Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2014
Alternative treatment of forearm double fractures: new design intramedullary nail.
This study aims to evaluate the results of intramedullary nail treatment in surgical treatment of adult displaced radius and ulna diaphyseal fractures. ⋯ Intramedullary fixation method has advantages, such as closed application, short surgery period, good cosmetic results and early return to movement. We think intramedullary fixation method may be used as an alternative treatment method to plate osteosynthesis in surgical treatment of radius and ulna diaphyseal fractures.
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Arch Orthop Trauma Surg · Oct 2014
The combat burst fracture study--results of a cohort analysis of the most prevalent combat specific mechanism of major thoracolumbar spinal injury.
In 2009-2010, military physicians hypothesized that a new pattern of spinal injury had emerged, resulting from improvised explosive device assault on up-armored vehicles, associated with a high rate of point of first contact fracture and neurological injury-the combat burst fracture. We sought to determine the incidence of all thoracolumbar (TL) burst fractures and combat burst fractures in 2009-2010 as compared to two antecedent years. ⋯ There was a 3.4- to 4.6-fold increase in TL burst fractures in 2009-2010 compared to antecedent years. The primary driver of this phenomenon was the marked increased in combat burst fractures. Mitigating/preventing the mechanism behind this major spinal injury is a key research initiative for the US military. Level of Evidence III (Case-control).
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Arch Orthop Trauma Surg · Oct 2014
Findings related to rotational malalignment in tibial fractures treated with reamed intramedullary nailing.
Rotational malalignment following closed intramedullary nailing of tibial fractures does not attract attention but is a complication which may lead to serious results. This study aimed to present findings related to rotational malalignment from rotational alignment measurements made clinically and with computerised tomography (CT) in patients who had undergone locked intramedullary nailing for tibial fracture. ⋯ A significant number of patients treated with intramedullary nailing for a tibial fracture may result in rotational malalignment. To determine rotational malalignment, a thorough clinical evaluation must be made and different kinds of clinical measurements taken and, when suspicions remain, determination should be made by CT.
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Since tunnel positioning is one of the key factors in anterior cruciate ligament (ACL) reconstruction and the variability of tunnel positioning in ACL reconstruction has so far never been analyzed, the objective of this study was to determine the inter- and intra-observer variability of tibial and femoral tunnel positioning in ACL reconstruction. ⋯ This study demonstrates that a reasonable inter- and intra-observer variability in ACL tunnel positioning exists even among experienced surgeons. Although deviations of 2-3 mm may seem to be acceptable at first sight, a range of up to 18.3 mm indicates that outliers exist, which can cause graft failure. More reliable reconstruction techniques should be developed to reduce the variability in tunnel positioning.
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Arch Orthop Trauma Surg · Oct 2014
Pathoanatomy and incidence of the posterolateral fractures in bicondylar tibial plateau fractures: a clinical computed tomography-based measurement and the associated biomechanical model simulation.
The aim of our study is to evaluate the incidence and pathoanatomy of posterolateral fragments and analyze the associated fracture mechanism in bicondylar tibial plateau fractures. ⋯ The incidence of posterolateral fractures is 44.32 % in bicondylar tibial plateau fractures. The morphology of posterolateral area can be referenced for the surgeon in the future clinical work. The information is also helpful for the design of locking plate and fracture modeling in biomechanical test. In addition, that posterolateral split and posterolateral depression might be caused by different injury mechanisms. Different angles of knee flexion under the axial impact loading are possibly the interpretations for these two fracture patterns.