Journal of orthopaedic trauma
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Case Reports
Repair of Displaced Partial Articular Fracture of the Distal Femur: The Hoffa Fracture.
The Hoffa fracture is a rare fracture pattern consisting of a unicondylar posterior fracture of the distal femur. This video demonstrates a case of Hoffa fracture repair using headless screw compression. ⋯ The Hoffa fracture is a rare injury typically seen after high-energy trauma. The surgical technique for treatment of the Hoffa fracture as seen in this video provides good stabilization and enables for early range of motion.
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To determine whether the position of the medial clamp tine during syndesmotic reduction affected reduction accuracy. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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This video demonstrates the technique of posterolateral bone grafting with iliac crest bone graft for a distal tibial nonunion. ⋯ The technique of posterolateral bone grafting with iliac crest bone graft for distal third tibia and fibula atrophic nonunion provides a reliable method for achieving union. If patients with injuries at high risk of nonunion are followed closely and intervention is performed in a timely manner, additional fixation or revision of fixation is not necessary if the addition of appropriate osteoinductive, osteoconductive, and osteogenic material to the nonunion is performed.
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Comparative Study
Implant Material, Type of Fixation at the Shaft, and Position of Plate Modify Biomechanics of Distal Femur Plate Osteosynthesis.
To investigate whether (1) the type of fixation at the shaft (hybrid vs. locking), (2) the position of the plate (offset vs. contact) and (3) the implant material has a significant effect on (a) construct stiffness and (b) fatigue life in a distal femur extraarticular comminuted fracture model using the same design of distal femur periarticular locking plate. ⋯ Using the same plate design, the study showed that implant material, screw type, and position of the plate affect the construct stiffness and fatigue life of the fixation construct. With this knowledge, the surgeon can decide the optimal construct based on a given fracture pattern, bone strength, and reduction quality.
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Operative management of patella fractures continues to be associated with poor outcomes and high reoperation rates. Traditionally, tension band fixation has been used for more simple fracture patterns; however, fixation remains a challenge particularly for comminuted fractures. ⋯ Earlier mobilization after plate osteosynthesis of patella fractures is possible because of a more robust construct, with the potential for decreased knee stiffness and improved functional outcomes. We present a video case of a 79-year-old man who sustained a displaced patella fracture treated with an anterior mesh plate.