Journal of orthopaedic trauma
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Rotational malalignment during femoral nailing is common. The difference in cortical width of the proximal and distal fracture fragments, the cortical step sign, is a commonly used yet poorly studied method of evaluating rotational alignment. This study aims to critically analyze the cortical step sign in cadaveric specimens using radiographic and direct measurements. ⋯ The cortical step sign, or incongruity of cortical widths on either side of a femur fracture, is indicative of rotational malreduction. Whether such malreduction is the result of internal rotation or external rotation, however, cannot be easily determined from this radiographic sign.
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Randomized Controlled Trial
Outcomes of minimally invasive plate osteosynthesis for metaphyseal distal tibia fractures.
Evaluation of clinical results and outcomes of low metaphyseal distal tibia fractures with minimal or no intra-articular involvement. These were treated using the minimally invasive plate osteosynthesis concept with a 3.5-mm locked medial tibial plafond plate and hybrid (locking and nonlocking) screw construct. ⋯ Minimally invasive medial plating using a hybrid locking plate technique in metaphyseal fractures of the distal tibia predictably restored limb alignment with a 5% reoperation rate and yielded mostly good-excellent ankle scores. There were residual impairments seen on whole-body outcomes measures.
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This study was performed to evaluate the results of operative treatment of ankle fractures in patients who required syndesmotic stabilization in addition to malleolar fracture fixation compared with patients who required malleolar fixation alone. ⋯ Patients who required syndesmotic stabilization in addition to malleolar fracture fixation had poorer outcomes at 12 months compared with patients who required malleolar fracture fixation alone. This information is important for patient counseling to manage expectations regarding outcomes after injury.
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To determine the 20 most cited articles and authors in the Journal of Orthopaedic Trauma during the first 20 years of publication, 1987 to 2007. ⋯ The influence of the Journal of Orthopaedic Trauma, its articles, and its authors is readily apparent in this review of the most cited articles and authors in the journal over its first 20 years of publication. This journal is a source of highly cited original articles and the work of many highly cited leaders in the field of orthopaedic trauma.
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Randomized Controlled Trial Comparative Study
No difference in functional and radiographic results 8.4 years after quadricortical compared with tricortical syndesmosis fixation in ankle fractures.
To assess long-term functional and radiologic results after two types of syndesmosis fixation, comparing one quadricortical syndesmotic screw fixation with two tricortical screw fixation in ankle fractures. ⋯ Follow up 8.4 years after surgery of ankle fractures with syndesmotic injury showed satisfactory functional results with only minor differences between the two groups of syndesmotic fixation. Obese patients had significantly poorer functional results. The presence of a posterior fracture fragment was an important negative prognostic factor regarding functional results. Plain radiographs overestimated tibiofibular synostosis. Synostosis on computed tomography, however, predicted impaired ankle function. A difference in syndesmotic width 1.5 mm or greater between the two ankles seemed to be associated with an inferior clinical result.