Journal of orthopaedic trauma
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Review Case Reports
Ulnar nerve laceration in a closed both bone forearm fracture.
Ulnar nerve injury is rarely associated with closed forearm fractures. This report describes a case of ulnar nerve laceration secondary to a closed fracture of the radius and ulna. Although a case report of an ulnar nerve laceration in an open fracture has been described, a review of the literature failed to reveal any cases in closed injuries. The standard surgical approach was modified to allow treatment of the fractures and microscopic repair of the nerve.
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Review Case Reports
Pelvic and bladder trauma: a case report and subject review.
Pelvic fracture and bladder rupture resulted in bladder wall entrapment in the fracture site of a patient involved in a severe motor vehicle accident. Although hematuria and bladder rupture are known to occur after fracture of the pelvis, our literature review showed no reports of this type of injury or management. Bladder extravasation was managed with catheter drainage and surgical extraction; viscus repair was performed for the bladder rupture. Fracture healing and bladder continuity resolved uneventfully.
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Comparative Study
Biomechanical study of nine different tibia locking nails.
We compared different nail types within the Bone/Implant-Complex to look for differences in stiffness for axial load, bending and torsion of the System. We simulated comminuted mid shaft fractures by a 2-cm defect osteotomy in paired human cadaver tibiae. We fixed tibiae with one of nine different interlocking nails [AO Unreamed Tibial Nail 9 mm (UTN9), AO Unreamed Tibial Nail 8 mm (UTN8), Russell & Taylor Delta Tibial Nail 9 mm (RTD), Russell & Taylor Reconstruction Tibial Nail 11 mm (RTR), Brooker & Wills Tibial Nail 11 mm (B&W), Grosse & Kempf Tibial Nail 11 mm (G&K), AO Universal Tibial Nail 11 mm (AOU), Klemm & Schellmann Tibial Nail 11 mm (K&S), and Börner & Mattheck Tibial Nail 11 mm (B-M)] according to the manufacturer's recommendations. ⋯ In axial load testing large diameter nails interlocked by large diameter interlocking bolts (G&K, K&S, B-M) showed significantly higher stiffness. For A-P bending no significant differences between implants were found, but isolated bones showed significantly higher A-P bending stiffness. In varus-valgus bending large diameter nails (RTR, G&K, K&S, B-M) showed significantly higher bending stiffness compared to low diameter (UTN8, B&W) implants.
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Titanium plates and screws have become widely used for the fixation of fractures and osteotomies. We began using them in 1992; however, several early hardware failure prompted a retrospective review of the occurrence of this complication. A 2-year time period was reviewed at two institutions with comparison of hardware failure rates using titanium and stainless steel implants. ⋯ At the second institution, 21 titanium and 138 stainless steel platings were performed over 2 years. There were four titanium implant failures in four patients and one stainless steel implant failure. Our experience suggests that these implants should be used with care, particularly in high-demand settings such as nonunion or noncompliance, and that further research needs to be conducted to establish appropriate clinical indications for their usage.
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Our purpose was to determine the incidence of deep-vein thrombosis (DVT) in patients who have had early operative fixation of fractures of the lower extremity distal to the hip. There is a high incidence of distal thrombosis in patients who have undergone early operative fixation of lower-extremity fractures. The incidence of DVT is higher with proximal extremity fractures than with distal extremity fractures. ⋯ This study suggests a higher DVT incidence in more proximal fractures, but little risk of embolization. Thrombus formation proximal to the popliteal fossa is rare. Older age, longer operating times, and longer times before fracture fixation all correlate with an increased incidence of DVT.