Journal of orthopaedic trauma
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Operative treatment of femoral fractures yields a predictably high union rate, but residual malrotation and leg length discrepancy remain a clinically significant problem. The aim of this study was to determine the safety and efficacy of using computerized navigation in controlling the length and rotation in femoral fracture surgery. ⋯ Therapeutic level IV. See instructions for authors for a complete description of the levels of evidence.
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To provide evidence on the midterm sexual-function- and health-related quality-of-life outcome of patients with a traumatic pelvic fracture, as recorded at least 12 months after their surgery. ⋯ Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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The purpose of this cadaveric study was to determine the proximity of the neurologic structures to the path of the screw inserted percutaneously into the ischial tuberosity. ⋯ The sciatic nerve and the posterior cutaneous nerve of the thigh appear to be safe during retrograde percutaneous screw fixation of a posterior column acetabular fracture through a central entry point in the ischial tuberosity. However, the inferior cluneal nerves that are responsible for the cutaneous sensitivity of the lower half of the gluteal region are at risk of injury.
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Osteoporosis (OP) results from an imbalance between bone production and absorption that results in decreased bone mass and microstructural deterioration of the bone trabeculae, leading to diminished bone quality and fragility fractures. It is synonymous with decreased bone strength and affects millions of people worldwide. The most commonly prescribed drugs for the treatment of OP are the bisphosphonates (BPs). ⋯ AFFs are uncommon; the increase in risk associated with BP use is very small and does not outweigh the benefit of fracture prevention in patients with OP. Evidence for the efficacy of BPs for the prevention of fractures in postmenopausal women with OP is very strong, and the current clinical practice of using BPs as first-line therapy for these patients should be continued. Further information is required to determine the appropriate duration and time of discontinuation of BP therapy.
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Review
Intraoperative fluoroscopic evaluation of screw placement during pelvic and acetabular surgery.
The surgical treatment of pelvic and acetabular fractures can be technically challenging. Various techniques are available for the reconstruction of pelvic and acetabular fractures. ⋯ Given the anatomic complexity of the intrapelvic structures and the 2-dimensional nature of standard fluoroscopy, multiple images oriented in different planes are needed to assess the accuracy of guide wire and screw placement. This article reviews the fluoroscopic imaging of common screw orientations during pelvic and acetabular surgery.