Journal of orthopaedic trauma
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Randomized Controlled Trial Comparative Study
Elastic stable intramedullary nailing versus nonoperative treatment of displaced midshaft clavicular fractures-a randomized, controlled, clinical trial.
To compare elastic stable intramedullary nailing (ESIN) with nonoperative treatment of fully displaced midshaft clavicular fractures in adults. ⋯ ESIN of displaced midshaft clavicular fractures resulted in a lower rate of nonunion and delayed union, a faster return to daily activities, and a better functional outcome. Clavicular shortening was significantly lower, and overall satisfaction was higher in the operative group.
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Comparative Study
Orthogonal pin construct versus parallel uniplanar pin constructs for pelvic external fixation: a biomechanical assessment of stiffness and strength.
The purpose of this study is to compare the structural stiffness of an orthogonal pelvic external fixator pin construct with 2 different parallel external fixator pin constructs in a simulated bone model. ⋯ An orthogonal pelvic external fixator pin construct produced a significantly stiffer construct for in-plane loading (flexion/extension moment) compared with either parallel pin construct; however, a parallel supra-acetabular pin construct was stiffer for out-of-plane loading.
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Predictors of moderate or severe pain 6 months after orthopaedic injury: a prospective cohort study.
To determine predictors of moderate or severe pain 6 months after orthopaedic injury. ⋯ Moderate or severe pain is commonly reported 6 months after orthopaedic trauma. Pain intensity at discharge and the effects of a "no-fault" compensation system are potentially modifiable factors that might be addressed through intervention studies to reduce the burden of persistent pain after orthopaedic trauma.
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To investigate the time required for elbow range of motion (ROM) recovery after supracondylar and lateral condylar fractures in children and to analyze the relationship between the ROM recovery and the related factors. ⋯ In the uncomplicated distal humerus supracondylar and lateral condylar fractures, it takes 5 weeks to restore original elbow ROM after removal of long arm cast without physical therapy. This information could be applied in the education material to caregivers of children with elbow injuries.
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Comparative Study
The stress response to bilateral femoral fractures: a comparison of primary intramedullary nailing and external fixation.
Concern has recently been expressed with regard to the physiologic effects of primary intramedullary femoral nailing in seriously injured patients. "Damage control orthopaedics" techniques have been proposed, which comprise principally the use of primary external fixation. The aim of this study was to compare the physiologic effects of external femoral fixation with those of intramedullary stabilization over the first 24 hours after femoral fracture using an established large animal (ovine) trauma model. ⋯ A higher pulmonary embolic load can be expected during early intramedullary femoral fracture stabilization compared with primary external fixation. However, the degree of stimulation to systemic coagulation and pulmonary inflammation by each type of surgery was comparable.