Abstract:
OBJECTIVES:To determine if there are differences in healing, complications, or number of procedures required to obtain union among open and closed tibia fractures treated with intramedullary (IM) nails inserted with and without reaming. DESIGN:Prospective, surgeon-randomized comparative study. SETTING:Level One trauma center. PATIENTS:Ninety-four consecutive patients with unstable closed and open (excluding Gustilo Grade IIIB and IIIC) fractures of the tibial shaft treated with IM nail insertion between November 1, 1994, and June 30, 1997. INTERVENTION:Interlocked IM nail insertion with and without medullary canal reaming. MAIN OUTCOME MEASURES:Time to union, type and incidence of complications, and number of secondary procedures performed to obtain union. RESULTS:For open fractures, there were no significant differences in the time to union or number of additional procedures performed to obtain union in patients with reamed nail insertion compared with those without reamed insertion. A higher percentage of closed fractures were healed at four months after reamed nail insertion compared with unreamed insertion (p = 0.040), but there was not a difference at six and twelve months. More secondary procedures were needed to obtain union after unreamed nail insertion for the treatment of closed tibia fractures, but the difference was not statistically significant given the limited power of our study (p = 0.155). Broken screws were seen only in patients treated with smaller-diameter nails inserted without reaming, and the majority occurred in patients who were noncompliant with weight-bearing restrictions. There were no differences in rates of infection or compartment syndrome. CONCLUSION:Our findings support the use of reamed insertion of IM nails for the treatment of closed tibia fractures, which led to earlier time to union without increased complications. In addition, canal reaming did not increase the risk of complications in open tibia fractures.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Finkemeier CG,Schmidt AH,Kyle RF,Templeman DC,Varecka TFdoi
10.1097/00005131-200003000-00007subject
Has Abstractpub_date
2000-03-01 00:00:00pages
187-93issue
3eissn
0890-5339issn
1531-2291journal_volume
14pub_type
临床试验,杂志文章,随机对照试验abstract::Traumatic spinal cord injuries have a tremendous impact on individuals, families, and society as a whole. Substantial heterogeneity in the patient population, their presentation and underlying pathophysiology has sparked debates along the care spectrum from initial assessment to definitive treatment. This article revi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000943
更新日期:2017-09-01 00:00:00
abstract::Periprosthetic humerus fractures are relatively uncommon occurrence that can be difficult to manage nonoperatively. Locking plate technology has enhanced the surgical management of these fractures. However, adequate fixation around the stem remains of some concern. We describe an osteosynthesis technique using a locki...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000646
更新日期:2016-11-01 00:00:00
abstract::The standard AO-plate was used as an external fixator in 31 patients with an infected nonunion or open fracture mainly of the upper extremity. With the use of this technique, good stability can be achieved with an inexpensive and relatively simple construction. The low profile of the frame is an advantage for the pati...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200301000-00010
更新日期:2003-01-01 00:00:00
abstract:OBJECTIVE:To determine the impact of smoking on intensive care unit (ICU) outcomes in patients who underwent operative fixation for spine trauma. DESIGN:Retrospective cohort study. SETTING:Single academic level I trauma center. PATIENTS:One hundred eighty-one consecutive surgical spine trauma patients from January 2...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001739
更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:To compare the 24-month risk of mortality between arthroplasty and internal fixation for undisplaced femoral neck fractures (FNFs). DESIGN:Retrospective cohort study. SETTING:Secondary data analysis of 2 multinational randomized controlled trials. PARTICIPANTS:Patients aged 50 years or older with a FNF. I...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001940
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVES:To determine whether opioid use disorders (OUDs) are associated with adverse perioperative outcomes in patients undergoing surgical fixation for proximal femur fractures. METHODS:The National Hospital Discharge Survey was queried to identify patients surgically treated for proximal femur fractures between 1...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001118
更新日期:2018-05-01 00:00:00
abstract:OBJECTIVES:To analyze long-term functional outcomes in patients with posttraumatic infected tibial nonunions having undergone bone transport with hexapod external fixator. DESIGN:Retrospective cohort study. SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS:Thirty-eight patients with infected nonunions of the tibi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001005
更新日期:2018-01-01 00:00:00
abstract::Fractures of the femur have long been a major cause of morbidity and mortality in developing countries and are most frequently caused by road traffic accidents. Intramedullary nail fixation has become the gold standard of care for diaphyseal fractures of the femur. However, modern techniques require proper implants, a...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000001407
更新日期:2019-05-01 00:00:00
abstract::Seat belt legislation has resulted in increased restraint use by passengers in automobiles in Washington State. At Harborview Medical Center in Seattle, we have observed an increased incidence of seat belt-related injuries. Twenty cases of Chance-type thoracolumbar flexion-distraction fractures were reviewed retrospec...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199105020-00006
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:To determine whether operating on "major" vertebral fractures leads to premature abortion of surgery and/or other acute cardiopulmonary complications. DESIGN:Retrospective review. CLINICAL SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS AND INTERVENTION:We retrospectively queried our institutional Tra...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001316
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVE:To determine if cancellous screw (CS) and sliding hip screw (SHS) technical factors during low-energy femoral neck fracture fixation affects a 24-month revision surgery rate and health-related quality of life (HRQL). DESIGN:Prospective randomized controlled study. SETTING:International, multicenter. PATIEN...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001891
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVE:To determine the biomechanical characteristics and potential clinical efficacy of a cementless modular femoral prosthesis consisting of a variable head (50 to 80 millimeters) and stem (length 120 to 280 millimeters, diameter 10 to 20 millimeters) component in patients with pertrochanteric femoral fracture. D...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200011000-00005
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE:To test the hypothesis that oblique screws at the ends of a plate provide increased strength of fixation as compared to standard screw insertion. DESIGN:Biomechanical laboratory study in synthetic bone test medium. METHODS:Narrow 4.5-mm stainless steel low-contoured dynamic compression plates were anchored ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200410000-00006
更新日期:2004-10-01 00:00:00
abstract::One major advancement in the treatment of femoral neck fractures has been the development of cannulated screws. This study investigates the integrity of five commercially available cannulated screw systems. Transcervical fractures were created in 25 adult femora and repaired by three cannulated hip screws of a randoml...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199408000-00004
更新日期:1994-08-01 00:00:00
abstract::Nail plate combination technique can be applied in the setting of periprosthetic and interprosthetic fractures to promote reliable healing with a biomechanically favorable construct. Here, technical aspects and discussion of the technique are reviewed through a case of an 87-year-old woman who suffered from an interpr...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001571
更新日期:2019-09-01 00:00:00
abstract::A unique case of coexistent intertrochanteric and subcapital fractures of the hip is presented. A review of the literature found only one previous report of the simultaneous occurrence of these fractures. Closed reduction with in situ pinning was performed. Other treatment alternatives are reviewed and discussed. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199304000-00008
更新日期:1993-01-01 00:00:00
abstract:OBJECTIVES:Noncompliance with postoperative follow-up visits remains a common problem in orthopaedic trauma. The aim of this study was to identify risk factors for loss of follow-up after orthopaedic trauma. DESIGN:Retrospective review. SETTING:Urban level 1 academic trauma center. PATIENTS:A total of 307 (226 men/8...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000346
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVES:To investigate the incidence of concomitant posterior malleolar fractures (PMFs) in operative, distal-third, spiral tibia fractures. DESIGN:Prospective protocol with retrospective review of data. SETTING:Single, Level 1 trauma center. PATIENTS/PARTICIPANTS:One hundred ninety-three consecutive, skeletally ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001307
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVES:Malalignment has been frequently reported after intramedullary stabilization of distal tibia fractures. Nails have also been associated with knee pain in several studies. Historically, plate fixation has resulted in increased risks of infection and nonunion. Our purposes were to compare plate and nail stabil...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/BOT.0b013e318213f709
更新日期:2011-12-01 00:00:00
abstract::This video demonstrates a displaced radial shaft fracture repaired through a dorsal (Thompson) approach to the forearm. The patient is an 18-year-old man who sustained a left elbow dislocation and ipsilateral radial shaft fracture (OTA/AO: 22-B2) while playing basketball. The patient underwent a closed reduction of th...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001827
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVES:Controversy exists regarding optimum management of lateral compression type 1 (LC1) pelvic ring injuries (OTA type 61-B2.1), particularly in patients with complete sacral fractures. We hypothesized that nonoperative treatment would result in acceptable functional outcomes. DESIGN:Database review. SETTING:L...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000130
更新日期:2014-12-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to analyze the appropriateness of transfer of patients with orthopaedic injuries to a Level I trauma center from surrounding Level II to IV centers. DESIGN:A prospective study was conducted over a 5-month period by collecting data on all orthopaedic patients being transferred ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181b18b89
更新日期:2010-06-01 00:00:00
abstract:OBJECTIVES:To quantify the obliquity and dimensions of the upper and second sacral segment iliosacral screw safe zones and to determine the differences between normal and dysmorphic sacral morphology. DESIGN:Retrospective cohort. SETTING:University Level I trauma center. PATIENTS/PARTICIPANTS:Fifty patients with pel...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181cf0404
更新日期:2010-10-01 00:00:00
abstract:OBJECTIVE:To evaluate and compare the mechanical stability of two different fixation techniques on experimentally induced calcaneus fractures. METHODS:Thirteen fresh frozen cadaver lower limbs had intraarticular calcaneal fractures produced with an impact loading device. Internal fixation was then performed through la...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199708000-00010
更新日期:1997-08-01 00:00:00
abstract::Unstable pelvic ring injuries are associated with an increased mortality rate, most commonly from severe hemorrhage. Circumferential pelvic antishock sheeting has proven effective for rapidly stabilizing the pelvic ring and has become an integral part of resuscitation protocols. Acute antishock sheet placement frequen...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181a87c6c
更新日期:2009-10-01 00:00:00
abstract::Percutaneous iliosacral screw (IS) fixation for pelvic ring injuries with the use of an O-arm imaging system has been associated with decreased procedure time and improved accuracy of IS screw placement compared with the use of fluoroscopic guidance. Specifically, patients with sacral dysmorphism require identificatio...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001213
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:We investigated the role of negative pressure therapy (NPT) in postoperative primary wound treatment and closure. To date, extensive evidence exists demonstrating the benefit of negative pressure dressings in the treatment of open wounds; our experiment tested the hypothesis that negative pressure dressings ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318211363a
更新日期:2011-12-01 00:00:00
abstract::This case report provides background reviewing mortality rates associated with falls from height before detailing the clinical history of a patient who survived a fall from a height of 43 stories. A multidisciplinary team treated both orthopaedic and nonorthopaedic injuries with the ultimate goal of preserving potenti...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318193bc8d
更新日期:2009-02-01 00:00:00
abstract:OBJECTIVES:To assess the outcomes of the surgical management of "isolated" displaced lateral malleolar fractures, comparing the techniques of lateral plating and antiglide plating as described previously. DESIGN:This is a retrospective review, being largely a surgeon-randomized comparative study. SETTING:The study wa...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200208000-00008
更新日期:2002-08-01 00:00:00
abstract:OBJECTIVES:We studied the safety of immediate weight bearing as tolerated (IWBAT) and immediate range of motion (IROM) following open reduction internal fixation (ORIF) of selected malleolar ankle fractures (defined as involving bony or ligamentous disruption of two or more of the malleoli or syndesmosis without articu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000002003
更新日期:2020-11-09 00:00:00