Articles: fracture-fixation.
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Randomized Controlled Trial Multicenter Study
Is surgery for displaced, midshaft clavicle fractures in adults cost-effective? Results based on a multicenter randomized, controlled trial.
To determine the cost-effectiveness of open reduction internal fixation (ORIF) of displaced, midshaft clavicle fractures in adults. ⋯ The cost-effectiveness of ORIF after acute clavicle fracture depended on the durability of functional advantage for ORIF compared with nonoperative treatment. When functional benefits persisted for more than 9 years, ORIF had a favorable value compared with many accepted health interventions.
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Multicenter Study Comparative Study
Is ulnar nerve transposition beneficial during open reduction internal fixation of distal humerus fractures?
The purpose of this study was to compare the incidence of ulnar neuritis with and without ulnar nerve transposition during open reduction and internal fixation (ORIF) of distal humerus fractures. ⋯ Patients who underwent ulnar nerve transposition at the time of ORIF of distal humerus fractures had almost four times the incidence of ulnar neuritis than those without transposition. We do not recommend routine transposition of the ulnar nerve at the time of ORIF of distal humerus fractures.
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Multicenter Study
Radiological outcomes of distal radius extra-articular fragility fractures treated with extra-focal kirschner wires.
The classical colles fracture (extra-articular, dorsally angulated distal radius fracture) in patients with osteoporotic bone is becoming increasingly more frequent. There still appears to be no clear consensus on the most appropriate surgical management of these injuries. The purpose of this study is to appraise the use of percutaneous extra-focal pinning, in the management of the classical colles fracture. ⋯ In female patients over 60 years of age, the best predictor of radial length, when k-wire fixation is to be used, is the radial length prior to fracture reduction. Thus if there is radial shortening visible in the initial radiographs as measured in terms of ulnar variance, one should consider a method of fixation other than inter-fragmentary k-wires.
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Multicenter Study
Functional outcome of shoulder hemiarthroplasty for fractures: A multicentre analysis.
In this multicentre study, data on 102 shoulder hemiarthroplasties for the treatment of fractures were analysed retrospectively with regard to tuberosity healing and functional outcome. ⋯ In this study, we found that anatomical tuberosity healing around the prosthesis improved functional outcome and range of motion.
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Multicenter Study
Treatment of extra-articular distal radial malunions with an intramedullary implant.
Malunited distal radius fractures pose considerable problems, especially for young, active individuals. Surgical correction with osteotomy, bone grafting, and internal fixation with plates and screws has been the treatment of choice. Locked intramedullary fixation is an alternative technique to provide bony stability while minimizing soft tissue irritation in the management of acute distal radius fractures, with acceptable clinical results. The purpose of this study was to describe our experience with the use of an intramedullary device combined with grafting to repair distal radial malunions. This fixation device is inserted through the radial styloid and obtains distal fixation with 3 fixed-angle locking screws. ⋯ Therapeutic IV.