Journal of orthopaedic trauma
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Multicenter Study
Surgeons and their patients disagree regarding cosmetic and overall outcomes after surgery for high-energy lower extremity trauma.
To determine whether surgeons' and patients' perceptions of outcomes after high-energy lower-extremity trauma are similar and to identify factors associated with disagreement. ⋯ Surgeons' perceptions of patients' cosmetic and overall outcomes differed significantly from those of patients. Agreement was significantly worse for certain subgroups of patients. Further study of this discordance might improve our understanding of patient dissatisfaction and allow development of a more patient-centered care process.
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Randomized Controlled Trial Comparative Study
Pin site care during circular external fixation using two different protocols.
Treatment of tibial fractures with Ilizarov external fixation is a valuable treatment alternative; however, development of problems at the pin site is one of the major drawbacks of this technique. Moreover, there is no general agreement regarding pin site care. The purpose of this study was to compare the efficacy of two different pin site care techniques after treatment of tibial fractures with an Ilizarov external fixator. ⋯ Pin site care can be performed without impairing patient comfort and without prohibition of showering. Pin site care can be self-managed by the patients without complex sterilization techniques.
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The objective of this study was to develop a single-channel telemetric intramedullary nail that measures anterior-posterior bending strains and determine whether these forces decrease sigmoidally when normalized to the ground reaction force during fracture healing. ⋯ No clear correlation between implant strain and fracture healing was observed using the single-channel system when subjected to one external loading regime (leg stance phase). However, ex vivo biomechanical testing demonstrated that load share changes could be detected when loads were directly applied to the bone in the absence of muscle and ligament forces. These data emphasize the need to fully characterize the complex biomechanical environment of the limb to determine the load changes resulting from fracture healing.