Journal of orthopaedic trauma
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The goals of this study are to evaluate mortality after Vancouver B periprosthetic fractures and determine predictors of mortality; compare mortality among patients with loose femoral stems treated with revision arthroplasty versus fixation alone; compare mortality among patients with radiographically "indeterminate" fractures treated with revision or fixation; and evaluate the rate of return to surgery for patients who underwent revision compared with fixation. ⋯ Prognostic level III. See Instructions for Authors for a complete description of levels of evidence.
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Multicenter Study
APC Injuries With Symphyseal Fixation: What Affects Outcome?
To evaluate the influence of the symphyseal position at union, implant failure, and the type of posterior ring injury on validated outcome measures. ⋯ Prognostic level IV. See Instructions for Authors for a complete description of levels of evidence.
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Comparative Study
Comparison of Outcomes and Complications of Isolated Acetabular Fractures and Acetabular Fractures With Associated Injuries.
To compare patients with acetabular fractures that are isolated (acetabular fracture alone) and acetabular fracture presenting with additional nonacetabular injury using functional outcomes, complications, and readmissions. ⋯ Prognostic level III. See Instructions for Authors for a complete description of levels of evidence.
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Although most clavicular fractures are amenable to nonoperative management, metadiaphyseal fractures are considerably more complex, with rates of suboptimal healing as high as 75% when treated nonoperatively. The poor results are ascribed to the deforming forces on the distal clavicle from the surrounding muscles and the weight of the arm. It recently has been noted that some operative fixations of these fractures are also failing when a standard superiorly placed plate is used. We hypothesized that anterior plating, when compared with superior plating, improves the strength and durability of the construct by redirecting the axis of the major deforming force across rather than in line with the screws of the construct. ⋯ Anteriorly plated distal third clavicular fractures have superior strength and durability compared with fractures plated superiorly when using a physician-contoured, 3.5-mm, limited-contact, dynamic compression plate in this cadaver model.
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This biomechanical study compared Vancouver B1 periprosthetic femur fractures fixed with either a locking plate and anterior allograft strut construct or an equivalent locking plate with locking attachment plates construct in paired cadaveric specimens. ⋯ Use of the anterior allograft strut created a stiffer construct compared with the LCP-LAP for the treatment of a Vancouver B1 periprosthetic femur fracture only in loading modes with increased medial-lateral bending. Although these static load results are indicative of the early postoperative environment, further fatigue testing is required to better understand the importance of the reduced medial-lateral stiffness over a longer period.