Journal of orthopaedic trauma
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Review Case Reports
An irreducible distal fibula dislocation while in-line skating.
We present a case report of a variation of a Bosworth fracture, which is a posterior dislocation of the proximal fragment of a distal fibula fracture. Our patient had a distal fibula dislocation without fracture. He was treated with an open reduction and internal fixation using syndesmotic screws. At his most recent follow-up, he was ambulating without pain.
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Review Case Reports
Variant of the Lisfranc fracture-dislocation: a case report and review of the literature.
Lisfranc fracture-dislocations are uncommon injuries with several variations. We present one such variation and include a pertinent review of the literature. ⋯ Anatomic reduction and stabilization of the lateral Lisfranc joints resulted only after open anatomic reduction and internal fixation of the metatarsal fractures. Two-year follow-up confirmed an excellent clinical and radiographic result.
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Comparative Study
A mechanical comparison of subtrochanteric femur fracture fixation.
To determine whether the mechanical properties of first-generation interlocking femoral nails are different from those of second-generation interlocking femoral nails in a subtrochanteric femur fracture model. ⋯ Second-generation nails provided significantly enhanced mechanical stiffness compared with first-generation femoral nails when used to treat both stable and unstable subtrochanteric femur fractures. Although these results were obtained by using a well-controlled, mechanically consistent model, clinical validation of an increased incidence of fracture unions or of decreased time to union is required before we can recommend that second-generation nails be used routinely to treat subtrochantenic femur fractures.
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To determine and compare the mortality rates of patients with bilateral versus unilateral femoral fractures and to determine the contribution of the femoral fracture to, and identify risk factors for, such mortality. ⋯ Patients with bilateral femoral fractures have a significantly higher risk of death, ARDS, and associated injuries than patients with unilateral femoral fractures. This increase in mortality is more closely related to associated injuries and physiologic parameters than to the presence of bilateral femoral fractures. The presence of bilateral femoral fractures should alert the clinician to the likelihood of associated injuries, a higher Injury Severity Score, and the potential for a more serious prognosis.
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Presentation of a new triangular osteosynthesis technique that permits early weight-bearing in vertically unstable sacral fractures. ⋯ Triangular osteosynthesis is a demanding procedure that can be performed on vertically unstable sacral fractures to allow early progressive weight-bearing with an acceptable complication rate.