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 angled blade plate (ABP) versus the Locking Condylar Plate (LCP) by assessing complications and secondary procedures in fractures amenable to treatment with either implant. DESIGN:Retrospective review. SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS:Seventy patients with 71 distal femoral fractures (OTA 33-A, 33-C1, 33-C2) amenable to either ABP or LCP with a mean age of 59.5 years (range, 20-92 years) were included. Seventeen fractures (24%) occurred adjacent to a previous knee arthroplasty (10 ABP and 7 LCP). The 2 groups were similar with respect to age, fracture pattern, and the presence of open fracture. Most injuries were the result of high-energy trauma, and 21% were open fractures. INTERVENTION:Thirty-two fractures (45%) were treated with an ABP, and 39 (55%) were treated with the LCP. MAIN OUTCOME MEASURES:Complications, including infection, nonunion, and malunion, and secondary operations were determined. RESULTS:After a mean of 26-month follow-up, 4 patients (6.0%) were treated for infections. Malunions occurred in 11% of LCP patients and in 1 ABP patient (3.4%, P = 0.14). All patients with malunions were older than 55 years. Seven patients (11%) were treated for nonunions. Six of the nonunions occurred after LCP (16% vs. 3.4%, P = 0.11) Complications were more frequent in LCP patients (35%) versus ABP patients (10%, P = 0.001). Complications were not related to fracture pattern, periprosthetic fracture, or open fracture. Mean age of patients with complications was 64 years (vs. 53 years, P = 0.01), and they were more likely to have lower energy mechanisms (P = 0.017). Overall, 18 patients (27%) underwent secondary procedures, including treatment of infection, nonunion, malunion, or prominent implant removal. Secondary procedures were more common after LCP (43%) versus ABP (6.9%, P = 0.0008) patients. Painful prominent implants were removed from 7 LCP patients (18%) and no ABP patients (P = 0.01). CONCLUSIONS:Distal femur fractures are often associated with prolonged healing and rehabilitation times, which increase substantially when complications occur. Internal fixation of these fractures may be performed successfully with ABP or LCP. In our review of fractures that could be treated with either implant, patients treated with locking plates had more complications and nonunions, requiring more secondary procedures to treat complications and to remove prominent implants. Furthermore, locking plates are substantially more expensive than conventional fixed-angle devices. Future investigation is needed in the form of a large randomized prospective study to clearly define clinical differences, functional outcomes, and costs of care. LEVEL OF EVIDENCE:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Vallier HA,Immler Wdoi
10.1097/BOT.0b013e318234d460subject
Has Abstractpub_date
2012-06-01 00:00:00pages
327-32issue
6eissn
0890-5339issn
1531-2291journal_volume
26pub_type
杂志文章abstract:OBJECTIVES:This study was designed to investigate the relationship between upper extremity (UE) injuries and occupant restraint systems among front seat occupants who were involved in frontal motor vehicle collisions (MVCs). DESIGN:Case-control. SETTING:The 1995 through 2002 National Automotive Sampling System (NASS)...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000161543.52643.ab
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVES:The incidence of osteoporotic proximal tibial fractures has increased during the last 2 decades. A promising approach in osteoporotic fracture fixation is polymethylmethacrylate-based cement augmentation of implants to gain better implant purchase in the bone. This study investigates the biomechanical benefi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000004
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVES:To evaluate the effect of both high-pressure pulsatile lavage and bulb syringe irrigation on the biomechanical parameters of fracture healing using an in vivo open noncontaminated diaphyseal femoral fracture model in rats. BACKGROUND:The utility of high-pressure pulsatile lavage irrigation on soft tissue de...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200207000-00008
更新日期:2002-07-01 00:00:00
abstract:OBJECTIVES:To describe the technique and to determine the outcome of operatively treated displaced scapular body or glenoid neck fractures using minifragment fixation through a modified Judet approach. DESIGN:Retrospective review of scapular or glenoid fractures. SETTING:Level 1 teaching trauma center. PATIENTS:All ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181a18216
更新日期:2009-09-01 00:00:00
abstract::The development of a strong trauma program is clearly one of the most important facets of successful business development. Several recent publications have demonstrated that well run trauma services can generate significant profits for both the hospital and the surgeons involved. There are many aspects to this task th...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000142
更新日期:2014-07-01 00:00:00
abstract::This report presents a case demonstrating the nonunion of a capital femoral physeal fracture with a large metaphyseal fragment in a 10-year-old boy. To our knowledge, there is no previously reported case of this type of nonunion. The treatment of this nonunion presented a potential risk of premature physeal closure an...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181c83a3b
更新日期:2010-08-01 00:00:00
abstract::Understanding complex acetabular fractures is difficult and may require three-dimensional reformatted computed tomographic (CT) images. This paper evaluates a technique, digital rotational imaging (DRI), that displays multiple oblique images of the pelvis and acetabulum. When viewed statically, DRI provides optimal il...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199801000-00011
更新日期:1998-01-01 00:00:00
abstract:OBJECTIVES:Anatomic reduction of the fibula with regard to the tibia is the goal when treating syndesmotic injuries. No objective method exists to describe the distal tibiofibular relationship. The primary and secondary objectives of this study was to describe and validate radiologic measurements of the syndesmosis and...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318284785a
更新日期:2013-11-01 00:00:00
abstract:INTRODUCTION:Proximal ulna fractures can cause a significant loss of forearm rotation, elbow stiffness, and disability. The objective of this study was to quantify the loss of forearm rotation after simulated varus and valgus malunions of the proximal ulna. METHODS:Eight cadaveric upper extremities were used to quanti...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31829f5ebc
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the results after closed reduction and percutaneous fixation of displaced fractures of the proximal humerus with the Humerusblock system. DESIGN:Prospective case series. SETTING:Level 1 trauma center. PATIENTS AND METHODS:Fifty-eight consecutive patients with displaced proximal humerus fracture...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181c81b1c
更新日期:2010-07-01 00:00:00
abstract::A case of an angulated, greenstick fracture of the scapula mimicking scapular winging in a skeletally immature 12-year-old boy is described. The bony deformity was visualized with plain radiography. CT was helpful in exclusion of a thoracic injury or an underlying neoplasm. Closed reduction yielded satisfactory result...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000174707.10980.f4
更新日期:2006-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to report the efficacy of the Kapandji technique performed in the prone position for humeral supracondylar fractures in children. DESIGN:Retrospective. SETTING:Level I trauma center. PATIENTS/PARTICIPANTS:We retrospectively reviewed 34 children with Gartland type III supracond...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000015
更新日期:2014-06-01 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
abstract:BACKGROUND:To determine whether the cost of nonoperative treatment, including those who require delayed operative treatment, is less than those receiving initial operative management. METHODS:We identified 4 recent randomized controlled trials comparing operative and nonoperative treatment of displaced midshaft clavic...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,meta分析,评审
doi:10.1097/BOT.0000000000000225
更新日期:2015-04-01 00:00:00
abstract:PURPOSE:Radial head fractures are some of the most common elbow fractures. Fractures with 3 or more fracture fragments have been shown to have worse outcomes when treated with open reduction and internal fixation (ORIF). Radial head replacement offers an alternative treatment for those more comminuted radial head fract...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001537
更新日期:2019-08-01 00:00:00
abstract::Posterior wall (PW) fractures are the most common fractures requiring surgical fixation in acetabular surgery. Extra-articular screw placement must be confirmed intraoperatively. Herein we describe the use of the inlet and obturator oblique view (the Leeds view) for screw placement in elementary PW and in associated b...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0000000000000724
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVES:To determine the angular rotation that maximizes screw tension without sacrificing screw pullout force yet minimizing loss of screw purchase. METHODS:Three pairs of human humeri in each of the 3 groups (osteopenic, osteoporotic, and normal) underwent screw tension and pullout protocols. For screw tension, 3...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000435631.71393.60
更新日期:2014-04-01 00:00:00
abstract:OBJECTIVE:This study was designed to determine the clinical relevant accuracy of CT-based navigation for drilling. DESIGN:Experimental model. SETTING:Laboratory. METHODS:Twelve drills of varying lengths and diameters were tested with 2 different set-ups. Group 1 used free-hand navigated drilling technique with foam ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVES:To determine whether fixation of pertrochanteric hip fractures with cephalomedullary nails (CMNs) with a neck-shaft angle (NSA) less than the native NSA affects reduction and lag screw cutout. DESIGN:Retrospective comparative study. SETTING:Level I trauma center. PATIENTS/PARTICIPANTS:Patients treated wit...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001096
更新日期:2018-04-01 00:00:00
abstract::Twenty-one patients with fractures of the ipsilateral femur and tibia were treated at Boston City Hospital from 1982 through 1987. Fourteen (67%) of the 21 patients sustained a total of 17 open fractures (76% of which were grade II or III wounds). Over 50% of the patients suffered concomitant ipsilateral knee injuries...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199004030-00013
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:To determine the relative amount of fixation of self-reinforced poly-L-lactide (SR-PLLA) rods and Kirschner wires in bovine cancellous bone by comparing their pullout strength DESIGN:An in vitro laboratory study was performed using bovine femurs. Ten two-millimeter-diameter pins of each type were inserted in...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200108000-00008
更新日期:2001-08-01 00:00:00
abstract:OBJECTIVES:To determine how often preoperative testing is requested for geriatric hip fracture patients, to assess the extent to which preoperative testing is associated with delayed surgery, and to measure the frequency with which preoperative testing changes patient management. DESIGN:Retrospective. SETTING:Academi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000444
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVES:To assess mechanism of injury as a clinical course predictor in patients with complete anterior and posterior pelvic ring disruptions [innominosacral dissociation (ISD)]. DESIGN:Retrospective review of radiographs and medical data. SETTING:R Adams Cowley Shock Trauma Center, Baltimore, Maryland, statewide ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199702000-00002
更新日期:1997-02-01 00:00:00
abstract::A retrospective review of 39 fractures of the femur in 37 patients caused by low- and mid-velocity handgun missiles treated with static interlocking nailing within 18 h of injury was conducted to evaluate the efficacy, safety, and cost savings of immediate intramedullary nailing in these injuries. Patients were follow...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199404000-00010
更新日期:1994-01-01 00:00:00
abstract::Young surgeons and their spouses experience a myriad of stresses in the first few years of practice. Issues related to job search, moving to a new community, learning one's craft, time management, changes to spouse's career, child rearing, and the ever blurring line between work time and free time may all contribute t...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182641fd8
更新日期:2012-09-01 00:00:00
abstract::We report an isolated anterior dislocation of the radial head in an adult after sustaining a fall on the outstretched arm. Based on history and presentation, we speculate that the injury occurred in a position of hyperextension and supination. Reduction was achieved by a pronation maneuver. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199505000-00014
更新日期:1995-01-01 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: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: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:OBJECTIVE:Comparison between a Less Invasive Stabilization System (LISS) using monocortical screws with angular stability and two conventional plate systems Condylar Buttress Plate (CBP) and Dynamic Condylar Screw (DCS) for the treatment of distal femoral fractures with respect to biomechanical properties. DESIGN:Biom...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200109000-00004
更新日期:2001-09-01 00:00:00