Journal of orthopaedic trauma
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To evaluate the efficiency of a solid femoral nail and interlocking spiral-blade, inserted without reaming (UFN/ spiral blade, Synthes-Stratec, Oberdorf, Switzerland), for the fixation of pathologic and impending pathologic fractures of the proximal femur, particularly those involving the subtrochanteric area. ⋯ Femoral nail insertion without reaming using an interlocking spiral blade provides appropriate stabilization of the proximal femur in case of metastatic lesions, even with extensive subtrochanteric involvement. Although the nails were inserted without reaming, this did not avoid the risk of fat embolization syndrome. This study only addressed results in patients with short-term survival.
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Evaluate the treatment of C3 distal femur fractures with limited internal fixation and tensioned wire circular external fixation. ⋯ C3 fractures of the distal femur are associated with severe soft tissue injuries and bone loss. Loss of function appears to be directly related to these factors. Treatment with limited internal fixation and tensioned wire external fixation has equivalent results to other methods but has a higher incidence of infection and complications. Joint motion is retarded by binding of the soft tissues with fixation wires and pins. The technique is recommended only for salvage of severely comminuted and open fractures of the distal femur with extensive soft tissue injury. Distal femur fractures with moderate comminution and soft tissue injury should be treated with alternate methods.
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Comparative Study
Evaluation of a new method of small fragment fixation in a medial malleolus fracture model.
To evaluate a new method of small fragment fixation in a medial malleolus fracture model. ⋯ Threaded K-wires show substantial pullout strength and similar resistance to offset axial load when compared with partially threaded cancellous screws. These threaded K-wires offer an alternative for the internal fixation of medial malleolus fractures.
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The purpose of this study was to evaluate the mechanical effects of using an injectable calcium phosphate cement, Norian Skeletal Replacement System (SRS), which is replaced by the native remodeling process, to augment sliding hip screw fixation of unstable intertrochanteric fractures in a cadaver model. ⋯ SRS augmentation of unstable, intertrochanteric fractures significantly improved overall stability, facilitated load transfer across the fracture, and decreased both shortening of the proximal femur and stress on the sliding hip screw.
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This study was undertaken to collect information about the organization of orthopaedic trauma services in different types of hospitals, with particular emphasis on hospital support arrangements in different practice situations. ⋯ There are differences in organization of orthopaedic trauma care between hospitals, which may be related to hospital size, academic affiliation, and orthopaedic department organization. Further study is necessary to determine whether organizational differences translate into differences in patient outcome after trauma.