Abstract:
OBJECTIVE:A new device for the treatment of intertrochanteric fractures that uses 2 cephalocervical screws in an integrated mechanism allowing linear intraoperative compression and rotational stability of the head/neck fragment has been developed. The aim of this study was to describe the results using this device for the treatment of stable and unstable intertrochanteric fractures. DESIGN:Prospective, consecutive. SETTING:Academic Trauma Center. METHODS:Between March 1, 2005, and July 31, 2006, 100 consecutive patients with an intertrochanteric fracture were treated with a new trochanteric antegrade nail (InterTan; Smith-Nephew, Memphis, TN). All living patients were followed up for a minimum of 1 year postoperatively (range 12-27 months). Clinical and radiographic examinations were performed until healing and at the 1-year anniversary of the index procedure. Healing, pain with ambulation, return to activities of daily living, the modified Harris hip score, and Barthel Index were used to evaluate outcomes. RESULTS:The mean age of the patients was 81.2 (+/-11.3) years. Thirty-seven patients died, 12 were too infirmed for follow-up, and 3 could not be located, leaving 48 patients available for final evaluation. The average surgical time was 41 minutes (13-95 minutes). This rose significantly with the complexity of the fracture (OTA/AO classification: A1 versus A3, P = 0.016). All fractures healed within 16 weeks (range 10-16 weeks). Radiographic analysis at healing revealed no loss of reduction, no uncontrolled collapse of the neck, no nonunions, no femoral shaft fractures, and no implant failures. Two cases in the series were poorly reduced and settled into varus malalignment. There was no varus malposition seen in the remaining 46 fractures. The mean prefracture Harris hip score (75.1 +/- 13.4) was significantly reduced at the time of follow-up (70.3 +/- 14.5, P = 0.003); 58% of the patients recovered their prefracture status. No significant difference was seen for the Barthel Index. CONCLUSIONS:The InterTan device appears to be a reliable implant for the treatment of intertrochanteric femoral fractures. Its design provides for stability against rotation and minimizes neck malunions (shortening) through linear intraoperative compression of the head/neck segment to the shaft. As a result of the negligible complication rate and improved clinical outcomes, this implant is now the standard treatment for all intertrochanteric fractures at our institution.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Ruecker AH,Rupprecht M,Gruber M,Gebauer M,Barvencik F,Briem D,Rueger JMdoi
10.1097/BOT.0b013e31819211b2subject
Has Abstractpub_date
2009-01-01 00:00:00pages
22-30issue
1eissn
0890-5339issn
1531-2291pii
00005131-200901000-00004journal_volume
23pub_type
临床试验,杂志文章abstract::Tubular poly(L-lactide) membranes with a pore size of 5-15 microns and a molecular weight of 70,000 Daltons were implanted into 24 New Zealand skeletally mature rabbits to cover 10-mm mid-diaphyseal defects of the radius of the forelimb. An identical defect on the contralateral limb was not treated with the membrane a...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199604000-00006
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVE:Ankle fractures are one of the most common operatively treated lower extremity fractures. Several studies indicate that patients often have residual effects after this injury. The purpose of this study is to use the SF-36 questionnaire at two times to assess patients' functional recovery and residual effects ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200201000-00007
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVES:The stiffness of locking plates provide increased stability for early fracture healing but may limit late interfragmentary motion (IFM) necessary for secondary bone healing. An ideal plating construct would provide early rigidity and late flexibility to optimize bone healing. A novel screw plate construct ut...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001664
更新日期:2020-03-01 00:00:00
abstract::Healthcare policy has changed drastically, and with the 50-year anniversary of the passage of Medicare approaching in 2015, the authors evaluate the development of the current healthcare system and its relationship to the development of modern orthopaedic trauma. With more changes in healthcare policy forthcoming, it ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000214
更新日期:2014-10-01 00:00:00
abstract::This report describes the use of articulating external fixation in patients with lower extremity trauma with segmental nerve defects. Four patients who would otherwise require nerve grafting underwent application of an articulated external fixator, allowing optimal positioning for end-to-end, tension-free nerve repair...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200304000-00008
更新日期:2003-04-01 00:00:00
abstract:OBJECTIVES:To compare the results between a new intramedullary Gamma nail and a compression hip screw in the treatment of trochanteric fractures. DESIGN:Prospective randomized. SETTING:Level 1 trauma center. PATIENTS:Two hundred ten consecutive patients older than 65 years with trochanteric femoral fractures. INTER...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/01.bot.0000151819.95075.ad
更新日期:2005-04-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to compare rates of surgical site infection (SSI) in patients with type 3 open fractures who had received cefazolin plus gentamicin versus piperacillin/tazobactam for antibiotic prophylaxis. DESIGN:Retrospective cohort study. SETTING:Level 1 trauma center. PATIENTS:Seven hund...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000554
更新日期:2016-08-01 00:00:00
abstract::A rare case of bilateral atlantoaxial rotatory dislocation (Fielding type V) in an adult is presented. The diagnosis was rapidly made by computed axial tomography. Prior reports of this entity have not clearly defined the pathoanatomy, which in our case was confirmed by three-dimensional tomographic reconstruction. We...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-199402000-00015
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:Heterotopic ossification (HO) develops frequently after modern high-energy penetrating war injuries. The purpose of this prospective study was to identify and characterize the unique cytokine and chemokine profile associated with the development of HO as it pertained to the systemic inflammatory response afte...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31825d60a5
更新日期:2012-11-01 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: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 ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200203000-00006
更新日期:2002-03-01 00:00:00
abstract:OBJECTIVES:Through an international survey, we assessed whether deciding to operatively treat an intra-articular distal radius fracture (DRF) is guided by identifiable patient and surgeon factors. In addition, we compared surgeons' treatment decisions with the American Academy of Orthopaedic Surgeons' Appropriate Use C...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/BOT.0000000000001517
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVES:To compare reports of implant fatigue failure submitted to the FDA of 2 commonly used cephalomedullary nails. METHODS:In total, 2724 medical device reports from the FDA's MAUDE database from Jan 2015 to Oct 2019 were reviewed for the Trochanteric Femoral Nail-Advanced (TFNa) and Gamma 3 implants. RESULTS:D...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001864
更新日期:2021-02-01 00:00:00
abstract:OBJECTIVES:The diagnosis and treatment of syndesmotic ankle fractures is controversial. This systematic review was performed to clarify the current understanding addressing several clinical questions that arise in the treatment of such injuries. DATA SOURCES:The English language literature was searched using PubMed, E...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000000937
更新日期:2018-01-01 00:00:00
abstract:OBJECTIVES:To compare the strength of fixation of percutaneous screw versus plate/screw fixation in a paired cadaver model of OTA 41-B3 (Schatzker type II) split-depression fractures of the lateral tibial plateau. METHODS:Six matched pairs of cadaveric knees were acquired. An OTA 41-B3 (Schatzker type II) split-depres...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001177
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVES:External fixator pins are thought to have improved pullout strength if inserted into both cortices and if pilot holes are drilled. We tested these hypotheses and investigated effects of osteoporosis and pin location on pin pullout strength. METHODS:Self-drilling external fixator pins were inserted using 4 t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182511ed7
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVES:Because locked plates as a neutralization device for lag screw fracture fixation have different biomechanics than that of unlocked plates, we investigated how this would affect lag screw load at the fracture site. The purpose of this study was to assess the load at a fracture site compressed with a lag screw...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31823b3dd1
更新日期:2012-09-01 00:00:00
abstract:OBJECTIVES:Biomechanical studies of osteoporotic bone have used synthetic models rather than cadaveric samples because of decreased variability, increased availability, and overall ease of the use of synthetic models. We compared the torsional mechanical properties of cadaveric osteoporotic bone with those of currently...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000782
更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To determine the ability of open reduction and plate fixation to restore articular congruity in the treatment of fractures of the distal radius with intraarticular comminution and displacement. DESIGN:Prospectively followed series. METHODS:Eighteen consecutive fractures of the distal radius with intraarticu...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200106000-00008
更新日期:2001-06-01 00:00:00
abstract::In an attempt to reduce pin loosening, a flanged external fixator pin has been designed and its bending stiffness has been compared with that of a standard pin. The pins were inserted into pilot holes previously drilled into a piece of teak hardwood. Loads of different magnitudes were applied at a fixed moment arm and...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199502000-00013
更新日期:1995-02-01 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::A case of open scapulothoracic dissociation with intact neurovascular status in an 8-year-old girl is reported. Scapulothoracic dissociation is a rare injury. Most cases present with significant soft tissue disruption in the shoulder region secondary to separation of the scapula from the thorax, and involve major vasc...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198802000-00009
更新日期:1988-01-01 00:00:00
abstract:OBJECTIVE:To study the effect of tourniquet control on intramedullary reaming. DESIGN:An experimental prospective nonsurvival animal study was performed using 5 mongrel dogs. A pneumatic tourniquet was randomized to either the right or left hind limb. Tibial intramedullary reaming was performed with progressively larg...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200411000-00004
更新日期:2004-11-01 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::This technique article presents a small-incision, gluteal-splitting approach for the treatment of select fractures involving the posterior acetabulum. The approach essentially involves the proximal portion of the Kocher-Langenbeck incision, and it can be extended to a larger exposure if needed. It is ideally suited fo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000211143.70424.f7
更新日期:2006-09-01 00:00:00
abstract:OBJECTIVES:For intramedullary nailing of tibial shaft fractures, a recent study has determined that the entry site should be just medial to the lateral tibial spine at the anterior margin of the articular surface. Gaining access to this site is often through a medial parapatellar or transpatellar approach. Several stud...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200211000-00001
更新日期:2002-11-01 00:00:00
abstract::In a 3-year prospective randomized trial, the prognostic value of osteoporosis in terms of predicting healing complications due to implant failures or loss of fracture reduction has been studied in 113 patients with inter-trochanteric hip fractures treated with either a sliding screwplate or Ender nailing. According t...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00005131-199310000-00006
更新日期:1993-01-01 00:00:00
abstract::Although the benefit of spinal canal decompression of traumatic thoracolumbar burst fractures is controversial, it remains a desirable procedure, as many reports describe improved neurologic outcome with spinal canal reconstruction. The optimal type of posterior instrumentation for reconstructing the spinal canal is u...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199112000-00004
更新日期:1991-01-01 00:00:00
abstract:OBJECTIVE:The treatment of some pelvic injuries has evolved recently to include the use of a subcutaneous anterior pelvic fixator (INFIX). We present 8 cases of femoral nerve palsy in 6 patients after application of an INFIX to highlight this potentially devastating complication to pelvic surgeons using this technique ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000193
更新日期:2015-03-01 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