Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Oct 2014
Early MRI diagnostics for suspected scaphoid fractures subsequent to initial plain radiography.
In the United Kingdom, diagnostic management of patients presenting to emergency department with a scaphoid injury varies. Follow-up plain radiographs, after an initial inconclusive X-ray, are common practice. We optimised the diagnostic pathway for these patients by focusing on the most appropriate diagnostic modality and on minimising the time to follow-up diagnostics. ⋯ The introduction of early MRI enhances scaphoid injury diagnostics and accelerates patient management. We therefore endorse the introduction of this approach on a wider scale through an update of the clinical guidelines for scaphoid injuries.
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Eur J Orthop Surg Tr · Oct 2014
Rotational malalignment after closed intramedullary nailing of femoral shaft fractures and its influence on daily life.
Any intraoperative rotational malalignment during intramedullary nailing (IMN) of femoral shaft fractures will become permanent. We hypothesized that rotational malalignment of the femur and its compensatory biomechanics may induce problems in the hip, knee, patellofemoral and ankle joints. We purposed to clarify the influence of a femoral rotational malalignment of ≥10° on daily activities. ⋯ A femoral rotational malalignment of ≥10° is symptomatic for the patients, and the hip, knee, and patellofemoral joints were affected. Because of the possibly altered joint loadings and biomechanics, these could render patients prone to degenerative joint disease. In addition, due to the high rates of rotational malalignment after femoral shaft fracture and consequent malpractice claims, it is important for surgeons to be more aware of rotational alignment during surgery.
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Eur J Orthop Surg Tr · Oct 2014
Comparative StudyA comparison of the functional and radiological results of Paris plaster cast and ulnar gutter splint in the conservative treatment of fractures of the fifth metacarpal.
In the treatment protocol of fractures of the fifth metacarpal, closed reduction and immobilization is generally recommended. This study aimed to compare the radiological and functional results of short-arm plaster cast and a forearm U-splint. ⋯ No superiority was seen in the clinical and radiological results of the two different treatment protocols applied to fractures of the fifth metacarpal. However, when the complications created by a plaster cast and pressure wounds are taken into consideration, the application of a short-arm U-splint can be said to be a better option.
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Eur J Orthop Surg Tr · Oct 2014
The effect of inferomedial screw on postoperative shoulder function and mechanical alignment in proximal humerus fractures.
The aim of the study was to evaluate the clinical and radiologic results of locking plate fixation with or without inferomedial screw (IMS) in surgically treated proximal humerus fractures. ⋯ Use of inferomedial screw running through the medial curvature of surgical neck prevents varus deformity and improves functional outcome after surgical treatment for proximal humerus fractures.
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Eur J Orthop Surg Tr · Oct 2014
Paediatric lateral humeral condyle fractures: internal oblique radiographs alter the course of conservative treatment.
At first presentation of paediatric humeral lateral condyle fractures, radiological methods such as computerised tomography, ultrasonography, magnetic resonance imaging, arthrography, and internal oblique radiography are used to determine stability. Very few studies show which radiological method should be used to evaluate displacement at follow-up for conservatively treated patients. This study aimed to show that internal oblique radiography is a simple, effective method to determine the subsequent development of fracture displacement in patients with an initially non-displaced or minimally displaced fracture. ⋯ Internal oblique radiography is the best imaging showing subsequent fracture displacement in initially non-displaced or minimally displaced humerus lateral condyle fractures. At the first week follow-up, anteroposterior and particularly internal oblique radiographs should be taken of conservatively treated patients.