scholarly journals Effect of Anti-Infective Reconstituted Bone Xenograft Combined with External Fixator on Serum CRP and PCT Levels and Prognosis of Patients with Bone Infection after Lower Extremity Long Bone Trauma

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Fei Wang ◽  
Yang Liu ◽  
Xiaofeng Qiu ◽  
Hao Fei ◽  
Wei Liu ◽  
...  
Keyword(s):  
Lower Extremity ◽  
External Fixator ◽  
Bone Destruction ◽  
Lower Extremities ◽  
Bone Infection ◽  
The Body ◽  
Long Bone ◽  
Good Effect ◽  
Bone Trauma ◽  
Serum Crp

Bone infection is one of the common complications of orthopedic surgery. After bone trauma occurs in the human body, the infection of Staphylococcus aureus and Gram-negative bacteria into the fracture area can lead to double infection of the soft tissue and bone tissue at the fracture site, leading to a variety of complications, mostly in the lower extremities. Bone infection easily causes bone destruction, bone nonunion, and bone defect, seriously affecting the quality of life of patients. The traditional treatment method of bone infection is to control the infection first and then repair the bone graft, but this method has a long course, poor efficacy, and high disability rate. In this study, anti-infective reconstituted bone xenograft (ARBX) combined with external fixation was used to treat patients with posttraumatic bone infections of the long bones of the lower extremities, to explore its efficacy, and to analyze its effects on serum CRP, PCT levels, and prognosis. Our results showed that ARBX combined with the external fixator had a good effect on the treatment of patients with bone infection after lower extremity long bone trauma, which could effectively enhance the repair and functional recovery of the limb bone, significantly alleviate the infection degree of patients, reduce the inflammatory response of the body, and have a good prognosis.

scholarly journals Risk factors associated with transport gap bending deformity after bone transport in the treatment of lower extremity bone defects caused by infection

2021 ◽  
Author(s):  
Kai Liu ◽  
Yanshi Liu ◽  
Feiyu Cai ◽  
Chenchen Fan ◽  
Alimujiang Abulaiti ◽  
...  
Keyword(s):  
Risk Factors ◽  
External Fixator ◽  
Lower Limb ◽  
Lower Extremities ◽  
Bone Defects ◽  
Bone Transport ◽  
Bone Infection ◽  
Limb Bone ◽  
Factors Associated ◽  
Independent Risk Factors

Abstract Background: The objective of this study was to observe the efficacy of bone transport using Orthofix external fixator in the treatment of lower limb bone defects caused by infection, and analyze the mechanism and risk factors of transport gap bending deformity (TGBD).Methods: From January 2008 to December 2019, 326 cases of infected bone defects of the lower extremities were treated by bone transport in our medical institution. The location and other relevant information of TGBD were collected, summarized, and analyzed. The Association for the Study and Application of the Method of Ilizarov (ASAMI) standard was applied to assess the bone and functional outcomes. Results: A total of 326 patients have reconstructed the bone defects in the lower extremities successfully, with a mean size of 6.2 centimeters (3.4 - 9.1 cm). TGBD was observed in 42 patients (12.8%) after removing the external fixator, including 32 tibias and 10 femurs, after a mean follow-up of 28.6 months (22 – 47 months). Age>45years, BMI>25kg/m2, defect of the tibia, diabetes, osteoporosis, glucocorticoid intake, duration of bone infection>24months, EFT>9months, EFI>1.8months/cm were associated significantly with a higher incidence of TGBD in the binary logistic regression analysis. The independent risk factors associated with TGBD included age>45 years, BMI>25 kg/m2, defect of tibia, diabetes, osteoporosis. Conclusions: The bone transport using the Orthofix external fixator is a safe and practical method in the treatment of lower limb bone defects caused by infection. The incidence of TGBD was 12.8%, and the top five risk factors included defect of tibia, BMI>25kg/m2, duration of bone infection>24 months, age>45years, and diabetes. Age>45years, BMI>25kg/m2, defect of tibia, osteoporosis, diabetes were the independent risk factors. The higher incidence of TGBD may be associated with more risk factors.

Surgical repair of long bone defects or trauma by guided tissue engineering with composite implants of porous bioactive glass-ceramic (A-WGC) particles bound by a plaster/CaO/P2O5 cement contained by a resorbable vicryl™ mesh

1995 ◽  
Vol 53 ◽  
pp. 800-801
Author(s):  
J.S. Hanker ◽  
L.C. Hanker ◽  
B.L. Giammara
Keyword(s):  
Orthopedic Surgery ◽  
Bone Repair ◽  
Surgical Repair ◽  
Bone Defects ◽  
The Body ◽  
Long Bone ◽  
Trauma Patients ◽  
Long Bones ◽  
Bone Trauma ◽  
Guided Tissue Engineering

One of the biggest problems associated with the repair of trauma in long bones is their requirement to withstand greater mechanical stress than any other bones of the body. After the success we achieved with composite hydroxylapatite (HA)/plaster(PP) in craniofacial bone repair in approximately 200 animals (cats and rats) and 300 humans in our laboratory, clinics and surgeries, it was felt that an area which could perhaps benefit from our experience in bone repair might be orthopedic surgery. When first informed of our desire to apply our biomaterials interest and experience to long bone trauma patients, others expected little success with these biomaterials that were so successful in craniofacial surgery.We felt, however, that success might be achieved for long bone repair with plaster of Paris (CaSO4·½H2O) and/or calcium phosphate. The feeling of my laboratory received some support from Larry Hench's 1988 article. In this article he pointed out that bioactive ceramics such as hydroxylapatite (HA) possibly could bond to bone.

scholarly journals STRUCTURE AND MECHANOGENESIS OF LONG BONE FRACTURES IN LOWER EXTREMITIES DUE TO FALL

2020 ◽  
Vol 20 (3) ◽  
pp. 179-184
Author(s):  
V.K. Sokol
Keyword(s):  
Bone Fractures ◽  
Body Height ◽  
Lower Extremities ◽  
Mechanical Injury ◽  
The Body ◽  
Lower Limbs ◽  
Long Bone ◽  
Long Bones ◽  
Upper Limbs ◽  
Pelvic Bones

Background. The study of the structure and mechanogenesis of falls is necessary to elucidate causal relationships in criminal catatrauma. Purpose of the study was to analyze the structure of mechanical injury resulting in fractures of the long bones of the lower extremities, and the mechanisms of their formation in victims as a result of a fall, according to the primary forensic examination. Material and methods. The study was carried out based on 130 reports of primary forensic examinations of victims with fractures of the femur and / or shin bones due to mechanical injury for the period February – June 2018. All victims were divided into 4 groups: group 1 included individuals sustaining mechanical injury; group 2 involved individuals sustaining injuries in car accidents; group 3 included patients with traumas from the fall, and group 4 included individuals with gunshot fractures. The methodology of the study was based on applying retrospective analysis, descriptive statistics. Results. In cases of catatrauma, the proportion of fractures of the lower extremities makes up 52%, while the proportions of fractures of the upper limbs, ribs and pelvic bones constitute 16% each; in case of car accident the fractures of low legs make up 82.1%, while the fractures of the upper limbs, ribs and pelvic bones constitute 7.8%; 2.4% and 7.7% each, respectively. There are two types of catatrauma included found out in this study: 1) household falls from the own body height (n = 4), and 2) falls from the height not exceeding 3 m (n = 9). The catatrauma mechanisms included the following: 1) active free uncoordinated fall from the own body height with the phase of primary collision with some isolated primary direct injuries; 2) passive free direct predominantly uncoordinated fall from a height of up to 3 m resulting in multiple combined injuries in the phase of primary collision (n = 4), and in the phases of primary and secondary collision of the body (n = 3). Conclusions. In the structure of mechanical injuries of the long bones in the lower extremities according to the initial forensic medical examination, falls from various heights rank the second position among the most frequent criminal injury (10%) after road traffic injuries (89,2%). Falls from own body height and from the height of up to 3 m were free, straight, and mostly uncoordinated, resulted in mainly primary direct injuries as the fractures of the long bones of the upper and lower limbs, ribs, pelvis, brain concussion, chest bruises and abdominal traumas.

scholarly journals Development and Validation of an Age-Specific Lower Extremity Finite Element Model for Simulating Pedestrian Accidents

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Jing Huang ◽  
Yongcheng Long ◽  
Yu Yan ◽  
Lin Hu
Keyword(s):  
Finite Element ◽  
Lower Extremity ◽  
Finite Element Model ◽  
Injury Risk ◽  
Soft Tissues ◽  
Lower Extremities ◽  
Element Model ◽  
Lower Extremity Injury ◽  
Long Bone ◽  
Injury Mechanisms

The objective of the present study is to develop an age-specific lower extremity finite element model for pedestrian accident simulation. Finite element (FE) models have been used as a versatile tool to simulate and understand the pedestrian injury mechanisms and assess injury risk during crashes. However, current computational models only represent certain ages in the population, the age spectrum of the pedestrian victims is very large, and the geometry of anatomical structures and material property of the lower extremities changes with age for adults, which could affect the injury tolerance, especially in at-risk populations such as the elderly. The effects of age on the material mechanical property of bone and soft tissues of the lower extremities as well as the geometry of the long bone were studied. Then an existing 50th percentile male pedestrian lower extremity model was rebuilt to depict lower extremity morphology for 30- to 70-year-old (YO) individuals. A series of PMHS tests were simulated to validate the biofidelity and stability of the created age-specific models and evaluate the lower extremity response. The development of age-specific lower extremity models will lead to an improved understanding of the pedestrian lower extremity injury mechanisms and injury risk prediction for the whole population in vehicle-pedestrian collision accidents.

scholarly journals Two stage management of long bone infection by using an antibiotic cement-coated locking plate: an outcome of 183 cases

2019 ◽  
Author(s):  
Chao Jia ◽  
Xiaohua Wang ◽  
Shengpeng Yu ◽  
Hongri Wu ◽  
Jie Shen ◽  
...  
Keyword(s):  
Infection Control ◽  
Internal Fixation ◽  
Bone Grafting ◽  
Clinical Effect ◽  
Locking Plate ◽  
Lower Extremities ◽  
Bone Infection ◽  
Long Bone ◽  
Antibiotic Cement

Abstract Background The purpose of this study was to evaluate the clinical effect of antibiotic cement-coated locking plate as temporary internal fixation for the treatment of long bone infection in lower extremities . Methods Retrospective analysis the clinical data of 183 patients with lower extremities long bone infection admitted to our hospital from January 2013 to December 2017. All patients were treated with locking plate internal fixation after primary debridement. Antibiotic cement was used to fill the bone defect and wrap the plate. After infection control, bone grafting to reconstruct the bone defect. Results There were 81 cases of femur, 100 cases of tibia and 2 cases of fibula, after the first stage, 16(8.7%) patients had recurrence of infection after the first stage which have to debridement again. 4 tibial infecton patients had poor wound healing, 2 femoral patients had fixation failure, and 1 patient had femoral fracture due to fall down. After a mean time of 32.0 months (range 12 to 66) follow up, the recurrence rate of infection was 14.2% (26/183). Among them, eighteen patients underwent bone grafting after re-debridement, 6 patients received permanent placement of antibiotic bone cement after debridement, and 2 patients refused further treatment and chose amputation. Bone healing was achieved in 175(95.9%) patients in the last follow-up, and the average time of bone union was 5.4 months (range 4 to 12 months). Conclusions Temporary internal fixation with antibiotic cement coated locking plate has good clinical effect in the treatment of lower extremities long bone infection. It does not increase the difficulty of bone infection control. Pay attention to possible difficulty of skin coverage when applied in calves. Key words: Antibiotic cement coated locking plate, Bone infection, Internal fixation

scholarly journals Molecular Mechanisms Associated with ROS-Dependent Angiogenesis in Lower Extremity Artery Disease

Antioxidants ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 735
Author(s):  
Greg Hutchings ◽  
Łukasz Kruszyna ◽  
Mariusz J. Nawrocki ◽  
Ewa Strauss ◽  
Rut Bryl ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Blood Vessel ◽  
Lower Extremity ◽  
Molecular Mechanisms ◽  
Lower Extremities ◽  
Tissue Response ◽  
Peripheral Arteries ◽  
Artery Disease ◽  
Lower Extremity Artery Disease

Currently, atherosclerosis, which affects the vascular bed of all vital organs and tissues, is considered as a leading cause of death. Most commonly, atherosclerosis involves coronary and peripheral arteries, which results in acute (e.g., myocardial infarction, lower extremities ischemia) or chronic (persistent ischemia leading to severe heart failure) consequences. All of them have a marked unfavorable impact on the quality of life and are associated with increased mortality and morbidity in human populations. Lower extremity artery disease (LEAD, also defined as peripheral artery disease, PAD) refers to atherosclerotic occlusive disease of the lower extremities, where partial or complete obstruction of peripheral arteries is observed. Decreased perfusion can result in ischemic pain, non-healing wounds, and ischemic ulcers, and significantly reduce the quality of life. However, the progressive atherosclerotic changes cause stimulation of tissue response processes, like vessel wall remodeling and neovascularization. These mechanisms of adapting the vascular network to pathological conditions seem to play a key role in reducing the impact of the changes limiting the flow of blood. Neovascularization as a response to ischemia induces sprouting and expansion of the endothelium to repair and grow the vessels of the circulatory system. Neovascularization consists of three different biological processes: vasculogenesis, angiogenesis, and arteriogenesis. Both molecular and environmental factors that may affect the process of development and growth of blood vessels were analyzed. Particular attention was paid to the changes taking place during LEAD. It is important to consider the molecular mechanisms underpinning vessel growth. These mechanisms will also be examined in the context of diseases commonly affecting blood vessel function, or those treatable in part by manipulation of angiogenesis. Furthermore, it may be possible to induce the process of blood vessel development and growth to treat peripheral vascular disease and wound healing. Reactive oxygen species (ROS) play an important role in regulation of essential cellular signaling pathways such as cell differentiation, proliferation, migration and apoptosis. With regard to the repair processes taking place during diseases such as LEAD, prospective therapeutic methods have been described that could significantly improve the treatment of vessel diseases in the future. Summarizing, regenerative medicine holds the potential to transform the therapeutic methods in heart and vessel diseases treatment.

scholarly journals ORTHOPEDIC INJURIES IN ADOLESCENT GYMNASTS: A SYSTEMATIC REVIEW

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0011
Author(s):  
Katie Kim ◽  
Michael Saper
Keyword(s):  
Lower Extremity ◽  
Upper Extremity ◽  
Weight Bearing ◽  
The Body ◽  
Adolescent And Young Adult ◽  
Body Region ◽  
Lower Extremity Injuries ◽  
Common Location ◽  
Orthopedic Injuries ◽  
Extremity Injuries

Background: Gymnastics exposes the body to many different types of stressors ranging from repetitive motion, high impact loading, extreme weight bearing, and hyperextension. These stressors predispose the spine and upper and lower extremities to injury. In fact, among female sports, gymnastics has the highest rate of injury each year. Purpose: The purpose of this study was to systematically review the literature on location and types of orthopedic injuries in adolescent (≤20 years) gymnasts. Methods: The Pubmed, Medline, EMBASE, EBSCO (CINAHL) and Web of Science databases were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify all studies reporting orthopedic injuries in adolescent and young adult gymnasts. All aspects of injuries were extracted and analyzed including location, type and rates of orthopedic injuries. Results: Screening yielded 22 eligible studies with a total of 427,225 patients. Twenty of 22 studies reported upper extremity injuries of which four specifically focused on wrist injuries. Eight studies reported lower extremity injuries. Nine studies reported back/spinal injuries. Seven studies investigated each body location of injury; one study reported the upper extremity as the most common location for injury and six studies reported the lower extremity as the most common location for injury. Of those seven studies, five (23%) reported sprains and strains as the most common injury. One study reported fractures as the most common injury. Conclusion: There is considerable variation in reported injury location. Some studies focused specifically on the spine/back or wrist. The type of gymnastics each patient participated in was also different, contributing to which area of the body was more heavily stressed, or lacking. Current literature lacks data to fully provide evidence regarding which body region is more frequently injured and the type of injury sustained.

scholarly journals Transplant-associated penile Kaposi sarcoma managed with single agent paclitaxel chemotherapy: a case report

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Matthew A. Anderson ◽  
Tracey Ying ◽  
Kate Wyburn ◽  
Peter M. Ferguson ◽  
Madeleine C. Strach ◽  
...  
Keyword(s):  
Kaposi's Sarcoma ◽  
Single Agent ◽  
Lower Extremities ◽  
Kaposi’S Sarcoma ◽  
The Body ◽  
Cutaneous Lesions ◽  
Rare Presentation ◽  
Post Transplant ◽  
Transplant Patients ◽  
Disseminated Disease

Abstract Background Kaposi’s sarcoma is an uncommon complication in renal transplant patients, and typically presents with cutaneous lesions on the lower extremities. Penile involvement has been reported only rarely. Management of cutaneous-limited disease is primarily reduction of immunosuppression and conversion to an mTOR-inhibitor, whereas the treatment of disseminated disease in transplant patients is more variable. Case presentation A 75-year-old male, originally from Somalia, received a deceased-donor kidney transplant for diabetic and hypertensive nephropathy. Seven months post-transplant he presented with lower limb lesions, oedema and bilateral deep vein thromboses. He then developed a fast-growing painful lesion on his penile shaft. A biopsy of this lesion confirmed KS, and a PET scan demonstrated disseminated disease in the lower extremities, penis and thoracic lymph nodes. His tacrolimus was converted to sirolimus, and his other immunosuppression was reduced. He was treated with single agent paclitaxel chemotherapy in view of his rapidly progressing, widespread disease. The penile lesion completely resolved, and the lower extremity lesions regressed significantly. His kidney allograft function remained stable throughout treatment. Conclusion This case illustrates a rare presentation of an uncommon post-transplant complication and highlights the need for a high index of suspicion of KS in transplant patients presenting with atypical cutaneous lesions. It serves to demonstrate that the use of single agent paclitaxel chemotherapy, switch to an mTORi and reduction in immunosuppression where possible produces excellent short-term outcomes, adding to the body of evidence for this management strategy in disseminated Kaposi’s sarcoma.

Prosthesis Design for Bilateral Hip Disarticulation Management

2014 ◽  
Vol 664 ◽  
pp. 423-428
Author(s):  
Mauricio Plaza Torres ◽  
William Aperador
Keyword(s):  
Body Weight ◽  
Lower Extremity ◽  
Hip Joint ◽  
Joint Capsule ◽  
The Body ◽  
Body Weight Support ◽  
Patient Mobility ◽  
Weight Support ◽  
Crush Injuries ◽  
High Level

Hip disarticulation is an amputation through the hip joint capsule, removing the entire lower extremity, with closure of the remaining musculature over the exposed acetabulum. Tumors of the distal and proximal femur were treated by total femur resection; a hip disarticulation sometimes is performance for massive trauma with crush injuries to the lower extremity. This article discusses the design a system for rehabilitation of a patient with bilateral hip disarticulations. The prosthetics designed allowed the patient to do natural gait suspended between parallel articulate crutches with the body weight support between the crutches. The care of this patient was a challenge due to bilateral amputations at such a high level and the special needs of a patient mobility.

scholarly journals Custom-Made Antibiotic Cement Nails in Orthopaedic Trauma: Review of Outcomes, New Approaches, and Perspectives

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Marcin K. Wasko ◽  
Rafal Kaminski
Keyword(s):  
Failure Mechanisms ◽  
Medullary Canal ◽  
Bone Infection ◽  
Long Bone ◽  
Current Evidence ◽  
Orthopaedic Trauma ◽  
Antibiotic Cement ◽  
Custom Made ◽  
Trauma Surgeons ◽  
Technique Failure

Since the first description in 2002 by Paley and Herzenberg, antibiotic bone cement nails (ACNs) have become an effective tool in the orthopaedic trauma surgeons’ hands. They simultaneously elute high amounts of antibiotics into medullary canal dead space and provide limited stability to the debrided long bone. In this paper, we perform a systematic review of current evidence on ACNs in orthopaedic trauma and provide an up-to-date review of the indications, operative technique, failure mechanisms, complications, outcomes, and outlooks for the ACNs use in long bone infection.

Sign in / Sign up

Export Citation Format

Share Document