Journal of orthopaedic trauma
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Comparative Study Clinical Trial Controlled Clinical Trial
Treatment of type II, IIIA, and IIIB open fractures of the tibial shaft: a prospective comparison of unreamed interlocking intramedullary nails and half-pin external fixators.
To compare unreamed intramedullary nailing (IMN) with external fixation (EF) in patients with Type II, IIIA, and IIIB open fractures of the tibial shaft. ⋯ Results suggest that unreamed interlocking intramedullary nails are more efficacious than half-pin external fixators, in particular with regard to maintenance of limb alignment. However, the severity of soft tissue injury rather than the choice of implant appears to be the predominant factor influencing rapidity of bone healing and rate of injury site infection.
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The aim of this study was to determine (a) whether delay in femur fracture stabilization beyond twenty-four hours in patients with head injury increased the risk of pulmonary complications and (b) whether immediate (up to twenty-four hours) femur fracture stabilization increased the risk of central nervous system (CNS) complications. ⋯ Delay in stabilization of femur fracture in head-injured patients appears to increase the risk of pulmonary complications. However, due to selection bias in this patient sample, this question cannot be definitively answered. Early fracture stabilization did not increase the prevalence of CNS complications.
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A technique for percutaneous placement of cannulated screws in the acetabulum is presented. Surgical technique is described, and fluoroscopic imaging techniques used to guide screw placement are also illustrated. The technique was used to limit soft tissue dissection in three patients. Results and examples are presented.
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Comparative Study
Fracture site motion with Ilizarov and "hybrid" external fixation.
To evaluate differences in fracture site motion by using different external fixators. ⋯ In a completely unstable fracture with poor bone apposition, the mechanical behavior of a four-ring Ilizarov external fixator is superior to the mechanical behavior of a unilateral "hybrid" frame.