Journal of orthopaedic trauma
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Randomized Controlled Trial
Distal interlocking screw placement in the femur: free-hand versus electromagnetic assisted technique (sureshot).
To compare the free-hand (FH) technique of placing interlocking screws to a commercially available electromagnetic (EM) targeting system in terms of operating time, radiation dose, and accuracy of screw placement. ⋯ Therapeutic level II.
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The purpose of this study was to determine significant factors that may impact the postoperative differences in femoral version (DFV) and differences in femoral length (DFL) between the fixed and uninjured sides after intramedullary nailing (IMN) secondary to gunshot wounds. ⋯ Prognostic level II.
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Review Comparative Study
Surgical fixation of Vancouver type B1 periprosthetic femur fractures: a systematic review.
Vancouver type B1 periprosthetic femur fractures occur around a stable implant and are typically treated with open reduction and internal fixation (ORIF). Different fixation techniques are described in the literature, and there is a lack of consensus regarding the best operative fixation strategy. The purpose of this investigation was to systematically review and compare the most commonly used fixation strategies for these fractures. ⋯ In total, 333 patients identified with an overall rate of 5% nonunion, 6% malunion, 5% infection, 4% hardware failure, 9% reoperation, and 15% total complications. When comparing outcomes for different modes of fixation, compared with cable plate/compression plate systems, locking plates had a significantly higher rate of nonunion (3% vs. 9% P = 0.02) and a trend toward a higher rate of hardware failure (2% vs. 7%, P = 0.07). There are limitations to this study, and further investigation with high-quality randomized controlled trials is needed to effectively compare treatment strategies.
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The null hypothesis of this study states that routine axial computed tomography (CT) images are obtained at a consistent and reproducible orientation relative to the sacrum. The secondary null hypothesis states that there is no difference in the measurement of the safe zone for placement of iliosacral screws when using routine axial CT images and standardized reconstructions in defined planes perpendicular and parallel to the sacrum. ⋯ Our null hypotheses were rejected: routine axial CT images were found to be at widely ranging orientations relative to the sacrum, and standardized CT images (CT inlet and CT outlet) demonstrated statistically significant differences in measurements of safe zones compared with routine axial CT images. Furthermore, the CT inlet and CT outlet views provide additional information regarding sacral landmarks that could be useful for preoperative planning.