Articles: fracture-fixation.
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Multicenter Study
Cephalomedullary screws as the standard proximal locking screws for nailing femoral shaft fractures.
In 2004, we modified our technique for the stabilization of femoral shaft fractures so that all fractures were stabilized using a reconstruction nail with proximal locking screws oriented into the femoral head. The rationale for this was twofold: first, potentially "missed" associated femoral neck fractures would be stabilized. Second, hip fractures that might occur later in life above the intramedullary nail might be avoided. The purpose of this study therefore was to determine whether there were any risks to patients treated for femoral shaft fractures with antegrade nails using cephalomedullary proximal locking screws. ⋯ Using a reconstruction nail and cephalomedullary proximal locking screws for antegrade femoral nailing of femoral shaft fractures was not associated with major complications in this series. This modification of standard femoral nailing offers potential advantages, including fixation of any "missed" associated femoral neck fractures and prevention of late hip fractures that might occur above the nail.
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Multicenter Study Controlled Clinical Trial
[Operative versus conservative treatment of non-displaced fractures of the scaphoid bone. Results of a controlled multicenter cohort study].
Within a prospective, multicenter cohort study we investigated whether operative treatment of scaphoid bone fractures leads to earlier return to previous activity levels. ⋯ Operative treatment primarily facilitates earlier return to previous activity levels, as well as better functional status, less pain and higher patient satisfaction, but conservative treatment seems to be safer and associated with a lower complication rate.
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Multicenter Study
Transpedicular screw fixation for type II Hangman's fracture: a motion preserving procedure.
Opinions have varied regarding the optimal treatment of an unstable Hangman's fracture. C2 pedicle screw instrumentation is a biomechanically strong fixation which although done through a simple posterior approach, is a technically demanding procedure. This prospective, non-randomized multicentre study included 15 consecutive patients with displaced type II traumatic spondylolisthesis of the axis. ⋯ Two pedicle screws (6.6%) showed minimal (defined as <2 mm) intrusion; one into the spinal canal and the other into the vertebral foreamen. Transpedicular screw fixation through the C2 pedicles is a safe and effective method in treating type II traumatic spondylolisthesis of the axis resulting in good clinical and radiological outcomes. Adequate reduction was achieved and motion segments were preserved with its use.
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Multicenter Study Comparative Study
Outcome of nonoperative vs operative treatment of humeral shaft fractures: a retrospective study of 213 patients.
Standard treatment for most humeral shaft fractures is nonoperative functional bracing; however, certain clinical scenarios necessitate operative intervention. There have been few studies in the literature comparing nonoperative and operative fixation of humeral shaft fractures. Two-hundred thirteen adult patients with a humeral shaft fracture who satisfied inclusion criteria were treated at 2 level 1 trauma centers with either a functional brace (nonoperative treatment group) or compression plating (operative treatment group). ⋯ No difference in time to union or ultimate ROM was found between the 2 groups. Closed treatment of humerus fractures had a significantly higher rate of nonunion and malunion while operative intervention demonstrated no significant differences in time to union, infection, or iatrogenic radial nerve palsy. Nonoperative management has historically been the treatment of choice for many humeral shaft fractures, however, in certain clinical scenarios these fractures may be well served by compression plating.
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J Bone Joint Surg Am · Jul 2010
Randomized Controlled Trial Multicenter Study Comparative StudyDynamic compared with static external fixation of unstable fractures of the distal part of the radius: a prospective, randomized multicenter study.
External fixation is an established method of treating certain types of distal radial fractures. We have designed a dynamic external fixator to treat these fractures. The purpose of the present study was to compare this device with current static bridging external fixators in terms of anatomical and functional results. ⋯ Continuous dynamic traction with a dynamic external fixator compares favorably with the use of static external fixators for the treatment of unstable fractures of the distal part of the radius.