Journal of orthopaedic trauma
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Screw perforation of the humeral head in locking plate osteosynthesis occurs in up to 30% of cases. The current study compared different fixation possibilities (eg, number and position of screws) to reduce screw perforation in the humeral head. ⋯ We recommend to position an inferomedial support screw, and at least 5 screws in the head fragment, when using a locking plate in proximal humerus fractures with disrupted medial hinge.
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The trauma opportunities: The numbers are 260 verified sites (American College of Surgeons), 1100 Centers performing as Regional or Community Trauma Centers currently in the continental 48 states, and 3256 hospitals performing in-patient orthopaedic surgery. Orthopaedic trauma surgeons still represent <10% of the total national surgeon complement. ⋯ This represents the supply side that has the potential to graduate in 2013 and beyond. These individuals face a wide variety of career options not previously available to past generations, but one has to know the business model differentiators to be successful: employed-employee (most common, least sustainable historically); employed-partner; partner-contract for service; partner-private practice; private practice-hospital partner (least common, most productive).
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Comparative Study
A comparison of pediatric forearm fracture reduction between conscious sedation and general anesthesia.
The purpose of this study was to compare the outcomes of children whose fractures were manipulated with nitrous oxide with those fractures manipulated under a general anesthetic. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
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To determine whether negative pressure wound therapy (NPWT) affects antibiotic elution in simulated femur fractures treated with antibiotic impregnated polymethylmethacrylate (PMMA) beads and whether fascial closure between beads and sponge affects the outcome. ⋯ Concurrent application of NPWT with antibiotic impregnated PMMA beads to simulated open femur fractures in pigs did not decrease local antibiotic concentrations but did decrease the total amount of eluted vancomycin and tobramycin locally available when the fascia was left open.
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To evaluate the effect of negative pressure wound therapy (NPWT) on deep infection rate in open tibial fractures. ⋯ Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.