Journal of orthopaedic trauma
-
Unstable pelvic ring injuries are associated with an increased mortality rate, most commonly from severe hemorrhage. Circumferential pelvic antishock sheeting has proven effective for rapidly stabilizing the pelvic ring and has become an integral part of resuscitation protocols. Acute antishock sheet placement frequently results in patient hemodynamic stabilization and an accurate pelvic reduction. In these situations, we describe a technique of maintaining the pelvic sheet position for continued use as a reduction aid and using working portals to insert definitive percutaneous pelvic implants.
-
Comparative Study
Biomechanical comparison of polyaxial-type locking plates and a fixed-angle locking plate for internal fixation of distal femur fractures.
To test the stability to axial loading of 2 new polyaxial locking screw-plate designs and analyze different angles of screw insertion. The noncontact bridging (NCB) polyaxial locking plate (Zimmer) and the POLYAX plate (DePuy) were compared with a fixed-angle less invasive stabilization system (LISS; Synthes). ⋯ There were no failures of either polyaxial screw-plate interface despite large forces and screw angle did not affect the overall strength of these constructs, supporting the biomechanical soundness of both polyaxial device designs under axial loading. However, the POLYAX supported smaller loads compared with the LISS and NCB while under axial loading. In addition, the mode of failure of the NCB plate, creating an intra-articular fracture propagating from the distal posterior screw hole, may be of some concern. Additional testing is needed to determine the clinical importance of the demonstrated differences among these plate designs.
-
Retrograde femoral nailing is a widely used treatment for fractures involving the distal third of the femur. Angular malunion of these fractures after retrograde intramedullary nailing is a known complication. We report our surgical technique and experience using blocking screws to aid in reduction and augment the stability of the fixation when using a retrograde intramedullary nail for distal femoral fractures.
-
Randomized Controlled Trial Multicenter Study
Nonoperative treatment of thoracic and lumbar spine fractures: a prospective randomized study of different treatment options.
To evaluate and compare nonoperative treatment methods for traumatic thoracic and lumbar compression fractures and burst fractures. ⋯ Brace treatment with supplementary physical therapy is the treatment of choice for patients with compression fractures of the thoracic and lumbar spine. Furthermore, more than 20% of all patients had moderate or severe back pain at long-term follow-up.
-
Review Case Reports
Surgical management of multiple painful rib nonunions in patient with a history of severe shoulder girdle trauma: a case report and literature review.
The authors report painful nonunions after multiple rib fractures in a 50-year-old man who sustained a displaced scapula fracture and multiple ipsilateral rib fractures. The rib nonunions were reconstructed after an 11-month trial of nonoperative management, which was unsuccessful. The nonunions healed and symptoms completely resolved.