Articles: joint-instability-etiology.
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Multicenter Study Comparative Study
Unstable cervical spine fracture after penetrating neck injury: a rare entity in an analysis of 1,069 patients.
The value of cervical spine immobilization after penetrating trauma to the neck is the subject of lively debate. The purpose of this study was to review the epidemiology of unstable cervical spine injuries (CSI) after penetrating neck trauma in a large cohort of patients. ⋯ The overall incidence of unstable CSI after penetrating trauma to the neck is exceedingly low at 0.4%. Following GSW to the neck, an unstable CSI was noted in <1% of patients. After cervical SW, however, no spinal instability was noted precluding the need for spinal precautions in these instances.
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Early stages of intervertebral disc degeneration are postulated to cause instability. In the literature, however, some authors report the opposite. These contradictory positions are probably supported by the mostly small number of segments which are investigated. ⋯ In conclusion, the results indicated that early stages of intervertebral disc degeneration do not necessarily cause rotational instability. In contrast, stability increased in flexion/extension and lateral bending. Only in axial rotation stability tended to decrease.
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The objective of this study was to determine which clinical factors influence the presence and extent of femoral malrotation during unreamed nail insertion performed without a fracture table. ⋯ Rotational malalignment greater than 15° was found in 22% of femurs treated in this study. Fracture comminution and time of day the surgery was performed had the greatest effect on the severity of malrotation.
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Clinical biomechanics · Mar 2011
Long-term functional implications of the iatrogenic rotational malalignment of healed diaphyseal femur fractures following intramedullary nailing.
The long-term functional implications for patients with iatrogenic femoral malrotation following femoral intramedullary nail fixation remain unclear. This study examined the extent and direction of rotational alignment of the femur treated with intramedullary nail fixation and its long-term functional effects on patients' standing, walking, and subjective outcome. ⋯ Patients can compensate for even significant femoral malrotation and tolerate it well. External femoral malrotation appears to be better compensated/tolerated than internal malrotation.
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Operational treatment of trochanteric fractures of the femur, independently of the applied connecting implant, carries the risk of various types of complications. In this paper the incidence of mechanical complications in performed osteosynthesis of trochanteric fractures of the femur was analyzed as well as the risk factors influencing them and their extent were assessed. The results showed statistically significant influence of the type of implant, the type of fracture and the patients' age. It has been proven that the use of Gamma nail decreases the risk of mechanical complications almost twofold in comparison with the Ender's posts, disregarding the type of trochanteric fracture of the femur.