Journal of orthopaedic trauma
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Comparative Study
Comparison of castile soap, benzalkonium chloride, and bacitracin as irrigation solutions for complex contaminated orthopaedic wounds.
The purpose of the present study was to determine the effects of cleaning a contaminated orthopaedic wound with different classes of wound irrigation solutions. ⋯ The rate of positive wound cultures due to P. aeruginosa is effectively reduced by irrigation with CS alone or by the sequential irrigation treatment. When used alone, the antiseptic BzC results in a higher rate of positive wound cultures and wound complications. The wound complications seen with irrigation with BzC alone are prevented by the sequential irrigation treatment (BzC followed by CS and NS). The rate of positive wound cultures in this model due to S. aureus is not decreased by irrigation with CS; however, the rate of positive wound cultures is safely and effectively decreased with the use of BzC.
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As tibial intramedullary nailing becomes the preferred treatment for tibial shaft fracture, removal of tibial nails will become more common. Removal of tibial intramedullary nails is not without complications, but a review of the literature found only one recent report of a fracture of the tibia during removal. A case report of a tibial fracture during removal of an Alta tibial nail is presented.
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Fractures of the medial third of the clavicle are the rarest of all clavicle fractures. We present two cases of medial clavicle fracture nonunions that were initially thought to be chronic anterior sternoclavicular dislocations and describe the entity of pseudo-dislocation of the sternoclavicular joint. Computed tomography should be performed on all patients with suspected or established injuries of the sternoclavicular region to ensure differentiation between fracture and dislocation.
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Randomized Controlled Trial Comparative Study Clinical Trial
Segment transport employing intramedullary devices in tibial bone defects following trauma and infection.
To compare two different methods of segment transport in posttraumatic and postseptic tibial defects by employing intramedullary tibial nails as the fixation system and to evaluate differences in the complication rate between external fixation and wire towropes as the transport system. ⋯ An intramedullary nail and wire towrope proves to be a reliable combination for segment transport in tibial defects following trauma and infection and provides a relatively high patient comfort rate and a low complication rate.
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To determine the effect of nutrition on patient outcome after hip fracture. ⋯ Patients at risk for poor outcomes after hip fracture can be identified using relatively inexpensive laboratory tests such as albumin and total lymphocyte count.