Journal of orthopaedic trauma
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To quantify the incidence of lumbopelvic instability in the setting of unilateral and bilateral sacral fractures and assess whether the presence of bilateral sacral fractures on axial imaging is a useful screening test for lumbopelvic instability. ⋯ Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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We hypothesize that the anatomic center of the distal tibia is just lateral and anterior to the center of the distal tibia articular surface in the coronal and sagittal planes, respectively, and that placement of the nail along this axis results in improved rates of malalignment when treating distal tibia fractures. ⋯ This is the first patient series that defines optimal tibial nail placement in the treatment of distal tibia fractures. Distal placement of the nail just lateral to the center of the talus and plafond, or along mechanical axis of the tibia, results in significantly reduced rates of malalignment on the coronal plane when compared to nail placement medial to the center of the talus or plafond. Fluoroscopic judgment of distal nail trajectory was improved on the mortise view using the talus as a reference when compared to using the anteroposterior view. On the sagittal plane, anatomic passive nail placement is just anterior to the center of the plafond. However, nonanatomic nail placement just posterior to the center of the plafond had a lower incidence of malalignment compared with nails placed anterior to the center of the plafond. Further study of appropriate nail positioning on the sagittal plane is needed.
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Assess the effect of proximal screw configuration on the strain in lateral plating of a simulated comminuted supracondylar femur fracture. ⋯ Plate strain in lateral plating of supracondylar femur fractures is decreased using nonlocking screws proximal to the fracture. Increasing the working length reduces plate strains over the working length yet should be cautioned because of increased interfragmentary shear motion.