Injury
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There is a clear lack of consensus on a validated definition of the term "polytrauma". This study presents and classifies the extent of injuries during wartime in Croatia using the Revised Trauma Score and Injury Severity Score (TRISS) and compares the scores with a clinical estimation based on subjective assessments of polytraumatised and non-polytraumatised patients. ⋯ The data show that clinical and subjective assessment of polytraumatised patients can be useful in the management of such cases and can be tested retrospectively using TRISS methodology.
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The objective of the study was to evaluate the effectiveness of the treatment of massive tibial bone defects by ipsilateral fibula transport. ⋯ Our study suggested that ipsilateral fibula transport in the treatment of massive tibial bone defects acquired satisfying functional results. It may be a better choice for the patients without suitable proximal or distal tibia remnant to transport.
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The aim of this study was to compare the efficiency of non-operative and surgical procedures in the treatment of ruptured Achilles tendon in athletes (professional and amateur). ⋯ The percutaneous method was easier technically than the open method. Time spent in hospital was 14.5 times shorter with the percutaneous procedure compared with the open procedure (percutaneous procedure: range 0.5-2 days, mean 0.79±0.36; open procedure: range 10-24 days, mean 11.46±2.70; p<0.00). Return to sport activities was twice as fast with the percutaneous procedure compared with the open procedure. There were no postoperative infections or reruptured Achilles tendon in the group treated with the percutaneous procedure. One patient in the group treated with the open procedure had postoperative infection (4.2%). In the non-surgical (conservatively treated) group, there were three reruptures of the Achilles tendon within one year, and one patient developed adhesions that resulted in loss of function and had to undergo an operation. The percutaneous method is the best method of surgical treatment for Achilles tendon rupture.
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Comparative Study
Nail-medullary canal ratio affects mechanical axis deviation during femoral lengthening with an intramedullary distractor.
Callus distraction of the femur using an intramedullary distractor has several advantages over the use of external fixators. However, difficulty in controlling the mechanical axis during lengthening may cause deformities and knee osteoarthritis. Purpose of the study is to answer the following questions: (1) is lengthening with an intramedullary device associated with a medial or lateral shift of the mechanical axis? (2) Which factors are associated with varisation/valgisation of the mechanical axis during lengthening? ⋯ Level IV, therapeutic study. See Instructions for Authors for a complete description of levels of evidence.
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The role of simulation in orthopaedic surgical training is becoming increasingly evident, as simulation allows repeated sustained practice in an environment that does not harm the patient. Previous studies have shown that the cognitive aspects of surgery are of equal if not greater importance in developing decision making than the practical aspects. ⋯ IFN on the Touch Surgery app demonstrated construct, face and content validity. Users can demonstrate cognitive competencies prior to performing surgical procedures in the operating room. The application is an effective adjunct to traditional learning methods and has potential for curricular implementation.