Injury
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Comparative Study
Are there any advantages in using a distal aiming device for tibial nailing? Comparing the Centro Nailing System with the Unreamed Tibia Nail.
The distal locking of an intramedullary tibial nail can be challenging and time consuming when performed freehand. This study was conducted to evaluate if a distal aiming device would reduce surgical time. ⋯ The use of an aiming device for distal locking of a tibia nail lengthens operation time rather than reducing it. Fluoroscopy was still needed in about half of the cases. No difference was seen in clinical outcomes. The use of a distal aiming device to lock a tibial nail appears to have no benefit.
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Older patients tend to have acetabular fractures with medial displacement patterns and associated comminution, particularly of the quadrilateral surface. Our goal was to investigate the appropriateness of open reduction and internal fixation using an infra-pectineal buttress plate for osteopenic acetabular fractures. ⋯ Internal fixation using the modified Stoppa approach to buttress the quadrilateral plate should be considered a viable alternative to total hip arthroplasty for the initial treatment of acetabular fractures in the elderly.
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In the emergency management of patients with pelvic fractures, there is ongoing debate about the roles of angiography and open pelvic packing. It is agreed that some form of haemorrhage control is required for patients who are haemo-dynamically unstable despite resuscitation. We set out to determine whether on-call general and orthopaedic surgeons would feel able to perform emergency surgical procedures for these patients and whether vascular radiology was available to them. ⋯ With appropriately targeted training it is likely that the care of patients with pelvic fractures can be significantly improved.
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Case Reports
Computer-assisted virtual surgical procedure for acetabular fractures based on real CT data.
To develop and evaluate a computer-assisted virtual surgical procedure for preoperative planning that simulates the reduction and plate fixation for acetabular fractures based on real computed tomography (CT) data using computer softwares on personal computers. ⋯ The virtual surgical procedure for acetabular fractures is feasible and useful clinically for surgeons to determine surgical planning. It may be a valuable tool for surgeons in learning about the nature of the fracture and in formulating an appropriate surgical plan.