Injury
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Recent literature suggests that fixation of trochanteric hip fractures with intramedullary nailing carries a higher 30-day mortality than with sliding hip screw. The present study aims to verify whether this statement is reflected in our practice. ⋯ Previous studies may have deterred surgeons from choosing an intramedullary device. However, we hope this study assists surgeons to make an informed decision on the choice of implant particularly when an intramedullary device is required to provide a more stable construct.
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Subchondral insufficiency fractures (SIF) and advanced osteoarthritis (OA) of the knee are usually seen in conjunction with bone marrow lesions (BMLs) and their differentiation may pose a significant diagnostic challenge. We aimed to develop a convolutional neural network (CNN) ensemble which could successfully differentiate between these two entities. ⋯ A CNN ensemble was highly accurate in differentiating between SIF and OA, achieving a higher or equal performance to MSK radiologists.
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The ankle syndesmosis is frequently disrupted in ankle injuries, with higher incidence in concomitant ankle fractures. There is debate regarding the most appropriate surgical management of these injuries, with the development of suture-button devices challenging the conventional approach of surgical stabilisation with syndesmotic screws. The primary aim of this study was to assess current practice variation at a national level, enabling a comparison with reported practice around the world. The secondary aims were to assess practice variation between operative indications and inconsistencies between surgeon device usage and personal preference should they be injured themselves. ⋯ Significant variability remains in the management of syndesmosis injuries. This survey of Australian orthopaedic surgeons reveals higher suture-button device use when compared to other countries.
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The incidence of ankle fractures is increasing and the clinical outcome is highly variable. ⋯ PROSPERO registration number CRD42020184830.
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Three-dimensional imaging has changed the understanding and management of tibial plateau fractures. In the 1970s, Schatzker proposed a classification for tibial plateau fractures, which highlighted the morphology of the six principal types. ⋯ The extended classification introduced the split wedge fragment and the continuity of the rim as the determinants of joint stability and the critical role that this plays in the management of tibial plateau fractures. The current manuscript re-emphasizes contemporary concepts of tibial plateau stability and depicts key issues which must be considered when planning the definitive surgical fixation of tibial plateau fractures.