Abstract:
:Limb salvage was successful in 25 patients treated for severe grade III upper extremity injuries. In a retrospective review of 20 men and five women, follow-up time averaged 26 months. These high-energy injuries were characterized by massive soft-tissue injury, highly comminuted fractures, and significant neurovascular injury. Farm, industrial, and vehicular accidents accounted for 80% of the cases. Over 50% of the patients had concomitant systemic and/or other significant extremity injuries. Initial treatment consisted of irrigation and debridement and fracture stabilization using external and/or internal fixation. An average of four additional surgical procedures was required to provide soft-tissue coverage and maximum possible functional recovery. Forty-eight percent of the extremities underwent free vascularized or pedicular flaps for coverage or reconstruction. At final follow-up observation, 12% of the extremities rated excellent, 20% rated good, 52% fair, and 16% were poor. Experience gained in managing these severe upper extremity fractures supports the following observations. (a) Grade III open fractures of the upper extremities are frequently associated with significant neural, vascular, and musculotendon injuries. (b) External fixation plays an important role in the stabilization of grossly contaminated fractures. (c) Residual functional disability is common, and most patients do not return to their previous occupation. (d) Staged reconstruction directed toward maximum functional return may take several years.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Levin LS,Goldner RD,Urbaniak JR,Nunley JA,Hardaker WT Jrsubject
Has Abstractpub_date
1990-01-01 00:00:00pages
432-40issue
4eissn
0890-5339issn
1531-2291journal_volume
4pub_type
杂志文章abstract::A laboratory study was performed to compare the stability and ultimate strength of three standard fixation techniques for split-type lateral tibial plateau fractures. The three methods of fixation were (a) three 6.5-mm cancellous lag screws with washers; (b) two 6.5-mm cancellous lag screws with washers and an additio...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199607000-00003
更新日期:1996-01-01 00:00:00
abstract:OBJECTIVES:To compare the Disability of the Arm, Shoulder, and Hand (DASH) and Constant scores, time to union, rate of union, patient cosmetic satisfaction rate, and the need for secondary procedures between 2.7- and 3.5-mm anteroinferior plating for Arbeitsgemeinschaft für Osteosynthesefragen (AO)/Orthopaedic Trauma A...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182693f32
更新日期:2013-03-01 00:00:00
abstract::Patella fractures are challenging orthopaedic injuries. Many commonly used fixation techniques can be ineffective and lead to poor clinical outcomes even with satisfactory reductions and fracture healing. In this investigation, we present the technique of cage plate fixation of patella fractures and the clinical outco...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0000000000000415
更新日期:2015-12-01 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:OBJECTIVES:The purposes of this study were to evaluate the cantilevered bending strength and failure modes of locking screws inserted at various angles in a plate with fully circumferential threaded holes. As an additional measure, the amount of screw head prominence at these angles was also assessed. METHODS:Standard...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000066
更新日期:2014-01-01 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::Over the last several decades, interest in global health across all fields of medicine, including orthopaedic surgery, has grown markedly. Cross-national collaborations are an effective means of conducting high-quality clinical research and offer many advantages over single-center investigations. Successful collaborat...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000466
更新日期:2015-12-01 00:00:00
abstract::We reviewed 13 cases of unstable cervical spine treated by stabilization with posterior Roy-Camille plates and fusion. The patients were treated between 1985-1988. Six patients had acute traumatic episodes, three patients had posttraumatic instabilities, one patient had laminectomy for cervical spondylotic myelopathy,...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-198903010-00005
更新日期:1989-01-01 00:00:00
abstract::Periprosthetic acetabular fractures sustained following acute trauma after total hip arthroplasty are rare and historically have poor outcomes. This article reviews 5 cases and the treatment algorithm used by a single orthopaedic surgeon specializing in acetabular fracture care with a co-surgeon specializing in arthro...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001400
更新日期:2019-02-01 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:OBJECTIVE:The aim of the current study was to see how different interlocking mechanisms would affect construct stability and overall failure in the treatment of two-part surgical neck fractures in the proximal humerus in vitro. METHODS:Left and right bones of eight pairs of fresh-frozen human cadaveric humeri were ass...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181ffdf9a
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:To determine the prognostic reliability, sensitivity, and specificity of the Hawkins sign. The Hawkins sign is a subchondral radiolucent band in the talar dome that is indicative of viability at 6 to 8 weeks after a talus fracture. It is visible in the anterior-posterior view, but seldom appears on lateral ra...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318148c665
更新日期:2007-09-01 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::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: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::The surgical treatment of pelvic and acetabular fractures can be technically challenging. Various techniques are available for the reconstruction of pelvic and acetabular fractures. Less invasive percutaneous fracture stabilization techniques, with closed reduction or limited open reduction, have been developed and ar...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e318288c0c3
更新日期:2014-01-01 00:00:00
abstract::Fracture compression can be achieved in many ways intraoperatively using either screws in compression plates, compression devices, or using intramedullary nails. The use of locked intramedullary nails combines the advantages of indirect fracture fixation and compression with minimal soft tissue disruption. This articl...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e31819f2779
更新日期:2009-05-01 00:00:00
abstract::Ipsilateral femoral shaft and tibial plateau fractures, termed a "floating knee" are rare and challenging injuries. There is limited literature guiding the operative technique and the outcomes associated with these injuries. The author's preferred technique is early intramedullary of the femoral shaft fracture with kn...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001944
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:Anterior knee pain is the most common complication after intramedullary tibial nailing. The cause is often multifactorial and varies among individuals. Violation of the anterior intermeniscal ligament (AIL) during intramedullary tibial nailing might be a possible source of postsurgical anterior knee pain. Al...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001258
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:Screw fixation of the injured syndesmosis restores stability but may reduce motion. The purpose of this study is to determine whether functional outcomes and radiographic results after ankle fracture are affected by the status of the syndesmosis screw. DESIGN:Retrospective review of a consecutive clinical se...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181a9f7a5
更新日期:2010-01-01 00:00:00
abstract::The effect of antibiotic bead chains on the evolution of infection cannot be studied entirely in man due to the ethical problems of obtaining valid controls. Therefore, a model of musculoskeletal injury was devised in rabbits by making a paraspinal wound, fracturing a spinous process, and contaminating the wound with ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199212000-00001
更新日期:1992-01-01 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::Pilon and ankle fractures and ligamentous injuries about the ankle often require external fixation to allow for soft tissue stabilization before definitive surgery. Often used external fixator constructs can cause obscuring of the site of injury on radiographs, pin tract infections, loosening of calcaenal pin fixation...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182604639
更新日期:2013-02-01 00:00:00
abstract::This biomechanical study compares two methods of internal fixation of the tibiofibular syndesmosis used in Weber type C malleolar fractures of the ankle. The transverse syndesmotic 3.5-mm screw was compared with two 1.5-mm Kirschner wires introduced obliquely across the distal tibiofibular syndesmosis. The influence o...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199406000-00006
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:To compare the biomechanical stability of extraarticular proximal tibia fractures reconstructed using a double-plate construct, locking plate system, hybrid external fixator, and single lateral periarticular plate, all from the same manufacturer. DESIGN:Standardized proximal tibial fractures (AO classificati...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200409000-00010
更新日期:2004-09-01 00:00:00
abstract:SUMMARY:In this study, we present a novel technique for reduction and fixation of complex, unstable proximal humerus fractures with diaphyseal extension with the assistance of fibula allograft. We treated 14 patients using this technique since 2009 and found that it improves the reduction and enhances fixation while ma...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31829a346d
更新日期:2014-03-01 00:00:00
abstract:OBJECTIVES:To radiographically demonstrate the upper sacral nerve root tunnel (USNRT) in both cadaveric specimens and a clinical cohort and to quantify its clinical relevance. SETTING:Level 1 trauma center and anatomy laboratory. PATIENTS AND PARTICIPANTS:Eleven cadaveric pelves and 23 consecutive patients who underw...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181a2e419
更新日期:2009-05-01 00:00:00
abstract::Rupture of the medial head of the gastrocnemius muscle ("tennis leg") is an affliction generally associated with athletic activity. The diagnosis is made by careful history and physical examination. Although its findings are characteristic, previous reports have documented misdiagnosis of this lesion as thrombophlebit...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199406000-00016
更新日期:1994-01-01 00:00:00
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 ...
journal_title:Journal of orthopaedic trauma
pub_type: 临床试验,杂志文章
doi:10.1097/BOT.0b013e31819211b2
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVES:With value-based payment models on the horizon, this study was designed to examine the perceptions of value-based care among orthopaedic traumatologists and how they influence their practice. DESIGN:Systems-based survey study. SETTING:Orthopaedic Trauma Association (OTA) research surveys. PARTICIPANTS:OTA...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001622
更新日期:2019-11-01 00:00:00