Journal of orthopaedic trauma
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The dynamic hip screw, which is routinely used for intertrochanteric hip fractures, also provides a technically simple means of fixation for intertrochanteric valgus osteotomies in the treatment of femoral neck nonunions. Eight patients underwent intertrochanteric valgus osteotomy for femoral neck nonunion using a dynamic hip screw for fixation. One patient died 4 months postoperatively of causes unrelated to the procedure. ⋯ All the hip fractures were classified as Pauwels type III preoperatively and Pauwels type II postoperatively. The average Harris Hip Score increased from 24 to 73. On radiographic review, no cases of osteonecrosis were identified postoperatively.
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Randomized Controlled Trial Comparative Study Clinical Trial
Trochanteric gamma nail and compression hip screw for trochanteric fractures: a randomized, prospective, comparative study in 210 elderly patients with a new design of the gamma nail.
To compare the results between a new intramedullary Gamma nail and a compression hip screw in the treatment of trochanteric fractures. ⋯ The new Trochanteric Gamma nail is an effective method for the treatment of trochanteric femoral fractures in elderly patients. The indication for either Trochanteric Gamma nail or compression hip screw is similar in stable fractures, but we recommend the use of the Trochanteric Gamma nail for unstable trochanteric fractures.
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Multicenter Study
Functional outcome of bilateral limb threatening: lower extremity injuries at two years postinjury.
To describe the functional outcome of bilateral limb-threatening injuries at 2 years postinjury and to evaluate whether a different decision-making process should be used for these patients as opposed to patients with unilateral limb-threatening injury. ⋯ The results indicate that treatment judgments should be based upon the results derived from the analysis of the larger unilateral limb cohort data. Patients with severe, bilateral lower extremity injuries should be counseled that regardless of treatment combinations, the function of each limb is similar at 24 months. The unilateral amputation/salvage group had a greater probability of going back to work. This is the major identifiable benefit to undergoing salvage versus amputation.
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Comparative Study
Standard multiplanar fluoroscopy versus a fluoroscopically based navigation system for the percutaneous insertion of iliosacral screws: a cadaver model.
To compare the safety and efficiency of standard multiplanar fluoroscopy (StdFluoro) and virtual fluoroscopy (VirtualFluoro) for use in the percutaneous insertion of iliosacral screws. ⋯ Most of the percutaneous iliosacral screws were safely inserted using StdFluoro and VirtualFluoro, and total surgical times were similar using both methods. As VirtualFluoro continues to evolve, improved efficiency in operative times may be expected. Currently, the most beneficial aspect of using VirtualFluoro during the insertion of percutaneous iliosacral screws appears to be significantly decreased use of fluoroscopy when compared to StdFluoro.