Journal of orthopaedic trauma
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Comparative Study Clinical Trial
Quality of life related to fracture displacement among elderly patients with femoral neck fractures treated with internal fixation.
To determine differences in outcome between undisplaced (Garden I and II) and displaced (Garden III and IV) femoral neck fractures in elderly patients treated with internal fixation. ⋯ There was a major difference in outcome on comparing undisplaced and displaced femoral neck fractures in elderly patients treated with internal fixation. The rate of fracture healing complications in patients with undisplaced fractures was low, and patients with healed fractures regained their prefracture quality of life level. The rate of fracture healing complications and reoperations in patients with displaced fractures was high, and even in patients with uneventfully healed fractures, there was a substantial decrease in the quality of life.
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Comparative Study
The relationship between admission hemoglobin level and outcome after hip fracture.
To determine the effect of admission hemoglobin level on patient outcome after hip fracture. ⋯ Patients at risk for poor outcomes after hip fracture can be identified by assessing hemoglobin levels at hospital admission.
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Comparative Study
Change over time of SF-36 functional outcomes for operatively treated unstable ankle fractures.
Ankle fractures are one of the most common operatively treated lower extremity fractures. Several studies indicate that patients often have residual effects after this injury. The purpose of this study is to use the SF-36 questionnaire at two times to assess patients' functional recovery and residual effects after operative stabilization of an unstable ankle fracture. ⋯ This study indicates that patients have significant improvement in functional outcome after release from orthopaedic follow-up but have a residual physical effect at twenty months after injury. These data are important to guide a patient's expectations after this injury and are also important in considering medicolegal and workers' compensation issues. Patients continue to have improvement in function after we have routinely released them from orthopaedic follow-up. Maximal medical improvement appears to be longer than four months from this injury.
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To determine the biomechanical consequences of cutting one centimeter off the tip of a tibial nail when treating distal tibia fractures with intramedullary nails. ⋯ Removal of one centimeter from the tip of a tibial nail allows placement of two distal interlocking screws in tibial fractures located four centimeters from the tibiotalar joint. The fixation strength achieved is comparable to that of standard intramedullary nailing of tibial fractures located five centimeters from the tibiotalar joint using two distal interlocking screws. Fixation strength with these distal fractures, however, is not strong enough to resist moderate compression-bending loads. Thus, patients with distal tibia fractures treated with intramedullary nailing must follow weight-bearing restrictions until significant fracture healing occurs to prevent coronal plane malalignment of the fracture.