Journal of orthopaedic trauma
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Comparative Study
Biomechanical comparison of fixation methods in transverse olecranon fractures: a cadaveric study.
Our null hypothesis was that no difference in fracture displacement would be detected between traditional monofilament wire and Kirschner wire placement versus three modified tension-band techniques for transverse olecranon fractures. ⋯ In transverse noncomminuted olecranon fractures, fixation with monofilament wire is superior with Kirschner wire placement into the anterior ulnar cortex. With intramedullary Kirschner wires, fixation using braided cable is significantly improved over that with monofilament wire. When using braided cable, figure-eight and circular loop designs allow similar displacements. Braided cable or anterior cortical Kirschner wire purchase increases the stability of fixation over that achieved with the traditional method.
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The purpose of this study was to assess the interobserver reliability and intraobserver reproducibility of the AO/ASIF and Rüedi and Allgöwer classifications for fractures of the distal tibia, and to determine the benefit of a computed tomography (CT) scan and experience on observer agreement for several fracture characteristics, including classification. ⋯ The AO/ASIF classification for fractures of the distal tibia has good observer agreement at the type level, but poor agreement at the group level. Experience tends to improve interobserver agreement, but not intraobserver agreement. Viewing CT scans does not improve agreement on classification, but it tends to improve agreement on articular surface involvement.
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To study lumbosacral junction injuries (LSJIs) associated with displaced sacral fractures. ⋯ Lumbosacral junction injuries should be suspected in cases of transforaminal sacral fracture, especially when these fractures are displaced. In such cases, we recommend that the lumbosacral junction be evaluated with appropriate CT scans.
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To assess the efficacy of treatment and develop an algorithm for management of nonunions of the femoral diaphysis. ⋯ Established femoral diaphyseal nonunions can be treated effectively, even in the presence of chronic sepsis. Selective use of a vascularized fibula transfer has proven beneficial in addressing intercalary defects. Plate fixation, with or without a vascularized fibula transfer, has been the predominant mode of skeletal stabilization in more complex reconstructions.
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Comparison of the effect of stainless steel and titanium low-contact dynamic compression plate application on the vascularity and mechanical properties of cortical bone after fracture. ⋯ Both titanium and stainless steel LCDCPs were equally effective in allowing revascularization, and neither provided a significant advantage in biomechanical properties of fracture healing at ten weeks.