Journal of orthopaedic trauma
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Comparative Study
Accuracy study of computer-assisted drilling: the effect of bone density, drill bit characteristics, and use of a mechanical guide.
This study was designed to determine the clinical relevant accuracy of CT-based navigation for drilling. ⋯ The core accuracy of the navigation system is high. Compared with the navigated free-hand technique, the results suggest that drill bit deflection interferes directly with the precision. The precision is decreased when using small diameter and longer drill bits.
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Review Case Reports
Avulsion fractures of the lesser tuberosity of the humerus in adolescents: review of the literature and case report.
Isolated fracture of the lesser tuberosity is an unusual phenomenon in children and adolescents. These injuries are difficult to diagnose acutely and often present as chronic shoulder pain. In this study, we report on 1 case of a displaced lesser tuberosity apophysis avulsion fracture in an adolescent treated with open reduction and internal fixation, as well as a review of the literature. ⋯ Postoperatively, he underwent a progressive physical therapy regimen. At 4 months follow-up, he had full range of motion, complete return of strength, and returned to competitive athletics. We report here on the successful surgical treatment of a fracture of the lesser tuberosity apophysis in an adolescent.
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Comparative Study
The posterior shearing tibial plateau fracture: treatment and results via a posterior approach.
This study was designed to describe the fracture patterns and early results of treatment of posterior shearing tibial plateau fractures. ⋯ Posterior shearing tibial plateau fractures form a consistent pattern. They can be successfully managed using a posterior approach with direct reduction and buttress fixation of articular fragments. Quality of articular reduction is one factor that influences short-term functional outcome.
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Comparative Study
Anterior knee pain after intramedullary nailing of a tibial shaft fracture: an ultrasound study of the patellar tendons of 36 patients.
Chronic anterior knee pain is a common complication following intramedullary nailing of a tibial shaft fracture. The etiology of pain is often not known. This study sonographically examined the patellar tendons of patients with a nailed tibial shaft fracture. ⋯ After intramedullary nailing of a tibial shaft fracture, patients with or without anterior knee pain show similar changes in the ultrasound investigation of their patellar tendons. Based on those findings, it does not appear to make any difference as to the approach used (paratendinous or transtendinous) for intramedullary nailing of the tibia.
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The dynamic hip screw, which is routinely used for intertrochanteric hip fractures, also provides a technically simple means of fixation for intertrochanteric valgus osteotomies in the treatment of femoral neck nonunions. Eight patients underwent intertrochanteric valgus osteotomy for femoral neck nonunion using a dynamic hip screw for fixation. One patient died 4 months postoperatively of causes unrelated to the procedure. ⋯ All the hip fractures were classified as Pauwels type III preoperatively and Pauwels type II postoperatively. The average Harris Hip Score increased from 24 to 73. On radiographic review, no cases of osteonecrosis were identified postoperatively.