Journal of orthopaedic trauma
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The goals of all orthopaedic surgeons treating articular cartilage injuries have been anatomic reduction and stable fixation of the articular cartilage surface with restoration of limb alignment and/or reestablishment of the joint stability, all while minimizing the risk of surgical complications. Recent developments in the study of articular cartilage injury have shown that there is a robust cellular response to joint injury. This response has been shown to involve the synoviocytes, chondrocytes, and osteocytes in and around the injured joint and if these responses are left unchecked, they can lead to the development of posttraumatic osteoarthritis (PTOA). ⋯ Gone is the simplistic view that if one can achieve articular congruity after intraarticular fracture, as well as joint stability after ligamentous injury, that our patients will do just fine. This review sheds new light on the molecular response to cartilage injury, how residual joint incongruity and instability affect the joint's ability to recover from injury, and how chondrocyte apoptosis in response to injury can influence joint. This article then briefly reviews how cellular and growth factors may be beneficial to the treatment of articular cartilage injury and how ultimately cartilage regeneration may be used in the future to salvage the joints ravaged by PTOA in response to injury.
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To evaluate inter-rater reliability of the modified Radiographic Union Score for Tibial (mRUST) fractures among patients with open, diaphyseal tibia fractures with a bone defect treated with intramedullary nails (IMNs), plates, or definitive external fixation (ex-fix). ⋯ In tibia fractures with bone defects, the mRUST seems similarly reliable to previous work in patients treated with IMN but is less reliable in those with plates or ex-fixes, or after removal of instrumentation.
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Comparative Study
Biomechanical Comparison of Tension Band Fixation of Patella Transverse Fracture: Headless Screws Versus Headed Screws.
This study aimed to investigate the stability and strength of tension band wire fixation using headless compression screws versus headed screws for transverse patella fractures. ⋯ Headless screw tension band fixation demonstrated superior biomechanical behaviors over standard headed screw fixation with higher construct rigidity, smaller interfragmentary motion, and greater fixation strength.
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Comparative Study
Radiographic Healing of Far Cortical Locking Constructs in Distal Femur Fractures: A Comparative Study With Standard Locking Plates.
To investigate the radiographic healing of far cortical locking (FCL) construct fixation in distal femur fractures compared with traditional locking plate (LP) constructs. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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To determine relative complication rates and outcome measures in patients treated under a standardized hip fracture program (SHFP). ⋯ Therapeutic Level III.