Injury
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Determining deltoid ligament incompetence in supination external rotation (SER) injuries commonly relies on stress radiography, given several studies demonstrating low predictive value of physical examination. Stress radiography can be difficult to obtain and may result in suboptimal radiographs with equivocal determination of stability. This study revisits the concept of medial ankle tenderness and its association with mortise instability. ⋯ Diagnostic study, Level II-1 (development of diagnostic criteria on basis of consecutive patients [with universally applied reference "gold" standard]).
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Approximately 2000 trochanteric fractures are operated in Finland annually. These fractures make a major burden to health care system and affected individuals. The role of routine follow-up has been questioned in multiple fracture types. ⋯ Routine follow-up visits are a burden both to the patients and health care system, with less than 1% leading to changes in treatment. Our suggestion is to give good instructions to patients and rehabilitation facilities instead of routine follow-up.
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Multiple small relaxing skin incisions oriented parallel to the longitudinal axis (so-called "pie-crusting") near traumatic lacerations or surgical incisions in edematous tissue beds have been utilized to achieve primary closure when edema or skin loss would otherwise have made this difficult. Our study hopes to demonstrate (1) biomechanical evidence that pie-crusting decreases wound closure tension and (2) provide a case series with data showing clinical results. ⋯ Pie-crusting may allow for easier wound closure and decrease the need for skin-grafting in edematous extremity wounds, with minimal patient morbidity.
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To investigate the incidence and pattern of injury in patients with a diagnosis of a fall from a stairlift. ⋯ Falls from stairlifts commonly result in limb injuries and most severe injuries are sustained to the head. When patients fall getting off from astairlift, have injuries to their head or thorax they have a higher ISS. The overall mortality is 15.7%. Given the increasing use of stairlifts in our ageing population, strategies should be considered to make these safer.
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Currently available dorsal locking plates for the treatment of distal radius fractures are far less then volar locking plates, and there is limited evidence about biomechanical strength of dorsal plates. The aim of this study is to develop a novel hybrid dorsal double plating, which enhance biomechanical strength in the articular fixation region and achieve the minimally invasive surgical technique requirement of distal radius fracture treatment by combining weighted topology optimization and finite element (FE) analysis METHODS: A dorsal template bone plate design (based on dorsal double plating (DDP)) was constructed to perform weighted topology optimization and FE analysis under six fracture models with 50%, 30%, and 20% weighting of the joint subjected to axial, bending, and torsion moments, respectively. A novel hybrid dorsal double plating (HDDP) was generated using the union of six single dorsal plates to subtract the intersection of the original template dorsal model. A 100 N axial load with 1 Nm bending and torsion moments were applied at the end of the distal radius onto six fracture FE models to investigate the biomechanical differences between the DDP and HDDP approaches. ⋯ It is concluded that the novel HDDP demonstrated better resistance to functional loads, provided sufficient screw fixation at the articular surface, and can be placed on the dorsal site of the distal radius through the standard dorsal approach to minimize invasive surgeries and eliminate tendon irritations.