonly used to treat diaphyseal fractures in both the tibia and femur. These nails can become problematic for the orthopaedic surgeon when they need to be removed, especially in the rare event that the nail has failed and broken. This can leave part of the nail deep in the bone and incarcerated. Multiple techniques have been described to remove a broken nail but we present a novel technique developed based on our experience.</p><p><strong>Technique: </strong>After all other methods to remove the broken nail have failed, a window technique can be employed. This requires a small window of bone to be removed from the cortex overlying the remaining IM nail. A carbide drill is then used to drill a hole into the nail to gain purchase. The edge of an osteotome is placed in the hole in the nail through the window and gently hammered upwards to push the nail towards the over-reamed nail entry point. The nail is repeatedly drilled and pushed until the nail can be removed. The bone window is then replaced.</p><p><strong>Conclusion: </strong>This is a novel technique that works when all other options including hooks, wire stacks and specialist nail removal techniques have failed. It is simple, efficient and effective for both the tibial and femoral nails.</p><p><strong>How to cite this article: </strong>Somerville CMB, Hanschell H, Tofighi M, <i>et al.</i> A Novel Surgical Technique for Extraction of a Firmly Integrated Broken Intramedullary Nail. Strategies Trauma Limb Reconstr 2022;17(1):55-58.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"17 1","pages":"55-58"},"PeriodicalIF":0.8,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/0a/stlr-17-55.PMC9166259.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10620706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and Incidence of Deep Bone Infection in Grade III Diaphyseal Open Tibial Fractures: Circular Fixator vs Intramedullary Nail.","authors":"Ibrahim Natalwala,&nbsp;Cher Bing Chuo,&nbsp;Isla Shariatmadari,&nbsp;Gavin Barlow,&nbsp;Elizabeth Moulder,&nbsp;Joanna Bates,&nbsp;Hemant Sharma","doi":"10.5005/jp-journals-10080-1536","DOIUrl":"https://doi.org/10.5005/jp-journals-10080-1536","url":null,"abstract":"<p><strong>Introduction: </strong>High-energy grade III open fractures of tibia are associated with significant complications and generate debate over the ideal fixation method. This study compares the clinical outcomes for circular frame fixation (CFF) vs intramedullary nail fixation (IMF) in grade III open tibial fractures.</p><p><strong>Materials and methods: </strong>Single-centre retrospective study of patients admitted from January 2008 to December 2016. All patients with grade III open diaphyseal tibial fractures (AO 42 A, B, C), treated with either CFF or IMF, were included. The primary outcome was deep bone infection (DBI). Secondary outcomes were delayed or non-union, secondary intervention, and amputation.</p><p><strong>Results: </strong>A total of 48 limbs in 47 patients had CFF, and 25 limbs in 23 patients had IMF. Median time to definitive fixation was significantly longer for CFF at 9 days (IQR 3-13) compared to IMF at 1 day (IQR 0-3.5) (<i>p</i> <0.001). The DBI rate was significantly lower (2 vs 16%) in the CFF group (<i>p</i> = 0.04). There were 14 limbs (29%) with delayed or non-union in the CFF group vs 5 limbs (20%) in the IMF group. In the CFF group, significantly more limbs required bone grafting for delayed or non-union (<i>p</i> = 0.03). However, there was a greater proportion of limbs in the CFF group with segmental fractures or bone loss (46 vs 4%) and these high-energy fracture patterns were associated with secondary bone grafting (<i>p</i> = 0.005), and with delayed or non-union (<i>p</i> = 0.03). A subgroup analysis of patients without segmental fractures or bone loss treated with either CFF or IMF showed no significant difference in secondary bone grafting (<i>p</i> >0.99) and delayed or non-union rates (<i>p</i> = 0.72). Overall, one patient in each group went on to have an amputation.</p><p><strong>Conclusion: </strong>Our study found that CFF had a lower rate of DBI compared to IMF. Injuries with high-energy fracture patterns (segmental fractures or bone loss) were more likely to have delayed or non-union and require secondary bone grafting. These factors should be considered when selecting the appropriate method of definitive fixation.</p><p><strong>How to cite this article: </strong>Natalwala I, Chuo CB, Shariatmadari I, <i>et al</i>. Outcomes and Incidence of Deep Bone Infection in Grade III Diaphyseal Open Tibial Fractures: Circular Fixator vs Intramedullary Nail. Strategies Trauma Limb Reconstr 2021;16(3):161-167.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"16 3","pages":"161-167"},"PeriodicalIF":0.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/fb/0f/stlr-16-161.PMC8778722.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39882425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Talar-tarsal Stabilisation: Goals and Initial Outcomes.","authors":"Peter Stevens,&nbsp;Alex Lancaster,&nbsp;Ansab Khwaja","doi":"10.5005/jp-journals-10080-1538","DOIUrl":"https://doi.org/10.5005/jp-journals-10080-1538","url":null,"abstract":"Abstract Background While surgical stabilisation of the subtalar joint (arthroeresis) in children remains controversial in the USA, it is widely practised worldwide, with reportedly good outcomes. We are presenting a series of patients who met our criteria for calcaneal lengthening, but whose parents chose the less invasive option of talo-tarsal stabilisation (TTS). The goal of this surgery was to forestall or prevent hindfoot osteotomy. Materials and methods With IRB approval, we conducted this retrospective review of 32 patients (60 ft), who underwent TTS for flexible planovalgus deformity and had a minimum of 1-year follow-up. The aetiology was idiopathic for the majority, with a few being neurogenic or syndromic. The age range was 6–15 years; the younger patients had neuromuscular aetiology or underlying syndromes. Concomitant procedures included percutaneous Achilles lengthening (33 ft), Kidner (9 ft) and guided growth for ankle valgus (2). Results In the early post-immobilisation phase, peroneal spasm occurred in four patients (6 ft). This resolved with Botox injection in the peroneus brevis in three patients and required transfer of the peroneus brevis to the peroneus longus in one patient. At follow-up, ranging from 1 to 4.5 years, 50 implants (83.4%) were retained and the patients reported satisfactory outcomes. Henceforth, those patients will be monitored on a p.r.n. basis. Due to lingering discomfort, implants were repositioned in one and removed in five patients (10 ft = 16.6%). Upon further follow-up, these patients have not manifested recurrent deformity. Therefore, subsequent salvage by osteotomy and/or lengthening of the calcaneus has not been necessary. Conclusion TTS for the symptomatic flatfoot, combined with other procedures as indicated, offers advantages over the currently more accepted methods of medial shift osteotomy or calcaneal lengthening. The outcome at 1 year is a good forecast of whether or not further treatment will be required. This is a simpler and preferred option as compared to other methods of surgical management and, in our experience, has obviated the need for osteotomy or lengthening of the calcaneus. Level of evidence IV retrospective case series. How to cite this article Stevens P, Lancaster A, Khwaja A. Talar-tarsal Stabilisation: Goals and Initial Outcomes. Strategies Trauma Limb Reconstr 2021;16(3):168–171.","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"16 3","pages":"168-171"},"PeriodicalIF":0.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1b/19/stlr-16-168.PMC8778731.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39882856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distal Forearm Replantation in a Child: A Case Report with a 30-year Follow-up.","authors":"Lee S Hee,&nbsp;Kim Hyung-Sik,&nbsp;Lim Hong-Chul","doi":"10.5005/jp-journals-10080-1532","DOIUrl":"https://doi.org/10.5005/jp-journals-10080-1532","url":null,"abstract":"<p><strong>Background: </strong>Amputation in the upper extremities influenced the quality of life a lot adversely. So, replantation was tried in many cases of amputation. Especially, due to good plasticity and healing capacity, replantation in children should be actively attempted. On the contrary, owing to growth potential in children, there are several late complications to happen like shortening and synostosis. There are only a few longterm follow-up reports of paediatric patients after replantation of upper extremities. We report a case of successful distal forearm replantation in a 2-year-old child who sustained a wringer injury by a sawing machine with a follow-up of 30 years.</p><p><strong>Case description: </strong>A 2-year-old female patient was brought to our institution after a wringer injury to the distal forearm by a sawing machine. She sustained a near-total amputation at the distal forearm level with only a skin tag. Replantation was performed 4 hours after the injury. Radius and ulnar fractures were fixed with Kirschner and roll wires. The radial and ulnar arteries were anastomosed and three veins were anastomosed too. The median, ulnar, and radial nerves were managed by epi-perineurorrhaphy. The muscles were readapted, flexor tendons were performed tenorrhaphy each by each, and extensor tendons were performed grouping tenorrhaphy. Ten years after the replantation, a supination motion block was developed but successfully managed.</p><p><strong>Conclusion: </strong>Replantation of upper limbs in children is an eceedingly worthwhile procedure. Though due to growth potential several complications were developed unlikely in adults. But those can be improved with additional procedures. Good plasticity and healing capacity of children make good functional outcomes in long-term follow-up. So, replantation of upper limbs in children should essentially be considered and aggressively performed.</p><p><strong>How to cite this article: </strong>Hee LS, Hyung-Sik K, Hong-Chul L. Distal Forearm Replantation in a Child: A Case Report with a 30-year Followup. Strategies Trauma Limb Reconstr 2021;16(3):179-183.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"16 3","pages":"179-183"},"PeriodicalIF":0.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7e/d7/stlr-16-179.PMC8778723.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39744480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical Exposure of the Distal Fibula to Protect the Peroneus Brevis Muscle Vascular Pedicle.","authors":"Esmee Irvine,&nbsp;Elliott Cochrane,&nbsp;Paul Harwood,&nbsp;David M Taylor,&nbsp;Waseem Bhat,&nbsp;Chris West","doi":"10.5005/jp-journals-10080-1540","DOIUrl":"https://doi.org/10.5005/jp-journals-10080-1540","url":null,"abstract":"<p><p>Ankle fractures are a common presentation to orthopaedic surgeons, with the lateral malleolus involved in 86% of cases. A soft tissue injury can be a concomitant feature of these injuries as a result of the primary injury or following secondary wound breakdown. The peroneus brevis muscle flap provides a reliable and robust option to cover the distal third of the lower limb. With an understanding of the anatomy and cautious dissection during periosteal elevation, the perforating vessels supplying the peroneus brevis can be preserved ensuring that a valuable reconstructive option is available.</p><p><strong>How to cite this article: </strong>Irvine E, Cochrane E, Harwood P, <i>et al.</i> Surgical Exposure of the Distal Fibula to Protect the Peroneus Brevis Muscle Vascular Pedicle. Strategies Trauma Limb Reconstr 2021;16(3):176-178.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"16 3","pages":"176-178"},"PeriodicalIF":0.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/87/17/stlr-16-176.PMC8778725.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39882860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the Growth of <i>Pseudomonas aeruginosa</i> and Its Influence on Osteolysis in Human Bone: An <i>In Vitro</i> Study.","authors":"Ahmed Al Ghaithi,&nbsp;Atika Al Bimani,&nbsp;Sultan Al Maskari","doi":"10.5005/jp-journals-10080-1534","DOIUrl":"https://doi.org/10.5005/jp-journals-10080-1534","url":null,"abstract":"<p><strong>Background: </strong>Isolation of the causal microorganisms in osteomyelitis presents a major challenge for treating clinicians. Several methods have been proposed to rapidly and accurately identify microorganisms. There has been an increasing interest in using Raman spectroscopy in the field of microbial detection and characterisation. This paper explores the use of Raman spectroscopy identification as one of the most difficult-to-isolate microorganisms causing osteomyelitis.</p><p><strong>Methods and results: </strong>Fresh healthy human bone samples were collected from patients undergoing a total knee replacement. These samples were then inoculated with fresh overnight <i>Pseudomonas aeruginosa</i> (PAO) cultures. Bacteria growth and bone ultrastructural changes were monitored over a period of 6 weeks. The experiment demonstrated ultrastructural bony destruction caused by osteolytic PAO secretions. Raman-specific spectral signatures related to the cellular membranes of PAO structures were spotted indicating survival of bacteria on the bone surface.</p><p><strong>Conclusion: </strong>This study showed the promising ability of Raman spectroscopy to identify the presence of bacteria on the surface of inoculated bone samples over time. It was able to detect the osteolytic activity of the bacteria as well as ultrastructure specific to PAO virulence. This method may have a role as an aid to existing diagnostic methods for fast and accurate bacterial identification in bone infection.</p><p><strong>How to cite this article: </strong>Al Ghaithi A, Al Bimani A, Al Maskari S. Investigating the Growth of <i>Pseudomonas aeruginosa</i> and Its Influence on Osteolysis in Human Bone: An <i>In Vitro</i> Study. Strategies Trauma Limb Reconstr 2021;16(3):127-131.</p>","PeriodicalId":21979,"journal":{"name":"Strategies in Trauma and Limb Reconstruction","volume":"16 3","pages":"127-131"},"PeriodicalIF":0.8,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/92/67/stlr-16-127.PMC8778729.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39882420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}