Journal of orthopaedic trauma
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Comparative Study
Operating room efficiency: benefits of an orthopaedic traumatologist at a level II trauma center.
Fellowship-trained orthopaedic traumatologists are presumably taught skill sets leading to "best practice" outcomes and more efficient use of hospital resources. This should result in more favorable economic opportunities when compared with general orthopaedic surgeons (GOSs) providing similar clinical services. The purpose of our study was to compare the operating room utilization and financial data of traumatologists versus GOSs at a level II trauma center. ⋯ Economic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Comparative Study
Radiologic outcome and patient-reported function after intramedullary nailing: a comparison of the retropatellar and infrapatellar approach.
The purpose of this study was to compare the patient-reported functional outcomes after intramedullary nailing of the tibia through a retropatellar or infrapatellar approach. Radiographic assessment of nail entry point and accuracy of fracture reduction were included to aid in the identification of variables that may explain any difference in patient-reported outcomes. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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To review a large series of tibial metaphyseal fractures treated with nailing in semi-extension (20-30 degrees) using a superomedial portal. To report on the quality and maintenance of reduction. To compare knee pain at final follow-up with a group nailed in hyperflexion (>90 degrees) with a standard inferior incision and parapatellar approach. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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The lateralizing vector of a flexible guide wire can result in eccentric lateral reaming of the proximal femur during intramedullary nailing procedures. This effect is especially true with peritrochanteric fractures that have a fracture line exit near the entry point, and in obese patients. ⋯ Use of a concave shaped retractor such as an Appendiceal or Richardson helps to "capture" the reamer shaft and control where proximal reaming occurs. We have found this method to be easy to use and effective when indicated.
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Observational Study
Dynamic fixation of distal femur fractures using far cortical locking screws: a prospective observational study.
Document fixation and healing of distal femur fractures stabilized by plate osteosynthesis using far cortical locking (FCL) screws. ⋯ Absence of implant and fixation failure suggests that dynamic plating of distal femur fractures with FCL screws provides safe and effective fixation.