Journal of orthopaedic trauma
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The trauma opportunities: The numbers are 260 verified sites (American College of Surgeons), 1100 Centers performing as Regional or Community Trauma Centers currently in the continental 48 states, and 3256 hospitals performing in-patient orthopaedic surgery. Orthopaedic trauma surgeons still represent <10% of the total national surgeon complement. ⋯ This represents the supply side that has the potential to graduate in 2013 and beyond. These individuals face a wide variety of career options not previously available to past generations, but one has to know the business model differentiators to be successful: employed-employee (most common, least sustainable historically); employed-partner; partner-contract for service; partner-private practice; private practice-hospital partner (least common, most productive).
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Because every orthopaedic traumatologist will interact with the legal system during their career--either as a treating physician of a patient involved in legal action, an expert witness, or as a defendant in a lawsuit--a basic understanding of the legal process is paramount to successfully serve in these roles. Common truths and misperceptions about medicolegal risk, expectations of care and documentation in the trauma setting, and information about being deposed and giving expert testimony will be discussed.
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To determine whether negative pressure wound therapy (NPWT) affects antibiotic elution in simulated femur fractures treated with antibiotic impregnated polymethylmethacrylate (PMMA) beads and whether fascial closure between beads and sponge affects the outcome. ⋯ Concurrent application of NPWT with antibiotic impregnated PMMA beads to simulated open femur fractures in pigs did not decrease local antibiotic concentrations but did decrease the total amount of eluted vancomycin and tobramycin locally available when the fascia was left open.
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Comparative Study
Screw placement for acetabular fractures: which navigation modality (2-dimensional vs. 3-dimensional) should be used? An experimental study.
Screw navigation techniques with different image guidance [2-dimensional (2D) vs. 3-dimensional (3D) fluoroscopy] were evaluated for acetabular fracture surgery. ⋯ Both navigation procedures securely prevent an intra-articular penetration during drilling, but the 3D image-based navigation procedure increases the overall accuracy compared with the 2D image-based navigation technique (misplacement rates of 2.5% vs. 10%). Especially, in very narrow corridors (as the infra-acetabular screw path), the use of 3D navigation should be preferred.
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To evaluate long-term results after protocoled treatment of supination-external rotation (SER) Type II-IV ankle injuries. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.