Journal of orthopaedic trauma
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The anterior curvature of the femur affects intramedullary nail insertion, revision prosthesis design, and the biomechanics of the proximal femur. Two previous studies, using small numbers of femurs, determined femoral curvature and showed that it was significantly greater than that of the several intramedullary nails they evaluated. In this study, the curvature of 948 femurs (474 matched pairs) was determined and compared with current intramedullary nails. The correlation of femoral curvature to age, gender, femoral size, and race was also evaluated. ⋯ Because ease of intramedullary nail insertion and possibility of cortical comminution are determined by a number of factors including insertion point and fracture location, it appears that a decrease in radii of curvature (less straight) of current nail designs is warranted, particularly for those larger diameter nails designed for hip fracture stabilization that have greater rigidity due to design or material.
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Randomized Controlled Trial Comparative Study Clinical Trial
Tricortical versus quadricortical syndesmosis fixation in ankle fractures: a prospective, randomized study comparing two methods of syndesmosis fixation.
To assess short-term functional results in 2 types of syn-desmotic fixation, comparing the traditional rigid quadricortical syndesmotic screw fixation with a more dynamic tricortical screw fixation. ⋯ Syndesmosis fixation with 2 tricortical screws is safe and improves early function. After 1 year, however, there were no significant differences between the 2 groups in functional score, pain, and dorsiflexion.
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Multicenter Study
The effect of perioperative anemia on clinical and functional outcomes in patients with hip fracture.
To describe the epidemiology of perioperative anemia in patients with hip fracture and assess the relationship between the hemoglobin measurements and clinical outcomes. ⋯ Substantial declines in hemoglobin were common in patients with hip fracture. Higher preoperative hemoglobin was associated with shorter length of stay and lower odds of death and readmission within 60 days of discharge. Postoperative hemoglobin was also related to length of stay and readmission rates.
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A modified ilioinguinal approach for acetabular fractures is presented. The approach allows surgical exposure of the anterior column as well as the contralateral rami, the symphysis pubis, and the medial wall of the acetabulum. Direct access to the quadrilateral surface and retroacetabular surface for plate or screw application is also possible.
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To assess the efficacy of the long Gamma nail in the treatment of subtrochanteric nonunions. ⋯ Subtrochanteric nonunion can be treated effectively using the long Gamma nail for skeletal stabilization, following removal of previously implanted devices.