Journal of orthopaedic trauma
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Third-generation cephalomedullary nails currently represent the gold standard in the treatment of unstable trochanteric femur fractures. Recently, an extramedullary rotationally stable screw-anchor system (RoSA) has been developed. It was designed to combine the benefits of screw and blade and to improve stability using a locked trochanteric stabilizing plate (TSP). The purpose of this study was to compare the biomechanical behavior of RoSA/TSP and the proximal femoral nail antirotation (PFNA). ⋯ There was no significant difference in biomechanical properties between the RoSA/TSP and the PFNA for the fracture pattern tested. However, failure modes differed between the 2 implants with greater femoral neck shortening observed in the RoSA/TSP group.
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Clinical Trial
Do Safe Radiographic Sacral Screw Pathways Exist in a Pediatric Patient Population and Do They Change with Age?
Iliosacral screw pathways in the first (S1) and second (S2) sacral segments are commonly used for adult pelvic ring stabilization. We hypothesize that radiographically "safe" pathways exist in pediatric patients. ⋯ Contrary to our hypothesis, almost all children aged 2-16 had a radiographically safe screw pathway for an iliosacral screw at S1, and most of the children had an available pathway for a TSTI screw at S2. However, only 51% had a pathway for a TSTI screw at S1.
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To analyze pelvic fracture mortality rates before and after initiation of a multidisciplinary pelvic fracture protocol. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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To document the high failure rate of a specific implant: the Synthes Variable Angle (VA) Locking Distal Femur Plate. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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Misperception on the fluoroscopic image showing a well-placed iliosacral (IS) screw can occur, when the screw is in reality misplaced. The purpose of this study was to demonstrate and highlight examples of misperception and suggest alternative inlet and outlet views to confirm adequate IS screw placement. ⋯ Our findings highlight that misperception can occur using standard inlet and outlet views. We suggest using 2 variations of the inlet views and 3 variations of the outlet views to avoid misperception in clinical practice.