Journal of orthopaedic trauma
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To locate the proper insertion point for a tibial intramedullary nail in the coronal plane. ⋯ The insertion point of a tibial nail should be over the medial aspect of the tibial tubercle in the coronal plane. Our data supports using a medial or patellar splitting approach for nail insertion. Insertion sites lateral to the tibial tubercle should be avoided.
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The case of a patient who sustained an avulsion fracture of the femoral head (Pipkin Type I) that was unrecognized is described. The patient was referred to the authors' institution four months after injury, and radiographic studies showed a malunited avulsion fracture of the femoral head to the acetabulum. The patient subsequently went on to an excellent result after surgical debridement. The authors recommend additional radiographic studies in cases to exclude unrecognized fractures where a possible hip subluxation may have occurred.
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Case Reports
Posteromedial dislocation of the elbow with associated intraarticular entrapment of the lateral epicondyle.
Traumatic elbow dislocation is relatively common in adolescents. Most cases occur in a posterolateral direction. Elbow dislocation is often accompanied by fractures, most frequently of the medial epicondyle. The authors report a rare case of posteromedial elbow dislocation and associated fracture of the lateral humeral epicondyle trapped within the joint.
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To determine whether teleradiology improved clinical decision making for the treatment of patients with acute fractures. ⋯ The routine use of electronically transmitted digitized radiographic images has the potential to improve clinical decision making for the care of patients with acute fractures.
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Comparative Study Clinical Trial
Quality of life related to fracture displacement among elderly patients with femoral neck fractures treated with internal fixation.
To determine differences in outcome between undisplaced (Garden I and II) and displaced (Garden III and IV) femoral neck fractures in elderly patients treated with internal fixation. ⋯ There was a major difference in outcome on comparing undisplaced and displaced femoral neck fractures in elderly patients treated with internal fixation. The rate of fracture healing complications in patients with undisplaced fractures was low, and patients with healed fractures regained their prefracture quality of life level. The rate of fracture healing complications and reoperations in patients with displaced fractures was high, and even in patients with uneventfully healed fractures, there was a substantial decrease in the quality of life.