Mark R. Brinker's research while affiliated with McBride Orthopedic Hospital and other places

Publications (126)

Article
Background Humeral nonunion is estimated to occur at a rate of 1.1% - 25% depending on the fracture location and pattern, mechanism of injury, patient compliance with the immobilization protocol, patient’s nutritional status and medical coomorbidities.9,12,21,23,29 Fracture nonunion can cause chronic pain, limited range of motion, and may hinder no...
Article
Purpose The purpose of this study was to evaluate whether fellowship training affected trends and complications of operative clavicle fracture treatment in newly trained orthopedic surgeons. Methods The American Board of Orthopedic Surgery (ABOS) database was utilized to identify cases of open treatment of clavicle fractures submitted by ABOS Part...
Article
Posttraumatic, limb length discrepancy in adults is a challenge to treat, and multiple treatment protocols over the years have shown varying levels of success and complications. Before the introduction of the PRECICE nail in 2011, our preferred method of limb lengthening used an Ilizarov or Taylor Spatial frame. To assess the PRECICE nail, we evalu...
Article
Objectives: To evaluate the diagnostic utility of leukocyte count (WBC), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) for distinguishing between septic and aseptic nonunions. Design: A single-gate (cohort) design was employed using one set of eligibility criteria applied to a consecutive sample of nonunions. Setting: Priv...
Article
Multiple studies have reported nonunion rates of 3% to 17% following peri-prosthetic fractures. Determining management strategies based on the available literature is difficult because existing studies are small and involve heterogeneous treatments and multiple surgeons. The purpose of this study was to describe a consecutive series of patients who...
Article
AIM To determine social, logistical and demographic factors that influence time to discharge in a short stay pathway (SSP) by following total knee arthroplasty (TKA). METHODS The study included primary TKA's performed in a highvolume arthroplasty center from January 2016 through December 2016. Potential variables associated with increased hospital...
Article
A substantial proportion of fractures can present with nonunion, and the management of nonunion continues to present a challenge for orthopaedic surgeons. A variety of biological, mechanical, patient, and injury factors can contribute to the occurrence of nonunion, and often the cause of nonunion may be multifactorial. Successful management often r...
Article
Objective: To evaluate the healing rate of aseptic nonunions of the distal third of the tibia treated with Ilizarov slow gradual compression and deformity correction. Design: Retrospective cohort study. Setting: Tertiary referral center. Patients/participants: Ninety-four consecutive adult patients with 94 distal third tibial aseptic nonunio...
Article
Background: High tibial osteotomy with acute correction and internal fixation can be used to correct malalignment and malorientation and reduce symptoms in patients with medial compartment osteoarthritis of the knee. To address the inadequacies of this technique, we performed a series of subtubercle tibial osteotomy (STO) procedures using circular...
Article
Objectives: At our institution, custom made antibiotic-laden cement nails fabricated during surgery using a thoracostomy catheter as a mold is commonly employed to treat long bone infection. As the outer diameter of the nails produced has not previously been described, we designed a study to measure the outer diameter of antibiotic-laden cement na...
Article
Objective: The purpose of this study is to report the extent of the effects of femoral nonunion on health-related quality of life. Design: Retrospective cohort. Setting: Tertiary referral center. Patients/participants: 187 consecutive patients (85 women, age 55.9 ± 16.9 years; 102 men, age 42.8 ± 16.1 years) with 188 nonunions of the femur,...
Article
Purpose: The purpose of this study is to report the results of a series of infected forearm nonunions treated from 1998 to 2012 using a staged reconstruction technique. Methods: At a median of 42 months follow-up, 7 patients who had an average segmental defect of 4.9 cm (range, 2.3-10.4 cm) were available for clinical and radiographic evaluation...
Article
Fracture nonunion is a failure of the biological processes of fracture-healing. Critical cellular events in fracture-healing include the inflammatory response, differentiation and proliferation of progenitor cells, formation of fibrocartilage callus, angiogenesis and subsequent mineralization of the callus, vascular union (restoration of normal med...
Article
An evidence-based description of aseptic tibial and femoral diaphyseal nonunions without segmental defects is based on a systematic search of MEDLINE. Aseptic nonunion of the femoral or tibial diaphysis without segmental defects and with an in situ nail, treated with reamed exchange nailing or augmentative plating and bone grafting, has consistentl...
Article
Background Nonunion of the distal femur after lateral plating is associated with axial malalignment, chronic pain, loss of ambulatory function, and decreased knee ROM. The addition of a medial locking plate with autogenous bone grafting can provide greater stability to allow bone healing and may be used to achieve union in these challenging cases....
Chapter
A 36 year old male sustained a high-energy Gustilo-Anderson Type IIIB open, comminuted tibia fracture and underwent serial irrigation and debridements resulting in an 18 cm tibial bone defect and significant soft tissue loss. The patient underwent soft tissue reconstruction with a gastrocnemius rotational flap and split-thickness skin grafting. The...
Article
Long bone nonunions have an important impact on a patient's quality of life. The purpose of this study was to compare long bone nonunions with use of the Time Trade-Off direct measure to compute utility scores and to determine which nonunion anatomic location had the lowest health-related quality of life. The Time Trade-Off assesses the percentage...
Article
Objectives: To evaluate the radiographic and clinical outcomes of a systematic approach to exchange nailing for the treatment of aseptic femoral nonunions previously treated with an intramedullary nail. Design: Retrospective cohort. Setting: Tertiary referral center. Patients: Fifty aseptic femoral nonunions in 49 patients who presented with an int...
Chapter
Below-knee amputation (BKA) requires 40 % less energy expenditure when compared with above-knee amputation (AKA) (Waters RL, Perry J, Antonelli D, Hislop H, J Bone Jt Surg 58(1):42–46, 1976), and compliance with prosthesis use is twice as likely with a BKA when compared with an AKA (Hagberg E, Berlin OK, Renström P, Prosthet Orthot Int 16(3):168–17...
Chapter
A 36 year old male sustained a high-energy Gustilo-Anderson Type IIIB open, comminuted tibia fracture and underwent serial irrigation and debridements resulting in an 18 cm tibial bone defect and significant soft tissue loss. The patient underwent soft tissue reconstruction with a gastrocnemius rotational flap and split-thickness skin grafting. The...
Article
The purpose of this study is to evaluate the effectiveness of a systematic approach to exchange nailing for the treatment of aseptic tibial nonunion. Retrospective cohort. Tertiary referral center. Forty-six aseptic tibial nonunion sites in forty patients (2 bilateral., 4 segmental) that presented with an intramedullary nail (IMN) an average of 16...
Chapter
Below-knee amputation (BKA) requires 40 % less energy expenditure when compared with above-knee amputation (AKA) (Waters RL, Perry J, Antonelli D, Hislop H, J Bone Jt Surg 58(1):42–46, 1976), and compliance with prosthesis use is twice as likely with a BKA when compared with an AKA (Hagberg E, Berlin OK, Renström P, Prosthet Orthot Int 16(3):168–17...
Chapter
Open tibia fractures with gross contamination present several challenges to the treating surgeon. These include the need for soft tissue reconstruction, increased risk for both early and delayed infection, and significant bone loss, requiring reconstruction. Bone transport with the use of an Ilizarov ring external fixator can provide a treatment st...
Article
Tibial nonunion is disabling, but to our knowledge no quantitative evaluation of its effect on health-related quality of life has been reported. We evaluated 243 tibial shaft fracture nonunions in 237 consecutive patients (seventy-nine female [age, 49.4 ± 14.9 years] and 158 male [age, 46.3 ± 15.4 years]) who were referred to a single surgeon at ou...
Article
Background: Modern interest in patient-reported outcomes measures (PROMs) in orthopaedics dates back to the mid-1980s. While gradual growth of activity in this area has occurred over the past 25 years, the extent to which this research methodology is applied in clinical practice to improve patient care is unclear. WHERE ARE WE NOW?: Historically,...
Article
Background: Comparative effectiveness research evaluates treatments as actually delivered in routine clinical practice, shifting research focus from efficacy and internal validity to effectiveness and external validity ("generalizability"). Such research requires accurate assessments of the numbers of patients treated and the completeness of their...
Article
Objective: To report the outcomes of percutaneous autologous bone marrow injection for nonunion or delayed union of the distal tibial metaphysis in patients with prior plating. Design: Consecutive case series. Setting: Tertiary center. Patients: Eleven consecutive patients (aged 24-51 years) were referred to us with a nonunion or delayed uni...
Article
We report a case in which Ilizarov distraction osteogenesis was used to lengthen the portion of calcaneum that remained after a radical debridement for osteomyelitis. The patient was able to walk normally in unmodified shoes at the end of his treatment.
Article
We report the results of Ilizarov gradual distraction to regain 6.7 cm of leg length in a severely contracted hip 11 months after a resection arthroplasty. Restoration of leg length allowed revision hip arthroplasty. At 24 months after the revision arthroplasty, the patient is ambulating independently and pain free. The use of Ilizarov gradual dist...
Article
This study evaluated 78 patients who fell after total knee arthroplasty. Eight patients (10.3%) had soft-tissue injuries that led to a poor clinical course (deep infection, unplanned return to the operating room, temporary or permanent resection arthroplasty, or knee arthrodesis). Factors related to a poor clinical course included copious bleeding...
Article
To determine whether patients with unexplained nonunions, patients with a history of multiple low-energy fractures with at least one progressing to a nonunion, and patients with a nonunion of a nondisplaced pubic rami or sacral ala fracture would have an underlying metabolic or endocrine abnormality that had not been previously diagnosed. Case seri...
Article
To describe the functional outcomes of treatment using the Ilizarov method for tibial nonunions in older patients (>60 years of age). Prospective case series. Tertiary referral center. Twenty-three consecutive patients with an average age of 72 years (61 to 92) who had tibial nonunions for an average duration of 13 months (3 to 46). Fourteen patien...
Article
To report the functional outcomes of Ilizarov treatment of infected nonunion of the distal humerus. Prospective case series. Tertiary referral center. Between July 1998 and August 2003, 6 consecutive patients (age 33 to 73 years) were referred to us with an infected nonunion of the distal humerus following failure of open reduction and internal fix...
Article
Exchange nailing is most appropriate for a nonunion without substantial bone loss. There is no clear consensus regarding the use of exchange nailing in the presence of active, purulent infection. The exchange nail should be at least 1 mm larger in diameter than the nail being removed, and it has been recommended that it be up to 4 mm larger when th...
Article
Does health-care payer type affect the rate of operative treatment and surgeons' work intensity for patients with orthopaedic conditions? We analyzed the clinical and financial data collected during 6 consecutive years (1999-2004) for a group practice of 40 orthopaedic surgeons. We examined the rate of operative treatment and surgeons' work intensi...
Article
To determine how axial rotation around the anatomic axis of the femur, as would occur with malrotation of a femoral fracture, affects frontal and sagittal plane alignment and knee joint orientation. Computer-generated models of the lower extremity were constructed using standardized dimensions. To simulate a malrotated fracture, these models were r...
Article
Our patient, who had no history of trauma, developed bilateral femoral neck fractures several years after pelvic irradiation. The well-documented sequelae of femoral neck fractures include avascular necrosis, nonunion, and malunion. Postirradiation pelvic pain, particularly in the absence of trauma, should be aggressively evaluated. With high clini...
Article
Ideally, acquired femoral malrotation as a complication of intramedullary nailing of a femoral shaft fracture should be identified and corrected early in the course of treatment. In this report, we present a previously undescribed precise surgical technique for acutely correcting an acquired femoral malrotation deformity 20 days after fixation of a...
Article
The purpose of this study was to determine the annual incidence rates of non-work-related traumatic fractures and dislocations (excluding head and facial injuries) referred for orthopaedic services in a large population enrolled under a capitated insurance contract. The number of fractures and dislocations that were referred for orthopaedic service...
Article
The utilization of orthopaedic services (office visits and surgery) to treat hand and wrist conditions is not well known. In this study, we report the utilization rates for patients referred for orthopaedic treatment of hand and wrist conditions in a large population of individuals enrolled in a capitated insurance plan. The study population consis...
Article
Background: The purpose of this study was to determine the annual incidence rates of non-work-related traumatic fractures and dislocations (excluding head and facial injuries) referred for orthopaedic services in a large population enrolled under a capitated insurance contract. Methods: The number of fractures and dislocations that were referred fo...
Article
To evaluate a new operative treatment of femoral nonunion following failed exchange nailing. Retrospective review, consecutive series. SETTING Office-based orthopaedic practice. Five consecutive patients (ages 31-67 years) were referred in with a femoral nonunion following exchange nailing an average of 28 months (range 11-55) after the initial tra...
Article
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Article
The current study compared patella tracking during simulated concentric and eccentric quadriceps contractions in 12 knees from cadavers using a three-dimensional electromagnetic tracking system. The patella shifted (translated) and tilted medially during approximately the initial 22 degrees tibiofemoral flexion. The patella then shifted and tilted...
Article
Correction of a distal femoral deformity may prevent or delay the onset of osteoarthritis or mitigate its effects. Accurate correction of deformity without production of a secondary deformity depends on precise localization and quantification of the deformity. We report a technique to correct distal femoral deformities in the coronal plane. Fourtee...
Article
Failure of internal fixation following treatment of a fracture or fracture nonunion presents a challenging clinical situation. In certain cases, Ilizarov external fixation may be the preferred method to treat bony injuries that have failed to unite following one or more attempts at internal fixation. This paper reviews the modes of failure followin...
Article
Orthopaedic practice expenses are the costs associated with providing treatment that are incurred by a physician's practice. Certain payer types are thought to increase orthopaedic practice expenses by increasing paperwork and other administrative activities. Our study investigated the hypothesis that orthopaedic practice expenses would vary signif...
Article
The utilization rate for orthopaedic services (office visits and surgery) is not well known. The purpose of this study was to determine the utilization rates for orthopaedic office visits and surgical procedures in a large population of captured lives. The study population comprised an average of 134,902 persons per month who were enrolled under a...
Article
This investigation examined whether gender, activity level, hand dominance, or age displayed bias for 5 common shoulder scores among 120 healthy collegiate or recreational athletes. Data were collected for 5 instruments: Constant-Murley, UCLA rating, pre-1994 American Shoulder and Elbow Surgeons, Shoulder Pain and Disability Index, and Oxford. Norm...
Article
Normative preoperative Short Form-12 Health Survey components summary scores have not been reported for patients who have knee conditions treated with arthroscopy. During one calendar year, 269 consecutive patients with a knee injury (119 meniscus lesions, 73 anterior cruciate ligament ruptures, 54 articular cartilage lesions, and 23 with patellar...
Article
This article reviews the clinical entity of medial patellar subluxation, including relevant anatomic andbiomechanical factors. Most cases of medial patellar subluxation occur as a late complication of lateral retinacular release. Symptoms include pain, disability, crepitus, and intermittent swelling. Clinical signs include subluxation of the patell...
Article
A study was undertaken to determine the confidence of graduating family practice residents in the management of musculoskeletal conditions and to determine the level of exposure of graduating family practice residents to fracture care. A 2-page questionnaire consisting of 50 items was sent to 680 graduating family practice residents at 100 randomly...
Article
The purpose of the current investigation was to present a standard method by which an orthopaedic practice can analyze its practice expenses. To accomplish this, a five-step process was developed to analyze practice expenses using a modified version of activity-based costing. In this method, general ledger expenses were assigned to 17 activities th...
Article
Orthopedic surgeons are trained to manage problems involving the musculoskeletal system. It would be helpful to identify certain procedures, anatomic areas, or issues related to the physician-patient relationship that could potentially lead to a malpractice lawsuit. Once the problems are identified, steps toward continuing education and physician a...
Article
To determine current practice for tibial arterial revascularization in trauma patients with tibial shaft fractures associated with infrapopliteal arterial injuries. Nationwide survey of board-certified vascular surgeons, proportionally stratified by geographic region. We surveyed a random sample (probability sample stratified by geographic region)...
Article
Quality health care has many definitions. Among those definitions is "care that consistently contributes to the improvement or maintenance of the quality and/or duration of life." The current evolution in health care has been fueled by three necessities frequently demanded by payers and employers: improvement in access, lowering of cost, and defini...
Article
To determine the satisfaction of orthopedic patients in regards to their health care plan, a four-page questionnaire was designed, pilot tested, and sent to 200 orthopedic surgeons randomly selected from members of the American Academy of Orthopaedic Surgeons in Texas. Fifty-seven orthopedic surgeons were not eligible to participate; our eligible c...
Article
Fractures of the medial third of the clavicle are the rarest of all clavicle fractures. We present two cases of medial clavicle fracture nonunions that were initially thought to be chronic anterior sternoclavicular dislocations and describe the entity of pseudo-dislocation of the sternoclavicular joint. Computed tomography should be performed on al...
Article
To quantify the changes in nutrient artery blood flow following reamed and unreamed nailing of intact canine tibias. In vivo animal study. Eighteen dogs underwent nutrient artery blood flow measurements over a fourteen-day period. The intervention groups consisted of controls (Group I), nailing without reaming (Group II), and nailing with reaming (...
Article
Supracondylar femur fractures above a total knee replacement are rare injuries that may be challenging to treat. We present a case of an elderly woman whose supracondylar femur fracture was not deemed amenable to conventional treatment. This patient underwent fixation of her femur fracture above a total knee replacement using an Ilizarov external f...
Article
Thirty-five consecutive patients were evaluated at an average follow-up time of 20 months after circumferential lumbar spinal fusion. All patients had degenerative conditions of the lumbar spine and same-day anterior spinal fusion by using titanium cages packed with autograft bone and posterior instrumentation combined with a posterolateral autogen...
Article
This study examined four commonly used sports knee evaluation instruments to establish normative data. A total of 91 volunteers who had not sought treatment for knee pain or any other knee complaint at any time in the past underwent a detailed medical history and examination of both of their knees. Three numerical systems (Feagin and Blake Knee Sco...
Article
The content and adequacy of orthopedic surgery residency training can be evaluated by several means. The Accreditation Council for Graduate Medical Education and the Residency Review Committee set standards with which residency programs must comply in order to be accredited. Residents' perceptions of the content and adequacy of their training is an...
Article
To assess the radiographic, histologic, and mechanical characteristics of new bone formation in large segmental bone defects treated with a new osteoconductive material, recombinant human osteogenic protein-1 (rhOP-1). In vivo animal study. Sixteen dogs (thirty-two limbs) with an ulna segmental defect (2.5 centimeters) were randomized to three trea...
Article
This retrospective study examined the outcome of 40 patients 50 or more years of age treated between September 1988 and September 1993 for tibial plateau fractures. Our analysis was based on a review of the medical records of all patients as well a patient self-assessment questionnaire. The 22 women and 18 men studied had a mean age of 60 (range, 5...
Article
The SF-36 Health Survey is a patient self-administered general health status evaluation designed to measure the impact of disease on an individual's perception of his or her health. Five hundred forty-four patients with five common shoulder conditions (anterior glenohumeral instability (149 patients), complete reparable rotator cuff tear (111 patie...
Article
Total knee arthroplasty was evaluated in 10 patients with post-traumatic osteoarthrosis secondary to work-related knee injuries (age- and sex-matched with 10 controls who had total knee arthroplasties for nonwork-related osteoarthrosis) to determine if Workers' Compensation status influenced treatment outcome. Using the Hospital for Special Surgery...
Article
Fifty consecutive patients completed standardized questionnaires regarding general health status as well as function of the shoulder before and an average of thirteen months after arthroscopic repair of a full-thickness tear of the rotator cuff. Comparison of the preoperative and postoperative responses to the questions demonstrated highly signific...
Article
Bone mineral density (BMD) was evaluated in the proximal femora (femoral neck, Ward's triangle, and greater trochanter) and lumbar spines of 25 black children and young adults with sickle cell anemia using dual-photon absorptiometry. Compared with normal subjects from the general population, the patients with sickle cell anemia exhibited lower bone...
Article
Full-text available
We conducted a prospective study to evaluate bone bruises, or trabecular microfractures, associated with isolated medial collateral ligament injuries. Magnetic resonance imaging was performed on 65 patients with isolated medial collateral ligament injuries determined by physical examination and imaging studies. Of these 65 patients, 29 (45%) had as...
Article
This study reviewed trauma registry data for information on the prevalence of alcohol and drug use in adult patients with fractures and dislocations admitted to Hermann Hospital, Houston, Texas, from January 1992 to December 1994. Of the 1776 adult patients aged 18 years or older, 1126 (63%) were tested for blood alcohol concentration, and 873 (49%...
Article
Posterior sternoclavicular joint (SCJ) dislocations are most often stable after reduction but may be associated with significant complications related to the location of the medial head of the clavicle within the mediastinum. In rare instances, a posterior SCJ dislocation is irreducible or redislocates after a closed reduction. Because of the poten...
Article
A new method of directly measuring nutrient artery blood flow using ultrasonic probes is described. These probes have provided reproducible results in our experiments. Advantages of ultrasonic probes include the direct measurement of blood flow through small arteries, ease of use, accuracy of measurement, applicability to a wide range of vessel dia...
Article
Four knee-scoring systems were used to evaluate 200 adult subjects who had no history of injury, abnormality, or treatment of the knees, hips, lower extremities, or spine. All subjects were in the age-range (fifty to 100 years; average, 65.5 years) typical of candidates for total knee replacement. In addition to a physical examination, complete dem...
Article
The financial and medical records of 11 patients diagnosed with a tibial nonunion were evaluated in order to assess the costs associated with the care of this clinical entity. The initial tibia fractures were seen at Hermann Hospital (Houston, Texas) between April 1991 and June 1993. We included only those patients who had a diagnosis of tibial sha...
Article
We quantitatively analyzed blood flow through the major arteries supplying the pig's femoral head during various hip positions and following ligation of various vessels in order to identify the vascular abnormalities which may be responsible for the development of avascular necrosis during the treatment of developmental dysplasia of the hip. Our fi...
Article
Tibial fractures with an associated vascular injury are a challenging management problem for the orthopedic and vascular surgeon. The effect of a concomitant vascular injury on fracture healing has not been specifically delineated previously. We performed a retrospective review of 29 fractures of the tibial shaft with an associated vascular injury...
Article
One hundred ninety-five consecutive patients underwent 195 primary unilateral total hip arthroplasties between January 1988 and December 1993. Patients were divided into three groups based on the type of anesthesia utilized for their procedure. Group I consisted of 108 patients (59 women and 49 men; average age 56 years) who had general endotrachea...
Article
Twenty consecutive primary noncemented total hip arthroplasties performed on 12 men with ankylosing spondylitis were available to be studied clinically and radiographically at an average follow-up period of 75 months (range, 27–121 months). The average patient age at the time of surgery was 35 years (range, 23–53 years). Harris hip scores averaged...
Article
Four hip scoring systems were used in evaluating 200 adult subjects who had no prior history of injury, pathologic condition, or treatment of the hips, knees, lower extremities, or spine. All subjects were in the age range typical of a total hip arthroplasty candidate (average age, 65 years; range, 50-100 years). In addition to a physical examinati...
Article
Twenty consecutive primary noncemented total hip arthroplasties performed on 12 men with ankylosing spondylitis were available to be studied clinically and radiographically at an average follow-up period of 75 months (range, 27–121 months). The average patient age at the time of surgery was 35 years (range, 23–53 years). Harris hip scores averaged...
Article
A retrospective analysis of 41 adult patients treated for a femoral neck fracture was performed to determine the variables that best predict total hospital charges. The patients were treated for an isolated femoral neck fracture at our hospital from January 1993 through December 1994. There were 13 men and 28 women. The average age at the time of i...
Article
Full-text available
We evaluated the results of a surgical procedure to correct medial subluxation of the patella in 63 patients (65 knees), most of whom had undergone a lateral retinacular release. We performed a direct repair or a reconstruction of the lateral patellotibial ligament using locally available tissue such as strips of iliotibial band or patellar tendon....
Article
Femoral neck fracture following surface replacement is a reported complication. Adjunct autogenous fibula strut bone grafting has been proposed as a means of reducing or eliminating this occurrence. This paper reports the long-term follow-up of two cases. One patient did well for 9 years prior to sustaining a traumatic femoral neck fracture while i...

Citations

... Among them, DICOM data and gray scale assignment is the most common one. The material process is completed in the FEA module of Mimics software [27]. In this finite element analysis of human spinal interbody fusion screw system, the gray value material assigning method was used to assign materials to open the model in Mimics software, and materials were attached in the FEA module. ...
... Previous reports on the use of IM lengthening nails often included small numbers of post-traumatic cases (5)(6)(7). Case series on post-traumatic lengthening are also limited (8)(9)(10)(11), with only 1 recent study reporting a larger series of patients (12). We report the results of, and complications associated with, IM lengthening with the Precice nail to treat posttraumatic lower-limb length discrepancy (LLD) in 34 adult patients. ...
... In addition, such common biomarkers have been routinely applied in assisted diagnosis of PJI [8]. However, recently, several investigations pointed out their limited values in diagnosis of FRI owing to their not-so-high sensitivities as well as specificities [6,[9][10][11]. All the abovementioned issues suggested that there still exist disputes regarding the utility of such inflammatory indicators for FRI diagnosis, and therefore, it is quite necessary that more investigations should be performed to solve the controversies, and moreover, potential novel inflammation cytokines should also be explored. ...
... Six studies out of 21 were focused on intra-operative periprosthetic tibia fractures, and one of these reported intraoperative fracture during revision TKA for prosthetic joint infections. 4 In addition, Vemulapalli et al. 5 reported on nonunion of PPFx of the lower extremity. Ten out of the total of 169 (5.91%) tibial fractures were managed conservatively. ...
... The conservative management is initially tried but if it is ineffective, Total Knee Replacement is the only option left. The diseases like osteoarthritis, rheumatoid arthritis are the major disease indications for joint replacement [11,12,13]. ...
... Patients with non-union suffer from tremendous secondary functional deficit and are frequently unable to participate in daily life, and substantially benefit from a structured therapeutic approach taking into account the occurrence of infection, impaired biology, and concurrent metabolic disorders [21]. An effective therapeutic approach is based on the application of growth factors, scaffolds, and mesenchymal stem cells (MSCs) into the fracture gap, while the mechanical environment is stabilized, designated as the "diamond concept". ...
... We found nine cases (22.5%) of these technical faults in our series. We also noted a clear male predominance (85%), like several series in the literature [12][13][14][15][16], and this peculiarity is thought to be due to male exposure [14][15][16], and skin opening can be correlated with the decrease in bone healing power as well as the initial bone loss which was observed in 57.5% of patients. On the clinical level, the main symptom is the pain associated or not with a functional impotence or an instability, and this pain is localized at the level of the fracture site, appearing with the mobility or the weight bearing [18]. ...
... High tibial osteotomy is one of the surgical methods for treating medial compartment knee osteoarthritis. Traditional HTO is divided into closing-wedge high tibial osteotomy (CWHTO) and open-wedge high tibial osteotomy (OWHTO), and both procedures can effectively correct the coronal weight-bearing line of the knee joint, transfer the lower limb alignment from the medial compartment of the knee joint to the lateral compartment, increase the stress area of the tibiofemoral joint, and reduce the pressure of the medial compartment to relieve medial compartment knee pain and help patients recover walking function [1][2][3][4][5][6][7][8][9][10][11][12][13]. The mechanical properties of a biostructure depend on its Young's modulus (E). ...
... Precedents were available to guide these surgeons. [15] 0/3 1/2/-Trauma ExFix 3: N/S 4 (113) 0.78 Dzhanelidze 1973 [16] 0/3 3/-/-Trauma ExFix 3: N/S 3.1 0.95 Popsuĭshapka 1978 [17] 0/1 1/-/-Trauma ExFix 1: No 6 (233) 0.8 Eldrige 1990 [18] 0/1 1/-/-Trauma ExFix 1: No 4.5 (64) N/S Latimer 1990 [19] 0/3 1/2/-Trauma ExFix 3: No 8 N/S Park 1996 [20] 0/ [28] 0/1 -/1/-Trauma ExFix 1: N/S 6 (62) 1 Schneider 2015 [29] 0/1 1/-/-Trauma ExFix 1: Consolidation 7.5 (155) 1.3 Lam 2016 [30] 0/1 1/-/-Trauma ExFix 1: Entirely 7 (114) 1.5 Paulsen 2016 [31] 1/0 1/-/-Trauma Nail Nail 14 (127) N/S Novikov 2017 [32] 1/0 1/-/-Trauma ExFix 1 No 7 (71) 0.7 Noguera 2018 [33] 0/2 1/1/-Congenital ExFix 2 No 3.8 2.2 Toon 2019 [34] 0/1 1/-/-Trauma ExFix 1 No 4.4 (72) 0.7 Hoellwarth 2020 [7] 9/0 -/-/9 N/S Nail Nail ...
... [6] size, and different IMN locking methods have been reported. [9,10] Plate over a retained IMN is considered an effective method in managing nonunions of the femoral diaphysis in recent years, since it strengthens the fracture site biomechanically without causing extra damage. [11][12][13] In the literature, to the best of our knowledge, no clinical study has compared the effectiveness and the results of exchange nailing against plate augmentation over a retained IMN in patients with a nonunion of the femoral shaft. ...