Journal of orthopaedic trauma
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Randomized Controlled Trial Comparative Study
Pain relief for reduction of acute anterior shoulder dislocations: a prospective randomized study comparing intravenous sedation with intra-articular lidocaine.
The aim was to compare the effectiveness of intra-articular lidocaine (IAL) versus intravenous Demerol and Diazepam (IVS) in reduction of acute anterior shoulder dislocation. ⋯ IAL was more cost effective than the IVS method. IAL provided adequate pain relief and fewer complications and is a viable option for analgesia during reduction of acute shoulder dislocation.
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Comparative Study Controlled Clinical Trial
Operative versus nonoperative management of displaced midshaft clavicle fractures: a prospective cohort study.
To compare results of primary internal fixation of acute displaced midshaft clavicle fractures with those managed nonoperatively in terms of fracture union and functional outcome. ⋯ In this prospective cohort study, primary open reduction and internal plate fixation of acute displaced midshaft clavicular fractures resulted in improved outcomes and a decreased rate of nonunion and symptomatic malunion compared with nonoperative treatment.
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Comparative Study
Biomechanical comparison of locking versus nonlocking volar and dorsal T-plates for fixation of dorsally comminuted distal radius fractures.
The purpose of this study was to gain insight into the effect of plate location and screw type for fixation of extra-articular distal radius fractures with dorsal comminution (Orthopaedic Trauma Association Type 23-A3.2). ⋯ No difference in all measured biomechanical parameters supports equivalence between constructs and surgeon discretion in determining operative method. Minimal fragment displacement and construct deformation during physiological testing support previous data that early postoperative motion can be recommended. Fragment displacement that occurs does so in the early periods of motion.
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A divergent dislocation of the elbow is a very rare injury, and only a few cases have been described in the literature. It is characterized as a dorsal dislocation of the ulnohumeral joint combined with a lateral dislocation of the proximal radius. All three articulations of the elbow joint are involved. ⋯ After gross reduction of the joint dislocation, definitive osteosynthesis of the distal radius fracture was performed. Subsequently, the coronoid process and lateral collateral ligament could be repaired anatomically, improving the stability of the elbow. An uneventful recovery with excellent elbow motion and stability was achieved.
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To investigate the usefulness of flexion and extension radiographs of the cervical spine as a screening tool for the acute evaluation of ligamentous injury in cases of awake blunt trauma in patients with a negative cervical computed tomography scan. ⋯ Flexion and extension radiographs do not appear to be clinically useful in assessing acute instability in patients hospitalized with blunt trauma with negative computed tomography scans.