Injury
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The aim of the present study was to determine the outcome for patients treated with flap reconstruction following deep ankle fracture infection with exposed hardware. Out of 3041 consecutive ankle fracture operations in 3030 patients from 2006 to 2011, we identified 56 patients requiring flap reconstruction following deep infection. Thirty-two of these patients could be examined at a follow-up visit. ⋯ Our study showed that successful treatment of a soft-tissue defect with exposed hardware following ankle fracture infections can be achieved with local flaps. Despite eventual reconstructive success, complications are common. Patients perceive a poorer health-related quality of life, have shoe wear limitations, and only half of them achieve their pre-injury level of function.
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Dislocated radial neck fractures of the third and fourth degree, according to the Judet classification, are rare events in children. These fractures account for 1% of all paediatric fractures. Their relatively low incidence is inversely proportional to the serious morphofuntional alterations that can follow without treatment. ⋯ Although the number of patients in the study was small, the results are encouraging and support the continued use of this one-step percutaneous reduction and fixation technique.
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Although there are different ways to treat bicondylar tibial plateau fractures, treatment remains as a challenge to most orthopaedic surgeons. The purpose of this study was to assess the outcomes of dual buttress plates fixation in treatment of bicondylar tibial plateau fractures and to determine risk factors for outcome. ⋯ Dual buttress plates technique provided a favourable quality of fracture reduction and satisfactory clinical function. Appropriate selection for operation chance, limited soft tissue stripping and filling of osseous defects may lessen or prevent serious complications. Fracture reduction quality and AO fracture type were independent risk factors for clinical function.
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It is our impression that many biomechanical studies invest substantial resources studying the obvious: that more and larger metal is stronger. The purpose of this study is to evaluate if a subset of biomechanical studies comparing fixation constructs just document common sense. ⋯ The results of a subset of biomechanical studies comparing fracture fixation constructs can be predicted prior to doing the study. As these studies are time and resource intensive, one criterion for proceeding with a biomechanical study should be that the answer is not simply a matter of common sense.
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Percutaneous iliosacral screw fixation of the posterior pelvic ring is a demanding procedure with high exposure to radiation. The conventional technique includes the use of three classical projections with the C-arm: inlet, outlet, and true lateral views. A projection in the axis of the upper sacral alar pedicles with a 30° cephalad and 30° ventral oblique view would help in obtaining a more accurate visualization of the safe corridor. Two subcutaneously placed K-wires, one placed horizontally and one vertically, may facilitate the starting point and aim changes by offering the surgeon an option for exactly matching the position of the sacrum with the image. The purpose of this study was to detect if the radiation application could be decreased by our new methodology. ⋯ Therapeutic, Level II.