Journal of orthopaedic trauma
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Comparative Study Clinical Trial
Intraoperative diagnosis of syndesmosis injuries in external rotation ankle fractures.
This study was designed to compare intraoperative fluoroscopic stress testing, static radiographs, and biomechanical criteria for the diagnosis of distal tibiofibular syndesmotic instability associated with external rotation type ankle fractures. ⋯ Preoperative radiographs and biomechanical criteria are unable to routinely predict the presence or absence of syndesmosis instability. Rigid bimalleolar fixation was frequently not sufficient to stabilize syndesmotic disruption. Intraoperative stress fluoroscopy is a valuable tool for detection of unstable syndesmotic injuries.
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Randomized Controlled Trial
Computer-assisted guidewire insertion for hip fracture fixation.
: This study was designed to test in a laboratory setting a novel computer-assisted fluoroscopic technique and a conventional fluoroscopic technique for open reduction and internal fixation (ORIF) of hip fractures. Our hypothesis is that a novel computer-assisted fluoroscopic technique will achieve acceptable guidewire placement in one pass, with decreased fluoroscopic time and with accuracy and precision better than conventional technique. ⋯ The computer-assisted technique was significantly more accurate and precise than conventional technique. It also required fewer drill tracks through the femur and exposed the patient and the surgical team to significantly less ionizing radiation.
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Comparative Study
The mechanical behavior of locking compression plates compared with dynamic compression plates in a cadaver radius model.
The purpose of this cadaveric study was to compare the mechanical behavior of a locked compression plate, which uses threaded screw heads to create a fixed angle construct, with a dynamic compression plate construct in a cadaver radius model. ⋯ Our findings indicated that LCP constructs may demonstrate subtle mechanical superiority compared with the LC-DCP. The LCP specimens had less energy absorption in the AP group and survived longer in the torsion group. Discordance of motion between measurement regions was observed only in the LC-DCP torsion group, and may have been caused by plate-bone slippage or bone-screw subcatastrophic failure. However, many other compared parameters were found to be similar, and the clinical significance of the few differences found between constructs mandates further investigation.
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This study was performed to determine 1) the rate of ankle fractures in the elderly in the United States stratified by hospital referral region, and 2) whether the percentage of ankle fractures treated surgically is affected by factors, such as fracture location, hospital referral region, concentration of orthopaedists, presence of a teaching hospital in that region, patient age, race, gender, or the number and type of specific medical comorbidities. ⋯ The term ankle fracture involves a wide spectrum of injuries. We found a large variation through the United States in both the rate of ankle fractures and the percentage of those that undergo surgical intervention.