Journal of orthopaedic trauma
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Fractures of the medial third of the clavicle are the rarest of all clavicle fractures. We present two cases of medial clavicle fracture nonunions that were initially thought to be chronic anterior sternoclavicular dislocations and describe the entity of pseudo-dislocation of the sternoclavicular joint. Computed tomography should be performed on all patients with suspected or established injuries of the sternoclavicular region to ensure differentiation between fracture and dislocation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Segment transport employing intramedullary devices in tibial bone defects following trauma and infection.
To compare two different methods of segment transport in posttraumatic and postseptic tibial defects by employing intramedullary tibial nails as the fixation system and to evaluate differences in the complication rate between external fixation and wire towropes as the transport system. ⋯ An intramedullary nail and wire towrope proves to be a reliable combination for segment transport in tibial defects following trauma and infection and provides a relatively high patient comfort rate and a low complication rate.
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To determine the effect of nutrition on patient outcome after hip fracture. ⋯ Patients at risk for poor outcomes after hip fracture can be identified using relatively inexpensive laboratory tests such as albumin and total lymphocyte count.
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Comparative Study
Schuhli augmentation of plate and screw fixation for humeral shaft fractures: a laboratory study.
Schuhli locking nuts provide a mechanism to lock 4.5-millimeter bone screws to a standard dynamic compression plate (DCP plate). It has been proposed that Schuhlis can provide increased fixation stability in areas of a proximal cortical defect or osteopenic bone and may keep screws from loosening and backing out from the plate. A biomechanical study was performed to investigate the effect of Schuhli augmentation of a ten-hole broad DCP plate for fixation of a simulated humeral shaft fracture versus standard DCP plate fixation. ⋯ In this model of humeral shaft fractures in the elderly, the addition of Schuhlis did not significantly change the mechanical stability of plate and screw fixation. However, load and angular deformation at failure were significantly greater in the Schuhli augmented specimens.
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Comparative Study
Anatomical variations of the lateral femoral cutaneous nerve and the consequences for surgery.
This two-part study was undertaken to (a) determine the course and variations of the lateral femoral cutaneous nerve in a cadaver study and (b) develop prospectively the preoperative protocol to diminish the possibility of a postoperative meralgia paresthetica; the latter was achieved by reviewing the patient series retrospectively for complaints of a lateral femoral cutaneous nerve (LFCN) lesion and by studying the relation of the course of the LFCN and meralgia paresthetica. ⋯ The practical importance of the present study lies in alerting the surgeon to a possible anatomical variation of the LFCN in about 25 percent of the patient population. It also confirms that the new perioperative protocol lowers the incidence of meralgia paresthetica.