Journal of orthopaedic trauma
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Comparative Study
The role of computed tomography in the assessment of open periarticular fractures associated with deep knee wounds.
To (1) determine the incidence and injury profile of open periarticular fractures about the knee joint in a cohort of patients presenting to the emergency department with a deep periarticular knee wound and to (2) determine the effectiveness of computed tomography (CT) scan to detect and guide management of these open fractures compared with plain radiographs (XRs). ⋯ Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Comparative Study
Assessment of radiographic fracture healing in patients with operatively treated femoral neck fractures.
This study was conducted to determine interrater and intrarater reliabilities on the healing assessment of femoral neck fractures between orthopedic surgeons and radiologists and to test the performance of a checklist system for hip fracture healing. ⋯ The level of agreement between and within orthopedic surgeon and radiologist reviewers in the assessment of fracture healing is low, though intrarater agreement is high. The RUSH score shows promise as a tool to improve agreement on fracture healing. Studies evaluating reliability and accuracy of healing with clinical information and temporal evaluation are needed and may further improve agreement.
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Comparative Study
A biomechanical comparison of one-third tubular plates versus periarticular plates for fixation of osteoporotic distal fibula fractures.
The purpose of this study was to test the biomechanical properties of locking and nonlocking plates using one-third tubular and periarticular plate designs in an osteoporotic distal fibula fracture model. ⋯ In biomechanical testing using an osteoporotic model of OTA 44-B2.1 fractures, periarticular plates were superior to one-third tubular plates in rotational stiffness only. Locking plates did not outperform their nonlocking counterparts. Periarticular plates should be considered when treating osteoporotic distal fibula fractures, but one-third tubular plates and nonlocking plates provide adequate fixation for these injuries.
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Comparative Study
Biomechanical comparison of standard iliosacral screw fixation to transsacral locked screw fixation in a type C zone II pelvic fracture model.
Iliosacral screw fixation into the first sacral body is a common method for pelvic ring fixation. However, this construct has been shown to be clinically unreliable for the percutaneous fixation of unstable Type C zone II vertically oriented sacral fractures with residual fracture site separation. The objective of this study was to biomechanically compare a locked transsacral construct versus the standard iliosacral construct in a Type C zone II sacral fracture model. ⋯ Fixation of unstable zone II sacral fractures using the combination of an iliosacral screw and a locked transsacral screw resists deformation and withstands a greater force to failure as compared to fixation with 2 standard iliosacral screws. This locked transsacral construct may prove advantageous, especially when a percutaneous technique is used for a Type C zone II vertically oriented sacral fracture injury pattern, which can result in residual fracture site separation.
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To report our experience with computed tomography (CT) scans to detect traumatic arthrotomies of the knee (TAK) joint based on the presence of intra-articular air. ⋯ Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.