Staged Fixation with Respect to Soft Tissue in Tibial Plateau Fractures with Acute Compartment Syndrome: Correlation Analysis of Complications.

Backgroud: Staged operations are commonly employed in the management of high-energy tibial plateau fractures (TPF) complicated by acute compartment syndrome (ACS); however, complications, such as nonunion, deep wound infection, and traumatic arthritis, often occur due to severe bone and soft-tissue damage. We aimed to report the radiological and clinical outcomes of staged surgical interventions performed following complete closure of the fasciotomy wound for the treatment of TPF complicated by ACS. Additionally, we analyzed factors associated with complications arising from these procedures.

Comparative study on anterior pelvic plating and pubic ramus screw fixation for straddle fracture: a matched-pair outcome analysis.

Purpose: Straddle fractures involving both the superior and inferior rami often require surgical fixation due to instability. This study compared the clinical and radiological outcomes of pubic ramus screw fixation (PRSF) and anterior pelvic plating (APP) for the treatment of these fractures to identify the superior method.

Methods: A retrospective analysis was conducted on 70 patients (37 males, 33 females; average age 47.

Comparison of clinical and radiographic outcomes of bilateral versus unilateral ramus fixation in straddle fractures with posterior pelvic ring injury.

Introduction: Superior and inferior ramus fractures, termed straddle fractures, are high-energy fractures often accompanied by unstable pelvic ring injuries. However, consensus is lacking regarding indications for surgical treatment or fixation methods. We aimed to compare clinical and radiological outcomes of unilateral ramus fixation (URF) and bilateral ramus fixation (BRF) for straddle fractures with unilateral posterior pelvic ring injuries.

Surgical complications after fixation of minimally displaced lateral compression type 1 pelvic ring injuries.

Purpose: To review surgical complications after fixation of stress-positive minimally displaced (< 1 cm) lateral compression type 1 (LC1) pelvic ring injuries.

Methods: A retrospective study at a level one trauma center identified patients who received surgical fixation of isolated LC1 pelvic ring injuries. Surgical complications and additional procedures were reviewed.

Comparative biomechanical analysis of reconstruction and cephalomedullary nails in the treatment of osteoporotic subtrochanteric fractures.

Introduction: This study aimed to compare the biomechanical properties of two types of intramedullary nails - reconstruction nails (RCN) and cephalomedullary nails (CMN) - each with different proximal fixations, in a model of an osteoporotic subtrochanteric femoral fracture. This study focused on assessing stiffness and load to failure of RCN and CMN nails to provide insight into their clinical applications in osteoporotic fracture treatments.

Materials And Methods: Ten synthetic osteoporotic femoral models were used to generate a comminuted subtrochanteric fracture model.

Comparative study of retrograde intramedullary nailing versus locking extramedullary plating in complete articular fractures with metaphyseal comminution of the distal femur.

Introduction: Fractures of the distal femur with metaphyseal comminution and complete intra-articular involvement (AO/OTA classifications 33C2 and 33C3) present challenges for reduction and fixation. However, an optimal fixation method remains unknown. This study aimed to compare the clinical and radiographic outcomes of locking extramedullary plating (LEP) and retrograde intramedullary nailing (RIN) for complete distal femoral intra-articular fractures with metaphyseal comminution.

Induced membrane technique with plate fixation has a lower complication rate than bone transport over a plate for segmental tibial defects larger than 5 cm.

Introduction: The treatment of segmental tibial bone defects remains a surgical challenge. While Bone Transport (BT) and Induced Membrane Technique (IMT) are effective strategies for regenerating bone, there are few comparative studies between them. This investigation undertakes a comparative analysis of BT and IMT for large segmental tibial defects stabilised through plate fixation.

Blocking screw (pin) technique to achieve an acceptable reduction in intramedullary of subtrochanteric femoral fractures: indications, techniques, and clinical outcomes.

Introduction: Subtrochanteric femur fractures treated with intramedullary nails present biomechanical benefits, early weight-bearing, and reduced soft tissue damage, promoting bone union. However, improper reduction due to muscular forces and fragmented proximal bone increases nonunion risk. This study evaluates the efficacy of the blocking screw technique in preventing malalignment during intramedullary nailing.

Which fixation produces the best outcome for distal femoral fractures? Meta-analysis and systematic review of retrograde nailing versus distal femoral plating in 2432 patients and 33 studies.

Purpose: The distal femur comprises a wide intramedullary cavity and thin cortical bone. Firm internal fixation of comminuted fractures with displacement is challenging. Although many comparative studies have reported retrograde intramedullary nailing (RIN) and distal femoral plating (DFP) as the usual fixation methods for distal femoral fractures, no clear conclusion has been reached.

Does Serum Vitamin D Influence the Prognosis of Critically Ill Patients with Trauma? A Prospective, Observational Study in a Trauma Center.

Background: Vitamin D concentrations are associated with sepsis, pneumonia, and mortality in critically ill patients. However, the role of vitamin D in critically injured patients with trauma remains unknown. This study investigated the effects of vitamin D concentrations on outcomes in critically injured patients with trauma.

Risk factors for pubic ramus fracture nonunion after conservative treatment of pelvic ring injuries: a retrospective cohort multicenter study.

Purpose: To determine the incidence of nonunion, clinical and radiological outcomes, and risk factors for nonunion in conservatively treated pubic ramus fractures among patients diagnosed with pelvic ring injury.

Methods: A total of 546 patients (192 men, 354 women) diagnosed with pubic ramus fracture, treated conservatively, and who had completed > 1 year follow-up at three level 1 trauma centers between January 2014 and December 2020, were enrolled. Clinical and radiological evaluations were compared between union and nonunion groups.

Fibular Fixation in Same-Level Distal Third Tibiofibular Fractures: Is Fibular Fracture Regarded as a Secondary Importance?

Background: Although most studies focused on the alignment or union of the tibia in same-level distal third tibiofibular fractures, the outcome of a concomitant fibular fracture is generally regarded as being of secondary importance in the literature. This study aimed to assess the outcomes of fibular fractures in same-level distal third tibiofibular fractures.

Methods: In this retrospective study, we enrolled 111 patients with same-level distal third tibiofibular fractures treated at our institute between January 2016 and August 2020.

Biomechanical performance evaluation of a modified proximal humerus locking plate for distal humerus shaft fracture using finite element analysis.

The extra-articular distal humerus plate (EADHP) has been widely used for surgical treatment of distal humerus shaft fracture (DHSF). However, the surgical approach, fixation methods, and implant positions of the EADHP remain controversial owing to iatrogenic radial nerve injury and complaints such as skin irritation related to the plate. Anterior plating with a modified (upside-down application) proximal humerus locking plate (PHILOS) has been proposed as an alternative, However, research on its biomechanical performance remain insufficient and were mostly based on retrospective studies.

Comparison of Postoperative Complications Between Trochanter Flip Osteotomy and Kocher-Langenbeck Approaches for the Treatment of Femoral Head Fractures: A Systematic Review and Meta-analysis.

Purpose: The study aims to identify the optimal approach for femoral head fracture (FHF) by comparing the postoperative complications and outcome score of the Kocher-Langenbeck posterior approach (KLP) and trochanteric flip osteotomy (TFO) through a systematic review and meta-analysis.

Methods: MEDLINE, Embase and the Cochrane Library were systematically searched for studies published up to 22 January 2023, which compared TFO to the KLP for FHF treatment. The main outcomes of this meta-analysis were the rate of postoperative complications including osteonecrosis of the femoral head (ONFH), heterotopic ossification (HO), and total hip replacement (THR) conversion rate and Thompson-Epstein (T-E) score at the final follow-up.

The role of an augmentative plating in the management of femoral subtrochanteric nonunion.

Introduction: Owing to its distinct biomechanical properties, nonunion is common (7-20%) after intramedullary (IM) nailing of subtrochanteric femoral fractures. Unlike diaphyseal nonunion, it is difficult to provide sufficient stability by exchanging nailing alone in subtrochanteric nonunion. This study investigated the clinical outcomes of femoral subtrochanteric nonunion initially treated with an IM nail and subsequently managed with minimally invasive augmentative plate fixation.

Tension band wiring versus screw fixation for the treatment of medial malleolar fractures: A systematic review and meta-analysis.

Introduction: Tension band wiring (TBW) and screw fixation (SF) are common surgical treatments for medial malleolar fractures (MMFs); however, no systematic review has identified which fixation method is superior. This study aimed to determine the most optimal MMF fixation method by comparing the clinical and radiological outcomes of TBW and SF through a systematic review and meta-analysis of the literature.

Hypothesis: We hypothesized that there may be differences in outcomes between TBW and SF for treating MMFs.

Incomplete Diaphyseal Atypical Femoral Fracture due to Increased Anterolateral Bowing: Treatment with Corrective Osteotomy and Intramedullary Nailing with Augmented Plate Fixation.

Background: Increased anterolateral bowing of the femur is associated with atypical femoral fractures among older patients (including both those receiving and those not receiving treatment with bisphosphonates) as well as a greater likelihood of occurring in the diaphyseal versus the subtrochanteric region. Prophylactic intramedullary (IM) nailing is recommended for the treatment of incomplete atypical femoral fractures, which are radiographically evident. However, this bowing deformity is considered to be a major obstacle to IM nailing as it may be associated with postoperative complications.

Efficacy of Staged Surgery in the Treatment of Open Tibial Fractures with Severe Soft Tissue Injury and Bone Defect.

Purpose: We aimed to report the clinical and radiological outcomes of staged surgery using the acute induced membrane technique with an antibiotic-impregnated cement spacer (ACS) and soft-tissue reconstructive surgery and to identify factors affecting clinical outcomes.

Materials And Methods: Thirty-two patients with severe open tibia fractures were treated via staged surgery from January 2014 to December 2019 and followed up for ≥1 year. In the first surgery, an ACS was inserted into the bone defect site along with debridement and irrigation and was temporarily fixed in place with an external fixator.

Effect of Calcar Screw in Locking Compression Plate System for Osteoporotic Proximal Humerus Fracture: A Finite Element Analysis Study.

This study proposes a finite element analysis (FEA) model for complex fractures at the osteoporotic proximal humerus and investigates the relevance of using a calcar screw in surgical treatments using this model. Two types of three-dimensional (3D) fracture models of patients with osteoporotic humerus were constructed reflecting the mechanical properties of the osteoporotic humerus, such as the Young's modulus and Poisson's ratio, and two load conditions mimicking the clinical environment were applied for simulation. Using the 3D models and the conditions, the FEA software calculated the concentration and distribution of stresses developing in the humerus, locking compression plate (LCP), and screws.

Cephalomedullary Nailing versus Dynamic Hip Screw Fixation in Basicervical Femoral Neck Fracture: A Systematic Review and Meta-Analysis.

Purpose: Although many studies have reported the use of dynamic hip screws (DHS) and cephalomedullary nailing (CMN) for basicervical femoral neck fracture (BFNF), no clear treatment protocols have been recommended. The present study aimed to compare the surgical outcomes associated with DHS and CMN to determine the appropriate fixation method for BFNF.

Materials And Methods: We systematically searched MEDLINE, Embase, and the Cochrane Library for studies published up to January 9, 2021 that compared the treatment outcomes between CMN and DHS in BFNF.

A case report of field amputation: the rescue of an entrapped patient through the "doctor car" system.

In certain circumstances, invasive procedures such as creation of a surgical airway, insertion of a chest drain, intraosseous puncture, or amputation in the field are necessary. These invasive procedures can save lives. However, emergency medical service teams cannot perform such procedures according to the law in Korea.

The effect of cerclage wiring with intramedullary nail surgery in proximal femoral fracture: a systematic review and meta-analysis.

Purpose: The aim of this study was to evaluate the utility of cerclage wiring with intramedullary nail surgery in the treatment of proximal femoral fractures.

Methods: MEDLINE, Embase, and Cochrane Library were systematically searched for studies that evaluated the impact of cerclage wiring on proximal femoral fractures published up to September 20, 2021. Pooled analysis identified differences in the (1) fracture healing profile, (2) perioperative variables, (3) complications, and (4) clinical outcome score between cerclage wiring and non-cerclage wiring.

Safety of surgical hip dislocation in femoral head fracture and dislocation (FHFD) and avascular necrosis risk factor analysis of FHFD: midterm results confirmed by SPECT/CT and MRI.

Background: The study aim was to report the treatment outcomes of trochanteric flip osteotomy (TFO) with surgical hip dislocation (SHD) for femoral head fracture and dislocation (FHFD) and to investigate the risk factors for avascular necrosis (AVN) of the femoral head.

Methods: The data of 34 patients (29 men, 5 women; mean age 37.9 years) diagnosed with FHFD and treated with TFO with SHD between May 2009 and February 2018 with an average follow-up period of 5.

Intramedullary nailing of subtrochanteric fractures in elderly patients: Comparative study of helical blade cephalomedullary nail versus reconstruction nail.

Introduction: Intramedullary nailing (IMN), which is a common method for treating subtrochanteric fractures, is conducted as cephalomedullary (CMN) or reconstruction (RCN) nailing. Numerous studies have reported the effectiveness of CMN, which requires a shorter surgery time and provides stronger fixation strength with blade-type devices. However, the radiographic and clinical outcomes of the use of CMN and RCN in elderly patients aged ≥65 years have not been compared yet.

Early definitive internal fixation for infected nonunion of the lower limb.

Background: The management of an infected nonunion of long bones is difficult and challenging. A staged procedure comprising radical debridement followed by definitive internal fixation was favored. However, no standard treatment has been established to determine the appropriate waiting period between initial debridement and definitive internal fixation.