Journal of orthopaedic trauma
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Comparative Study
Internal fixation of supracondylar femoral fractures: comparative biomechanical performance of the 95-degree blade plate and two retrograde nails.
The biomechanical stability of supracondylar femoral fractures fixed with a condylar blade plate (plate), a Green Seligson Henry nail (GSHN), or a new retrograde unreamed supracondylar femoral nail (new nail) based on the AO unreamed femoral nail were compared. ⋯ In fixation of extraarticular comminuted supracondylar distal femur fractures, results indicate that (a) the new nail provides equal or greater stability than does the plate, except when large torsional loads are anticipated, and (b) the new nail provides stability equal to the GSHN for axial loading and lesser stability against off-axis loads. As is evident in this and other studies, intramedullary implants are less torsionally stiff than are plates. The torsional stiffness of the new nail is expected to be sufficient because it is comparable to many available nails, and low torsional moments are expected for healing femoral supracondylar fractures.
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Comparative Study
Intramedullary fixation of high subtrochanteric femoral fractures: a study comparing two implant designs, the Gamma nail and the intramedullary hip screw.
To compare two implants, the Gamma nail and the intramedullary hip screw (IMHS ), in the treatment of high subtrochanteric femoral fractures. ⋯ The lower complication rate associated with the use of the IMHS implant could be attributable in part to the learning curve in the use of intramedullary implants. However, we consider that the evolution of the implant design contributes to the result.
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Randomized Controlled Trial Comparative Study Clinical Trial
Dynamic hip screw with trochanteric stabilizing plate in the treatment of unstable proximal femoral fractures: a comparative study with the Gamma nail and compression hip screw.
To compare the results after operative treatment of unstable per- and subtrochanteric fractures with the Gamma nail, compression hip screw (CHS), or dynamic hip screw with a laterally mounted trochanteric stabilizing plate (DHS/TSP). ⋯ The TSP may be an aid in the treatment of these difficult fractures because the problem with femoral shaft fractures using the Gamma nail is avoided and the medialization of the distal fracture fragment frequently associated with the CHS is prevented.
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This study sought to identify the long-term functional results of various posterior pelvic lesions and to determine whether such injuries benefit from exact reduction. ⋯ This study shows that when the posterior injury is a fracture of the iliac wing or a mixed fracture with SI propagation, a long-term satisfactory functional result can be obtained without an exact reduction even in cases of vertical instability. Simple methods are usually sufficient, and it seems unnecessary to propose more aggressive treatment. It is important, however, to recognize that SI fracture-dislocations (17 percent in this series) seem to be quite different from pure SI disruptions in terms of persistent pain. Moreover, it appears that exact reduction of pure SI lesions is critical for good functional results, something that is difficult to obtain with conservative procedures. Sacral fractures represent a special problem for the surgeon because of the frequency of fair results in which neurologic lesions whose pathophysiology is poorly known seem to be responsible.
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To evaluate the functional outcome of displaced acromioclavicular (AC) injuries in polytrauma patients. ⋯ A displaced acromioclavicular joint injury in a polytrauma patient has a greater effect on shoulder function than isolated acromioclavicular joint injuries when evaluated by both disease-specific and general health outcomes. Standard treatment methods may be inadequate for this group of patients.