Journal of orthopaedic trauma
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Randomized Controlled Trial Multicenter Study
Reamed versus unreamed intramedullary nailing of the femur: comparison of the rate of ARDS in multiple injured patients.
To compare the rate of Acute Respiratory Distress Syndrome (ARDS) in multiply injured patients with femoral shaft fractures, treated with intramedullary femoral nails inserted with or without reaming. ⋯ The overall incidence of ARDS was found to be low with primary stabilization of femoral shaft fractures with intramedullary nailing. There was no difference in the incidence of ARDS between the reamed and unreamed groups, given the sample size.
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To determine the value of static progressive splinting in helping patients with posttraumatic elbow stiffness regain functional motion and avoid operative treatment for stiffness. ⋯ Static progressive splinting can help gain additional motion when standard exercises seem stagnant or inadequate, particularly after the original injury. Operative treatment of stiffness was avoided in most patients.
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Femoral neck nonunions are a difficult complication in the treatment of femoral neck fractures and have traditionally been managed using an intertrochanteric valgus osteotomy and blade plate. We propose an alternative method, a proximal femoral valgus osteotomy using a sliding hip screw instead of a blade plate. This technique eliminates many of the difficulties experienced with the valgus osteotomy and blade plate by employing a device and instrumentation that is more familiar to orthopedic surgeons. The technique is reproducible and has been used successfully in a series of 4 patients.
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The elbow joint is vulnerable to stiffness, especially after trauma. The aim of this study was to evaluate the results of open arthrolysis for posttraumatic elbow stiffness. ⋯ Open elbow arthrolysis for patients with posttraumatic stiffness improves joint function and provides patient satisfaction. The best results, in terms of gain of motion and patient satisfaction, were obtained in patients with severe stiffness who had operations within the first year after initial trauma.
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To describe the associated injuries, demographic distribution, and management of patients sustaining open clavicle fractures. ⋯ Open clavicle fractures are a rare injury. Patients often have associated pulmonary and cranial injuries. Ipsilateral upper extremity and shoulder girdle injuries are common, whereas concomitant neurologic and vascular injuries are infrequent. The majority of patients have rapid and uneventful healing of their fractures after surgical treatment.