The American journal of orthopedics
-
When adequate fracture reduction cannot be achieved with closed techniques, internal fixation can restore anatomy and improve functional outcomes. Volar plating, dorsal plating, and radial plating are well-described techniques that are useful in isolation or in combination, depending on the specific fracture pattern. In this article, we review each of these techniques and provide case examples to illustrate their applicability.
-
Successful treatment of pilon fractures requires a thorough understanding of the injury, proper timing of treatment, and use of the proper implant placed in the correct location. This article describes the factors involved in treatment decisions.
-
In July 2003, the Accreditation Council for Graduate Medical Education (ACGME) established nationwide guidelines for resident working environments and duty hours. Following these guidelines became a requirement for all accredited residency programs. Two years after implementation, we conducted a national survey to assess the opinions and attitudes of orthopedic residents and program directors toward the ACGME work-hour regulations and the effects of these regulations on resident education, resident quality of life, and patient care. ⋯ There was overall agreement among the 3 groups that resident quality of life had improved as a result of work-hour regulations. For patient care, junior residents viewed the new regulations positively for surgical training and patient care, whereas senior residents and program directors disagreed. This survey showed meaningful differences in the attitudes and opinions of junior residents, senior residents, and program directors toward the new ACGME work-hour regulations.