Journal of orthopaedic trauma
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To compare the efficacy of negative pressure wound therapy (NPWT) versus conventional dressings (CD) in the management of open fractures. ⋯ Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
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To characterize the fracture patterns and comminution zones for complete articular (OTA/AO 34C type) patellar fractures, using a computed tomography mapping technique. ⋯ The patterns of fracture lines and comminution zones OTA/AO 34C type fractures were repeatable on the constructed maps. A transverse fracture line on the inferior pole which was observed in the C2 and C3 type fractures may be used for the modification of current classification systems to direct treatment.
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Secondary Fracture Prevention: Consensus Clinical Recommendations from a Multistakeholder Coalition.
Osteoporosis-related fractures are undertreated, due in part to misinformation about recommended approaches to patient care and discrepancies among treatment guidelines. To help bridge this gap and improve patient outcomes, the American Society for Bone and Mineral Research assembled a multistakeholder coalition to develop clinical recommendations for the optimal prevention of secondary fractureamong people aged 65 years and older with a hip or vertebral fracture. The coalition developed 13 recommendations (7 primary and 6 secondary) strongly supported by the empirical literature. ⋯ Individuals beingtreatedfor osteoporosis shouldbe reevaluated for fracture risk routinely, includingvia patienteducationabout osteoporosisandfracturesandmonitoringfor adverse treatment effects. Patients shouldbestronglyencouraged to avoid tobacco, consume alcohol inmoderation atmost, and engage in regular exercise and fall prevention strategies. Finally, referral to endocrinologists or other osteoporosis specialists may be warranted for individuals who experience repeated fracture or bone loss and those with complicating comorbidities (eg, hyperparathyroidism, chronic kidney disease).
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Precontoured quadrilateral surface buttress (PQSB) plates have grown in popularity for acetabular fracture fixation. However, our experience has pushed us to hypothesize that their use as sole means of fixation may cause fracture malreduction. A biomechanical model was created to investigate this theory. ⋯ PQSB plates for acetabular fractures cause malreduction when applied in isolation in this biomechanical model. If a PQSB plate is chosen for fixation, we suggest the use of a columnar lag screw at minimum to hold reduction before plate application.