Journal of orthopaedic trauma
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To review our experience with nonoperative versus operative management of patients with patellar delayed union or nonunion. ⋯ Our findings suggest that patients with minimally symptomatic delayed union or nonunion of the patella can be successfully treated nonoperatively with the knowledge that the fracture will not unite. Operative management of symptomatic patients can be expected to achieve union and increase function of the knee.
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Twelve of 14 proximal third tibial shaft fractures were successfully treated with a new technique for intramedullary nailing of these fractures. The average anterior displacement was 3.0 mm (range 0-17). ⋯ There was one nonunion. The technique's success is dependent on neutralizing the primary factors causing malreduction: wide effective diameters of tibial nails, narrow diameter of the medial tibial metaphysis, and a posteriorly directed sagittal plane entrance angle.
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To establish the incidence and clinical effects of anterior knee pain after intramedullary nailing of the tibia. ⋯ Anterior knee pain is a significant complication of intramedullary nailing of the tibia.
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Randomized Controlled Trial Comparative Study Clinical Trial
The treatment of femoral shaft fractures using intramedullary interlocked nails with and without intramedullary reaming: a preliminary report.
To compare operative and postoperative variables in the treatment of femur fractures using interlocked intramedullary nails with and without reaming. ⋯ Reamed canal preparation led to faster healing of distal fractures treated with statically locked intramedullary nails. Blood loss was greater in the reamed group but this did not translate into increased transfusion requirements. In this series, there was no advantage to nail insertion without reaming.