Journal of orthopaedic trauma
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There is substantial variation in the classification and management of scapula fractures. The first purpose of this study was to analyze the interobserver reliability of the OTA/AO classification and the New International Classification for Scapula Fractures. The second purpose was to assess the proportion of agreement among orthopaedic surgeons on operative or nonoperative treatment. ⋯ The New International Classification was more reliable. Body and process fractures generated more disagreement than intraarticular fractures and need further clear definitions.
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We hypothesized that open reduction and internal fixation (ORIF) of displaced acetabular fractures in geriatric patients result in a low rate of conversion to hip arthroplasty and satisfactory hip-specific validated outcome scores at medium-term follow-up. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Proximal ulna fractures can cause a significant loss of forearm rotation, elbow stiffness, and disability. The objective of this study was to quantify the loss of forearm rotation after simulated varus and valgus malunions of the proximal ulna. ⋯ Proximal ulna varus and valgus malunions lead to a significant loss of forearm pronation, supination, and total arc of motion. Valgus deformities lead to a loss of supination, whereas varus deformities lead to a greater loss of pronation.
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The literature on pelvic ring disruptions is based largely on nonstandardized and nonvalidated radiographic outcomes. A thorough review of the literature revealed only 3 described methods for measuring radiographic displacement and 1 frequently used grading system for displacement. We aimed to test the reliability of these previously published radiographic measurement methods and grading system. ⋯ Radiographic measurement in pelvic x-rays to date has been nonvalidated, and we found the interobserver reliability on common methods, including overall impression and absolute displacement in millimeters, to be poor. The inlet/outlet ratio as described by Sagi was reliable only with wide displacement. The cross measurement technique allows least observer choice and had excellent reliability but does not give a measurement that we can easily interpret based on convention in pelvic fracture description.