Journal of orthopaedic trauma
-
Comment Letter Review
Paradoxical fat embolism after intramedullary rodding.
-
To evaluate the unreamed femoral nail with spiral blade (UFN-SB) in the treatment of nonpathologic subtrochanteric and segmental femoral fractures. ⋯ There is predictive value of the Seinsheimer classification as to outcome using UFN-SB. The UFN-SB is an option for the treatment of subtrochanteric or segmental fractures of the femur, especially in patients with a good quality of bone. The complications using this device are not caused by the learning curve, but by the characteristics of the implant and the type of fracture for which it is used. The implant should not be used in elderly women with a reversed oblique fracture or a subtrochanteric fracture with an intertrochanteric component.
-
To determine the biomechanical characteristics of four different fixation constructs for split depression fractures of the lateral tibial plateau (OTA classification 41B3.1). ⋯ There was no significant difference in the overall construct stiffness between the four fixation constructs. Fixation constructs with a raft of subchondral screws were more resistant to local depression loads. This supports the use of a raft construct when a central depression is a significant component of the overall fracture pattern. Condylar tilt data showed a persistent weakness in the postfixation lateral plateau regardless of fixation construct when compared with the intact specimen. This supports the current clinical practice of delayed weight-bearing for ten to twelve weeks.
-
A technique for closed reduction and percutaneous screw fixation of fractures of the iliac wing and fracture-dislocations of the sacro-iliac joint is presented. Twenty-seven pelvic fractures were treated with attempted closed reduction followed by percutaneous screw fixation. Closed reduction failed in two patients. ⋯ All but two of the patients who were working before injury returned to work. All but one of the patients was satisfied with the outcome of their pelvic fracture treatment. Closed reduction and percutaneous screw fixation of fractures of the posterior portion of the iliac wing yields acceptable reductions, with minimal blood loss and limited damage to the surrounding soft tissues.
-
Comparative Study
Migration of the lag screw within the femoral head: a comparison of the intramedullary hip screw and the Gamma Asia-Pacific nail.
To study the functional difference in the performances of sliding femoral head screws by comparing the displacement of the screw in relation to the femoral head in hips treated with the Gamma Asia-Pacific nail (GN) and hips treated with the intramedullary hip screw (IMHS). ⋯ These results indicate that the displacement of the femoral head screw of the IMHS was less than the lag screw of the GN. However, it is still unknown whether this smaller displacement of the IMHS is clinically significant for reducing the rate of screw cut-out after surgery.