Wilkinsharrison0257
During the waterstart, he must be sitting on the beach and cannot shorten his left leg. This prosthesis adjusts its tension depending on the weather and water conditions and if the subject changes sports in such a way that it should be tensioned or relaxed depending on the needs of the new sport.
This prosthesis is adapted for kitesurfing and allows precise adjustments to kitesurfing maneuvers. It has allowed the user to perform the movements of the sport with success.
This prosthesis is adapted for kitesurfing and allows precise adjustments to kitesurfing maneuvers. It has allowed the user to perform the movements of the sport with success.
To analyze the current incidence of postoperative infection for OTA/AO type C fractures of the tibial plateau and tibial plafond.
Three medical databases PubMed/MEDLINE, ScienceDirect, and the Cochrane Library, were utilized in our systematic literature search. Search results were restricted to articles transcribed in English/Spanish and publication date after January 1, 2000, to present day.
Inclusion criteria were studies reporting postoperative infection data for OTA/AO type 41C, 43C, or equivalent fractures of skeletally mature individuals. A minimum of six total fractures of interest and a frequency of 75% overall were required. Studies reporting on pathologic fractures, stress fractures, or low-energy fracture types were excluded.
Two authors independently screened abstracts, evaluated full-text manuscripts, and extracted relevant data from included studies. Any instances of discrepancy were resolved within the study committee by consensus.
Outcomes were expressed using direct proportions (PR) with a 95% confidence interval (CI). The effects of comorbidities on infection rates were reported using odds ratios (ORs) with a 95% CI. All analyses utilized a DerSimonian-Laird estimate with a random-effects model based on heterogeneity. The presence of publication bias was evaluated using funnel plots and Egger's tests.
Patients with these specific fractures develop infections at a notable frequency. The rates of deep infections were approximately 6% in tibial plateau fractures and 9% in tibial plafond fractures. this website These results may be useful as a reference for patient counseling and other future studies aimed at minimizing postoperative infection for these injuries.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Calcaneal fractures often require contralateral, uninjured calcaneus radiographs as a template. The purpose of this study was to establish mean values for calcaneal radiographic parameters in an uninjured urban American population and perform side-by-side comparison with respect to age, sex, laterality, and radiograph obliquity.
Retrospective analysis of consecutive patients.
14-hospitals including1 Level I trauma center.
Retrospective review of >800 uninjured patients with bilateral foot and calcaneus radiographs obtained between June and December 2019 was performed. Inclusion criteria were the following age 18 to 89 without fracture, previous foot surgical procedures, radiographic evidence of arthrosis in ankle, hindfoot, or midfoot, osteomyelitis, tumor or foot deformities.
The lateral radiographs were independently reviewed by three observers, measuring Böhler's Angle (BA), Crucial Angle of Gissane (CAG), calcaneal length (CL), calcaneal height (CH), calcaneotalar ratio (CTR), and radiograph obliquity (XRO).
The mean values of BA, CAG, CL, CH, and CTR were established. Side-by-side comparisons were completed with respect to age, sex, laterality, and XRO.
There were no statistically significant differences in side-by-side measurements of the BA, CAG, CL, or CH. XRO had significant effects on the measurements of BA, CAG, CH, and CTR. Side-by-side comparisons showed greater inter-subject variability than within subject differences.
We did not observe any differences in commonly measured calcaneal radiographic parameters. CAG is not a reliable parameter for diagnostic and operative planning purposes. We conclude that the use of contralateral calcaneus radiographs as templates for calcaneus fractures is a valid technique.
Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.
To compare risk of reoperation for femoral neck fracture patients undergoing fixation with cancellous screws (CS) or sliding hip screws (SHS) based on surgeon fellowship (trauma-fellowship-trained versus non-trauma-fellowship-trained).
Retrospective review of FAITH data.
Eighty-one centers across eight countries.
819 patients ≥ 50 years-old with low energy hip fractures requiring surgical fixation.
Patients were randomized to CS or SHS in the initial dataset.
The primary outcome was risk of reoperation. Secondary outcomes included death, serious adverse events, radiographic healing, discharge disposition, and use of ambulatory devices postoperatively.
There was no difference in risk of reoperation between the two surgeon groups (p > 0.05). Patients treated by orthopaedic trauma surgeons were more likely to be overweight/obese and have major medical comorbidities (p < 0.05). There was a higher risk of serious adverse events, higher likelihood of radiographic healing, and higher odds of discharge to a facility for patients treated by trauma-fellowship-trained surgeons (p < 0.05).
Based on this data, risk of reoperation for low energy femoral neck fracture fixation is equivalent regardless of fellowship training. The higher likelihood of radiographic healing noted in the trauma-trained group does not appear to have a major clinical implication as it did not affect risk of reoperation between the two groups. Patient-specific factors present pre-injury, such as body habitus and medical comorbidities, may account for the lower odds of discharge to home and higher risk of postoperative medical complications for patients treated by orthopaedic trauma surgeons.
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.
(1) To describe the percutaneous technique used to reduce and fix a posterior malleolar fracture with anteroposterior (AP) screws in patients managed with a fibular intramedullary nail, (2) describe the selection of patients to whom this technique can be applied, and (3) report the clinical and patient reported outcome of this intervention.
Retrospective review.
Academic orthopaedic trauma center.
Thirty-two consecutive patients with a mean age of 65 years (range, 39-90) over a thirteen-year period identified from a prospective database.
Unstable ankle fractures managed surgically with a fibular nail and percutaneous fixation of the posterior malleolar component.
The primary short-term outcome was complications related to posterior malleolar fracture fixation. The primary mid-term outcome was the Olerud-Molander Ankle Score (OMAS). Secondary outcomes included the Manchester-Oxford Foot Questionnaire (MOXFQ), EuroQol-5D (EQ-5D), health, pain and satisfaction.
Thirty of the 32 (94%) posterior malleolar fractures united uneventfully. Post-operative loss of talar reduction occurred in two patients (6.3%), which in one patient (3.1%) eventually required a hindfoot nail arthrodesis. There were no soft tissue complications related to the AP screws or the fibular nail fixation. At a mean follow-up of 3.7 years (range, 1-8) the median OMAS, MOXFQ, EQ-5D, health, pain and satisfaction scores were 80.0, 23.4, 0.85, 80.0, 85.0 and 87.5 respectively.
Percutaneous ankle fracture fixation with a fibular nail and posterior malleolar screws results in reliable fracture stabilisation, good patient outcomes and high treatment satisfaction.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
To analyze the functional, neurological and radiological outcomes after anterior surgery in thoracolumbar burst fractures.
Prospective observational study.
Tertiary care Hospital.
36 patients with thoracolumbar burst fractures (T11-L2).
Anterior decompression, anterior column reconstruction with mesh cage, and instrumented stabilization.
Functional (VAS, ODI, SCIM), neurological (ASIA Impairment Scale), and radiological (Kyphosis, Anterior vertebral height loss, Canal encroachment%) parameters.
Patients were prospectively followed for mean duration of 5.9± 3.2 years (2.4-10 years). Statistically significant improvement was noted in functional outcomes from pre-op values (p-value<0.001).29 patients (80.5%) had improvement in neurology after surgery at final follow-up with a positive correlation with % change in canal encroachment (r=0.64, p-0.018). Mean pre-operative kyphosis of 29.1±11.9 degrees got corrected to 9.4±3.8 degrees in immediate post-op and 15.7±11.8 at final follow-up(p<0.001)plete description of levels of evidence.
Since management of bi-condylar tibial plateau fractures are complicated even for expert surgeons, with using a coronal fracture model we aimed to compare two kinds of double locked plating techniques which were consisted of the lateral locking plate and the medial locking plate inserted medial-anteriorly (MA) or medial-posteriorly (MP).
Fourteen fresh-frozen tibias stabilized with the MA or MP methods were allocated into two groups with similar BMD values. Implanted samples were tested under incremental fatigue loading conditions utilizing a customized load applicator. An optical motion tracking system was employed to assess relative displacements and rotations of fracture fragments during loading. Static and dynamic global stiffness, failure load, failure cycles, a well as movements of fracture fragments were measured.
There were no significant differences between the two fixation methods regarding global stiffness, failure load, or failure cycles (p= 0.67-0.98, depending on the parameter). The kinematic evaluations, however, revealed that different positions of the medial locking plates altered the directions of movements for the medial-anterior or medial-posterior fracture segments.
The mechanical stability of tibia-implant constructs fixed with the double plating methods was not remarkably affected by the location of the medial locking plate. Depending on clinical conditions and surgeons' preferences, bi-condylar tibial plateau fractures can be managed with either MA or MP methods.
The mechanical stability of tibia-implant constructs fixed with the double plating methods was not remarkably affected by the location of the medial locking plate. Depending on clinical conditions and surgeons' preferences, bi-condylar tibial plateau fractures can be managed with either MA or MP methods.
To report functional outcomes of unilateral sacral fractures treated both operatively and nonoperatively.
Prospective, multicenter, observational.
16 level 1 trauma centersPatients/participants Skeletally mature patients with unilateral zone 1 or 2 sacral fractures categorized as displaced nonoperative (DN), displaced operative (DO), nondisplaced nonoperative (NN), nondisplaced operative (NO).
Pelvic displacement was documented on injury plain radiographs. Short Musculoskeletal Function Assessment (SMFA) scores were obtained at baseline and 3, 6, 12, and 24 months following injury. Displacement was defined as greater than 5 mm in any plane at the time of injury.
286 patients with unilateral sacral fractures were initially enrolled, mean age 40 and mean Injury Severity Score (ISS) 16 were included. One hundred twenty-three patients completed 2 year follow up as follows; 29 DN, 30 DO, 47 NN, and 17 NO with 56% loss to follow-up at 2 years. Highest dysfunction was seen at 3 months for all groups with mean SMFA dysfunction scores; 25 DN, 28 DO, 27 NN, 31 NO.
