Journal of orthopaedic trauma
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To determine the effectiveness of circular wire external fixation in the treatment of complex (Schatzker Type VI) fractures of the tibial plateau. ⋯ Results perhaps would have been improved by more frequent open reduction, bone grafting, and internal fixation of fractures with severely depressed articular fragments. However, the use of circular external fixation obtained results comparable with other series, and we believe it is appropriate for treatment of these complex tibial fractures, especially those with a poor soft-tissue envelope.
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To evaluate the results of radial head excision for the treatment of elbow fracture-dislocations with an unsalvageable comminuted radial head fracture and no other associated fractures. ⋯ Acute radial head excision for the treatment of elbow fracture-dislocations provides satisfactory short-term clinical results when there are no other associated intraarticular fractures. However, the long-term significance of the early degenerative changes is not known.
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To assess the accuracy of a previously undescribed method of determining tibial nail length based on anatomic landmarks. ⋯ The tibial tubercle-medial distance (TMD) proved an easy, inexpensive, and accurate method of preoperative nail assessment.
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Comminuted iliac fractures are uncommon and difficult to treat. The purpose of this study is to further delineate the fractures, to present a management protocol, and to evaluate the results of treatment. ⋯ Comminuted iliac fractures occur in two distinct patterns and are associated with numerous local injuries that complicate management. Management protocols should include early open reduction and stable internal fixation. Traumatic open wounds should not be closed primarily. Primary closure with closed suction drainage is effective in the management of associated degloving injuries. Extension of the fracture into the greater sciatic notch warrants further evaluation with pelvic angiography.
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To determine the optimal starting points for placement of S1 and S2 iliosacral screws as well as the pertinent anatomy surrounding the S1 and S2 vertebral bodies. ⋯ The iliosacral screw starting point at the posterior sacral body and inferior S1 foramen was the safest when considering the entire population. Careful attention to the size and orientation of the S2 vertebral body should be taken if S2 iliosacral screws are placed.