Journal of orthopaedic trauma
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The aim of the present study was to analyze the long-term outcome of mid-clavicle fractures in adults and to evaluate the clinical importance of displacement and fracture comminution. ⋯ This review demonstrates that few patients with fractures of the mid-part of the clavicle require operative treatment.
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To confirm the need to check anteversion (AV) of the intact femur to prevent malrotation deformity following intramedullary nailing in femoral shaft fracture. ⋯ Because true neutral rotation of the distal fragment alone is not accurate in preventing malrotation deformity of the femur following intramedullary nailing, we recommend measuring AV in both intact and fractured femurs and correcting rotational malalignment if it exists at the time of femoral nailing. Rotational alignment did not change significantly unless we failed to externally reduce the fracture due to a flexion deformity of the proximal fragment.
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Comparative Study
Skeletal traction versus external fixation for pediatric femoral shaft fractures: a comparison of hospital costs and charges.
To compare the hospital costs, charges, and reimbursement for treatment of pediatric femur fractures by two treatment methods: external fixation and 90-90 traction with spica casting. ⋯ External fixation of pediatric femoral shaft fractures results in decreased hospital costs and length of hospitalization, but produces significantly less income for the hospital when compared with skeletal traction followed by spica casting.
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To describe an intrapelvic compartment syndrome analogous to abdominal compartment syndrome and to characterize its diagnosis and treatment. ⋯ An intrapelvic compartment syndrome can be defined as bilateral ureteral obstruction and renal failure caused by a massive intrapelvic hematoma with increased retroperitoneal pressure. Diagnostic differentiation of anuria in patients with pelvic ring or acetabular fractures must include intrapelvic compartment syndrome. Early diagnosis and treatment are mandatory.
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To evaluate the effects of pulsatile lavage and bulb syringe irrigation on fracture healing in vivo. ⋯ Pulsatile lavage irrigation of fresh intraarticular fractures in rabbits has a detrimental effect on early new bone formation; this effect, however, is no longer apparent two weeks following irrigation. While this study evaluated the effects of pulsatile lavage irrigation in noncontaminated fractures without extensive soft tissue injury, the detrimental effects observed on early new bone formation may translate to an increased risk of nonunion in the setting of a contaminated open fracture with extensive soft tissue injury. Based on the results of this investigation, the selective use of pulsatile lavage irrigation appears warranted. In the absence of gross wound contamination, irrigation with a bulb syringe appears less likely to impair fracture healing than does pulsatile lavage irrigation. Expansion of the model used in this study to include bacterial contamination and soft tissue crushing may further elucidate the effects of pulsatile lavage irrigation on fracture healing.