Journal of orthopaedic trauma
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Understanding the anatomy of proximal ulna is important when treating complex injuries, since nonanatomic reconstruction may lead to malunion, arthrosis, and instability. The proximal ulna has a sagittal bow, termed the proximal ulna dorsal angulation (PUDA). The purpose of this study was to evaluate the magnitude of angular malalignment at the PUDA that would lead to radial head subluxation. ⋯ Proximal ulna malalignment combined with an annular ligament tear affect the biomechanics of the elbow and can lead to radial head subluxation. This study demonstrates the importance of an anatomic reconstruction, specifically recreation of each individual's unique PUDA. Thus, in the setting of a comminuted proximal ulna fracture with associated annular ligament insufficiency, radiographs of the contralateral elbow may assist with the restoration of the normal anatomy to limit radial head instability.
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Randomized Controlled Trial
Indomethacin prophylaxis for heterotopic ossification after acetabular fracture surgery increases the risk for nonunion of the posterior wall.
To determine if indomethacin has a positive clinical effect for the prophylaxis of heterotopic ossification (HO) after acetabular fracture surgery. To determine whether indomethacin affects the union rate of acetabular fractures. ⋯ Therapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.
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Comparative Study
Short versus long cephalomedullary nails for the treatment of intertrochanteric hip fractures in patients older than 65 years.
To compare failure rates between short and long cephalomedullary nails used for the treatment of intertrochanteric hip fractures in patients over 65 years of age. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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To evaluate preoperative neck resorption and postoperative valgus orientation as predictors of union and functional outcome after valgus intertrochanteric osteotomy for treatment of neglected femoral neck fractures and nonunions. ⋯ Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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The benefits of cement augmentation with fixation of osteoporotic pertrochanteric fractures have been previously demonstrated. The objective of this study was 3-fold: (1) To quantify the intraosseous pressure produced during cement augmentation of the perforated proximal femoral nail antirotation (PFNA) blades; (2) To assess whether the pressure generated is influenced by the injection rate; and (3) To assess the amount of force applied during the injection. ⋯ This in vitro model is the first one to demonstrate that femoral head cement augmentation is associated with a small transient increase in intraosseous pressure with sequential fast and slow 1 mL injections of up to 6 mL PMMA. We conclude that cement augmentation of the perforated PFNA blade carries a low risk of pressure-induced avascular necrosis.