Journal of orthopaedic trauma
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The objectives of this study were to provide computed tomography (CT)-based description of the anatomic specifics of lateral compression (LC)-1 pelvic ring disruptions and to describe injury severity to other body systems and their correlation with fracture anatomy. ⋯ LC-1 fractures of the pelvic ring represent a spectrum of injuries, with a large proportion having complete disruption of the sacrum. This complete injury of the sacrum is predicted by Denis type, severity of anterior ring disruption, abdominal AIS, and potentially location of rami fracture and ISS. CT scanning best defines these injuries.
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Bicondylar tibial plateau fractures featuring extensive articular involvement have a record of mixed clinical results. Recent discussion has focused on the significance of a posteromedial articular fragment in bicondylar injuries. This fragment has often gone unrecognized or has not been addressed. The posteromedial fragment is defined as any posteriorly based articular fracture of the medial plateau with the fracture line exiting the medial cortex. This study is designed to produce a detailed description of the incidence, size, and shape of this fracture, as this may be helpful in driving the choice of both approach and fixation for these injuries. Furthermore, a better understanding of this fracture's morphology may lead to a better ability to model the biomechanical reliability of laterally based locking fixation in securing the reduction of this fracture fragment. ⋯ Given the high frequency, significant portion of the joint involved, significant displacement, and pattern suggestive of instability, surgeons need to be cognizant of this pattern and may need to consider directly reducing and fixating this fragment through a posteromedially based approach. Overall morphologic findings of the posteromedial fragment are highly consistent with other recent data on this pattern. This information may also be useful in modeling fracture fixation for future study.
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To investigate whether locking screws offer any advantage over nonlocking screws for plate fixation of humeral shaft fractures for weight-bearing applications. ⋯ Synthetic and cadaveric bone testing showed that locking screws offer no obvious biomechanical benefit in this application.
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This introduction summarizes historical aspects regarding improvements in the treatment of open fractures and complicated wounds. Before the development of standardized surgical wound treatment and antisepsis, amputations were frequently required to prevent sepsis and death. Nowadays, the use of modern sealing techniques has caused a further dramatic reduction in the infection rates and an improvement of the healing response, thus enabling orthopaedic surgeons to perform skin graft coverage, where previously plastic surgeons had to perform skin flaps.
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The primary aim was to describe the epidemiology of the Holstein-Lewis humeral shaft fracture, its association with radial nerve palsy, and the outcome regarding recovery from the radial nerve palsy and fracture healing. The secondary aim was to analyze the long-term functional outcome. ⋯ The Holstein-Lewis humeral shaft fracture was associated with a significantly increased risk of acute radial nerve palsy. The overall outcome regarding fracture healing, radial nerve recovery, and function was very good regardless of the primary treatment modality, that is, operative or nonoperative treatment. The indication for primary operative intervention in this fracture type appears to be relative.