Abstract:
OBJECTIVE:To determine the biomechanical characteristics of four different fixation constructs for split depression fractures of the lateral tibial plateau (OTA classification 41B3.1). DESIGN:Laboratory investigation using a cadaveric simulated split depression tibial plateau fracture model. SETTING:Split depression tibial plateau fractures were created, reduced, and instrumented in a matched pair design. Specimens were tested for stiffness using a materials testing machine. INTERVENTION:Tibias were instrumented with an L-buttress plate, four 3.5-millimeter subchondral raft screws with an antiglide plate, an L-buttress plate with cancellous allograft, or four 3.5-millimeter subchondral raft screws placed through a periarticular plate. MAIN OUTCOME MEASUREMENTS:Vertical subsidence of the lateral tibial plateau was measured for the entire construct and for the local depression. The relative medial and lateral condylar tilt with central loading was also measured. RESULTS:There was no significant difference between the four fixation methods for overall longitudinal stiffness of the proximal tibial fracture fixation construct (range, 2,026 to 2,666 newtons per millimeter). The local depression stiffness for the raft-periarticular plate and raft-antiglide plate were 425 newtons per millimeter and 342 newtons per millimeter, respectively, versus 243 newtons per millimeter and 210 newtons per millimeter for the two large fragment buttress constructs. There was no significant difference between the local depression stiffness for the two raft constructs. There was no significant difference between the local depression stiffness for the two buttress plate constructs. Local depression stiffness was found to be significantly greater for the raft-periarticular plate construct when compared with the large fragment buttress plate construct without bone graft (p = 0.0314). Condylar tilt data showed a significant difference between the medial tilt observed in the prefracture specimen and the lateral tilt observed after fixation (p less-than-or-equal 0.017) for all constructs. CONCLUSIONS:There was no significant difference in the overall construct stiffness between the four fixation constructs. Fixation constructs with a raft of subchondral screws were more resistant to local depression loads. This supports the use of a raft construct when a central depression is a significant component of the overall fracture pattern. Condylar tilt data showed a persistent weakness in the postfixation lateral plateau regardless of fixation construct when compared with the intact specimen. This supports the current clinical practice of delayed weight-bearing for ten to twelve weeks.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Karunakar MA,Egol KA,Peindl R,Harrow ME,Bosse MJ,Kellam JFdoi
10.1097/00005131-200203000-00006subject
Has Abstractpub_date
2002-03-01 00:00:00pages
172-7issue
3eissn
0890-5339issn
1531-2291journal_volume
16pub_type
杂志文章abstract:OBJECTIVES:In the distal femur, locked plating is efficacious when coronal fractures preclude the use of a conventional fixed-angle device. However, minimal comparative data exist for supracondylar fracture patterns, which could be treated with other devices. The purpose of this study was to compare the 95-degree angle...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318234d460
更新日期:2012-06-01 00:00:00
abstract::A rare case of a complete fracture-separation of the proximal radial epiphysis is described in a pediatric patient. A further complicating factor is the delay in diagnosis that may worsen prognosis. An emphasis on early detection by physical examination and imaging studies, as well as consideration of treatment option...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-199506000-00013
更新日期:1995-06-01 00:00:00
abstract::This study was done to determine whether fixation with the Uppsala internal fixation technique into the subchondral bone of the femoral head in the treatment of cervical hip fractures could lead to elevation of the femoral head cartilage. Combined arthrography and frontal tomography of the hip joint in the plane of th...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198909000-00004
更新日期:1989-01-01 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:PURPOSE:The purpose of this OTA-approved pilot study was to compare the clinical and functional outcomes of the knee joint after infrapatellar (IP) versus suprapatellar (SP) tibial nail insertion. DESIGN:Prospective, randomized. SETTING:Level I trauma center. METHODS:After institutional review board approval, skelet...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/BOT.0000000000000499
更新日期:2016-03-01 00:00:00
abstract::Bone grafts are the second most common tissue transplanted in the United States, and they are an essential treatment tool in the field of acute and reconstructive traumatic orthopaedic surgery. Available in cancellous, cortical, or bone marrow aspirate form, autogenous bone graft is regarded as the gold standard in th...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000001420
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVES:To determine whether there is a patient-reported functional difference between combat-related knee disarticulations (KDs) and transfemoral amputations (TFAs). SETTING:Role 3 Military Trauma Centers. PATIENTS:We identified and contacted all KDs and TFAs performed at the Walter Reed National Military Medical...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001440
更新日期:2019-06-01 00:00:00
abstract:UNLABELLED:To determine which of 2 techniques for the treatment of periprosthetic femoral shaft fractures is of greater stiffness. DESIGN:A laboratory study using 8 pairs of matched, embalmed femurs. METHODS:Femurs implanted with a cemented total hip prosthesis had a simulated periprosthetic femur fracture created di...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000199119.38359.96
更新日期:2006-02-01 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::Severe crush injuries to the midfoot often involve comminuted cuneiform or tarsal navicular fractures. Treatment principles for the bony injury of the crushed midfoot include maintenance of the medial column length and alignment, as well as appropriate stable fixation after open or closed fracture reductions. This is ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-200308000-00007
更新日期:2003-08-01 00:00:00
abstract:OBJECTIVES:To assess the treatment preferences of orthopaedic surgeons for displaced three- and four-part proximal humerus fractures. DESIGN:Cross-sectional survey. SETTING:Academic and nonacademic institutions across Canada. PATIENTS/PARTICIPANTS:Members of the Canadian Orthopedic Trauma Society and the Joint Ortho...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181bdc46a
更新日期:2010-04-01 00:00:00
abstract:OBJECTIVES:To determine if inpatient counseling with additional counseling could increase smoking cessation. DESIGN:Prospective study. SETTING:Level I trauma center. PATIENTS/PARTICIPANTS:Current smokers with an operative fracture randomly assigned to control (no counseling), brief counseling (inpatient counseling),...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000002028
更新日期:2020-11-25 00:00:00
abstract:OBJECTIVES:To determine the association of preinjury opioid use on incidence of fasciotomy after lower extremity trauma. DESIGN:Retrospective case-control study. SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS:We identified 245 consecutive patients treated with fasciotomy for compartment syndrome of the lower e...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001650
更新日期:2020-03-01 00:00:00
abstract:OBJECTIVES:To evaluate the rate of, and reasons for, conversion of closed treatment of humeral shaft fractures using a fracture brace, to surgical intervention. DESIGN:Multicenter, retrospective analysis. SETTING:Nine Level 1 trauma centers across the United States. PATIENTS:A total of 1182 patients with a closed hu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001666
更新日期:2020-04-01 00:00:00
abstract:OBJECTIVES:To correlate functional deficits after surgical treatment of displaced intraarticular calcaneal fractures (DIACFs) as measured through dynamic pedobarography with clinical and radiographic long-term results. DESIGN:Retrospective single-center study. SETTING:Level 1 trauma center. PATIENTS:Sixty-five patie...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001325
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVES:The purpose of this article was to present results of cases using a subcutaneous bone pouch technique and to assess the potential "autosterilization" effect that occurs when these contaminated free bone fragments are placed in nontraumatized tissue. DESIGN:Retrospective review of prospectively collected dat...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000352
更新日期:2015-12-01 00:00:00
abstract::Severe open foot and ankle injuries are still a challenge for the orthopaedic surgeon. Their treatment is even more difficult in third world countries and in war settings where high-energy trauma with severe soft tissue damage is more frequent. Lack of equipment, poor resources and hygiene, and different cultural syst...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181d4be0f
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVES:To determine if mean ultimate strength or failure mechanism differed between comminuted olecranon fractures created at the proximal 25% or 50% of the trochlear notch and fixed with precontoured posterior locking plates (PLPs). METHODS:Comminuted osteotomies were created in 10 matched pairs of cadaveric uppe...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001279
更新日期:2018-11-01 00:00:00
abstract:OBJECTIVES:The purpose of this prospective study was to evaluate the safety, efficacy, and functional outcome of the locked proximal humerus plate (LPHP) to treat proximal humerus fractures. DESIGN:Prospective clinical trial. SETTING:University orthopedic center. PATIENTS:Over a 25-month period, 64 consecutive patie...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0b013e3181d2d04c
更新日期:2011-01-01 00:00:00
abstract::The application of a pelvic clamp for provisional stability of unstable pelvic fractures has been advocated in the orthopaedic literature. Although the technique has gained some supporters, problems with placement and associated complications have prevented widespread acceptance. We have modified the pelvic clamp (ACE...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000175156.92743.db
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVES:Tibia fractures are the most common long bone fracture. Criteria for closed and open reduction are based on the amount of fracture shortening, angulation, and rotation, with high success rates achieved if acceptable alignment is maintained. However, there exists limited data available regarding the long-term...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000603
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:To evaluate objectively the effectiveness of current surgical management of displaced acetabular fractures. To provide insight into how these evaluation methods can be used to identify areas in which improvements in surgery and rehabilitation can be pursued to improve patient outcomes. DESIGN:Consecutive cas...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200202000-00001
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVES:To evaluate the reduction and outcome of selected intraarticular calcaneal fractures treated with percutaneous Essex-Lopresti reduction and fixation. DESIGN:Prospective consecutive series. SETTING:Level one trauma center and tertiary university hospital. PATIENTS/PARTICIPANTS:Twenty-six consecutive patien...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199809000-00007
更新日期:1998-09-01 00:00:00
abstract:OBJECTIVE:To observe the results and describe the technique of closed reduction and placement of a two-pin supra-acetabular external fixator, followed by immediate weight bearing, in the treatment of displaced vertically stable lateral compression pelvic fractures. DESIGN:Prospective, consecutive. SETTING:Regional tr...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:2006-01-01 00:00:00
abstract:OBJECTIVES:Lateral locked plating for proximal tibial fractures with metaphyseal disruption provides a biomechanically stable and biologically favorable alternative to conventional medial/lateral plate fixation. New polyaxial screw technology incorporates expanding screw bushings, allowing variable angle screw placemen...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/QAI.0b013e3181a25368
更新日期:2009-08-01 00:00:00
abstract:OBJECTIVES:To determine whether bundled payments are feasible in the orthopaedic fracture setting, and the potential economic implications of this reimbursement structure. DESIGN:Prospective. SETTING:Multicenter. PATIENTS/PARTICIPANTS:Between 2004 and 2014, a total of 23,643 operatively treated patients with fractur...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000742
更新日期:2017-03-01 00:00:00
abstract:OBJECTIVE:To determine whether knee arthrodesis with simultaneous lengthening using the Ilizarov method for a nonreconstructable knee joint with bone loss and infection is a successful salvage procedure. DESIGN:Retrospective review of patients. SETTING:University hospital-based orthopaedic practice. PATIENTS:From 19...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200503000-00004
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVES:To document the high failure rate of a specific implant: the Synthes Variable Angle (VA) Locking Distal Femur Plate. DESIGN:Retrospective. SETTING:Urban University Level I Trauma Center. PATIENT/PARTICIPANTS:All distal femur fractures (OTA/AO 33-A, B, C) treated from March 2011 through August 2013 were re...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000391
更新日期:2016-01-01 00:00:00
abstract:OBJECTIVE:To determine the effectiveness of exchange reamed nails for treatment of aseptic femoral delayed unions and nonunions. DESIGN:Retrospective chart review. PATIENTS:Nineteen patients admitted to the Carolinas Medical Center Level I trauma center from 1990 to 1996 for repair of femoral shaft fracture nonunion ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200006000-00005
更新日期:2000-06-01 00:00:00
abstract::Radial head fractures are common injuries comprising 1/3 of the fractures about the elbow. As a secondary valgus stabilizer of the elbow, radial head fractures can compromise elbow stability leading to long-term pain, dysfunction, and degenerative change. Furthermore, radial head fractures can be accompanied by associ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000001641
更新日期:2019-12-01 00:00:00