Abstract:
:In our search for an osteosynthesis device that would tolerate the surgical errors of the inexperienced surgeon, we tested in vitro femoral stiffness in 75 human osteoporotic femora after internal fixation of a cervical neck osteotomy using three commonly used devices: two von Bahr screws (A. Ericsson AB, Sweden), two cannulated screws (Uppsala type, Olmed AB, Sweden), and two hookpins (LiH, PSAB, Sweden). The first device has its main grip in the cancellous bone by threads; the second has grip in cancellous and subchondral bone by threads; and the third, which has no threads, has its grip in cancellous bone by a hook pin. The intact specimen was in all instances stiffer (22-63%) than the osteosynthesized specimen (p < 0.001). An osteosynthesized femur with perfectly reduced bone ends was 14-23% stiffer than when reduction of the bone ends was insufficient, irrespective of device malposition (p < 0.001). Insufficient reduction of the osteotomy leaving a 20 degrees dorsal angulation of the femoral head combined with too far ventrally placed screws resulted in the lowest femoral stiffness. If reduction of osteotomy was sufficient, screws placed too far ventrally or converging screws did not result in decreased stiffness compared with optimal screw placement. Irrespective of the quality of reduction, osteosynthesis with the Uppsala screw resulted in all instances in a higher stiffness than using the other devices (p < 0.01). With the Uppsala screw design, femoral stiffness after optimal osteosynthesis was reduced by 22% compared with the intact femur, and in the most unfavorable position with combined malreduction and malpositioning it was reduced by 42%. Corresponding values for the von Bahr screws were 29% and 46%, respectively, and for the LiH screws 47% and 63%, respectively. Use of a device with threads and grip in the subchondral bone is recommended for fixation of femoral neck fractures in osteoporotic bone. Furthermore, the importance of anatomical reduction for fracture fixation is emphasized.
journal_name
J Orthop Traumajournal_title
Journal of orthopaedic traumaauthors
Hernefalk L,Messner Kdoi
10.1097/00005131-199608000-00009subject
Has Abstractpub_date
1996-01-01 00:00:00pages
416-20issue
6eissn
0890-5339issn
1531-2291journal_volume
10pub_type
杂志文章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::The Virtual Fracture Clinic (VFC) has proved beneficial in reducing footfall within the hospital setting, improving the cost of running a trauma service, while satisfying the majority of referred patients. The mandatory upscaling of telemedicine use, specifically the enhancement of the VFC, amidst the COVID-19 pandemi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001894
更新日期:2020-09-01 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::The difficulty in assessing femoral rotation during intramedullary nailing is well-established. Navigation systems allow the surgeon to detect and set the version of the injured leg at the desired angle. We report the first cases of navigated femoral nailing using noninvasive registration of the contralateral uninjure...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31812f69a9
更新日期:2007-11-01 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:BACKGROUND:Combined rupture of the anterior cruciate ligament (ACL) and patellar tendon (PT) is a rare injury pattern. Currently, little evidence exists to help guide management decisions for these patients. METHODS:A systematic literature search was conducted using PubMed (MEDLINE) and Scopus (EMBASE and MEDLINE) for...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001219
更新日期:2018-08-01 00:00:00
abstract:OBJECTIVES:To explore the effect of intramedullary pin size on the biology of a healing fracture, specifically endochondral angiogenesis. We hypothesized that fracture fixation with a smaller pin would permit greater interfragmentary strain resulting in increased total amount of vascular endothelial growth factor withi...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001555
更新日期:2019-10-01 00:00:00
abstract::Results of hemiarthroplasty for complex four-part proximal humerus fractures in the elderly have been unreliable. Although patients often achieve pain relief, return of above-shoulder level function can be challenging, because tuberosity nonunion, malunion, and/or resorption is quite common. The reverse shoulder repla...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181f22088
更新日期:2011-05-01 00:00:00
abstract::The current literature tends to favor rigid internal fixation with plates for symptomatic midclavicular nonunions. From 1985 to 1992, 14 patients with clavicular nonunions were treated by open reduction and intramedullary Steinman pin fixation with onlay iliac crest bone grafting. The average age of patients was 36 ye...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199404000-00002
更新日期:1994-01-01 00:00:00
abstract:OBJECTIVE:To characterize the presentation and outcomes of calcaneal avulsion fractures. DESIGN:Case series. SETTING:Two ACS Level I trauma centers. PATIENTS/PARTICIPANTS:Forty-seven calcaneal avulsion fractures isolated from a cohort of 1365 calcaneus fractures treated over a 17-year period. MAIN OUTCOME MEASUREME...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,多中心研究
doi:10.1097/BOT.0000000000001582
更新日期:2019-11-01 00:00:00
abstract::Orthopaedic surgery and biomechanics are intimately partnered topics in medicine. Biomechanical principles are used to design implants and fashion treatment protocols. Although it would seem that biomechanical principles in the design of fixation devices and fracture repair constructs have been already finalized, ther...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章,评审
doi:10.1097/BOT.0000000000001126
更新日期:2018-03-01 00:00:00
abstract:OBJECTIVE:Risk for bleeding complications during and after early hip fracture surgery for patients taking clopidogrel and other anticoagulants have not been defined. The purpose of this study is to assess the perioperative bleeding risks and clinical outcome after early hip fracture surgery performed on patients taking...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e318240d70f
更新日期:2012-10-01 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::A simulation study of distal interlocking of an intramedullary nail was performed using newly devised, portable stereo fluoroscopy. Two intramedullary nails in which ten holes were drilled perpendicular to the long axis and at various angles to the diameter were inserted into a femoral and a tibial bone model. Ten dri...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199705000-00014
更新日期:1997-05-01 00:00:00
abstract::Ipsilateral elbow and forearm fractures are quite rare in children. We present a Monteggia lesion with ipsilateral supracondylar humerus fracture in a 13-year-old girl. Through early surgical management, a successful result was achieved. We believe that, to minimize any initial or subsequent complications in such frac...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-199901000-00015
更新日期:1999-01-01 00:00:00
abstract:OBJECTIVES:Hospitals and providers that accept transfer patients risk lower ratings on publically reported quality measures that are inadequately adjusted for infirmity and complexity. We compared the outcomes of transferred patients and nontransferred patients after treatment of a hip fracture and sought to determine ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31821146b1
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:Accurate prediction of likelihood of reoperation in patients with tibial shaft fractures would facilitate optimal management. Previous studies were limited by small sample sizes and noncomprehensive examination of possible risk factors. OBJECTIVE:We conducted an observational study to determine which progno...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200305000-00006
更新日期:2003-05-01 00:00:00
abstract::The 2-step closed reduction maneuver was developed to aid in the rarely encountered inferior shoulder dislocation. The maneuver converts the humeral head from an inferior dislocation to an anterior dislocation and then reduces the humeral head into the glenoid. The operator places one hand on the shaft of the humerus ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200605000-00010
更新日期:2006-05-01 00:00:00
abstract::We present a case of a 19-year-old woman with a closed diaphyseal femur fracture and who had fixation of the fracture using a newer lateral entry nail, which resulted in an intraoperative proximal femur fracture. The patient underwent revision the following day and subsequently returned to regular activity without sig...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e3181a53790
更新日期:2010-04-01 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:To observe and report the clinical results of indirect plating techniques in the treatment of femoral shaft nonunions originally treated with intramedullary nailing. DESIGN:Prospective consecutive. SETTING:Regional trauma center. PATIENTS:A consecutive series of twenty-three patients with nonunion of femor...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200105000-00004
更新日期:2001-05-01 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:OBJECTIVE:To determine whether operating on "major" vertebral fractures leads to premature abortion of surgery and/or other acute cardiopulmonary complications. DESIGN:Retrospective review. CLINICAL SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS AND INTERVENTION:We retrospectively queried our institutional Tra...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001316
更新日期:2019-01-01 00:00:00
abstract:OBJECTIVES:To compare single versus multiple procedures in the same surgical setting. We hypothesized that complication rates would not be different and length of stay would be shorter in patients undergoing multiple procedures. DESIGN:Prospective, cohort. SETTING:Level 1 trauma center. PATIENTS/PARTICIPANTS:A total...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000556
更新日期:2016-08-01 00:00:00
abstract:OBJECTIVE:To determine if the addition of a dorsal ulnar pin plate provides improved stability characteristics in the management of intra-articular distal radius fractures with an associated dorsal ulnar fragment. METHODS:OTA/AO type C3 fractures, with a dorsal ulnar fragment of one-third or one-half the width of the ...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001776
更新日期:2020-09-01 00:00:00
abstract::From 1998 to 2006, 578 patients who were skeletally immature with proximal humerus fractures were treated at our institution. During that time period, 4 patients (0.7%) had associated brachial plexus and major peripheral nerve palsies. Average age at the time of injury was 12.3 years (range 10-14 years). Two fractures...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0b013e31816b7898
更新日期:2008-04-01 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:Noncompliance with postoperative follow-up visits remains a common problem in orthopaedic trauma. The aim of this study was to identify risk factors for loss of follow-up after orthopaedic trauma. DESIGN:Retrospective review. SETTING:Urban level 1 academic trauma center. PATIENTS:A total of 307 (226 men/8...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000000346
更新日期:2015-11-01 00:00:00
abstract:OBJECTIVES:This study evaluated whether patients with a left-sided femoral neck fracture (FNF) treated with a sliding hip screw (SHS) had a higher implant failure rate than patients treated for a right-sided FNF. This was performed to determine the clinical relevance of the clockwise rotational torque of the femoral ne...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/BOT.0000000000001934
更新日期:2020-11-01 00:00:00
abstract:OBJECTIVES:To assess the outcomes of the surgical management of "isolated" displaced lateral malleolar fractures, comparing the techniques of lateral plating and antiglide plating as described previously. DESIGN:This is a retrospective review, being largely a surgeon-randomized comparative study. SETTING:The study wa...
journal_title:Journal of orthopaedic trauma
pub_type: 杂志文章
doi:10.1097/00005131-200208000-00008
更新日期:2002-08-01 00:00:00