Journal of orthopaedic trauma
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Ankle fractures are among the most common surgically treated fractures. The incidence of syndesmotic injury in ankle fractures is 13%-20%. ⋯ Recently, a suture button-type device has been used instead of the traditional trans-syndesmotic screw-type fixation. This case-based video demonstrates a technique for using suture button-type devices to repair syndesmotic ankle injuries and presents the data regarding the outcomes of this novel technique.
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Randomized Controlled Trial
Tranexamic Acid Use in Open Reduction and Internal Fixation of Fractures of the Pelvis, Acetabulum, and Proximal Femur: A Randomized Controlled Trial.
To assess the safety and efficacy of tranexamic acid (TXA) use in fractures of the pelvic ring, acetabulum, and proximal femur. ⋯ Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Multicenter Study
New Five-Factor Modified Frailty Index Predicts Morbidity and Mortality in Geriatric Hip Fractures.
Although the 11-factor modified frailty index (mFI-11) has been shown to predict adverse outcomes in elderly patients undergoing surgery for hip fractures, the newer 5-factor index has not been evaluated in this population. The goal of this study is to evaluate the mFI-5 as a predictor of morbidity and mortality in elderly patients undergoing surgical management for hip fractures. ⋯ Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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To report the mortality data and life expectancy of geriatric hip fracture patients who underwent nonoperative management and compare that with a matched operative cohort. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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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.