Journal of orthopaedic trauma
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Randomized Controlled Trial Comparative Study Clinical Trial
Should insertion of intramedullary nails for tibial fractures be with or without reaming? A prospective, randomized study with 3.8 years' follow-up.
To determine if any differences exist in healing and complications between reamed and unreamed nailing in patients with tibial shaft fractures. ⋯ Unreamed nailing in patients with tibial shaft fractures may be associated with higher rates of secondary operations and malunions compared with reamed nailing. The time to fracture healing was significantly longer with unreamed nails.
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Comparative Study
Bifocal compression-distraction in the acute treatment of grade III open tibia fractures with bone and soft-tissue loss: a report of 24 cases.
To evaluate the results of bifocal compression-distraction method for the acute treatment of open tibia fractures with bone and soft-tissue loss. ⋯ Bifocal compression-distraction osteogenesis is a safe, reliable, and largely successful method for the acute treatment of open tibia fractures with bone and soft-tissue loss. Further nonoperative or operative treatment can correct most complications.
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Review Comparative Study
Infrapectineal plating for acetabular fractures: a technical adjunct to internal fixation.
Acetabular fractures with medial displacement patterns, particularly medial displacement of the quadrilateral surface, may be technically challenging to treat. Minimal bone stock, limited anatomic access, and difficulty in obtaining stable internal fixation in the true pelvis contribute to the surgical challenge of open reduction and internal fixation. ⋯ An undercontoured plate is secured posteriorly along the sciatic buttress posterior to the joint and the quadrilateral plate and anteriorly on the posterior surface of the pubic ramus. By resisting medial secondary redisplacement, this technique adds to stable fixation for acetabular fractures involving medial displacement, particularly of the quadrilateral plate.
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Multicenter Study
Outcome of open reduction and internal fixation of surgical neck nonunions of the humerus.
The purpose of this study was to evaluate the results of open reduction and internal fixation of nonunions of the surgical neck of the humerus. ⋯ Open reduction and internal fixation with autogenous bone graft results in excellent outcomes even in patients >65 years old and patients with significant medical problems. This treatment method offers predictable fracture healing and has a low complication rate.
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To correlate interosseous membrane (IOM) tears of the ankle to the height of fibular fractures in operative ankle fractures. ⋯ The level of the fibular fracture does not correlate reliably with the integrity or extent of the interosseous membrane tears identified on MRI in operative ankle fractures. One cannot consistently estimate the integrity of the IOM and subsequent need for transsyndesmotic fixation based solely on the level of the fibular fracture. An intraoperative syndesmotic stress test is recommended to establish the presence or absence of syndesmotic instability.