Injury
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Comparative Study
Locking plate fixation of humeral head fractures with a telescoping screw. A comparative biomechanical study versus a standard plate.
Locking plate fixation of humeral head fractures bares the risk of glenohumeral screw penetration. In order to circumvent this problem it is recommended to insert shorter locking screws having at least a 6mm distance to the humeral head cortex. This in turn may reduce fixation stability and may lead to early varus displacement. One second frequent failure mechanism is cranial displacement of the greater tubercle. The study evaluates the biomechanical properties of a locking plate employing an additional telescoping screw that may enhance resistance to varus displacement. Screw in screw fixation of the greater tubercle may reduce the rate of cranial displacement. ⋯ The HTS plate provides high fixation stability in an in vitro humeral head fracture model and securely prevents displacement of the greater tubercle.
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Fractures in children are the second most common presentation of child abuse. In younger children, especially in those less than 18 months, fractures should be considered suspicious of a non-accidental injury (NAI). Risk factors associated for abuse are: age younger than 12 months, non-ambulatory status, delayed presentation, unknown or inconsistent history of mechanism of injury, and presence of any other injuries. Our objective was to identify the incidence of fractures in children below the age of 24 months who presented to our institution's Emergency Department (ED), and identify which cases should arouse suspicion around possible NAI. ⋯ Age is a strong determinant when accessing NAI and a non-ambulant child presenting with a femur or skull fracture should be regarded highly suspicious of NAI. The time interval between the injury and presentation to the ED must be recorded in all notes when assessing a child for NAI.
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By analysing the injuries of the orthopaedic wounded during the 2010 Yushu earthquake, we aim to provide useful medical information for the rational application and allocation of medical resources and better implementation of medical relief in earthquake-stricken areas. ⋯ The patients who experienced fractures in the Yushu earthquake were mostly adults. This was correlated with population composition in Yushu area. This time all the orthopaedic injuries were relative mild with less complication as nerve injury or crush syndrome mainly because of the characteristics of the house structure in Yushu area.
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Case Reports
Percutaneous cerclage wiring for reduction of periprosthetic and difficult femoral fractures. A technical note.
Combining closed reduction techniques with minimally invasive plate osteosynthesis (MIPO) or intramedullary nailing is a technically challenging procedure, especially when dealing with complex femoral fractures such as periprosthetic fractures. Cerclage wiring is a well known adjunct for fracture reduction and fixation. However, it is usually performed by open reduction, requiring wide surgical exposures, that results in soft tissue stripping. ⋯ Percutaneous wiring is an alternative reduction technique to facilitate the reduction and maintenance of difficult femoral fractures, which reduces the radiation exposure to the surgeon.