Journal of orthopaedic trauma
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Although numerous systems have been proposed, there is no universally accepted classification or scoring system for thoracolumbar spine injuries. Some have gained popularity, but most systems have never been modified or advanced beyond their initial introductory state. To the authors' knowledge, no thoracolumbar classification system has ever been validated in a systematic and scientific manner. ⋯ Of the three phases of validating a fracture classification system described by Audige et al, TLICS has successfully passed through phase 1 (development) and phase 2 (multicenter agreement studies). With modifications made in response to phase 2 studies, TLICS will be ready to enter into the clinical validation phase. Although TLICS will initially be assessed for its ability to predict type of treatment, it is the authors' hope that, with appropriate analysis, the system will also be predictive of injury severity and clinical outcomes. These qualities remain to be demonstrated through rigorous prospective clinical investigation.
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Randomized Controlled Trial Comparative Study
Comparison of a technique using a new percutaneous osteosynthesis device with conventional open surgery for displaced patella fractures in a randomized controlled trial.
To compare the percutaneous patellar osteosynthesis system (PPOS) technique with open surgery for patella fractures. ⋯ PPOS for patella fractures was associated with shorter surgical time, less pain, better mobility angles, higher functional score up to 2 years, and a lower incidence of complications than open surgery.
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Comparative Study
Comparison of lateral locking plate and antiglide plate for fixation of distal fibular fractures in osteoporotic bone: a biomechanical study.
The purpose of this study was to compare the biomechanical properties of posterolateral antiglide plating and lateral locked plating for fixation of displaced short oblique fractures of the fibula in osteoporotic bone. ⋯ The posterolateral antiglide plate demonstrated improved biomechanical stability as compared to the lateral locking plate in osteoporotic bone. In situations where fixation needs to be optimized, use of an antiglide plate may be favored over a lateral locking plate construct.
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Comparative Study
Biomechanical analysis of blade plate versus locking plate fixation for a proximal humerus fracture: comparison using cadaveric and synthetic humeri.
To compare the mechanical stability of a fixed-angle blade plate with that of a locking plate in a cadaveric proximal humerus fracture-fixation model subjected to cyclic loading. A secondary objective was to evaluate whether the use of synthetic humerus specimens would replicate significant differences found during cadaveric tests. ⋯ For simulated humeral neck fractures subjected to cyclic loading, locking-plate constructs demonstrated significantly greater torsional stability and similar bending stability to blade plates in a cadaveric specimen model. In contrast, these same constructs performed similarly with torsional loading when using synthetic humerus specimens. These results indicate potential advantages for locking-plate fixation. They also indicate that the synthetic specimens tested may not be appropriate for evaluating fixation stability in the humeral head, where cancellous bone fixation predominates.
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Randomized Controlled Trial Multicenter Study
Reamed versus unreamed intramedullary nailing of the femur: comparison of the rate of ARDS in multiple injured patients.
To compare the rate of Acute Respiratory Distress Syndrome (ARDS) in multiply injured patients with femoral shaft fractures, treated with intramedullary femoral nails inserted with or without reaming. ⋯ The overall incidence of ARDS was found to be low with primary stabilization of femoral shaft fractures with intramedullary nailing. There was no difference in the incidence of ARDS between the reamed and unreamed groups, given the sample size.