Journal of orthopaedic trauma
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Breakage of an interlocking screw is a known complication in tibial fractures treated by intramedullary nailing. This happens most often in delayed union or nonunion because of the lack of progressive load transference from the nail to the healing bone. To treat this problem, the nail and screws need to be removed. This article describes a simple technique for the removal of broken interlocking screws.
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To describe the epidemiology, early results of treatment, and complications associated with open fractures of the forearm in children. ⋯ Open fractures of the forearm in children, treated with prompt administration of parenteral antibiotics followed by debridement, were associated with a fairly low incidence of complications. Although we found that the use of some form of internal fixation tended to reduce both the need to remanipulate these fractures (p = 0.08), and to minimize the incidence of angular deformity greater than 10 degrees (p = 0.16), these findings did not reach statistical significance.
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Comparative Study
Mechanical comparison of endosteal substitution and lateral plate fixation in supracondylar fractures of the femur.
To assess for improved rigidity with the addition of a medial endosteal plate to laterally plated supracondylar femoral fractures. ⋯ The addition of a 4.5-millimeter endosteal plate to a lateral buttress plate provides significantly increased stability, as compared with lateral plating alone in a femoral supracondylar fracture model during simulated axial and torsional loading. Neither fixation construct, however, restored the torsional stability of the distal femur to its preinjury (intact) level.
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To evaluate the use of lag screw only fixation of noncomminuted oblique fractures of the lateral malleolus in patients younger than fifty years of age. ⋯ Lag screw only fixation is a useful and successful method for appropriately selected lateral malleolar fractures.
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To determine factors associated with angular malalignment of femoral shaft fractures treated with intramedullary nails and to determine differences in the incidence of angular malalignment based on fracture location, fracture comminution, and method of treatment (i.e., antegrade or retrograde). ⋯ Patients with fractures of the proximal third of the femoral shaft treated with intramedullary nails are at highest risk for malalignment. Proximal fracture location, distal fracture location, and unstable fracture pattern are associated with increasing fracture angulation.