Journal of orthopaedic trauma
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We hypothesize that clinical results and patient outcomes following treatment of olecranon fractures with a congruent elbow plating system will be comparable to other available plating systems. Our results will be compared to previously published reports. ⋯ Congruent anatomic plating is a safe, effective option for the treatment of olecranon fractures with a low rate of hardware removal and stability with early motion.
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The purpose of this study is to evaluate clinical results and outcomes of a strict cohort of high-energy injuries of the metaphyseal distal tibia with minimal or no intraarticular involvement treated using the minimally invasive plating concept. ⋯ Minimally invasive medial plating will restore limb alignment and yield successful clinical outcomes for high-energy metaphyseal fractures of the distal tibia. Despite the significant reoperation rate and prolonged time to union, most patients can expect a predictable return of function. Strong consideration should be given to adjunctive measures in at-risk patients, including those with highly comminuted fracture patterns, bone loss, or Type II or III open fractures.
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To report our institutional experience with the use of a bioartificial dermal substitute (Integra) combined with subatmospheric pressure [vacuum-assisted closure (VAC)] dressings followed by delayed split-thickness skin grafting for management of complex combat-related soft tissue wounds secondary to blast injuries. ⋯ Bioartificial dermal substitute grafting, when coupled with subatmospheric dressing management and delayed split-thickness skin grafting, is an effective technique for managing complex combat-related soft tissue wounds with exposed tendon. This can potentially lessen the need for local rotational or free flap coverage.
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Describe the use of a radiographic parameter (pelvic incidence) to assess the sagittal plane reduction of H-type sacral fractures associated with spinopelvic dissociation, and assess the relationship between standing lumbar lordosis to pelvic incidence after spinopelvic dissociation. ⋯ Pelvic incidence is a potentially useful radiographic parameter that can be used to assess the adequacy of sagittal plane reduction in patients with spinopelvic dissociation injuries.
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Comparative Study
Biomechanical considerations in plate osteosynthesis: the effect of plate-to-bone compression with and without angular screw stability.
We compared the biomechanical stability of bone-plate constructs using a compression plate (CP), an internal fixator (IF), and a combination plate (CP/IF). ⋯ Under compression, IF provides similar fixation in comminuted fractures and was better than the CP for avoiding loss of reduction, whereas under torsional loading, CP was more important for stiffness, plastic deformation, and load to failure than IF. However, combination (CP/IF) fixation seems advisable in intraarticular and extraarticular fractures of long bones with a metaphyseal comminution. These data may be utilized by surgeons to build a more specific treatment plan in patients with these fracture types.