Injury
-
Randomized Controlled Trial
Biomechanical analysis of "Barrel hoop plate" technique for the posterolateral fragments of tibial plateau fractures with different displacement tendency.
The purpose of our study is to evaluate the three-dimensional biomechanical properties of "Barrel Hoop plate" in two kinds of artificial posterolateral tibial plateau fracture fragment (PLF) by using of synthetic models, each of which has an initial amplifying displacement tendency. ⋯ The results demonstrated that the 2.7 mm "Barrel Hoop plate" had a greater capacity of anti-three-dimension axes displacement of PLF. The 3.5 mm Anterolateral plate had the advantage in anti-lateral displacement and anti-inferior displacement but was weak at anti-posterior displacement of PLF. The 2.7 mm Posterolateral plate was stronger in anti-posterior, however, weak in anti-inferior displacement capacity.
-
Several randomized studies have compared arthroplasty and internal fixation (IF) and found better patient reported outcome measure (PROM) and fewer reoperations for arthroplasty. But consensus is lacking regarding which method to use in the "young elderly" patients aged 60-69; IF tend to fail in up to 1/3 of the cases but can offer the benefits of a biologically intact hip if successful. To add to this, revision of failed IF with secondary arthroplasty has increased risk for complications. This register study aims to describe current treatment and mortality rates for displaced hip fractures based on register data, with focus on young elderly. A secondary aim is to compare changes in PROM between treatments. ⋯ In young elderly patients THA is a common treatment for displaced FNF in Sweden. Patients in this segment treated with HA differ from patients treated with THA and IF, with baseline results in PROM indicating poorer health and function, as well as higher mortality and lower response rates. We found no differences in crude mortality between IF and THA treatment, and no significant influence from treatment on PROM outcome comparing THA and IF.
-
Intertrochanteric fractures are common fragility fractures in elderly patients. The importance of a reliable classification system for these fractures has been increasingly recognized. The aim of this study was to test the hypothesis that three-dimensional classification by CT has better intra- and inter-observer reliability than conventional two-dimensional classification. ⋯ The findings of this study confirm that the fragment-based classification system has high reliability. Surgeons should be aware that the three-dimensional fragment-based CT system for classification of intertrochanteric fractures has better intra-observer and inter-observer reliability than the conventional two-dimensional systems.
-
The addition of 3D CT scans for observers evaluating tibial plateau fractures decreases agreement and diagnostic accuracy, possibly due to obstruction of the view by unfractured bones (i.e., patella, fibula, and femur) in 3D reconstructions. ⋯ Diagnostic, level 1.
-
Lateral humeral condyle fracture is one of the most common fractures in children. However, the prediction of the stability of the fracture with a cutoff displacement of 2 mm remains controversial. The aim of this study was to evaluate the reliability of the routine cutoff displacement of 2 mm in predicting the stability of paediatric lateral humeral condyle fractures. ⋯ The routine cutoff displacement of 2 mm may not reliably reflect the stability of paediatric lateral humeral condyle fractures. The cutoff value is sensitive but not specific for predicting whether the cartilage hinge is intact.