Journal of orthopaedic trauma
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The purpose of this study was to determine the efficacy of proximal humerus locking plates (PHLP) and to clarify predictors of loss of fixation. ⋯ This series presents the experience using PHLP in 5 Level 1 trauma centers. There were no intraoperative complications related to the locking plate systems. Despite the use of fixed-angle devices, loss of fixation occurred, primarily in the presence of varus malreduction. Our findings suggest that avoiding varus should substantially decrease the risk of postoperative failures.
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Comparative Study Clinical Trial
Reattachment of the tuberosities with cable wires and bone graft in hemiarthroplasties done for proximal humeral fractures with cable wire and bone graft: 58 patients with a 22-month minimum follow-up.
The stability of 2 fixation techniques for the tuberosities in patients with 3- or 4-part proximal humerus fractures treated with hemiarthroplasties was compared. ⋯ In hemiarthroplasties for proximal humeral fractures, the reattachment of the tuberosities with cable wire and bone grafting gives consistently better radiographic and functional results than with suture fixation alone.
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During complex image-guided orthopedic trauma procedures, repetitive fluoroscopic scout imaging is performed. A number of preparatory positioning images often must be taken to reproduce a comparable projection. These scout images have no intrinsic clinical relevance but nevertheless expose the patient and the surgical team to considerable radiation, which could be avoided. This study presents and validates a method to decrease intraoperative radiation. ⋯ Navigated C-arm positioning avoids multiple scout images and yields sufficient precision for clinical deployment. Radiation exposure can be reduced considerably by a combination of instrument navigation and navigated C-arm positioning.
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To evaluate patients with Bosworth-type fibular entrapment injuries of the ankle. ⋯ The Bosworth lesion is a severe injury of the ankle, and its successful treatment requires a correct diagnosis based on careful initial clinical and radiographic evaluation and early surgical treatment.
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Fracture of the femoral shaft is a common injury that is often treated with closed locked intramedullary nailing. Associated injuries such as ipsilateral femoral neck fracture, neurological or vascular compromise, and soft tissue injury of the knee are well known, but surprisingly little information exists regarding soft tissue injury of the hip in the setting of a femoral shaft fracture. In this case a 35-year-old man status-post closed femoral shaft fracture fixation was found to have a symptomatic ipsilateral labral tear and was successfully treated with arthroscopic debridement.