Journal of orthopaedic trauma
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The authors present a case in which an interlocked intramedullary nail placed to secure a left femoral shaft fracture was deformed twelve months after surgery because of secondary trauma. The nail was straightened by sectioning through half of its diameter with a drill for metal under minimal soft tissue dissection, then removed and replaced with another nail. The femur subsequently healed without complications.
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To present the technique and early results of percutaneous stabilization of U-shaped sacral fractures with attention to neurologic recovery and maintenance of fracture reduction of the sacrum. ⋯ These sacral fractures are rare and occur after significant spinal axial loading. A paradoxic inlet view of the upper sacrum on the anteroposterior plain pelvic radiograph heralds the diagnosis. Delayed diagnosis is avoided by a high clinical suspicion, early lateral sacral radiographs, and pelvic computed tomography scans. Surgical stabilization may assist in early mobilization of the patient from recumbency and prevents progressive deformity with associated nerve root injury. Percutaneous fixation diminishes potential blood loss and operative times, yet still allows subsequent sacral decompression of the local neural elements using open techniques when necessary. Early percutaneous iliosacral screw fixation is effective treatment for these injuries.
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Randomized Controlled Trial Comparative Study Clinical Trial
Bone graft in the operative treatment of displaced intraarticular calcaneal fractures: is it helpful?
To determine whether autologous bone graft supplementation with open reduction and internal fixation (ORIF) of displaced intraarticular calcaneal fractures (DIACFs) is beneficial in achieving and maintaining restoration of calcaneal height and anatomic reduction of the posterior facet. ⋯ We found no objective radiographic or functional benefit to the use of bone graft supplementation in the operative treatment of DIACFs.
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To describe the technique and results of using blocking screws and intramedullary nails to treat patients with fractures of the proximal third of the tibial shaft. ⋯ Blocking screws are effective to help obtain and maintain alignment of fractures of the proximal third of the tibial shaft treated with intramedullary nails.
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Comparative Study
Heterotopic ossifications in patients after severe blunt trauma with and without head trauma: incidence and patterns of distribution.
To investigate the incidence and distribution of heterotopic ossifications in patients with blunt multiple trauma with and without associated head trauma. ⋯ There was a high incidence of heterotopic ossification around those joints that were initially classified as uninjured in patients without head trauma. This finding suggests that pathogenic pathways independent of head trauma, such as long-term ventilation, play a main role. Causative factors for the development of heterotopic ossification at initially uninjured joints in long-term ventilated patients with multiple trauma with and without head trauma remain to be elucidated.