Solitary coronal shear fractures of femo- ral condyle, such as Hoffa＇s fracture, are usually associated with supracondylar or intercondylar fractures of the femur. These fractures are rare and seen in the context of ...Solitary coronal shear fractures of femo- ral condyle, such as Hoffa＇s fracture, are usually associated with supracondylar or intercondylar fractures of the femur. These fractures are rare and seen in the context of high energy mechanism leading to multiple injuries; therefore a thorough workup of the patient is required to rule out other significant injuries. Hoffa＇s fracture associated with femo- ral shaft and proximal tibial fractures is extremely rare and no such injury has been reported previously. We report two such cases which were managed with standard operativefixation techniques and demonstrated good to excellent func- tional outcome after a follow-up of one year. This report emphasizes that high index of suspicion is required for di- agnosis of these injuries and a thorough workup is manda- tory to rule out other associated injuries. We also propose a possible mechanism of injury.展开更多
Purpose： To report complications in the management of complex closed proximal tibial fractures. Method： A retrospective study was conducted to analyze the infectious and noninfectious complications encountered in th...Purpose： To report complications in the management of complex closed proximal tibial fractures. Method： A retrospective study was conducted to analyze the infectious and noninfectious complications encountered in the management of high-energy Schatzker type V and VI tibial plateau fractures. All patients were treated at the level 1 trauma centre between January 20tl and March 2014. Sixty two patients were included in the study. The mean patient age was （43.16 ±11.59） years with 60 males and 2 females. Infectious complications like superficial and deep infection, wound dehiscence, malalignment in the immediate postoperative period and in follow-up period were noted. Results： The overall complication rate was 30.65% （19 out of 62）. Infectious complications were noted in 20.97% cases （13162）. In majority of the cases （8113）, superficial infection was seen which managed with regular dressing and antibiotic administration. The patients （5/13） who had developed deep-seated infection were subjected to repeated debridements, flap coverage, implant removal or amputation depending upon the host response. Thirteen patients had experienced noninfectious complications. Hardware related complications were noticed in six patients and four among them received a secondary procedure. Malalignment was observed in seven patients but only single patient underwent subsequent operative intervention. Conclusion： Proximal tibial plateau fractures especially Shatzker type V and VI are associated with extensive soft tissue damage even in closed injuries. The complications encountered in the management of these fractures can be minimized with appropriate patient selection and minimal soft tissue dissection.展开更多
Objective： Tibial shaft fractures are straightforward to treat but when associated with soft tissue injury particularly at the nail entry/plate insertion site or there is significant comminution proximally or a large...Objective： Tibial shaft fractures are straightforward to treat but when associated with soft tissue injury particularly at the nail entry/plate insertion site or there is significant comminution proximally or a large butterfly fragment/a second split component in the posterior coronal plane, it is a challenge to the treating surgeon. The aim of the present report is to describe the technique of posterior coronal plating in such a scenario and its ad- vantages. Methods： Between July 2008 and June 2011, 12 patients were prospectively treated by this approach using 4.5 mm broad dynamic compression plates. Results： The time of bony consolidation and full weight bearing averaged 21.7 weeks （range, 16-26 weeks）. Patients were followed up for at least 24 months （range, 24-48 months）. At 1 year postoperatively, no loss in reduction or alignment was observed. Mean Hospital for Lower Extremity Measurement Functional Score was 72.8 （range, 64-78）. All patients were satisfied with their treatment outcomes. Conclusion： Direct posterior approach and fixation using prone position helps to visualise the fracture fragments and provide rigid fixation. The approach is simple and extensile easily, apart from advantages of less soft tissue and hardware problems compared to standard medial or lateral plating.展开更多
文摘Solitary coronal shear fractures of femo- ral condyle, such as Hoffa＇s fracture, are usually associated with supracondylar or intercondylar fractures of the femur. These fractures are rare and seen in the context of high energy mechanism leading to multiple injuries; therefore a thorough workup of the patient is required to rule out other significant injuries. Hoffa＇s fracture associated with femo- ral shaft and proximal tibial fractures is extremely rare and no such injury has been reported previously. We report two such cases which were managed with standard operativefixation techniques and demonstrated good to excellent func- tional outcome after a follow-up of one year. This report emphasizes that high index of suspicion is required for di- agnosis of these injuries and a thorough workup is manda- tory to rule out other associated injuries. We also propose a possible mechanism of injury.
文摘Purpose： To report complications in the management of complex closed proximal tibial fractures. Method： A retrospective study was conducted to analyze the infectious and noninfectious complications encountered in the management of high-energy Schatzker type V and VI tibial plateau fractures. All patients were treated at the level 1 trauma centre between January 20tl and March 2014. Sixty two patients were included in the study. The mean patient age was （43.16 ±11.59） years with 60 males and 2 females. Infectious complications like superficial and deep infection, wound dehiscence, malalignment in the immediate postoperative period and in follow-up period were noted. Results： The overall complication rate was 30.65% （19 out of 62）. Infectious complications were noted in 20.97% cases （13162）. In majority of the cases （8113）, superficial infection was seen which managed with regular dressing and antibiotic administration. The patients （5/13） who had developed deep-seated infection were subjected to repeated debridements, flap coverage, implant removal or amputation depending upon the host response. Thirteen patients had experienced noninfectious complications. Hardware related complications were noticed in six patients and four among them received a secondary procedure. Malalignment was observed in seven patients but only single patient underwent subsequent operative intervention. Conclusion： Proximal tibial plateau fractures especially Shatzker type V and VI are associated with extensive soft tissue damage even in closed injuries. The complications encountered in the management of these fractures can be minimized with appropriate patient selection and minimal soft tissue dissection.
文摘Objective： Tibial shaft fractures are straightforward to treat but when associated with soft tissue injury particularly at the nail entry/plate insertion site or there is significant comminution proximally or a large butterfly fragment/a second split component in the posterior coronal plane, it is a challenge to the treating surgeon. The aim of the present report is to describe the technique of posterior coronal plating in such a scenario and its ad- vantages. Methods： Between July 2008 and June 2011, 12 patients were prospectively treated by this approach using 4.5 mm broad dynamic compression plates. Results： The time of bony consolidation and full weight bearing averaged 21.7 weeks （range, 16-26 weeks）. Patients were followed up for at least 24 months （range, 24-48 months）. At 1 year postoperatively, no loss in reduction or alignment was observed. Mean Hospital for Lower Extremity Measurement Functional Score was 72.8 （range, 64-78）. All patients were satisfied with their treatment outcomes. Conclusion： Direct posterior approach and fixation using prone position helps to visualise the fracture fragments and provide rigid fixation. The approach is simple and extensile easily, apart from advantages of less soft tissue and hardware problems compared to standard medial or lateral plating.
