Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Dec 2013
The value of valgus stress radiographs in the workup for medial unicompartmental arthritis.
High tibial osteotomy and unicompartmental knee arthroplasty are surgical treatment options for unicompartmental knee arthritis; these procedures are indicated for patients who do not have severe arthritis in the lateral compartment. Valgus stress radiographs sometimes are used to make this evaluation, but this test has not been critically evaluated. ⋯ Valgus stress radiographs provided no added benefit to the radiographic assessment of the lateral compartment cartilage and regarding the correctability of the varus deformity.
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Clin. Orthop. Relat. Res. · Dec 2013
Comparative StudyRetrograde versus antegrade intramedullary nailing of gunshot diaphyseal femur fractures.
The use of retrograde nailing for gunshot wound femur fractures is controversial due to concerns of knee sepsis after this procedure since the knee is entered to introduce the nail into the canal. ⋯ With the numbers available, immediate retrograde nailing appears as safe and effective as antegrade nailing for gunshot femur fractures. Immediate retrograde nailing is as safe as antegrade nailing for gunshot femur fractures.
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Clin. Orthop. Relat. Res. · Dec 2013
ReviewThe initial trauma center fluid management of penetrating injury: a systematic review.
Damage-control resuscitation is the prevailing trauma resuscitation technique that emphasizes early and aggressive transfusion with balanced ratios of red blood cells (RBCs), plasma (FFP), and platelets (Plt) while minimizing crystalloid resuscitation, which is a departure from Advanced Trauma Life Support (ATLS) guidelines. It is unclear whether the newer approach is superior to the approach recommended by ATLS. ⋯ Patients with penetrating injuries who require massive transfusion should be transfused early using balanced ratios of RBC, FFP, and Plt. Randomized, controlled trials are needed to determine optimal ratios for transfusion.