Journal of orthopaedic trauma
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Comparative Study
Biomechanical comparison of standard iliosacral screw fixation to transsacral locked screw fixation in a type C zone II pelvic fracture model.
Iliosacral screw fixation into the first sacral body is a common method for pelvic ring fixation. However, this construct has been shown to be clinically unreliable for the percutaneous fixation of unstable Type C zone II vertically oriented sacral fractures with residual fracture site separation. The objective of this study was to biomechanically compare a locked transsacral construct versus the standard iliosacral construct in a Type C zone II sacral fracture model. ⋯ Fixation of unstable zone II sacral fractures using the combination of an iliosacral screw and a locked transsacral screw resists deformation and withstands a greater force to failure as compared to fixation with 2 standard iliosacral screws. This locked transsacral construct may prove advantageous, especially when a percutaneous technique is used for a Type C zone II vertically oriented sacral fracture injury pattern, which can result in residual fracture site separation.
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Comparative Study
A biomechanical comparison of one-third tubular plates versus periarticular plates for fixation of osteoporotic distal fibula fractures.
The purpose of this study was to test the biomechanical properties of locking and nonlocking plates using one-third tubular and periarticular plate designs in an osteoporotic distal fibula fracture model. ⋯ In biomechanical testing using an osteoporotic model of OTA 44-B2.1 fractures, periarticular plates were superior to one-third tubular plates in rotational stiffness only. Locking plates did not outperform their nonlocking counterparts. Periarticular plates should be considered when treating osteoporotic distal fibula fractures, but one-third tubular plates and nonlocking plates provide adequate fixation for these injuries.
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To describe the use of the saline load test (SLT) using a new definition that more adequately characterizes its use in the emergency department (ED) setting. ⋯ Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
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This study was designed to evaluate risk factors of infection after bicondylar tibial plateau fractures. We hypothesized that open fractures and smoking would be associated with deep infection requiring reoperation. ⋯ Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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To report the outcomes of percutaneous autologous bone marrow injection for nonunion or delayed union of the distal tibial metaphysis in patients with prior plating. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.