Articles: fracture-fixation.
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Observational Study
Epidemiology, classification, and treatment of 2084 Lisfranc injuries: An observational study from the Swedish fracture register.
Lisfranc injuries are potentially severe but relatively uncommon. Limited epidemiological data regarding Lisfranc injuries of the midfoot are available. This study aimed to describe the injury's epidemiology, injury mechanism, and primary treatment. ⋯ Lisfranc injuries are the consequence of a broad spectrum of injury mechanisms, are primarily induced by low-energy trauma and found in all age groups in adults. The majority of Lisfranc injuries are treated non-operatively. This comprehension can aid in accurate diagnosis and management in everyday clinical practice.
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Studies have demonstrated successful outcomes with early weightbearing following open reduction internal fixation (ORIF) of specific ankle fractures. The external validity of an early weightbearing protocol and its effects on patient-reported outcome information scores (PROMIS) has yet to be investigated. This study aimed to investigate the effects of an early weightbearing protocol for all operatively treated ankle fractures and its impact on clinical outcomes and complications. ⋯ This study found that early weightbearing after ORIF of unstable ankle fractures leads to similar PROMIS scores and ankle ROM without increased complications. In addition, smokers were found to have worse ankle ROM when compared to nonsmokers at final follow-up.
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Ballistic fractures of the femoral neck, rare injuries that overwhelmingly affect younger adults, pose significant challenges to the treating surgeon. However, there is limited literature that the treating surgeon can leverage to guide their treatment decisions. The goal of this study is to describe the demographics, associated injuries, outcomes, and complications associated with ballistic femoral neck fractures. ⋯ Nearly 1 in 3 patients with ballistic femoral neck fractures sustain concomitant vascular injury and almost half sustain another osseous injury. In this series, only 62 % of patients who underwent operative reduction and fixation healed their fractures, and nearly 40 % of patients treated with operative reduction and fixation developed a post-operative complication. Given the poor outcomes and high complication rates associated with these injuries, surgeons should counsel patients with ballistic femoral neck fractures accordingly. Further research into the optimal treatment of ballistic femoral neck fractures is needed.
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Fragility fractures of the pelvis are becoming increasingly important in an ageing society. However, they are under-represented in the current research literature. In particular, unstable bilateral fragility fractures of the sacrum (FFP IVb) benefit from surgical treatment, but individual fracture patterns need to be considered in the surgical decision. This study describes the sacral anatomy in patients with FFP IVb pelvic fractures, with particular emphasis on the identification and evaluation of possible trans-sacral screw corridors, with particular emphasis on the transverse fracture components. ⋯ III.
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Arch Orthop Trauma Surg · Feb 2025
Morphologic profiles of comminuted midshaft clavicle fractures: a preliminary study.
Previous literature lacks parametric analysis of clavicle fracture morphology. The aim of this study was to describe the features of comminuted midshaft clavicle fracture in surgically treated patients. ⋯ Comminuted midshaft clavicle fracture frequently had coronal plane fracture lines. Wedge-shaped or multifragmentary fragments were predominantly located anteriorly or inferiorly. In the posterior-superior portion of the clavicle, cortical contact was found to guide reduction.