Abstract:
OBJECTIVES:To compare the static and dynamic mechanical properties of a modified crossed cannulated screw (CS) configuration, the inverted triangle (IT) cannulated screw configuration, and a compression hip screw (CHS) with derotation screw in Pauwels type III femoral neck fractures. METHODS:Thirty synthetic femora were divided into 3 groups, and vertical femoral neck osteotomies were made. Ten osteotomized femora were fixed with a CS configuration, 10 were fixed with 3 parallel screws in an IT configuration, and the remaining 10 osteotomized femora were fixed with a CHS construct. All groups were tested using a cyclic (up to 15,000 load cycles) axial loading protocol, and survivors were statically loaded to failure. Cycles to failure, load to failure, and stiffness were calculated. The Kaplan-Meier method was used to estimate survival functions and were compared among fixation methods. The relationship between construct structural properties (maximum load and stiffness) and treatment were assessed using general linear modeling. RESULTS:All CHS fixation constructs survived the 15,000 cycle loading protocol. They endured longer (P = 0.034) than the CS fixation constructs (mean failure 13,332 cycles), but were not different from IT fixation constructs (mean failure 13,592 cycles). Maximum loads to failure for CS (3870 N) and IT (3756 N) fixation constructs were not different, but were less (P < 0.0001) than the maximum loads to failure for the CHS fixation constructs (5654 N). These findings parallel the results of the axial stiffness measurements: CS fixation constructs (663.01 N/mm) were not stiffer than IT fixation constructs (620.0 N/mm), but were less (P = 0.0005) than the axial stiffness of the CHS fixation constructs (1241.86 N/mm). CONCLUSIONS:The biomechanical performance of the CHS fixation method was superior to both the CS fixation method and the IT fixation method using a synthetic femoral model and this test protocol. Biomechanical performance of the latter 2 groups was indistinguishable. We recommend the use of CHS with the derotational screw construct for Pauwels III femoral neck fractures whenever possible.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Johnson JP,Borenstein TR,Waryasz GR,Klinge SA,McClure PK,Chambers AB,Hayda RA,Born CTdoi
10.1097/BOT.0000000000000836subject
Has Abstractpub_date
2017-07-01 00:00:00pages
363-368issue
7eissn
0890-5339issn
1531-2291journal_volume
31pub_type
杂志文章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::Pediatric femoral shaft fractures present many challenging patient care decisions. Nonoperative treatment approaches still dominate care of the youngest age groups while surgical intervention is commonplace in virtually all older children. Treatment is determined primarily by patient age as modified by clinical factor...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001016
更新日期:2017-11-01 00:00:00
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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
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journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0b013e3181f17b33
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVES:Open fractures with bone loss are common, disabling injuries. Biodegradable, load-bearing scaffolds able to carry high concentrations of local antibiotics are an emerging technology to address these injuries. This study investigates the use of such scaffolds with gentamicin (along with bone morphogenetic pro...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181ed1349
更新日期:2010-09-01 00:00:00
abstract::When attempting to remove an intramedullary nail, the extraction device can fail. This can occur due to stripping of the proximal threads or, more rarely, due to entrapped broken metal devices (impacted cap screws; broken introducers, extractors, or taps). This latter situation is particularly problematic if access to...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199702000-00012
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abstract::Femoral neck nonunions are a difficult complication in the treatment of femoral neck fractures and have traditionally been managed using an intertrochanteric valgus osteotomy and blade plate. We propose an alternative method, a proximal femoral valgus osteotomy using a sliding hip screw instead of a blade plate. This ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/00005131-200608000-00006
更新日期:2006-07-01 00:00:00
abstract::After open reduction of a burst fracture of L1, transpedicular bone grafting of the fractured vertebral body was performed. Bone grafts accidentally slipped into the spinal canal through the damaged medial wall of the pedicle. No adverse effects were noted clinically, but this case illustrates that transpedicular bone...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199209000-00019
更新日期:1992-01-01 00:00:00
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journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000103
更新日期:2014-01-01 00:00:00
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journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
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更新日期:2009-07-01 00:00:00
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journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199808000-00009
更新日期:1998-08-01 00:00:00
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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::Fifty-eight percent of the total infections in Italy of COVID-19 were found in northern Italy, in particular, Lombardy. From February 21, 2020, to March 23, 2020, 20 patients with a fracture and a diagnosis of COVID-19 were hospitalized. Demographic data, COVID-19 symptoms, laboratory and radiographic examinations, an...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001905
更新日期:2020-10-01 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
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journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/01.bot.0000520889.69599.f3
更新日期:2017-07-01 00:00:00
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journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001322
更新日期:2019-01-01 00:00:00
abstract::Obtaining optimal results in the treatment of extraarticular distal tibia fractures can be challenging. Plate and screw and intramedullary fixation have proven to be effective treatments, but are associated with significant complication rates when used for open fractures and patient with severe medical comorbidities. ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000694
更新日期:2016-11-01 00:00:00
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 neurovascula...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:
更新日期:1990-01-01 00:00:00
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journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001760
更新日期:2020-08-01 00:00:00
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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
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journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199410000-00013
更新日期:1994-10-01 00:00:00
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journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000000475
更新日期:2016-03-01 00:00:00
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journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,随机对照试验
doi:10.1097/BOT.0000000000001388
更新日期:2019-04-01 00:00:00
abstract:OBJECTIVES:Posttraumatic invasive fungal infections threaten critically injured combat-related injuries and require a combination of extensive surgery and systemic antifungal therapy, along with topical antimicrobials used adjunctively to control the infection. We evaluated the in vitro activity of topical agents in va...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3182830bf9
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:To report our experience with computed tomography (CT) scans to detect traumatic arthrotomies of the knee (TAK) joint based on the presence of intra-articular air. DESIGN:Retrospective review. SETTING:Level I trauma center. PATIENTS:Sixty-two consecutive patients (63 knees) underwent a CT scan of the knee ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31828219bc
更新日期:2013-09-01 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::Long-bone deformity may be significantly symptomatic. A uniplanar corrective osteotomy uses a single cut to correct coronal, sagittal, and axial plane deformity simultaneously. Careful preoperative planning is required in addition to a comprehensive understanding of the magnitude and plane of the true deformity of the...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001519
更新日期:2019-08-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine the efficacy of a fluoroscopically guided hip capsulotomy. METHODS:Ten fresh-frozen paired cadaveric hips were injected under fluoroscopic guidance with saline sufficient to generate an intra-articular pressure greater than 58 mmHg. The pressure was monitored continuo...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181e93cbe
更新日期:2011-04-01 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: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