Journal of orthopaedic trauma
-
To determine if physical examination (PE) of the posterior pelvis in awake and alert trauma patients with known pelvic ring injuries can accurately predict a potentially unstable posterior ring injury and guide the use of computed tomography (CT) more effectively. ⋯ PE, specifically palpation of the posterior pelvis, in patients with pelvic fractures can accurately detect injuries of the posterior ring.
-
Comparative Study
Knee dislocations: where are the lesions? A prospective evaluation of surgical findings in 63 cases.
To evaluate soft-tissue injury patterns in a large series of patients with knee dislocations to identify frequency and associations that may aid in surgical planning. ⋯ This study showed a wide variety of injury patterns. Knees had to have at least two ligaments injured to be dislocatable but not necessarily both cruciate ligaments. Sports injuries have the same pattern of injury as motor vehicle accidents, suggesting similar forces of injury. The study demonstrates a high incidence of reattachable avulsion injuries to ligaments and soft tissues in dislocatable knees. These may not be as easily dealt with if surgery is delayed beyond 3-4 weeks.
-
Comparative Study
Physeal fractures of the distal radius and ulna: long-term prognosis.
The long-term prognosis of injuries to the distal physis of forearm bones, including complications such as radioulnar length discrepancy and styloid nonunion, has not been extensively studied. Reliable radiographic prognostic criteria to predict physeal disturbance at trauma are also lacking. The aim of this study is to investigate both issues. ⋯ None of the patients reviewed at follow-up, including those with radioulnar length discrepancy of less than 1 cm and those with styloid nonunion, complained of any symptom related to their previous injury, not even those engaged in heavy manual labor. Of the 10 patients with either radial or ulnar shortening of more than 1 cm, only 2 with radial growth arrest and marked radioulnar length discrepancy had severe functional problems. Growth disturbances of more than 1 cm following distal radial physeal injury occurred only in Ogden type 1C, 2B, and 2D lesions, whereas in distal ulnar physeal injuries, growth disturbances occurred regardless of the Ogden classification type.
-
Comparative Study
Comparison of internal bone transport and vascularized fibular grafting for femoral bone defects.
To compare results between vascularized fibular grafting and internal bone transport for large bone defects of the femur. ⋯ With vascularized fibular grafting, careful monitoring of circulation and early intervention surgery is necessary to avoid vascular failure. With internal bone transport, repeated radical debridement until control of infection is achieved, bone grafting at the docking site for early union, and avoiding stress fracture are recommended to improve bone results.
-
To investigate the clinical and functional outcome in an elderly population with acetabular fractures after low-energy trauma treated acutely with a total hip arthroplasty supported by a reinforcement ring (Burch-Schneider antiprotrusion cage) and autologous bone grafting of the acetabulum. ⋯ Primary total hip replacement with a reinforcement ring and bone grafting of the socket seems to be a promising treatment alternative in displaced acetabular fractures in elderly patients with osteoporotic bone, except in those with an increased risk of dislocation.