Injury
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Multicenter Study
Indicators of injury recovery identified by patients, family members and clinicians.
A focus on what is important to patients has been recognized as an essential pillar in care to ensure safe patient care that focuses on outcomes identified as important by patients. Despite this, asking trauma patients and their families what they consider should be the priorities of care and recovery has been neglected. ⋯ Description of the indicators of recovery after traumatic injury that matter to patients, family members and clinicians enable an understanding of similarities and differences. Further testing in a broader cohort of participants is essential to identify patient reported outcome measures that might be used in trauma care and associated research.
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Multicenter Study
Is radiograph glenopolar angle accurate for extraarticular scapular neck fractures?
Plain radiographs still play a role in management of extraarticular scapular neck fractures. Glenopolar angle (GPA) is one of the radiograph measurements that is used to determine the necessity for surgery. Our aim was to establish reliability of GPA on plain radiograph in patients with extraarticular scapular neck fractures. ⋯ Plain radiograph can provide a clinician with a reasonable estimation of the GPA. Glenoid inclination has a greater influence on GPA compared to medial shortening.
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The induced membrane technique was designed by Masquelet et al. to address segmental bone defects of critical size in adults. It has been used after bone defects of traumatic, infectious and tumoral origin with satisfactory results. Recently, it has been used in children but, after an initial enthusiasm, several cases of failure have been reported. ⋯ The induced membrane technique is suitable for bone defects of critical size in children. It is a reliable technique with no need of micro vascular surgery. However, we found several risk factors of failure for the use of the induced membrane technique to address segmental bone defect of critical size in children.
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Clinical Trial
Can applied external fixators be sterilized for surgery? A prospective cohort study of orthopaedic trauma patients.
Temporary external fixators are often used to stabilize fractures when definitive fracture surgery must be delayed. Sometimes, external fixators are left in place during repeat operations, including definitive internal fixation of tibial pilon and tibial plateau fractures. It is unknown how well current surgical preparation sterilizes these devices, which become part of the surgical field. Our hypothesis was that our institution's standard surgical preparation creates a low rate of culture-positive environments on external fixators at the time of surgical skin incision. ⋯ Using 70% alcohol on external fixators plus either ChloraPrep for closed wounds or povidone iodine for open wounds seems to result in a low rate of positive cultures. Most species that were isolated are infrequently identified as sources of surgical site infections. This preparation protocol might be effective at producing a relatively clean environment at the time of surgery for patients with external fixators already in place.
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Observational Study
3D printing-assisted osteotomy treatment for the malunion of lateral tibial plateau fracture.
Osteotomy and internal fixation are usually the most effective way to treat the malunion of lateral tibial plateau fractures, and the accuracy of the osteotomy is still a challenge for surgeons. This is a report of a series of prospectively study of osteotomy treatment for the malunion of lateral plateau fractures with the aid of 3D printing technology. ⋯ 3D printing technology is helpful to accurately design osteotomy operation, reduce the risk of postoperative deformity, decrease intraoperative blood loss, shorten the operation time, and can effectively improve the treatment effect.