Journal of orthopaedic trauma
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All-terrain vehicle (ATV)-related trauma is increasing nationally. This study highlights the demographics, mechanisms, and associated orthopaedic injuries for ATV-related traumas that presented to our Level I trauma center over an 8-year period and addresses the effects of statewide legislation on injury occurrences. ⋯ This trauma center is in a unique position to highlight a national problem. Over half (52%) of the patients had an orthopaedic injury defined as a fracture or dislocation. Before measures can be implemented to effect change, we must first be aware of the exact nature and spectrum of injuries associated with ATV use.
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Fractures of the femur above a total knee arthroplasty (TKA) are becoming increasingly common in the osteoporotic, aging populations of developed countries. Treatment of these fractures is complicated by the presence of a knee prosthesis, frequently limiting the bone available for distal fracture fixation. The recent application of minimally invasive surgical techniques and locked plate technology to this problem offers the promise of stable, fixed-angle fixation of small distal fracture fragments with limited surgical exposure. The purpose of this study is to report the clinical and radiographic outcomes of fracture fixation using this technique in patients with periprosthetic femur fractures above TKA. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Computed tomography (CT) is reported to be superior to plain radiography for imaging the syndesmosis, but CT criteria differentiating normal from abnormal tibiofibular relationships do not exist. The purpose of this study was to define normal tibiofibular relationships at the syndesmosis on axial CT imaging and to report the reliability of these measurements. ⋯ Measurements of tibiofibular relationships made on axial CT images are reliable. Because of significant anatomic variation between individuals, using a patient's contralateral ankle for comparison provides a precise definition of normal tibiofibular relationships. These criteria allow for the detection of subtle variations in the tibiofibular relationships indicating instability and provide a tool for postoperatively assessing the reduction of the injured syndesmosis.
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To describe medical care and surgical outcome after functional reconstructive surgery in late-presenting patients who already had at least one prior operation. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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The purpose of this study was to determine if lag screw position affects the biomechanical properties of a cephalomedullary nail used to fix an unstable peritrochanteric fracture. ⋯ The inferior lag screw position produced the highest axial and torsional stiffness. Anterior and posterior lag screw positions produced the lowest stiffnesses and load-to-failure. Inferior placement of the lag screw on the anteroposterior radiograph and central placement on the lateral radiographs is recommended.