Rigid Intramedullary Nailing of Femoral Shaft Fractures in Skeletally Immature Patients Using a Lateral Trochanteric Entry Portal.

Introduction: We describe rigid intramedullary nailing using a trochanteric entry for internal fixation of femoral shaft fractures in older children and adolescents.

Step 1 Preparation Prior To Incision: Appropriate preparation prior to the operation is key to minimizing intraoperative and postoperative complications.

Step 2 Perform Incision And Exposure: A well-positioned incision will facilitate and reduce difficulty with ideal guidewire placement.

Twenty-Year Experience with Rigid Intramedullary Nailing of Femoral Shaft Fractures in Skeletally Immature Patients.

Background: Debate exists over the safety of rigid intramedullary nailing of femoral shaft fractures in skeletally immature patients. The goal of this study was to describe functional outcomes and complication rates of rigid intramedullary nailing in pediatric patients.

Methods: A retrospective review was performed of femoral shaft fractures in skeletally immature patients treated with trochanteric rigid intramedullary nailing from 1987 to 2009.

Fingertip injuries: an update on management.

Injuries to the fingertip are common. The goal of treatment is restoration of a painless, functional digit with protective sensation. The amount of soft-tissue loss, the integrity of the nail bed, and the age and physical demands of the patient should be considered when selecting a treatment method.

Avoiding unplanned resections of wrist sarcomas: an algorithm for evaluating dorsal wrist masses.

Ganglion cysts, soft-tissue masses that commonly occur about the wrist, are often excised without imaging or biopsy. In this article, we report a series of incompletely excised soft-tissue sarcomas about the wrist and offer an algorithm for their evaluation. We describe a series of 4 consecutive patients who each presented after incomplete resection of a soft-tissue sarcoma mistakenly diagnosed as a ganglion cyst.

Influence of resident education in correctly diagnosing extremity soft tissue sarcoma.

Background. One-third of all extremity soft tissue sarcomas are misdiagnosed and inappropriately excised without proper preoperative diagnosis and planning. This study aimed at examining the clinical judgment of residents in both general and orthopaedic surgery and at determining whether resident education plays a role in appropriately managing unknown soft tissue masses.

The mechanical stability of extra-articular distal radius fractures with respect to the number of screws securing the distal fragment.

Purpose: The treatment of distal radius fractures with volar locked plating (VLP) has gained popularity. Many different designs and sizes of plates afford a wide variety of configurations of locking screws that can be placed into the distal fracture fragment. The purpose of this study was to determine whether using half of the distal locking screws decreased stability when compared with using all possible distal locking screws with 4 different VLP systems.

Upper extremity myonecrosis caused by Edwardsiella tarda resulting in transhumeral amputation: case report.

Necrotizing soft tissue infections are rapidly progressive infections with a high rate of mortality. One type of necrotizing soft tissue infection is caused by marine gram-negative bacteria and commonly occurs in immunocompromised hosts. These types of infections are more common in patients with chronic liver disease, possibly because of impaired iron metabolism.

Predictors and clinical significance of local recurrence in extremity soft tissue sarcoma.

Background: Limb salvage surgery (LSS) has gained widespread acceptance as the current treatment for treating extremity soft tissue sarcoma (STS) and has been greatly refined since its inception. Combined with improved adjuvant treatment modalities, rates of local relapse have greatly decreased. Nonetheless, local recurrence still occurs and identifying the cause and the subsequent effects of local recurrence can provide valuable insights as LSS continues to evolve.

Primary excision compared with re-excision of extremity soft tissue sarcomas--is anything new?

Background: Soft tissue sarcomas (STS) are rare and are commonly excised outside of a sarcoma center without appropriate preoperative planning. Studies have shown varying results in survival and outcome when comparing patients undergoing re-excision to patients undergoing a single, planned excision.

Methods: This retrospective study evaluated 278 patients treated for STS of the extremities between January 2000 and July 2006.

Metal-backed versus all-polyethylene tibias in megaprostheses of the distal femur.

In megaprostheses, the tibial component is rarely a source of failure. The evolution of these implants has followed standard arthroplasty trends moving from majority use of all-polyethylene tibias (APT) to high volume use of metal-backed tibial (MBT) components. We report the results of 72 endoprostheses using either MBT (n = 42) or APT (n = 30) implanted between 1994 and 2006.