Femoral neck osteosynthesis using interfragmentary compression or position screw in synthetic bones. What are the mechanical differences?

Purpose: We aim to compare interfragmentary compression with the position osteosynthesis in the fixation of different femoral neck fractures (FN) in synthetic bones subjected to vertical load.

Methods: Forty-two synthetic femurs were subjected to neck fractures and separated into 3 groups according to the Pauwels classification: Pauwels I had 6 units (PI); Pauwels II, 24 units, with and without comminution (PII); and Pauwels III, 12 units, with and without comminution (PIII). After, they were fixed with 2 different ways: three 7, 0 mm cannulated lag screws (CSs) versus three 6, 5 mm solid fully threaded screws (SSs).

Importance of computed tomography in posterior malleolar fractures: Added information to preoperative X-ray studies.

Background: Ankle fractures are common lesions of the lower limbs. Approximately 40% of ankle fractures affect the posterior malleolus (PM). Historically, PM osteosynthesis was recommended when PM size in X-ray images was greater than 25% of the joint.

Depression fractures of the posterolateral tibial plateau: Treatment by lateral femoral epicondyle osteotomy approach.

Objective: The best surgical exposure and fixation method for fractures affecting the posterolateral corner of the tibial plateau remain debatable. This study describes a surgical approach to treat lateral depressions of the posterolateral tibial plateau with or without rim involvement by osteotomy of the lateral femoral epicondyle associated with osteosynthesis with a one-third tubular horizontal belt plate to stabilize the fracture fragment.

Method: We evaluated 13 patients with fractures of the tibial plateau affecting the posterolateral region.

INTERFERENCE OF EXTERNAL DAMAGE CONTROL FIXATION IN DEFINITIVE OSTEOSYNTHESIS.

Introduction: Indications for provisional external fixation prior to the definitive treatment of fractures are associated with the control of local and systemic damage and the impossibility of definitive osteosynthesis in the emergency.

Objective: To identify complications associated with external fixation prior to definitive internal osteosynthesis.

Methods: This is a comparative, prospective study (Level II).

Treatment of femur pseudoarthrosis using wave plate: Evaluation of consolidation and its relationship with graft type.

Introduction: In the pathogenesis of femoral pseudoarthrosis, the arched shape of the bone is important when determining traction force on the anterolateral plane and posteromedial compression. In plate osteosynthesis, flexion forces affect the implant and can determine its breakdown and osteosynthesis failure. The wave plate seeks to solve the problem by transferring the support to the cortex under the plate or creating the resistance of a leaf spring.

Epiphyseal fragment as a predictive factor of failure in fixation of proximal fractures of the humerus.

Introduction: Fractures of the proximal humerus are frequent and are widely studied with regards to their treatment indications. The aim of this article is to establish a correlation between the size of the epiphyseal fragment in fractures of the proximal humerus and the probability of loss of reduction after a surgical procedure.

Methods: A total of 47 surgically treated proximal humeral fractures were reviewed.

Weight Discharge in Postoperative of Plateau Fracture Tibialis: Systematic Review of Literature.

Tibial plateau fractures are a risk to the functional integrity of the knee, affecting the axial alignment and capable of leading to pain and disability of the individual. Early weight bearing and joint mobilization can prevent these functional deficits. the goal of the present study was to conduct a systematic review of the literature about studies that quote the beginning, evolution, and progression criteria for weight-bearing in postoperative period of tibial plateau fractures.

Late postoperative analysis of the tip-apex distance (TAD) in pertrochanteric fractures: is there an accommodation of the implant within the bone?

Introduction: This study measured the tip-apex distance (TAD) values in the immediate postoperative period and following weight-bearing and fracture impaction in patients undergoing osteosynthesis with dynamic hip screw and cephalomedullary nail.

Objective: To correlate the Baumgaertner index in the immediate postoperative period with values obtained after impaction of the fracture with the accommodation of the cephalic implant in the femoral head.

Patients And Methods: Radiographic TAD measurements were taken with AGFA-VIEW of 82 patients with a mean age of 72 years with pertrochanteric fractures who were operated on and the fracture fixed with DHS- Synthes, TFN-Synthes, or Gamma Nail III-Stryker in the immediate postoperative period, and following weight-bearing and fracture impaction (mean 3-8 weeks after surgery).

Fat embolism syndrome in femoral shaft fractures: does the initial treatment make a difference?

Objective: To identify the risk factors correlated with the initial treatment performed.

Methods: This is a retrospective study involving a total of 272 patients diagnosed with femoral shaft fractures. Of the patients, 14% were kept at rest until the surgical treatment, 52% underwent external fixation, 10% received immediate definitive treatment, and 23% remained in skeletal traction (23%) until definitive treatment.

Tibial shaft fracture and ankle injury - Case report.

The authors report on a case of tibial shaft fracture associated with ankle injury. The clinical, radiological and surgical characteristics are discussed. Assessment of associated injuries is often overlooked and these injuries are hard to diagnose.

Postoperative infection in patients undergoing inspection of orthopedic damage due to external fixation.

Objective: To conduct a retrospective analysis on cases undergoing inspection of orthopedic damage, at an orthopedic emergency service in a teaching hospital, with the aim of evaluating patients with postoperative infection after conversion to internal osteosynthesis.

Methods: This was a retrospective analysis covering the period from June 2012 to June 2013, on patients who underwent inspection of orthopedic damage due to external fixation and subsequently were converted to definitive osteosynthesis using a nail or plate.

Results: We found an infection rate of 13.

Tertiary survey in trauma patients: avoiding neglected injuries.

Introduction: Medical personnel in trauma centres in several countries have realised that undiagnosed injuries are common and are now focussing their attention on reducing the incidence of these injuries. Tertiary survey is a simple and easy approach to address the issue of undiagnosed injuries in trauma patients. Tertiary survey consists of reevaluating patients 24 hours after admission by means of an anamnesis protocol, physical examination, review of complementary tests and request for new tests when necessary.

Tertiary assessment of trauma patients in a hospital in the city of São Paulo: a question of necessity.

Objective: To minimize the occurrence of missed injuries, the tertiary evaluation was introduced consisting of reassessment of the patient, 24 hours after admission, with: complete history, physical examination, review of exams and diagnostic testing if necessary.

Methods: Observational study evaluating trauma patients admitted to a teaching hospital in São Paulo, according to a protocol for tertiary evaluation.

Results: Between February and May 2012, for 12 weeks, 182 patients were submitted to tertiary evaluation, 100 (55%) polytraumatized and 82 (45%) were victims of low-energy trauma.

Biomechanical Study: Resistance Comparison of Posterior Antiglide Plate and Lateral Plate on Synthetic Bone Models Simulating Danis-Weber B Malleolar Fractures.

Objective: The purpose of this study was to compare different positions of plates in lateral malleolar Danis-Weber B fractures on synthetic bone: a lateral plate and a posterior antiglide plate.

Methods: Short oblique fractures of distal fibula at the level of the syndesmosys were simulated with a fibular osteotomy in sixteen synthetic fibula bones (Synbone®). Eight fractures were fixed with lateral plating associated with an independent lag screw, and the other eight were fixed with posterior antiglide plating with a lag screw through the plate.