Journal of orthopaedic trauma
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The classic ilioinguinal approach has become well established in the treatment of acetabular fractures. However, in certain cases with extensive low anterior column or anterior wall fractures less than optimal exposure may be obtained. ⋯ In addition, the risk of iatrogenic lateral femoral cutaneous nerve damage is diminished. In this article the technique of this modification is described and illustrated.
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Clinical Trial
Surgical dislocation of the femoral head for joint debridement and accurate reduction of fractures of the acetabulum.
To evaluate fracture reduction, femoral head viability, and outcome of selected acetabular fractures treated operatively using a modified Kocher-Langenbeck approach with a trochanteric flip osteotomy and surgical dislocation of the femoral head. ⋯ This study indicates that this technique for surgical dislocation of the femoral head is safe and facilitates assessment of fracture reduction in selected acetabular fractures.
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The purpose of this study is to identify and characterize the nature of internal knee derangement associated with ipsilateral femur fractures. ⋯ Given the large number of soft tissue injuries about the knee, it would be prudent to emphasize the importance of a thorough intraoperative examination once the femur fracture has been stabilized. Additionally, there should be a low threshold to obtain an MRI if the postoperative clinical examination suggests an associated knee injury. Bone bruises, which can only be identified by MRI studies, are increasingly being acknowledged as a source of persistent symptoms.
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To determine if age, fracture pattern, systolic blood pressure on arrival, base deficit, or the Revised Trauma Score is predictive of mortality, transfusion requirements, use of pelvic arteriography, later complications, or injuries associated with the pelvic ring disruption. ⋯ Shock on arrival and the Revised Trauma Score are useful predictors of mortality and transfusion requirements, Injury Severity Score, and Abbreviated Injury Scores for the head and neck, face, chest, abdomen, and extremities. In addition, the Revised Trauma Score predicts the use of pelvic arteriography and later complications. Age predicted transfusion requirement, Injury Severity Score, the chest and skin Abbreviated Injury Scores, use of arteriography, and death.
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The assessment of fracture healing is both a clinically relevant and frequently used outcome measure following lower extremity trauma. However, it remains uncertain whether there is a consensus in the assessment of fracture healing among orthopaedic surgeons. Variability in the assessment of healing may have important implications in surgeons' decisions to intervene when they perceive fracture healing is slow to progress. ⋯ There is a lack of consensus in the assessment of fracture healing in tibial shaft fractures among orthopaedic surgeons. Varying definitions of nonunion and malunion may influence the decision to intervene in an effort to promote fracture healing and/or realign the fracture.