Operative Versus Nonoperative Treatment of Acute Displaced Distal Clavicle Fractures: A Multicenter Randomized Controlled Trial.

Objectives: To evaluate the differences in patient outcomes after operative or nonoperative treatment of displaced, type II distal clavicle fractures.

Design: Multicenter, prospective, randomized controlled trial.

Setting: Level I trauma centers.

Prospective Randomized Clinical Trial Investigating the Effect of the Reamer-Irrigator-Aspirator on the Volume of Embolic Load and Respiratory Function During Intramedullary Nailing of Femoral Shaft Fractures.

Objectives: We sought to determine whether the use of the Reamer-Irrigator-Aspirator (RIA) device resulted in a decreased amount of fat emboli compared with standard reaming (SR) when performing intramedullary (IM) nailing of femoral shaft fractures.

Design: Prospective randomized clinical trial.

Setting: Multi-centered trial, level I trauma centers.

Biomechanical Concepts for Fracture Fixation.

Application of the correct fixation construct is critical for fracture healing and long-term stability; however, it is a complex issue with numerous significant factors. This review describes a number of common fracture types and evaluates their currently available fracture fixation constructs. In the setting of complex elbow instability, stable fixation or radial head replacement with an appropriately sized implant in conjunction with ligamentous repair is required to restore stability.

Atypical Femoral Fracture Despite Prophylactic Intramedullary Nailing: A Case Report.

Case: A forty-three-year-old woman on bisphosphonate therapy sustained an atypical femoral fracture that was successfully treated with an intramedullary nail. After she developed radiographic and clinical signs of an impending stress fracture of the contralateral femur, prophylactic nailing was performed. However, seven months postoperatively, she sustained a spontaneous, complete fracture of the prophylactically nailed femur at the site of the lateral cortical stress lesion.