Journal of orthopaedic trauma
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To define the anatomic "safe zone" for placement of external fixator half pins into the anterior and lateral femur. ⋯ The safe zone for anterior external fixator half pin placement into the femur is on average 20 cm in length and can be as narrow as 12 cm. Anterior pins should begin 7.5 cm above the superior pole of the patella to avoid inadvertent knee joint penetration. Because the entire lateral femur is safely available for half pin placement, including distally, we recommend the use of alternative frame constructs with either anterolateral or lateral pins given the limitations and risks of anterior pin placement.
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Femoral shaft fractures are usually treated with anterograde or retrograde nails that typically do not provide femoral neck fixation. Ipsilateral femoral neck fractures occur with 2.5%-10% of femoral shaft fractures; 19%-55% of associated femoral neck fractures are missed with plain films and 5%-22% with computed tomography (CT). This study was performed to determine if routine reconstruction nailing of all femoral shaft fractures with or without occult femoral neck fractures is cost effective. ⋯ Economic Level II. See Instructions for Authors for a complete description of levels of evidence.
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To investigate what factors contribute to increased length of stay (LOS) and increased costs in treatment of elderly patients with hip fractures. ⋯ Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
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To determine the clinical and functional outcomes of high-grade (types II and III) open calcaneus fractures managed with a protocol of modern wound care, open reduction via the medial hindfoot wound, and percutaneous screw fixation. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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To determine if the use of a novel proximal femoral locking plate could reduce the incidence of femoral neck shortening and improve clinical outcomes after open reduction internal fixation (ORIF) for femoral neck fractures as compared with historical controls. ⋯ ORIF of femoral neck fractures using a locking plate construct yielded unacceptably poor outcomes in this patient population. We hypothesize that the stiffness of this construct prevents any fracture site micromotion, placing the mechanical burden on the implant, which can result in failure at the bone-screw interface or fatigue failure of the implant itself.