J Trauma
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Comparative Study
Modified technique of percutaneous posterior columnar screw insertion and neutralization plate for complex acetabular fractures.
To overcome the complexity of acetabular fractures, several techniques, such as extensive surgical exposure, transtrochanteric osteotomy, and columnar screw fixation, were reported. However, all these techniques have their disadvantages and limitations. We report the surgical results of a modified technique with posterior columnar screw insertion and neutralization plate in a single Kocher-Langenbeck approach for complex acetabular fractures. ⋯ This study provided a modified surgical technique of percutaneous insertion of posterior columnar screw that appeared to be safe and reliably hold the column in place for healing.
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The ability to return to running and sports participation after lower extremity limb salvage has not been well documented previously. Although the ability to ambulate without pain or assistive devices is generally a criteria for a good limb salvage outcome, many patients at our institution have expressed a desire to return to a more athletic lifestyle to include running and sports participation. The purpose of this study was to investigate the types of athletic endeavors our high-energy lower extremity trauma patients were able to pursue after limb salvage. ⋯ Aggressive rehabilitation, an energy-storing ankle-foot orthosis, and running gait retraining can restore an active recreational lifestyle to patients who have undergone lower extremity limb salvage.
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The purpose of this study was to describe pelvic fractures and their associated injuries in service members who either died of wounds or were killed in action during Operation Iraqi Freedom and Operation Enduring Freedom and define any differences in associated injuries between penetrating versus blunt injury to the pelvis. ⋯ Large pelvic vessel and hollow viscus injuries occur more frequently in penetrating combat-related pelvic fractures, whereas intra-abdominal solid organ, head, and cardiopulmonary injuries are more common in blunt pelvic injuries.
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The "palm tree-like wiring" introduced by Kapandji and its modifications for proximal humeral fractures should be given the generic name "retrograde intramedullary multiple pinning through the deltoid 'V'" (IMPV). IMPV is still preferable for treating valgus-impacted four-part fractures in which K-wires have the advantage of working as an internal fixation material as well as a tool in fracture reduction. ⋯ IMPV is considered to be a preferable reducing and stabilizing method for valgus-impacted four-part fractures regardless of patient age. Additionally beneficial is being able to use the intramedullary pins as a tool for bone fragment reduction.
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Prehospital care of combat casualties is a critical phase of emergency medical practice on the battlefield. The Joint Theater Trauma Registry (JTTR) was developed to standardize a system of data collection for combat casualty care; however, the degree of population and granularity of prehospital data were unknown. ⋯ Both poor population of data points and poor granularity of prehospital data entered into the JTTR were observed. It appears that the volume and quality of reporting of role-I data were better for OIF than OEF for this study period. Further investigations into the obstacles to free flow of role-I casualty clinical data, and the means to mitigate this situation, are warranted.