Minimally Invasive Versus Open Distal Fibular Plating for AO/OTA 44-B Ankle Fractures.


Open reduction and internal fixation (ORIF), the standard treatment for unstable ankle fractures, has well-known wound complications. Minimally invasive surgery (MIS) has been proposed to decrease these complications. The objectives of this study were to describe an algorithm of MIS for fibular plating and compare the radiographic restoration of fibular anatomy, functional outcomes, and complications between ORIF and MIS for ankle fractures.


This retrospective study included 71 patients with AO/OTA 44-B ankle fractures treated by a single surgeon. ORIF group consisted of 34 patients (54.5-month follow-up) and MIS group was composed of 37 patients (55.9-month follow-up). Among 37 MIS patients, 13 patients were treated with minimally invasive percutaneous plate osteosynthesis and 24 patients with minimally invasive trans-fracture approach according to our MIS algorithm. Operative outcomes were evaluated and compared between the 2 groups by radiographic measurements, functional assessment, and complications.


The MIS group had less blood loss but longer operative time and greater exposure to fluoroscopy. Radiographic measurements revealed similar union time, fibular length, talocrural angle, medial clear space, and tibiofibular clear space in both groups. Lower visual analogue pain score was observed in the MIS group in the early postoperative period. At last follow-up, there were no significant differences regarding pain score, American Orthopaedic Foot & Ankle Society ankle-hindfoot score, and range of motion between the 2 groups. Total complication rate was significantly higher in the ORIF group.


Patients with AO/OTA 44-B fractures treated with MIS fibular plating achieved similar radiographic and functional outcomes but had less pain in the early postoperative period and fewer wound complications compared with those treated with ORIF.

Level Of Evidence

Level III, retrospective comparative study.

Even Low-Levels of Common Metal Linked to Weaker Bones

Reuters Health Information

By Lisa Rapaport

(Reuters Health) — Low levels of exposure to the metal cadmium may increase the risk of weaker bones and fractures in elderly men, a Swedish study suggests.

Cadmium is a naturally occurring metal used in batteries and found in cigarette smoke and exhaust from fossil fuels or waste incineration. As a result of crops grown in contaminated soil, many foods also contain cadmium.

Long-term exposure to high levels of the metal, typically through smoking or contaminated food, has been linked to certain cancers as well as osteoporosis, which disproportionately affects women. But little was known about the risks of low-level exposure or the effects on men, the researchers note.

«Previous studies have been conducted mainly in women or in populations with higher exposure to cadmium, but now we find that also low-level exposure in men has negative effects on the skeleton,» lead study author Dr. Maria Wallin, an environmental health researcher at Sahlgrenska University Hospital and the University of Gothenburg in Sweden, said by email.

For the current study, Wallin and colleagues followed more than 900 elderly men for an average of nine years.

At the start of the study, the men were 75 years old, on average, and they were typically a little bit overweight. More than half were former smokers and 8% currently smoked.

When men joined the study, between 2002 and 2004, researchers tested urine for cadmium exposure, reviewed X-rays and health registry data for bone health and fracture information, and also examined results from questionnaires on diet, smoking and exercise habits.

They sorted the men into four quartiles based on their level of cadmium exposure.

By the end of the study period in 2013, the men with the highest cadmium exposure were 30% more likely to have had fractures than those with the lowest exposure, and they were 40% more likely to have had fractures linked to osteoporosis.

For the subset of men who never smoked, the group with the highest cadmium exposure was 50% more likely to have had fractures than those in the lowest exposure group, and they were 90% more likely to have fractures linked to osteoporosis.

The results in nonsmokers are particularly striking because these men tend to have much lower overall cadmium exposure than their peers who are current or former smokers, the researchers note in their report in the Journal of Bone and Mineral Research, online November 17.

«The best way to reduce your exposure to cadmium is to stop smoking,» Wallin noted.

One limitation of the study is that fractures tied to osteoporosis are unusually high in Sweden, which may mean the findings aren’t as meaningful for people in other countries, the authors concede. It’s also possible that because the men in the study were quite old, the effect of cadmium might be different for younger men.

Cadmium is found naturally in the soil at very low concentrations, and certain agricultural practices can release more of the metal into the environment and lead to presence of the metal in the food supply, noted Dr. Anna Callan, a researcher at Edith Cowan University in Joondalup, Australia, who wasn’t involved in the study.

«Because cadmium is present in so many food types, there is no simple way to reduce dietary exposure,» Callan said by email. «The best advice is to follow a balanced and varied diet and to eat low-fat dairy foods as a source of calcium to help build strong bones.»


J Bone Miner Res 2015.


14 декабря 2015 года нас посетил профессор Индии, города   New Delhi FORTIS ESCORTS BONE & SPINE INSTITUTE, THE BONE CLINIC DR. NITIRAJ OBEROI. Визит профессора OBEROI был тепло принят со стороны сотрудников кафедры «Травматологии-ортопедии, ВПХ и нейрохирургии» медико-педагогического факультета Ташкентской Медицинской Академии и главного врача РКБ №1 Ибрагимова А.Ю.


Главный врач РКБ №1 открыл мероприятие свое приветственой речью и рассказал гостям историю клиники и её дальнейшее развитие. Профессор Асилова С.У. дала слово профессору OBEROI и он рассказал собравшимся про заболевания позвоночника, его последствия, остеопороз, эндопротезирование крупных суставов и мини инвазивные артроскопические методы лечения, а также свой опыт применения.


В 14.00 профессор DR. NITIRAJ OBEROI посетил Ташкентскую Медицинскую Академию. Гостя встретил проректор по научной части ТМА профессор Ш.А.Баймурадов и поблагодарил его за приезд. Обе стороны надеятся на сотрудничество между учебными заведениями по вопросам учебы и науки.


Профессор DR. NITIRAJ OBEROI прочитал открытые лекции на темы “Эндопротезирование тазобедренного и коленного суставов” и “Лечение миниинвазивным артроскопическим методом повреждения коленного сустава” студентам магистратуры и клиническим ординаторам. Студенты слушали лекции с интересом. Лекция прошла замечательно.


В заключении профессор С.У.Асилова поблагодарила участников и собравшихся и проявила надежду на сотрудничество по научным и практическим вопросам.

Участники лекции и сотрудники ТМА вернулись с теплыми воспоминаниями.

Визит профессора Университета Модена Италии Pier Giorgio Vasina и его коллектива

17 ноября 2015г состоялся визит профессора Pier Georgio Vassina из Медицинского Университета Модены, Италия. В первую очередь профессор Вассина посетил кафедру Травматологии-ортопедии, нейрохирургии и ВПХ Медико-педагогического факультета, где его тепло встретили коллектив кафедры во главе с заведующим к.м.н.Хужаназаровым И.Э.


Во время приветственной речи профессор Pier Georgio Vassina ознакомил студентов, коллектив кафедры и сотрудников клиники РКБ №1 с собственным опытом по эндопротезированию тазобедренных суставов, а также с преимуществами разработанной им техники малоинвазивного оперативного доступа к нему.


В 14ч00мин профессор Pier Georgio Vassina посетил Ташкентскую Медицинскую Академию. Тут его приветствовали проректор по научной работе профессор Боймурадовым Ш.А. В приветственной речи профессор Боймурадов Ш.А. выразил признательность и надежду на глубокое сотрудничество между двумя университетами в сфере науки и образования.


Профессор Pier Georgio Vassina прочитал открытую лекцию для студентов магистратуры на тему «Передний доступ в хирургии тазобедренных суставов». Студенты с интересом прослушали лекцию. Был задан ряд вопросов как со стороны студентов, так и со стороны профессорско-преподавательского состава относительно техники операции, и ее преимуществах, а также о собственном опыте профессора Vassina.


В заключительной речи профессор Боймурадов Ш.А. выразил глубокую признательность коллеге и еще раз подчеркнул о необходимости тесного сотрудничества и интеграции в мировое научное сообщество.


Делегаты и сотрудники Ташкентской Медицинской Академии расстались с чувством удовлетворения от проведенного дня.