Trauma

Latest journal articles about orthopaedic trauma and fracture management from Journal of Orthopaedic Trauma, Archives of Orthopaedic and Trauma Surgery, Orthopaedics and Traumatology: Surgery and Research, The Bone & Joint Journal, Journal of Bone and Joint Surgery, Clinical Orthopaedics and Related Research, Acta Orthopaedica, Orthopedic Clinics of North, America, Journal of Orthopaedic Surgery and Research, Orthopedics

Related Articles Measuring femoral and rotational alignment: EOS system versus computed tomography. Orthop Traumatol Surg Res. 2013 Jul 19; Authors: Folinais D, Thelen P, Delin C, Radier C, Catonne Y, Lazennec JY Abstract INTRODUCTION: Computed tomography (CT) is currently the reference standard for measuring femoral and tibial rotational alignment. The EOS System is a new biplanar low-dose radiographic device that allows 3-dimensional lower-limb modelling with automated measurements of femoral and tibial rotational alignment (torsion). HYPOTHESIS: Femoral and tibial torsion measurements provided by the EOS System are equivalent to those obtained using CT. MATERIALS AND METHODS: In a retrospective analysis of 43 lower limbs in 30 patients, three senior radiologists measured femoral and tibial torsion on both CT and EOS images. Agreement between CT and EOS values was assessed by computing Pearson's correlation coefficient and interobserver reproducibility by computing the intraclass correlation coefficient (ICC). RESULTS: Femoral torsion was 13.4° by EOS vs. 13.7° by CT (P=0.5) and tibial torsion was 30.8° by EOS vs. 30.3° by CT (P=0.4). Strong associations were found between EOS and CT values for both femoral torsion (P=0.93) and tibial torsion (P=0.89). With EOS, the ICC was 0.93 for femoral torsion and 0.86 for tibial torsion; corresponding values with CT were 0.90 and 0.92.

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Related Articles A Risk Calculator for Short Term Morbidity and Mortality Following Hip Fracture Surgery. J Orthop Trauma. 2013 Jul 18; Authors: Pugely AJ, Martin CT, Gao Y, Klocke NF, Callaghan JJ, Marsh JL Abstract OBJECTIVE:: Hip fractures are a common source of morbidity and mortality amongst the elderly. While multiple prior studies have identified risk factors for poor outcomes, few studies have presented a validated risk stratification calculator. METHODS:: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify 4,331 patients undergoing surgery for hip fracture between 2005 and 2010. Patient demographics, comorbidities, laboratory values, and operative characteristics were compared in a univariate analysis, and a multivariate logistic regression analysis was then used to identify independent predictors of 30 day morbidity and mortality. Weighted values were assigned to each independent risk factor, and used to create predictive models of 30 day morbidity, minor complication risk, major complication risk, and total complication risk. The models were internally validated with randomly partitioned 80% / 20% cohort groups.

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Related Articles Pediatric femoral shaft fractures: treatment strategies according to age - 13 years of experience in one medical center. J Orthop Surg Res. 2013;8(1):23 Authors: Sela Y, Hershkovich O, Sher-Lurie N, Schindler A, Givon U Abstract OBJECTIVE: The objective of this study was to analyze our experience in treating femoral shaft fractures with different strategies, focusing on the first year after injury when the choice of method would have the greatest impact. METHODS: We reviewed the medical records of all children treated for femoral shaft fractures in our institution between 1997 and 2010. They were divided according to therapeutic approach: spica cast, skin traction, titanium elastic nail (TEN), external fixator, intramedullary medullary nail (IMN), and plating. RESULTS: The 212 patients included 150 boys and 62 girls (M/F ratio 2.4:1, mean age 5 years, range 0-16). The postoperative radiographic results demonstrated solid union in all patients, with no malunions. Of the 151 children in the spica cast group, 10 required re-manipulation and casting due to loss of reduction with unaccepted angulation, 10 had contact dermatitis, and 2 had fever and pressure sores. All 21 elastic nail group children underwent re-operation to

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Related Articles Outcomes after operative fixation of complete articular patellar fractures: assessment of functional impairment. J Bone Joint Surg Am. 2013 Jul 17;95(14):e961-8 Authors: Lazaro LE, Wellman DS, Sauro G, Pardee NC, Berkes MB, Little MT, Nguyen JT, Helfet DL, Lorich DG Abstract BACKGROUND: Patellar fractures are debilitating injuries that compromise the knee extensor mechanism and are frequently associated with poor outcomes. The purpose of this study was to quantify the functional outcomes of operative treatment of patellar fractures. METHODS: Functional outcome data on thirty patients with an isolated unilateral patellar fracture were prospectively obtained at three, six, and twelve months postoperatively. RESULTS: All fractures healed. There were two complications (7%) related to the surgery (wound dehiscence and refracture), and eleven patients (37%) underwent removal of symptomatic implants. The tibial plateau-patella angle demonstrated patella baja in seventeen (57%) of the patients. Anterior knee pain during activities of daily living was experienced by twenty-four (80%) of the patients. Clinical improvement occurred over the first six months. However, functional impairment persisted at twelve months, with objective testing demonstrating that the knee extensor mechanism on the injured side had deficits in strength (-41%), power (-47%), and endurance (-34%) as compared with the uninjured side.

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Related Articles What's New in Orthopaedic Trauma. J Bone Joint Surg Am. 2013 Jul 17;95(14):1333-42 Authors: Ricci WM, Spiguel A, McAndrew C, Gardner M PMID: 23864182 [PubMed - in process]Read more... http://www.ncbi.nlm.nih.gov/pubmed/23864182?dopt=Abstract