Journal of orthopaedic trauma
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To describe medical care and surgical outcome after functional reconstructive surgery in late-presenting patients who already had at least one prior operation. ⋯ Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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The purpose of this study was to determine if lag screw position affects the biomechanical properties of a cephalomedullary nail used to fix an unstable peritrochanteric fracture. ⋯ The inferior lag screw position produced the highest axial and torsional stiffness. Anterior and posterior lag screw positions produced the lowest stiffnesses and load-to-failure. Inferior placement of the lag screw on the anteroposterior radiograph and central placement on the lateral radiographs is recommended.
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Reduction of the articular surface in displaced tibial plateau fractures is still challenging and may result in joint incongruence, leading to posttraumatic arthrosis. Conventional techniques use bone tamps and similar instruments, which can increase the surgical trauma due to their size. "Balloon tibioplasty" is a novel minimally invasive technique for the reduction of depressed tibial plateau fractures. We successfully applied an inflatable balloon, commercially available from kyphoplasty, to elevate the depressed articular fragments. ⋯ Balloon tibioplasty was applied in 5 patients with displaced tibial plateau fractures (OTA type B2/3). No intra- or postoperative complications were observed. This new technique may be a useful tool to facilitate the reduction of select depressed tibial fractures in the future.
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Randomized Controlled Trial
Sensitivity of the saline load test with and without methylene blue dye in the diagnosis of artificial traumatic knee arthrotomies.
To determine whether methylene blue dye significantly improves the sensitivity of the saline load test for detection of a traumatic arthrotomy of the knee. ⋯ Diagnostic Level I. See Instructions for Authors for a complete description of levels of evidence.
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Multiple scapula classification systems exist in the literature and were developed using a consensus approach with one or several experts agreeing on a classification without stringent validation. None have gained widespread acceptance. A decision was made by the OTA classification committee and the AO Classification Advisory Group to collaborate on the development of a new validated classification system capable of addressing the limitations of the existing systems. ⋯ This basic coding system allows clinicians to describe and classify scapula fractures with a reasonable degree of reliability. This validated classification that has resulted from this process has been accepted by a disparate group of orthopaedic traumatologists as a better option for clinical communication and research documentation.