Journal of orthopaedic trauma
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The lateralizing vector of a flexible guide wire can result in eccentric lateral reaming of the proximal femur during intramedullary nailing procedures. This effect is especially true with peritrochanteric fractures that have a fracture line exit near the entry point, and in obese patients. ⋯ Use of a concave shaped retractor such as an Appendiceal or Richardson helps to "capture" the reamer shaft and control where proximal reaming occurs. We have found this method to be easy to use and effective when indicated.
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Observational Study
Dynamic fixation of distal femur fractures using far cortical locking screws: a prospective observational study.
Document fixation and healing of distal femur fractures stabilized by plate osteosynthesis using far cortical locking (FCL) screws. ⋯ Absence of implant and fixation failure suggests that dynamic plating of distal femur fractures with FCL screws provides safe and effective fixation.
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To describe and investigate the injury pattern and outcomes of high-energy transsyndesmotic ankle fracture dislocations, or "Logsplitter" injuries, in which the talus is axially wedged into the tibiofibular joint. ⋯ Transsyndesmotic ankle fracture dislocations, or "Logsplitter" injuries, represent an exceptional pattern of high-energy fractures with significant syndesmotic disruption, potential soft tissue compromise, and possible associated plafond injuries. Careful attention to radiographic findings can identify unique fracture characteristics relative to operative decision-making. Outcomes are comparable to those of high-energy pilon fractures, thereby providing the treating surgeon with prognostic information.
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The aim of our study was to assess the intersubject and intrasubject variations of distal tibiofibular syndesmosis on computed tomography (CT) scans and to define standardized measures to verify syndesmosis reduction. ⋯ If P translation of the fibula is present, malreduction should be considered. Sagittal translation measurements are not affected by the size of the joint or the gender of the patient, in contrast to traditionally used cross-sectional measurement methods.
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Much attention has been given to lower extremity amputations that occur more than 90 days after injury, but little focus has been given to analogous upper extremity amputations. The purpose of this study was to determine the reason(s) for desired amputation and the common complications after amputation for those combat-wounded service members who underwent late upper extremity amputation. ⋯ Service members undergoing late upper extremity amputation seem to have different pre- and postoperative complications than those patients undergoing late lower extremity amputations. It was common for the amputee to not wear their prostheses and to experience similar complications after amputation, albeit in a less severe form.