Injury
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Lower patient satisfaction and high rates of plate prominence has led to the use of lower profile, smaller plates in the treatment of midshaft clavicle fractures. Specifically regarding the use of 2.7mm reconstruction plates, there lacks biomechanical comparison to its more robust 3.5mm counterpart. This study was designed to compare the mechanical properties of anteroinferior plate fixation on a clavicle fracture model using either 2.7mm or 3.5mm reconstruction plates. ⋯ While our results show clear mechanical superiority of 3.5-mm reconstruction plates over 2.7-mm plates, superior results in the clinical setting may not necessarily translate. With exceptional mechanical strength also noted for the 2.7mm plate, well above the biomechanical properties of an intact clavicle, these results may obviate the need for robust plates in general.
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The purpose of this study was to assess the medium-term results of reconstruction of the extensor mechanism using the medial gastrocnemius while also providing soft tissue coverage. ⋯ For severe traumatic knee injuries with the combination of soft tissue defects and disruption of the extensor mechanism, the medial gastrocnemius flap provides an excellent reconstructive option to address both problems simultaneously. The results of this small case series support the use of this limb salvage technique.
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Both plate and intramedullary nail fixations, including straight and anatomic nails, have been clinically adopted for the treatment of displaced mid-shaft clavicle fractures. However, the biomechanical performances of these fixations and implants have not been well evaluated. This study aims to compare the construct stability, stress distribution and fracture micro-motion of three fixations based on finite element (FE) method. ⋯ The plate fixation significantly stabilizes the fracture gap, reduces the implant stress, and serves as the recommended fixation for the mid-shaft clavicle fracture. The CRx is an alternative device to treat clavicle shaft fracture, but the shoulder excessive activities should be avoided after operation.
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Randomized Controlled Trial Comparative Study
Comparison of clinical and radiologic outcomes between non-operative and operative treatment in 5th metatarsal base fractures (Zone 1).
The treatment of Zone 1 fractures of the 5th metatarsal base with >2mm of displacement remains controversial. We prospectively analyzed 29 patients with 5th metatarsal base fractures (Zone 1) during 2009-2014. Radiography was performed to assess the degree of fracture gap and metatarsal length. ⋯ Visual analog scale (VAS) score and American orthopedic foot and ankle society (AOFAS) score were obtained at the initial consult and at the last follow-up after treatment; change of the 5th metatarsal length was also measured at the initial consult and after complete bony union. Our study demonstrated that radiographic union of all cases was observed with a significant decrease in VAS and AOFAS scores, regardless of the initial fracture gap and type of management. Additionally, there was no difference seen in final VAS scores for patients with longer metatarsals when compared to those in whom the metatarsals were unchanged or shortened.