Journal of orthopaedic trauma
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Recent studies on ankle syndesmosis injuries have shown that a significant amount of rotational malediction of the distal fibula are missed and may lead to poor functional outcome. A new set of radiographic criteria were developed to help detect distal fibula internal and external rotation using conventional fluoroscopy. The criteria were tested using a cadaveric model for Weber C ankle fractures fixed with the fibula in various degrees of internal and external rotation. Using the criteria orthopaedic trauma surgeons were able to improve their accuracy and agreement on assessment of degree and direction of fibula rotation.
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Multicenter Study Comparative Study
A comparison of more and less aggressive bone debridement protocols for the treatment of open supracondylar femur fractures.
This study compared results of aggressive and nonaggressive debridement protocols for the treatment of high-energy, open supracondylar femur fractures after the primary procedure, with respect to the requirement for secondary bone grafting procedures, and deep infection. ⋯ Therapeutic level III.
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The aim of the present study was to determine whether 3-dimensional (3D) fluoroscopic navigation combined with a preoperative computer tomography (CT)-based plan could enable surgeons to perform safe and reliable iliosacral screw insertion despite their limited experience. ⋯ The CT-3D-fluoroscopy matching navigation system reduced the malposition rate of percutaneous iliosacral screw insertion when performed by less experienced surgeons.
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The optimal exposure interval for anteromedial coronoid fractures is unknown. The purpose of this study was to quantitatively compare the osseous and ligamentous exposure of the medial elbow using the flexor carpi ulnaris (FCU)-Splitting and Hotchkiss Over-the-Top approaches. ⋯ The FCU-Splitting approach provides more extensive exposure of the anteromedial coronoid and proximal ulna and the medial ligamentous structures than the Hotchkiss Over-the-Top approach.
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Comparative Study
The effect of fracture pattern stability on implant loading in OTA type 31-A2 proximal femur fractures.
Internal fixation of OTA type 31-A2 proximal femoral fractures can be performed with either a sliding hip screw and side plate (SHS-P) or a sliding hip screw and intramedullary nail (SHS-IMN). Controversy exists as to which is the best implant for these types of fractures. The primary aim of this study was to investigate the stability of 31-A2 fractures as a function of loss of medial cortical buttress. The secondary aim was to assess the influence of fracture stability on the different internal fixation constructs. ⋯ Type 31-A2 fractures become increasingly unstable with increased medial comminution (or fragment size). SHS-P constructs were more load sharing than SHS-IMN constructs. These findings may help guide the surgeon in choice of implant for a 31-A2 intertrochanteric fracture, leaning toward SHS-IMN for the more unstable fracture patterns.