Journal of orthopaedic trauma
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To determine the prevalence and patterns of foot injuries following motorcycle trauma. ⋯ Motorcycle accidents continue to be a source of severe injury, especially to the foot. The most common foot injury is a metatarsal fracture; however, there must be a high index of suspicion for associated injuries. Although these injuries are associated with a low mortality rate, they require prompt assessment and treatment to limit long-term morbidity and disability. The difference in foot injury pattern and mortality between the parent population and our series, among other factors, potentially may be influenced by the actual mechanism of contact with the road surface and the modifying action of the foot during the accident.
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The application of the pelvic clamp as a tool for emergency stabilization of unstable pelvic ring fractures has proved to be a life-saving procedure. Using correct technique, the pelvic clamp can be applied within a few minutes after the patient's admission. To avoid severe complications (eg, pin perforation into the pelvis) during the application, anatomic landmarks for the correct pin placement have to be defined. ⋯ The ideal insertion point of the pins is an anatomic region on the lateral cortex of the ileum, where an easily palpable "groove" is formed by angulations of the lateral cortex of the iliac wing. Being increasingly used as an entry point for percutaneous transiliosacral screw fixations of sacroiliac joint injuries and sacral fractures, this region, which is close to the sacroiliac joint, represents an ideal point for maximum compression of the posterior pelvic ring. With the described technique, this "groove" can be identified easily even in emergency situations by blunt palpation with an instrument, avoiding the time-consuming use of a fluoroscope in most cases.
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Percutaneous internal fixation of pelvic fractures has gained popularity allowing rapid mobilization with reduced surgical related morbidity; however, this method depends on conventional fluoroscopy, which exposes the patient and the surgeon to a significant amount of radiation. The use of computerized fluoroscopic navigation systems enables the simultaneous use of several radiographic projections. These preliminary fluoroscopic views are taken when the operating team stands at a distance from the radiation source. ⋯ Fluoroscopic verification of screw placement demonstrated a deviation
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To compare the screw sliding characteristics and biomechanical stability of four-part intertrochanteric hip fractures stabilized with an intramedullary nail using either one large-diameter lag screw (intramedullary hip screw [IMHS]; Smith & Nephew, Memphis, TN) or two small-diameter lag screws (trochanteric antegrade nail [TAN]; Smith & Nephew, Memphis, TN). ⋯ The two constructs showed equivalent rigidity and stability in all parameters assessed in elastic and cyclical tests. The TAN had a greater ultimate failure load.
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The study evaluated the outcome of the treatment of patients who sustained high-energy, compression-type injuries of the distal radius. ⋯ Reduction and plating of the lunate facet in conjunction with standard external fixation permits: 1) visualization and reduction of the palmar lunate facet; and 2) reduction of palmar tilt to neutral tilt without significant radial shortening. This technique should be considered as an acceptable option in the treatment of high-energy fractures of the distal radius.