Injury
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The early fracture treatment in patients with multiple injuries should be focused on damage control. The fracture type and its location, local soft tissue condition as well as the patient's physiological condition shall determine the time and type of fracture treatment. ⋯ The use of external fixator (ExFix), which will be replaced by IM-implants in most cases at a later stage, provides adequate temporary fracture stabilization with less collateral damage. Good clinical results can be expected in patients with long bone fractures if the principles of damage control surgery are applied and local complications are prevented through proper reduction, firm fixation, early soft tissue reconstruction, and early rehabilitation.
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To assess the clinical results of using mesh plate in management of displaced comminuted fracture patella. ⋯ Low profile mesh plate is a good option in management of comminuted fracture patella with good clinical outcome. This new surgical technique may be particularly useful in comminuted fractures when patellectomy would otherwise be considered.
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Individuals who have sustained an injury from a road traffic crash (RTC) are at increased risk for long lasting health problems and non-return to work (NRTW). Determining the predictors of NRTW is necessary to develop screening tools to identify at-risk individuals and to provide early targeted intervention for successful return to work (RTW). The aim of this study was to identify factors that can predict which individuals will not RTW following minor or moderate injuries sustained from a RTC. ⋯ The results are promising, because they suggest that having information about two factors, which are easily obtainable, can predict with accuracy those who will require additional support to facilitate RTW.
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Intramedullary nailing of diaphyseal long bone fractures is a standard procedure in today's trauma and orthopedic surgery due to the numerous advantages (e.g. minimal invasive, limited soft tissue damage, load stability). In the last decade indications have been extended to the metaphyseal region. This was associated with problems and complications due to the reduced bone-implant interface. ⋯ This results in increased implant anchorage in the soft metaphyseal bone, thus construct stability significantly improved. Additional options like angular stable locking have been introduced and furthermore enhanced construct stability especially in poor bone stock. As a perspective locking screw augmentation shows promising results in first biomechanical testing.