Journal of orthopaedic trauma
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Multicenter Study
Accuracy of reduction of ipsilateral femoral neck and shaft fractures--an analysis of various internal fixation strategies.
Controversy surrounds the selection of the proper internal fixation device for treatment of ipsilateral fractures of the femoral neck and shaft. The purpose of this study was to review a large consecutive series of patients to learn more about the efficacy of various internal fixation strategies in maintaining an excellent reduction of both fractures. ⋯ Open reduction and internal fixation of a displaced femoral neck fracture followed by retrograde nailing of the femoral shaft allowed accurate reduction and uneventful union of both fractures in most patients. The use of a cephalomedullary device to address both fractures simultaneously led to a significantly higher rate of malreduction of one of the fractures.
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Comparative Study Controlled Clinical Trial
A comparative study of clinical and radiologic outcomes of unstable colles type distal radius fractures in patients older than 70 years: nonoperative treatment versus volar locking plating.
To compare final functional and radiographic outcomes of closed reduction and casting (CAST) with open reduction and internal fixation (ORIF) with palmar locking plate for unstable Colles type distal radius fractures (DRFs) in low-demand patients older than 70 years. ⋯ Radiographic results (dorsal tilt, radial inclination, and radial shortening) after unstable dorsally displaced DRFs are significantly better in patients treated by ORIF using a volar fixed-angle plate rather than those treated by cast immobilization (P < 0.05). At a mean follow-up time of 4 years and 7 months, the clinical outcomes of active range of motion, the PRWE, DASH, and Green and O'Brien scores do not differ between the 2 methods of treatment. The pain level was significantly less in the CAST group (P < 0.05), and this group experienced no complications. There was no difference between the subjective and functional outcomes for the surgical and the nonsurgical treatments in a cohort of patients older than 70 years. Unsatisfactory radiographic outcome in older patients does not necessarily translate into unsatisfactory functional outcome. Nonoperative treatment may be the preferred method of treatment in this age group.
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Clinical Trial
Open reduction internal fixation and primary total hip arthroplasty of selected acetabular fractures.
The purpose of our study was to analyze the outcomes of patients treated with combined open reduction internal fixation (ORIF) and primary total hip arthroplasty (THA) for selected cases of acetabular fractures. ⋯ Treatment of acetabular fractures remains challenging particularly in the presence of severe osteopenia, comminution, or associated femoral head fracture. In appropriately selected patients, ORIF and primary THA provide an acceptable treatment option.
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Case Reports Clinical Trial
Reduction of displaced pelvic ring disruptions using a pelvic reduction frame.
The need for reduction in displaced pelvic ring disruptions is well established, but actual techniques to perform this difficult task are evolving. Reduction is often difficult, especially if minimally invasive techniques are used. ⋯ This lessens the usual assistance, training, and hardware placement difficulties associated with the surgical treatment of these injuries. The basic surgical technique and 2 cases of acute fracture treatment are presented.
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Clinical Trial
Intraoperative 3-dimensional imaging in foot and ankle trauma-experience with a second-generation device (ARCADIS-3D).
Intraoperative 3-dimensional imaging with the first available device (ISO-C-3D; Siemens, Germany) has shown potential benefit in foot and ankle surgery. The aim of the study was to assess the clinical use of the second-generation device (ARCADIS-3D; Siemens) in comparison with earlier experience with the first-generation device. ⋯ Intraoperative 3-dimensional visualization with the ISO-C-3D/ARCADIS-3D can provide useful information that cannot be obtained from plain films or conventional C-arms. The second-generation device (ARCADIS-3D) provides faster scan and evaluation that reduces time spent. No other benefits were seen.