Eur J Trauma Emerg S
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Eur J Trauma Emerg S · Feb 2008
Long Term Outcomes after Arthroscopic Management of Tibial Plateau Fractures.
Tibial plateau fractures are efficiently treated using arthroscopy when limited to one condyle. Operative technique and early results are now well documented. However, long term results have not been widely reported. The goal of this study was to evaluate clinical and radiological outcomes of arthroscopically treated tibial plateau fractures in the long term. ⋯ Comparisons with historical long-term studies regarding open reduction and internal fixation show similar outcomes. No specific secondary degenerative problem would alleviate the advantages of the arthroscopic management of tibial plateau fractures in the early post-operative period.
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We present a case of a distal tibial fracture in a pregnant patient treated with an intermedullary device. The risks associated with operative treatment of fractures in pregnancy are discussed. ⋯ Surgical intervention allowed the mother to have a normal delivery. The patient had an excellent outcome with no adverse effects reported by either mother or baby.
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Eur J Trauma Emerg S · Feb 2008
When Should Open Reduction and Internal Fixation Ankle Fractures Begin Weight Bearing? A Systematic Review.
The objective of this paper was to review the literature to assess when open reduction and internal fixation ankle fractures should commence weight bearing for the best outcome. An electronic search was undertaken of the databases AMED, Cinahl, Embase, Medline (via Ovid), Pedro and Pubmed, from their inception to November 2005. References lists were scrutinised and a hand search was also performed. ⋯ Neither early nor later weight bearing significantly improves or jeopardises outcomes. However, due to the plethora of methodological limitations and limited evidence, it is not possible to reference this conclusion with conviction. Further large, well-designed randomized controlled trials are required to evaluate this area.
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Complications still occur in musculoskeletal surgery despite improvements in operating techniques and optimization of implants. Problems include delayed fracture healing, non-unions and extensive osseous infections. Growth factors for local application are in clinical use, but have not become widely accepted. ⋯ In a preliminary study, gentamicin-coated intramedullary tibial nails were implanted in patients exhibiting fractures with severe soft tissue damage. The preliminary findings do not allow conclusions to be drawn in respect of therapy of fractures with severe soft tissue damage or revision surgery. However, the coating seems to be suitable as a "key technology" for the incorporation of active ingredients and might be helpful in revision arthroplasty.
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Eur J Trauma Emerg S · Feb 2008
Early Results of Scapular Fractures Treated Operatively at a Level One Trauma Center.
Certain scapular fractures are best treated with open reduction to restore form and function to the glenohumeral joint. The purpose of this study was to review the results of operative treatment of scapular fractures at a level one trauma center. ⋯ Open reduction and internal fixation is associated with anatomic reduction, a low complication rate, and satisfactory functional results at short-term follow-up.