Journal of orthopaedic trauma
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Comparative Study
A comparison of optical and electromagnetic computer-assisted navigation systems for fluoroscopic targeting.
Freehand targeting using fluoroscopic guidance is routine for placement of interlocking screws associated with intramedullary nailing and for insertion of screws for reconstruction of pelvic and acetabular injuries. New technologies that use fluoroscopy with the assistance of computer guidance have the potential to improve accuracy and reduce radiation exposure to patient and surgeon. We sought to compare 2 fluoroscopic navigation tracking technologies, optical and electromagnetic versus standard freehand fluoroscopic targeting in a standardized model. ⋯ Both optical and electromagnetic computer-assisted guidance systems have the potential to improve accuracy and reduce radiation use for freehand fluoroscopic targeting in orthopaedic surgery.
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Case Reports
Irreducible fracture-dislocation of the ankle caused by an entrapped medial malleolus at the syndesmosis.
A 55-year-old fisherman sustained an unusual and irreducible fracture-dislocation of the ankle joint. An entrapped medial malleolar fragment was discovered by computed tomography between the distal tibia and lateral malleolus. ⋯ At the 18-month follow-up visit, the patient was working normally and was asymptomatic. At previous visits, he demonstrated a full range of ankle motion and had normal radiograph.
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Bicondylar tibial plateau fracture management remains therapeutically challenging, partly because of multiplanar articular comminution. This study was performed to evaluate the frequency and morphologic characteristics of the posteromedial fragment in this injury pattern. ⋯ A posteromedial fragment was observed in nearly one third of the bicondylar plateau fractures evaluated. The morphologic features of this fragment may have clinical implications when using currently available laterally applied fixed-angle screw/plate implants to stabilize these injuries. Alternate or supplementary fixation methods may be required when managing this injury pattern.