Long bone nonunions have an important impact on a patient's quality of life. The purpose this study was to compare long with use the Time Trade-Off direct measure compute utility scores and determine which nonunion anatomic location had lowest health-related assesses percentage remaining life that patient would be willing trade for perfect health.Eight hundred thirty-two consecutive data were identified retrospectively studied from prospectively collected database. Nonunions infections those...

To report the mortality data and life expectancy of geriatric hip fracture patients who underwent nonoperative management compare that with a matched operative cohort.Retrospective cohort study.Level 1 trauma center.Geriatric (65 years age older) femoral neck or intertrochanteric (OTA/AO 31A 31B) patients.Operative treatment either arthroplasty, cannulated screws, sliding screw device, cephalomedullary nail compared cohort.In-hospital, 30-day, 1-year mortality.Two hundred thirty-one...

With regard to supination-external rotation type-IV (SER IV) ankle fractures, there is no consensus regarding which patient, injury, and treatment variables most strongly influence clinical outcome. The purpose of this investigation was examine the impact articular surface congruity on functional outcomes operatively SER IV fractures.A prospectively generated database consisting treated fractures reviewed. Postoperative computed tomography (CT) scans were used assess joint congruity. Ankles...

Background: Rotational ankle fractures often have unstable syndesmotic injuries that require reduction and stabilization. Multiple studies focused on methods to assess reduction; however, the clinical importance of anatomic remains unclear. The purpose this study was determine whether quality influenced outcomes following operative treatment with injuries. Methods: Patients were included from an institutional trauma registry if they had sustained rotational intraoperative evidence...

Background: The optimal method of treatment for Lisfranc fracture-dislocations remains controversial, and the role primary partial arthrodesis combined osseous-ligamentous injuries is unclear. This study reviewed outcomes treated by arthrodesis. Methods: Patients who underwent a primarily ligamentous or osseous fracture-dislocation were retrospectively assessed at followup according to radiographic, clinical standardized patient-based outcomes. Twenty-five patients (12 ligamentous, 13...

To determine if ligamentous and meniscal injuries as determined by initial magnetic resonance imaging altered clinical outcomes after the fixation of tibial plateau fractures.Comparative cohort study.Academic level I trauma center.Eighty-two patients from a prospective database operatively treated fractures met inclusion criteria, which consisted injury radiographs, preoperative knee (MRI), minimum 12 months outcomes.In addition to radiographs computed tomography scans for fracture...

Patella fractures are challenging orthopaedic injuries. Many commonly used fixation techniques can be ineffective and lead to poor clinical outcomes even with satisfactory reductions fracture healing. In this investigation, we present the technique of cage plate patella 9 initial patients surgically treated at our institution. This allows direct visualization articular reduction, provides multiplanar fixation, effectively stabilizes inferior pole comminution, reduces risk vascular...

Objectives: To compare radiographic and clinical outcomes of supination external rotation type IV equivalent (SER E) ankle fractures (AO/OTA classification 44-B2.1) treated with transsyndesmotic screw fixation those deltoid posterior inferior tibiofibular ligament (PITFL) repair. Design: Case series single-surgeon retrospective analysis a prospective database. Setting: Academic level I trauma center. Patients: Forty-five SER E fulfilled all inclusion/exclusion criteria at least 12 months...

Background: Pronation external rotation (PER) ankle fractures are relatively uncommon but serious injuries. Although recent studies have demonstrated good outcomes of PER IV after operative treatment, the effect dislocation on functional has not yet been evaluated. The objective this study was to compare short-term in with and without dislocation. Methods: Our database surgically treated using an anatomic fixation approach by senior author from 2003 2013 reviewed. All fracture patients older...

Objectives: To compare the external rotation stability of 3 different syndesmotic stabilization techniques in a cadaveric ankle fracture model. Methods: Nondestructive stresses 4 N·m were applied to 8 limbs using hydraulic loading frame. Four conditions tested repeated-measures design: intact and repair after destabilizing ligamentous injury with disruption. The tricortical trans-syndesmotic screw fixation, posterior inferior tibiofibular ligament (PITFL) repair, combined PITFL deltoid...

The purpose of this study is to report the rate anatomic reduction, articular subsidence, and clinical outcomes for Schatzker II tibial plateau fractures treated with structural bone allografts.This a retrospective case series.Academic Level I Trauma Center.A trauma registry was used identify 77 fractures.Schatzker fracture open reduction internal fixation graft using either Plexur P (N = 29) or fibular allograft 48).The primary outcome subsidence. Secondary included malreduction including...

To examine the impact of preoperative coronal plane deformity on functional and radiographic outcomes endosteal strut augmentation proximal humerus fracture fixation.Single surgeon, retrospective analysis a prospective database. Case series.Academic level 1 trauma center.Seventy-two patients with isolated fractures fulfilled all inclusion/exclusion criteria minimum follow-up 12 months.Proximal open reduction internal fixation laterally placed humeral locking plate placement an allograft...

To quantify the radiographic tibia and fibula shaft fracture characteristics that are associated with a concomitant ipsilateral ankle injury.Retrospective case-control study.Academic level I trauma center.Seventy-one adult patients an operatively treated tibial met inclusion/exclusion criteria.Preoperative radiographs were categorized according to pattern, location spatial relationship each other. Preoperative computed tomographic scans then evaluated assess for presence of articular...

Background: Reduction and stabilization of the syndesmosis in unstable ankle fractures is important for mortise congruity restoration normal tibiotalar contact forces. Of syndesmotic ligaments, posterior inferior tibiofibular ligament (PITFL) provides most strength maintaining stability, previous work has demonstrated significance restoring PITFL function when it remains attached to a malleolus fracture fragment. However, little known regarding nature injury absence fracture. The goal this...

Operative indications for supination-external rotation (SER) ankle fractures depend on the integrity of medial structures. Despite importance assessing deep deltoid ligament injuries, accuracy common diagnostic tests has not been established.The objective this study was to compare ability injury (non-stress) and stress radiographs magnetic resonance imaging (MRI) diagnose ruptures in operative SER fractures.Patients were included who underwent surgical fixation had appropriate manual test...

Background: A pronation external rotation (PER) ankle fracture is a relatively uncommon injury. The purpose of this study was to examine the immediate and short-term clinical outcomes operatively treated PER IV fractures compare them with similarly cohort supination (SER IV) fractures. Methods: 22 108 SER were identified from single surgeon’s prospectively collected database 2004 2010. All patients fragment ligament specific fixation during same time period by surgeon. Postoperative...

A nonunion of the distal tibial metaphysis in close proximity to articular surface is a challenging clinical problem. Many commonly used techniques surgeon's treatment armamentarium can be ineffective because relative lack bone stock. This study describes technique en bloc excision all infected or nonunited with an application circular external fixator and limb shortening. After parental antibiotics, when appropriate, docking site, distraction osteogenesis proximal tibia performed second frame.

This study aimed to determine if standardized updates at specific perioperative events affect anxiety and satisfaction of the family members length surgical procedure affects with updates.This was a randomized control trial. In group, surgeons communicated only once near completion procedure. intervention families received electronic 3 significant during A postoperative survey rating member levels, using Likert scale 0-5, administered.Mean level overall did not differ between groups...