Injury
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Pauwels classification, which categorizes types of femoral neck fractures, cannot fully reflect the three-dimensional characteristics of this injury. The purpose of our study was to determine the morphological characteristics of Pauwels III fractures through computed tomography image analysis and summarize the relevant biomechanical characteristics of different morphological fractures. ⋯ Biomechanical differences across the three subtypes of Pauwels III femoral neck fractures could increase our understanding of the biomechanical characteristics that underlie the Pauwels type III femoral neck fractures (such as, three-dimensional morphology and the stress distribution of bone and implant) that have been associated with high failure rates.
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The Internet is a resource that patients can use to learn about their injuries, treatment options, and surgeon. Previously, it was demonstrated that orthopaedic trauma patients are unlikely to use a reliable, provided source. It is unknown however, if patients are seeking information from elsewhere. The purpose of this study was to determine if orthopaedic trauma patients utilize the Internet and what websites are utilized. Our hypothesis was that the majority of patients use the Internet and when they do, are unlikely to use a reliable source. ⋯ Prognostic, Level II.
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Removal of screws from a titanium locking plate is often difficult once the screw has seized and the head is damaged. Such stripped screws are removed with an extraction screw, which can be used manually or on power. We aim to compare the extraction rates using both these methods. ⋯ We recommend manual extraction with a T handle, rather than a power tool when removing the stripped locking screws (p-value <0.001). We feel that the haptic feedback provided when using manual extraction allows the surgeon to engage the extraction screws onto the damaged heads, thereby improving the extraction rates.
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Although intraoperative imaging is important for assessing the quality of several steps during fracture fixation, most trainees and surgeons have received little formal education on this topic and report they learn "on the job" and "through practice". A planning committee of orthopedic trauma surgeons was established to design a curriculum using "backward planning" to identify patient problems, identify gaps in surgeons' knowledge and skills, and define competencies as a framework for education in order to optimize patient care. ⋯ Case-based, interactive seminars and courses addressing knowledge, skills, and attitudes to optimize the use of intraoperative imaging during the fixation of common fractures help address unmet educational needs for trainees and complements existing formal training.