Articles: fracture-fixation.
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Bmc Musculoskel Dis · Mar 2020
Randomized Controlled Trial Multicenter Study Comparative StudyStudy protocol for the DEFENDD trial: an RCT on the Dynamic Locking Blade Plate (DLBP) versus the Dynamic Hip Screw (DHS) for displaced femoral neck fractures in patients 65 years and younger.
The Dynamic Locking Blade Plate (DLBP) was recently introduced for fixation of displaced femoral neck fractures (FNF) and has been well received. Although the results of this implant in young patients are promising, the DLBP has not yet been compared to a standard device such as the Dynamic Hip Screw (DHS). The aim of this study is to compare the clinical outcome and costs of displaced FNF treated with internal fixation by means of either the DLBP or the DHS in patients up to 65 years of age. We hypothesize that the DLBP is superior compared to the DHS in terms of revision surgery rate, union rate, incidence of avascular necrosis and implant related failure. ⋯ The outcome of the DEFENDD trial will provide high-level evidence of which implant is favourable for the treatment of femoral neck fractures in young patients (≤65 years).
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Multicenter Study
Supination adduction ankle fractures: Ankle fracture or pilon variant?
Supination adduction (SAD) fractures are rotational ankle fractures with a characteristic vertical medial malleolus fracture and tension failure fibula fracture. While these fractures are considered rotational injuries, they can have joint impaction that could lead to early joint degeneration. The purpose of this study was to characterize SAD ankle fractures and compare these injuries with partial articular pilon fractures. ⋯ Level 3, Prognostic.
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Multicenter Study Clinical Trial
Clinical outcomes of proximal femoral fractures treated with a novel carbon fiber-reinforced polyetheretherketone intramedullary nail.
We developed a new carbon fiber-reinforced polyetheretherketone (CFR/PEEK) intramedullary nail for proximal femoral fractures. This study aimed to examine the efficacy and safety of the CFR/PEEK intramedullary nail for use in the treatment of patients with proximal femoral fractures. ⋯ There were no adverse reactions or failures related to the CFR/PEEK implant, and it provided satisfactory clinical results and a high union rate. Thus, use of the novel CFR/PEEK intramedullary nail is feasible.
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Multicenter Study
Does surgical approach affect sagittal plane alignment and pilon fracture outcomes?
Sagittal plane alignment beyond articular reduction and its effect on clinical outcomes has not been emphasized. Surgical approach may influence a surgeon's ability to correct the sagittal plane alignment. The purpose of our study was to evaluate how surgical approach impacts anterior distal tibial angle (ADTA) and lateral talar station (LTS). Our hypothesis was that the anterolateral (AL) approach would improve the sagittal plane parameters due to the primary plate placement. ⋯ The sagittal plane alignment does not appear to be affected by the surgical approach. Therefore, the surgical approach to pilon fractures should be based on the fracture pattern and the patient's soft tissue envelope. This study shows that the AM is a relatively safe and effective approach to complex fractures and the surgeon should consider the specific fracture pattern and patient soft tissue envelope when choosing the specific approach.
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Randomized Controlled Trial Multicenter Study Comparative Study
Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial.
Observational studies have suggested that accelerated surgery is associated with improved outcomes in patients with a hip fracture. The HIP ATTACK trial assessed whether accelerated surgery could reduce mortality and major complications. ⋯ Canadian Institutes of Health Research.