Injury
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Case Reports
Survivorship of the native hip joint after percutaneous repair of acetabular fractures in the elderly.
Our purpose was to examine survivorship of the native hip joint in patients ages 60 and over who underwent percutaneous reduction and fixation of acetabular fractures. A retrospective review at a University Level I Trauma Center was performed. Our institutional trauma database was reviewed. ⋯ There were no statistically significant associations between conversion to arthroplasty and age, sex, closed vs. limited open reduction, and simple vs. complex fracture pattern. Percutaneous fixation is a viable treatment option for patients age 60 or greater with acetabular fractures. Rates of conversion to total hip arthroplasty are comparable to open treatment methods and if conversion is required, soft tissues are preserved for future surgery.
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Sacroiliac (SI) screw fixation represents an effective method to stabilise pelvic injuries. However, to date neither reliable radiological landmarks nor effective anatomical classifications of the sacrum exist. This study investigates the influence of variability in sacral shape on secure transverse SI-screw positioning. ⋯ A boundary ratio of 1.5 predicts a sufficient bone stock for at least one 7.3 mm screw. Furthermore, the evaluation of the outlet projection can be used to assess the safety of the operation. Basically, a preoperative lateral pelvic image should be mandatory.
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To establish whether the modified anatomic plate (MAP) performs as well as the anatomic plate (AP), dynamic hip screw (DHS) and proximal femoral nail (PFN) from a biomechanical perspective. ⋯ The biomechanical features of the MAP were similar to those of the PFN. The MAP generated optimal loads at both the fracture site and the proximal femur. FE methods and biomechanical tests revealed that the MAP is associated with both intra- and extra-medullary fixation features, even though the load was applied as an extramedullary stimulus.
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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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Paediatric pelvic fractures have been infrequently reviewed. The study was performed to highlight the unique features of pelvic fractures in children. ⋯ Paediatric pelvic fractures differ from their adult counterpart in aetiology, fracture type, and associated injury pattern. They represent a reliable marker for severe trauma. Prospective studies are required to define optimal treatment guidelines, particularly in older children.