Journal of orthopaedic trauma
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To evaluate the outcome of patients with posterolateral tibial plateau fractures after open reduction and internal fixation with a fibula osteotomy-free posterolateral approach. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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To identify the current implant and diagnostic imaging preferences among orthopaedic trauma experts for the treatment of high-energy vertical femoral neck fractures in young adult patients. ⋯ Therapeutic Level V. See Instructions for Authors for a complete description of levels of evidence.
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We have all been there: a screaming attending; an argument with anesthesia; a crashing patient, to name a few examples. A stressful situation in the operating room (OR) can unfortunately be a common occurrence. Many of these situations can be avoided if the team had been better prepared or had better communication. ⋯ Without your leadership, the ship will sink. Preparation, communication, and respect are essential elements that affect both patient outcomes and the atmosphere in the OR. In this article, we will highlight several pearls that will help you become and remain the best leader you can: the "Captain of the Ship."
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The posterolateral approach to the distal tibia allows excellent visualization, direct reduction, and stabilization of posterior malleolar fractures. Concomitant fractures of the lateral malleolus may be internally fixed through the same approach. The approach may also be used for pilon fractures and for bone grafting in nonunions. This study aims to establish the safe zone of proximal dissection to avoid injury to the peroneal vessels when performing the posterolateral approach to the distal tibia. ⋯ The posterolateral approach to the distal tibia allows direct reduction of posterior malleolus fractures. The peroneal artery may bifurcate and perforate through the interosseous membrane as little as 41 mm from the tibial plafond. Dissection around this region should be performed with care due to the wide variation in vasculature, however, once the peroneal artery is mobilized, a buttress plate can easily be placed beneath it.
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The purpose of this study was to compare the infection risk when internal fixation plates either overlap or did not overlap previous external fixator pin sites in patients with bicondylar tibial plateau fractures and pilon fractures treated with a 2-staged protocol of acute spanning external fixation and later definitive internal fixation. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.