Journal of orthopaedic trauma
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Comparative Study
Early and delayed treatment of dorsal transscaphoid perilunate fracture-dislocations.
Transscaphoid perilunate fracture-dislocations are complex injuries. The aim of this study is to discuss and compare open reduction and internal fixation for acute and delayed transscaphoid perilunate fracture-dislocations and review the literature. ⋯ We recommend open reduction and internal fixation for early and delayed transscaphoid perilunate fracture-dislocations.
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To review the efficacy of the current diagnostic methods of acute compartment syndrome (ACS) after leg fractures. ⋯ Early diagnosis of an ACS is important. Despite its drawbacks, clinical assessment is still the diagnostic cornerstone of ACS. Intracompartmental pressure measurement can confirm the diagnosis in suspected patients and may have a role in the diagnosis of this condition in unconscious patients or those unable to cooperate. Whitesides suggests that the perfusion of the compartment depends on the difference between the diastolic blood pressure and the intracompartmental pressure. They recommend fasciotomy when this pressure difference, known as the Delta p, is less than 30 mm Hg. Access to a precise, reliable, and noninvasive method for early diagnosis of ACS would be a landmark achievement in orthopaedic and emergency medicine.
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We conducted a study to evaluate the long-term functional outcomes of patients with an isolated tibial shaft fracture treated with locked intramedullary nailing. ⋯ At a median 14 years after tibial nailing of isolated tibial fractures, patients' function is comparable to population norms, but objective and subjective evaluation shows persistent sequelae which are not insignificant. This study is the first to describe the long-term functional outcomes after tibial shaft fractures treated with intramedullary nailing nails. It may allow surgeons to better inform patients on the expected long-term function after intramedullary nailing of a tibia fracture. It may also prove useful when comparing intramedullary nailing nailing to other treatment techniques.
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Comparative Study
The biomechanics of ipsilateral intertrochanteric and femoral shaft fractures: a comparison of 5 fracture fixation techniques.
The aim of the present study was to examine biomechanically 5 different construct combinations for fixation of ipsilateral intertrochanteric and femoral shaft fractures. ⋯ All constructs showed no statistical differences when compared with one another, with the exception of construct E, which provided the least torsional stiffness. However, the current in vitro model did not simulate fracture healing or support offered by soft tissues, both of which would affect the stiffness and load-to-failure levels reached.
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Case Reports
Scapulothoracic dissociation with acromioclavicular separation: a case report of a novel fixation method.
We present a case of 39-year-old female with a scapulothoracic dissociation and acromioclavicular (AC) separation and who had fixation of the AC joint with a locking plate, coracoclavicular screw, and transarticular AC screw. The coracoclavicular and AC relationships were maintained during postoperative rehabilitation and after hardware removal. Use of a locking plate can lead to good functional outcome without the complications associated with the use of pin and wire constructs or without violating the subacromial space.