The Experts below are selected from a list of 195 Experts worldwide ranked by ideXlab platform
Gregory A Zych - One of the best experts on this subject based on the ideXlab platform.
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tibial Fracture stability analysis of external Fracture Immobilization in anatomic specimens in casts and braces
Clinical Orthopaedics and Related Research, 1993Co-Authors: Joseph B Zagorski, Loren L Latta, Alan R Finnieston, Gregory A ZychAbstract:: Plaster casts, custom-fabricated Fracture braces, and prefabricated Fracture braces were compared in the laboratory for the stability they provided to closed, experimental, diaphyseal Fractures of the tibia and fibula on anatomic specimens. The stability was comparable for each type of device tested for the loading conditions of isolated compression, bending, and torsion. Length stability (overriding at the Fracture site) was poor, rotation was marginal (by clinical standards), and angulation was very good. Selective removal of portions of each cast and brace demonstrated that the classic patellar-tendon-bearing (PTB) extension proximally and below ankle extensions distally had insignificant effects on stability of these middle-third diaphyseal Fractures for the conditions tested. The soft-tissue compression provided by a snug, tapered "cylindrical" sleeve, which encompassed the soft tissues from the tibial tubercle to the flare of the distal tibia and fibula, provided the stabilizing effect for all of the devices tested.
A. Dzus - One of the best experts on this subject based on the ideXlab platform.
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A RANDOMIZED, CONTROLLED TRIAL OF ABOVE ELBOW VS BELOW ELBOW CASTS IN PEDIATRIC DISTAL THIRD FOREARM FractureS
2008Co-Authors: Eric Bohm, V. Bubbar, K. Yong-hing, A. DzusAbstract:We undertook a prospective, single blinded, randomized, controlled trial of one hundred children treated with either an above or below elbow cast for treatment of closed, distal third forearm Fractures requiring reduction. The re-manipulation rate in the below elbow group was 2% (95%CI: 0–11%) compared to 6% (95%CI: 2–15%) in the above elbow group, p=0.62. Above elbow casts do not appear to improve Fracture Immobilization nor reduce the requirement for re-manipulation in pediatric distal third forearm Fractures. Debate exists regarding the benefits of using below elbow casts instead of above elbow casts for maintaining reduction in pediatric distal third forearm Fractures. The literature indicates a loss of reduction rate of 14.6% of children treated in an above elbow cast and 2.5% in those treated with a below elbow cast. We undertook a prospective, single blinded, randomized, controlled trial of one hundred children treated with either an above or below elbow cast for treatment of closed, distal third forearm Fractures requiring reduction. Outcome measures included re-manipulation rate, Fracture displacement during cast wear, and cast complications. One hundred patients were suitably enrolled; fifty-four received an above elbow cast, forty-six received a below elbow cast. The two groups were similar in terms of age and gender. The above elbow group contained a higher proportion of both bone Fractures (41/54) than the below elbow group (27/46). There were no significant differences between the two cast groups in initial, post-reduction or cast-off Fracture angulation; nor any difference in the amount of Fracture displacement during cast wear. The number of cast complications was similar between the two groups. The re-manipulation rate in the below elbow group was 2% (95%CI: 0–11%) compared to 6% (95%CI: 2–15%) in the above elbow group, p=0.62. Above elbow casts do not appear to improve Fracture Immobilization nor reduce the requirement for re-manipulation in pediatric distal third forearm Fractures. Funding Hip Hip Hooray, Saskatoon
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above and below the elbow plaster casts for distal forearm Fractures in children a randomized controlled trial
Journal of Bone and Joint Surgery American Volume, 2006Co-Authors: Eric Bohm, V. Bubbar, Ken Yong Hing, A. DzusAbstract:Background: Closed Fractures of the distal third of the forearm are the most common Fractures of childhood, but the method of Immobilization after closed reduction is controversial. This study was undertaken to determine whether below-the-elbow casts are as effective as above-the-elbow casts in immobilizing these types of Fractures and to identify patient and treatment considerations that are related to loss of reduction. Methods: We designed a blinded, randomized, controlled trial. The criteria for reduction and remanipulation were set a priori. The primary outcome measure was Fracture Immobilization as reflected by reangulation in the cast and by the need for remanipulation. Exploratory analysis with use of stepwise logistic regression analysis was undertaken to search for factors predictive of loss of reduction. Results: A total of 102 children were enrolled in the study and were allocated to two groups: the above-the-elbow cast group (fifty-six children) and the below-the-elbow cast group (forty-six children). The mean age was 8.6 years, and sixty-one patients were boys. The groups did not differ with respect to the initial Fracture angulation, postreduction angulation, reangulation during cast Immobilization, and angulation of the Fracture at the time of cast removal. In the above-the-elbow cast group, twenty-three (42%) of fifty-five children with adequate radiographs met the criteria for remanipulation compared with fourteen (31%) of forty-five children with adequate radiographs in the below-the-elbow cast group (p = 0.27); only four of these thirty-seven children actually underwent remanipulation. Children with Fractures of both the radius and ulna (p = 0.01) and those with residual angulation after reduction (p = 0.0001) were at the highest risk of meeting the criteria for remanipulation. The rates of complications related to the cast did not differ between the groups. Conclusions: Below-the-elbow casts perform as well as above-the-elbow casts in maintaining reduction of Fractures in the distal third of the forearm in children, and the complication rates are similar. Factors that are associated with a higher risk of loss of reduction include combined radial and ulnar Fractures and residual angulation of the Fracture after the initial reduction. Level of Evidence: Therapeutic Level I. See Instructions to Authors for a complete description of levels of evidence.
Jaime Chisholm - One of the best experts on this subject based on the ideXlab platform.
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prospective study of military special operations medical personnel and lower extremity Fracture Immobilization in an austere environment
Foot & Ankle Orthopaedics, 2020Co-Authors: Ltc Kevin D Martin, Lt Trevor J Mcbride, Cpt Alicia Unangst, Jaime ChisholmAbstract:Background:Austere Fracture Immobilization equipment and techniques are often overlooked, with few studies critically evaluating the process. The purpose of this study was to evaluate current auste...
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Fracture Immobilization in an austere environment a comparative study of military special operations medical personnel using a sam splint vs a one step spray on foam
Foot & Ankle Orthopaedics, 2019Co-Authors: Kevin D Martin, Alicia Unangst, Jaime ChisholmAbstract:Category:TraumaIntroduction/Purpose:Improved body-armor and mine resistant vehicles have improved battlefield survivability, but now nearly 50% of casualties have a musculoskeletal extremity injury...
Salviano Tramontin Belettini - One of the best experts on this subject based on the ideXlab platform.
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Immobilization with modified thomas splint and synthetic casting for long bone Fracture correction in large animals
Acta Scientiae Veterinariae, 2015Co-Authors: C. F. Orlandini, Denis Steiner, W Del C Martins, Gabriel Coelho Gimenes, Andre Giarola Boscarato, Luiz Romulo Alberton, Salviano Tramontin BelettiniAbstract:Background: Several techniques have been used for the treatment of Fractures in large animals, once these animals are frequently subject to trauma that interrupts bone continuity, especially in long bones. The choice for the technique depends on the configuration of the Fracture, damage to the adjacent tissue, and presence or absence of bone exposure. The success of the modified Thomas splint, associated to synthetic casting has been reported in several studies. However, there still are restrictions to the use of this technique. Thus, the objective of the present study is to report the use of Immobilization by the modified Thomas splint, coupled with synthetic casting, for the treatment of Fractures in long bones of bovine and equine animals. Cases: The five animals were treated at the Veterinary Hospital of the Universidade Paranaense, being four bovines and one equine, all presenting Fractures in long bones, resulting from accidental trauma. The equine, weighting 300 kg, presented Fracture in the third metacarpal bone, previously submitted to Immobilization through external fixation type II. Three bovines, weighting 50, 200, and 500 kg, presented Fractures in the metacarpals, with the smallest presenting exposed Fracture, another bovine, weighting 300 kg, presented Fractures in the radius and ulna. The animals were examined and submitted to sedation and anesthesia for manual reduction of the Fracture and Immobilization. For such, the animals were placed in lateral decubitus, and the hurt member was covered in tubular mesh and bandage for synthetic casting. Afterwards it was placed a steel frame molded according to the limb anatomy, from the hoof to the elbow of the animal, in a way which the frame itself prevented the animal to touch the ground. In one of the bovines it was necessary to extend the steel frame above the olecranon due to Fracture extensiveness. Radiographies for assessment of the technique were produced every 15 days after the procedure, and have shown complete realignment and bone reconstruction sufficient for splint removal after a period that varied from 45 to 75 days. Discussion: Immobilization was easily performed in all cases reported, being a procedure applicable in field situations. The use of synthetic casting for the Fracture Immobilization in equines and bovines, coupled with several other techniques for internal or external fixation, provides light weight, resistance and water resistance to the system. In this study it was observed in all cases the adequate stability in the Fracture line, support and unimpeded locomotion, as well as perfect consolidation of the Fractures in animals of a broad spectrum of body weights. No claudication was observed, with exception for case 1, which, due to the size of the bone callus, a very mild claudication persisted. In this case the animal could not be used for sports anymore, but was kept for breeding. Case 4, despite the severeness and height of the Fracture, had complete recovery, and could return to sportive activities, being a rodeo bull. All the other animals had normal zootechnical performance and were kept in their respective herds. These results were accomplished without the common complications related to the use of plates, screws, and pins, that cause migrations, osteolysis, and osteitis. The use of modified Thomas splint coupled with synthetic casting presents itself as an effective technique for the Immobilization of long bone Fractures in large animals, promoting an easily applicable and low cost treatment.
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imobilizacao com muleta de thomas modificada e gesso sintetico para reparacao de fraturas de ossos longos em grandes animais Immobilization with modified thomas splint and synthetic casting for long bone Fracture correction in large animals
2015Co-Authors: C. F. Orlandini, Denis Steiner, Gabriel Coelho Gimenes, William Del Conte Martins, Andre Giarola Boscarato, Luiz Romulo Alberton, Salviano Tramontin BelettiniAbstract:Background: Several techniques have been used for the treatment of Fractures in large animals, once these animals are frequently subject to trauma that interrupts bone continuity, especially in long bones. The choice for the technique depends on the configuration of the Fracture, damage to the adjacent tissue, and presence or absence of bone exposure. The success of the modified Thomas splint, associated to synthetic casting has been reported in several studies. However, there still are restrictions to the use of this technique. Thus, the objective of the present study is to report the use of Immobilization by the modified Thomas splint, coupled with synthetic casting, for the treatment of Fractures in long bones of bovine and equine animals. Cases: The five animals were treated at the Veterinary Hospital of the Universidade Paranaense, being four bovines and one equine, all presenting Fractures in long bones, resulting from accidental trauma. The equine, weighting 300 kg, presented Fracture in the third metacarpal bone, previously submitted to Immobilization through external fixation type II. Three bovines, weighting 50, 200, and 500 kg, presented Fractures in the metacarpals, with the smallest presenting exposed Fracture, another bovine, weighting 300 kg, presented Fractures in the radius and ulna. The animals were examined and submitted to sedation and anesthesia for manual reduction of the Fracture and Immobilization. For such, the animals were placed in lateral decubitus, and the hurt member was covered in tubular mesh and bandage for synthetic casting. Afterwards it was placed a steel frame molded according to the limb anatomy, from the hoof to the elbow of the animal, in a way which the frame itself prevented the animal to touch the ground. In one of the bovines it was necessary to extend the steel frame above the olecranon due to Fracture extensiveness. Radiographies for assessment of the technique were produced every 15 days after the procedure, and have shown complete realignment and bone reconstruction sufficient for splint removal after a period that varied from 45 to 75 days. Discussion: Immobilization was easily performed in all cases reported, being a procedure applicable in field situations. The use of synthetic casting for the Fracture Immobilization in equines and bovines, coupled with several other techniques for internal or external fixation, provides light weight, resistance and water resistance to the system. In this study it was observed in all cases the adequate stability in the Fracture line, support and unimpeded locomotion, as well as perfect consolidation of the Fractures in animals of a broad spectrum of body weights. No claudication was observed, with exception for case 1, which, due to the size of the bone callus, a very mild claudication persisted. In this case the animal could not be used for sports anymore, but was kept for breeding. Case 4, despite the severeness and height of the Fracture, had complete recovery, and could return to sportive activities, being a rodeo bull. All the other animals had normal zootechnical performance and were kept in their respective herds. These results were accomplished without the common complications related to the use of plates, screws, and pins, that cause migrations, osteolysis, and osteitis. The use of modified Thomas splint coupled with synthetic casting presents itself as an effective technique for the Immobilization of long bone Fractures in large animals, promoting an easily applicable and low cost treatment.
Joseph B Zagorski - One of the best experts on this subject based on the ideXlab platform.
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tibial Fracture stability analysis of external Fracture Immobilization in anatomic specimens in casts and braces
Clinical Orthopaedics and Related Research, 1993Co-Authors: Joseph B Zagorski, Loren L Latta, Alan R Finnieston, Gregory A ZychAbstract:: Plaster casts, custom-fabricated Fracture braces, and prefabricated Fracture braces were compared in the laboratory for the stability they provided to closed, experimental, diaphyseal Fractures of the tibia and fibula on anatomic specimens. The stability was comparable for each type of device tested for the loading conditions of isolated compression, bending, and torsion. Length stability (overriding at the Fracture site) was poor, rotation was marginal (by clinical standards), and angulation was very good. Selective removal of portions of each cast and brace demonstrated that the classic patellar-tendon-bearing (PTB) extension proximally and below ankle extensions distally had insignificant effects on stability of these middle-third diaphyseal Fractures for the conditions tested. The soft-tissue compression provided by a snug, tapered "cylindrical" sleeve, which encompassed the soft tissues from the tibial tubercle to the flare of the distal tibia and fibula, provided the stabilizing effect for all of the devices tested.
