Injury
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Comparative Study
Comparing Femoral Version After Intramedullary Nailing Performed by Trauma-Trained and Non-Trauma Trained Surgeons: Is There a Difference?
As with some procedures, trauma fellowship training and greater surgeon experience may result in better outcomes following intramedullary nailing (IMN) of diaphyseal femur fractures. However, surgeons with such training and experience may not always be available to all patients. The purpose of this study is to determine whether trauma training affects the post-operative difference in femoral version (DFV) following IMN. ⋯ Post-operative version or percentage of DFV >15° did not significantly differ following IMN of diaphyseal femur fractures between surgeons with and without trauma fellowship training. However, prospective data that removes the inherent bias that the more complex cases are left for the traumatologists are required before a definitive comparison is made.
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In the United States there are more than 230,000 total hip replacements annually, and periprosthetic femoral fractures occur in 0.1-4.5% of those patients. The majority of these fractures occur at the tip of the stem (Vancouver type B1). The purpose of this study was to compare the biomechanically stability and strength of three fixation constructs and identify the most desirable construct. ⋯ To treat periprosthetic fractures, bicortical screw placement should be attempted to maximize load to failure and torsional/sagittal bending stiffness.
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Traumatic soft tissue defect is a common issue for the trauma surgeon. The aim of this study was to evaluate the use of a dermal regeneration template (DRT) associated to a split-thickness skin graft (STSG) to cover severe traumatic wounds involving exposure of deep functional structures. ⋯ Eighteen months' follow-up demonstrated that DRT reconstruction is a simple, reliable, efficient tool to treat complex traumatic soft tissue defects.
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Ulnar nerve compression is common at the elbow, but less common at the wrist. The purposes of this study were to report a series of nine patients with pure ulnar nerve deep branch compression by a ganglion and to evaluate the outcome following a surgical treatment. ⋯ A ganglion causing ulnar nerve deep branch compression is rare. Early surgical treatment can result in satisfactory functional recovery.
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Comparative Study
Femoral malrotation after intramedullary nailing in obese versus non-obese patients.
Intramedullary nailing (IMN) of obese patients with femoral fractures can be difficult due to soft tissue considerations and overall body habitus. Complications including malrotation can occur and have significant impact on postoperative function. The purpose of this study was to evaluate femoral rotation after intramedullary nailing of obese and non-obese patients to see if there was a difference in rotation, complications and any risk factors for malrotation. ⋯ Based on this study, BMI did not have an effect on postoperative difference in femoral version. In fact, in our multivariate regression analysis, BMI of over 30 was actually predictive of significantly lower difference in femoral version. While other studies have documented the intraoperative difficulties encountered with obese patients with femur fractures, the outcome of femoral rotation is not affected by an increasing BMI.