Does the Fibula Need to be Fixed in Complex Pilon Fractures?

Objectives: To review a series of patients with complex plafond injuries with a metadiaphyseal dissociation who did not have the fibula fixed and compare with patients who had their fibula fixed using patients without a fibula fracture as a control group.

Design: Retrospective case-control study.

Setting: Level 1 Trauma center at a university hospital.

The perfect reduction: approaches and techniques.

Anatomic reduction of femoral neck fractures is difficult to obtain in a closed fashion. Open reduction provides for direct and controlled manipulation of fracture fragments. This can be accomplished via multiple approaches.

Risk factors for fracture mobility six weeks after initiation of brace treatment of mid-diaphyseal humeral fractures.

Background: Recent studies have identified specific subsets of diaphyseal humeral fractures for which functional bracing is less effective. The present study tested the hypothesis that a gap between fracture fragments may be a risk factor (after accounting for other potential risk factors) for fracture instability six weeks after functional bracing of humeral shaft fractures.

Methods: We retrospectively identified seventy-nine adult patients (forty-six men, thirty-three women; forty-two fractures on the right side, thirty-seven fractures on the left), each with an acute, closed, AO type-A2 (oblique, ≥30°) or type-A3 (transverse, <30°) mid-diaphyseal humeral shaft fracture treated nonoperatively at three different level-I trauma centers from June 2004 to August 2011.

Extra-articular proximal tibial fractures: nail or plate?

The surgical goals for treating proximal tibial fractures are to restore articular congruity, the mechanical axis, and knee motion while avoiding soft-tissue complications. The fracture pattern should be correctly identified and understood. For fractures with minimal intra-articular extension, fracture fixation with an intramedullary nail can decrease the risk of infection because it uses a small incision that is not placed directly over the injured soft tissue, and it provides better axial load sharing than a plate.

Initial management and classification of pelvic fractures.

Pelvic fractures represent a significant transfer of kinetic energy to the body, and more than 80% of patients with unstable pelvic fractures have additional musculoskeletal injuries. A systematic approach with prompt intervention is critical in the initial management of patients with pelvic fractures. If intra-abdominal bleeding is suspected, diagnostic peritoneal lavage, focused assessment with sonography for trauma, or a CT examination is usually performed.

Open fractures of the distal radius: the effects of delayed debridement and immediate internal fixation on infection rates and the need for secondary procedures.

Purpose: There are few clinical data evaluating the outcome of surgery for open distal radius fractures based on treatment method. Specifically, the major contributing factors to infection are largely unknown. The purpose of this study is to determine the effect of early versus delayed debridement and the choice of initial external versus internal fixation on infection rates and the need for secondary procedures.