Journal of orthopaedic trauma
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Chronic anterior knee pain is a common complication following intramedullary nailing of a tibial shaft fracture. The source of pain is often not known nor is the reason for a simultaneous decrease in thigh muscle strength. Anterior knee pain has also been reported following an anterior cruciate ligament rupture. No previous investigation has assessed whether weakness of the thigh muscles is associated with anterior knee pain following intramedullary nailing of tibial shaft fractures. ⋯ Based on this prospective study, we conclude that anterior knee pain after intramedullary nailing of a tibial shaft fracture, although of multifactorial origin, may be related to deficiency in the flexion strength of the thigh muscles.
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To review our series of open calcaneal fractures compared with other series. ⋯ Our findings do not reflect as high a complication rate for open calcaneal fractures as previously reported. We support previous claims that definitive hardware placement at the time of initial irrigation and debridement probably is not warranted: Definitive fracture stabilization can and should wait until soft tissue coverage is fully assessed.
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To evaluate the results of a vacuum-assisted closure device in patients presenting with open high-energy soft tissue injuries. ⋯ The vacuum-assisted closure appears to be a viable adjunct for the treatment of open high-energy injuries. Application can be performed as a bedside procedure but additional soft tissue reconstruction may be needed for definitive coverage. This device does not replace the need for formal debridement of necrotic tissue, but it may avoid the need for a free tissue transfer in some patients with large traumatic wounds.
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To evaluate the results of valgus intertrochanteric osteotomy for varus nonunion and malunion of trochanteric fractures. ⋯ Valgus intertrochanteric osteotomy is an effective procedure that reliably restores hip function in trochanteric malunion or nonunion.
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To evaluate functional outcomes, morbidity and mortality rates, and psychological and psychosomatic status in patients treated for completely unstable pelvic injuries (Tile class C). ⋯ Morbidity and mortality rates are higher in patients with a completely unstable pelvic ring injury. Emergency department stabilization and reconstruction of the pelvic ring with optimal operative techniques in these patients can reduce morbidity and mortality rates. Anterior and posterior internal fixation results in satisfactory clinical and radiologic outcomes. The affective status of patients is an important aspect that should be considered during the entire care of the patient.