Journal of orthopaedic trauma
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Comparative Study
Biomechanical considerations in plate osteosynthesis: the effect of plate-to-bone compression with and without angular screw stability.
We compared the biomechanical stability of bone-plate constructs using a compression plate (CP), an internal fixator (IF), and a combination plate (CP/IF). ⋯ Under compression, IF provides similar fixation in comminuted fractures and was better than the CP for avoiding loss of reduction, whereas under torsional loading, CP was more important for stiffness, plastic deformation, and load to failure than IF. However, combination (CP/IF) fixation seems advisable in intraarticular and extraarticular fractures of long bones with a metaphyseal comminution. These data may be utilized by surgeons to build a more specific treatment plan in patients with these fracture types.
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To compare the prevalence of anterior knee pain and functional impairment post-tibial nailing to the contralateral knee and a background population. ⋯ There is a significant preinjury prevalence of anterior knee pain. Postnailing knee pain severity correlates with that in the uninjured limb. Relative risk of anterior knee pain postnailing is twice that of a comparative population.
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The authors report a case of a complete posterior dislocation of the acromioclavicular (AC) joint with an ipsilateral medial epiphyseal clavicular fracture in a 20-year-old male. Open reduction was indicated because a maintained closed reduction of the AC joint was unsuccessful, and the described treatment maintained a successful reduction.