Journal of orthopaedic trauma
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Traditional repair of the disrupted pubic symphysis includes application of pointed clamps to the pubic tubercles and/or pubic body for fracture reduction. Recent studies have reported rates of sexual dysfunction of 42%-90% after repair of these injuries. The purpose of this study is to define the anatomy of the spermatic cord relative to the pubic tubercle and other local structures to assess the risk of sustaining an iatrogenic injury during clamp placement. ⋯ The spermatic cord is located lateral and immediately adjacent to the pubic tubercle after it exits the inguinal canal and passes into the scrotum. As such, the spermatic cord seems to be at a significant risk of sustaining injury when pointed forceps are placed on the tubercles, as is often recommended during the repair of pubic diastasis.
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To quantify the effects of dorsal translation deformities of the distal radius with and without dorsal angulation on volar displacement of the ulnar head during simulated active forearm rotation, both with the triangular fibrocartilage complex (TFCC) intact and sectioned conditions. ⋯ These results emphasize the clinical importance of evaluating the magnitude of both dorsal translation and dorsal angulation when managing displaced distal radius fractures and malunions.
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Randomized Controlled Trial Multicenter Study Comparative Study
A prospective randomized multicenter trial comparing clinical outcomes of patients treated surgically with a static or dynamic implant for acute ankle syndesmosis rupture.
To compare the clinical and radiographic outcome after stabilization of an acute syndesmosis rupture with either a static implant (a 3.5-mm metallic screw through 4 cortices) or a dynamic device (TightRope; Arthrex). ⋯ Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Randomized Controlled Trial Multicenter Study
A double-blind, randomized controlled trial of the prevention of clinically important venous thromboembolism after isolated lower leg fractures.
Among patients with isolated below-knee fractures, previous studies have detected asymptomatic deep vein thrombosis in 10%-40% using contrast venography. However, the clinical relevance of these thrombi is unknown; there is considerable uncertainty about the risk: benefit of routine thromboprophylaxis and clinical practice guidelines differ in their recommendations. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Review Meta Analysis
Outcomes of Talar Neck Fractures: A Systematic Review and Meta-analysis.
To report the rates of osteonecrosis and subtalar arthritis after talar neck fractures and to examine if rates have changed over time. ⋯ The overall rate of osteonecrosis was 0.312. Rates for Hawkins' types I-IV were 0.098, 0.274, 0.534, and 0.480, respectively. The mean rate of subtalar arthritis was 0.49 but increased to 0.81 in studies with >2 years of follow-up. Complication rates are high in talar neck fractures, and patients should be counseled accordingly.