Journal of orthopaedic trauma
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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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The process of finding the ideal orthopaedic practice and negotiating a satisfactory employment agreement may be arduous and stressful. The keys to success are similar to attaining proficiency in orthopaedic surgery and include having an insight into your personality, your future needs, and desires; and committing the requisite time for preparation, planning and study to accumulate sufficient knowledge for the tasks. The internet permits access to diverse sources of information, which allows for planning, retrieval of reference materials and for benchmarking contracts and job offers. ⋯ A thoughtful contract should clarify mutual understandings, expectations, and serve as a guide for resolving both anticipated and unanticipated events. A review of common employment benefits and contract provisions is listed for quick reference. If emotional involvement is a concern to the prospective employee, consider hiring an intermediary to help with the negotiations, contract evaluation, and provisions.
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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.