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J Clin Orthop Trauma 2019 Jan-Feb;10(1):155-160. Epub 2017 Jul 29.

Departamento de Radiologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.

Femoral head fractures occur almost exclusively as a result of a traumatic hip dislocation. Treatment is typically an emergency and includes the reduction of the dislocated hip under anesthesia. As a rule, the earlier the reduction, the better the outcome. Read More

Clin Orthop Relat Res 2019 Apr;477(4):863-869

D. T. Meijer, B. D. J. G. Deynoot, S. A. Stufkens, G. M. M. J. Kerkhoffs, J. N. Doornberg, Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, The Netherlands D. T. Meijer, Trauma Unit, Department of Surgery, Academic Medical Center, Amsterdam, The Netherlands I. N. Sierevelt, Slotervaart Center of Orthopedic Research and Education, Department of Orthopaedic Surgery, Medical Centre Slotervaart, Amsterdam, The Netherlands J. C. Goslings, Department of Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands G. M. M. J. Kerkhoffs, Academic Center for Evidence-based Sports Medicine, Amsterdam Collaboration for Health and Safety in Sports, IOC Research Center, Amsterdam, The Netherlands J. N. Doornberg, Flinders University, Adelaide, Australia.

Background: Psychosocial factors, such as depression and catastrophic thinking, might account for more disability after various orthopaedic trauma pathologies than range of motion and other impairments. However, little is known about the influence of psychosocial aspects of illness on long-term symptoms and limitations of patients with rotational-type ankle fractures, including a posterior malleolar fragment. Knowledge of the psychosocial factors associated with long-term outcome after operative treatment of trimalleolar ankle fractures might improve recovery. Read More

Unfallchirurg 2019 Feb;122(2):110-119

Klinik für Unfallchirurgie, Departement Chirurgie, Kantonsspital Graubünden, Loëstr. 170, 7000, Chur, Schweiz.

The cornerstones for treatment of articular fractures are gentle handling of soft tissues and anatomical reconstruction of the articular surface with stable fixation, which enables a functional aftercare. By respecting these principles, satisfactory functional and radiological results with low complication rates can be achieved even for complex fracture patterns. Fracture complexity varies with the energy load during the trauma mechanism. Read More

Injury 2018 Jun;49 Suppl 1:S56-S60

Department of Trauma, Hand and Reconstructive Surgery, University Hospital Jena, Jena, Germany.

Locking plates have led to important changes in bone fracture management, allowing flexible biological fracture fixation based on the principle of an internal fixator. The technique has its indications and limitations. Most of the typical failure patterns arise from basic technical errors. Read More

Injury 2018 Mar;49(3):449-456

Academic Department of Trauma & Orthopaedic Surgery, University of Leeds, Clarendon Wing, Floor A, Great George Street, Leeds General Infirmary, LS1 3EX Leeds, United Kingdom.

Spinopelvic injuries result from high energy trauma with overloading through the sacrum. These lesions can accomplish either bone fractures, ligament injuries or, most commonly, both. They may be accompanied with other associated life threatening injuries and cause biomechanical instability with potential fracture non-union, mal-union and subsequent lifetime pain and disability. Read More

Indian J Orthop 2018 Mar-Apr;52(2):161-169

Fourth Department of Orthopaedics and Traumatology, KAT Hospital, Kifissia, 2 Nikis Street, 145 61, Athens, Greece.

Background: Tibial plateau fractures are common due to high energy injuries. The principles of treatment include respect for the soft tissues, restoring the congruity of the articular surface and reduction of the anatomic alignment of the lower limb to enable early movement of the knee joint. There are various surgical fixation methods that can achieve these principles of treatment. Read More

Chin J Traumatol 2018 Aug 21;21(4):187-192. Epub 2018 Feb 21.

Department of Orthopaedics, Harvard Medical School, Chief Orthopaedic Trauma Service, Massachusetts General Hospital, Boston, MA, USA. Electronic address:

The principles of open fracture management are to manage the overall injury and specifically prevent primary contamination becoming frank infection. The surgical management of these complex injuries includes debridement & lavage of the open wound with combined bony and soft tissue reconstruction. Good results depend on early high quality definitive surgery usually with early stable internal fixation and associated soft tissue repair. Read More

Arch Craniofac Surg 2016 Dec 23;17(4):186-189. Epub 2016 Dec 23.

Department of Plastic Surgery, Konkuk University School of Medicine, Seoul, Korea.

Frontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are controversial. The subbrow approach enables accurate reduction and internal fixation of the fractures in the anterior table of the frontal sinus by allowing direct visualization of the fracture. Read More

Injury 2017 Jun 9;48 Suppl 1:S82-S90. Epub 2017 May 9.

Department of Trauma and Orthopaedics, University of Edinburgh, Royal Infirmary of Edinburgh, Edinburgh, UK.

Non-union is a devastating consequence of a fracture. Non-unions cause substantial patient morbidity with patients suffering from loss of function of the affected extremity, increased pain, and a substantial decrease in the quality of life. The management is often associated with repeated, unsuccessful operations resulting in prolonged hospital stays, which has social and economic consequences to both the patient and the healthcare system. Read More

Ulus Travma Acil Cerrahi Derg 2017 Mar;23(2):150-155

Department of Orthopaedic, Sohag Teaching Hospital, General Organization for Teaching Hospitals and Institutes, Egypt.

Background: Comminuted fracture of the lower patellar pole has characteristics of both patellar fracture and avulsion of the patellar tendon. Therefore, components of both injury types should be considered during treatment. None of the traditional techniques has proven sufficient alone. Read More

J Orthop Traumatol 2017 Sep 28;18(3):275-281. Epub 2017 Feb 28.

Orthotrauma Research Center, University of Amsterdam Orthopaedic Residency Program (PGY 4), Amsterdam, The Netherlands.

Background: In some settings, specific techniques for open reduction and internal fixation are preferred based on the eminence of a surgeon or professional organization. An emphasis on technical aspects of surgery that are not proved superior and vary substantially from surgeon to surgeon can be confusing for trainees. This study applied a numerical grading of the technical aspects of tension band wire (TBW) fixation for olecranon fracture; assessed the interobserver agreement of each criterion; and measured the correlation of the technical grading and objective and subjective long-term outcomes. Read More

Arch Orthop Trauma Surg 2016 Dec 15;136(12):1663-1672. Epub 2016 Sep 15.

Department of Trauma, Reconstructive Surgery and Rehabilitation Medicine, Ferdinand-Sauerbruch-Str., 17475, Greifswald, Germany.

Background: Open fractures are orthopaedic emergencies that carry a high risk for infection, non-union and soft tissue complications. Evidence-based treatment is impeded by the lack of high-quality evidence-based studies. The aim of this investigation was to elucidate the current practice of open fracture management in Germany and to determine major differences in treatment. Read More

Sports Health 2016 Jul 18;8(4):324-30. Epub 2015 Aug 18.

Edinburgh Orthopaedic Trauma Unit, Royal Infirmary of Edinburgh, Edinburgh, UK.

Context: Acute tibial shaft fractures represent one of the most severe injuries in sports. Return rates and return-to-sport times after these injuries are limited, particularly with regard to the outcomes of different treatment methods.

Objective: To determine the current evidence for the treatment of and return to sport after tibial shaft fractures. Read More

BMC Musculoskelet Disord 2016 Jan 15;17:27. Epub 2016 Jan 15.

Department of Orthopedics, Chinese PLA General Hospital, No.28 Fuxing Road, Haidian District, Beijing, 100853, People's Republic of China.

Background: The aim of this study was to design a new minimally invasive percutaneous lag screw guide apparatus and to verify its adjuvant treatment of acetabular anterior column fracture on pelvis specimens.

Methods: This guide apparatus was self-developed based on the principles of "two points form a line" and "Rectangle". Using C-arm fluoroscopy, this guide apparatus was used to conduct minimally invasive percutaneous lag screw internal fixation of acetabular anterior column fractures. Read More

Ulus Travma Acil Cerrahi Derg 2015 Jul;21(4):279-84

Department of Hand and Upper Extremity Surgery, Metin Sabancı Baltalimani Bone Diseases Training and Research Hospital, Istanbul, Turkey.

Background: Metacarpal fractures are among the most common fractures of the hand. They may lead to loss of function if treated improperly. These injuries can be treated conservatively. Read More

Craniomaxillofac Trauma Reconstr 2015 Sep 13;8(3):246-50. Epub 2015 Jan 13.

Department of Oral and Maxillofacial Surgery, St. Luke's Hospital, Bethlehem, Pennsylvania.

In general, dentoalveolar fractures are a common injury seen in emergency departments, dental offices, and oral and maxillofacial surgery practices. These injuries can be the result of direct trauma or indirect trauma. Direct trauma more often causes trauma to the maxillary dentition due to the exposure of the maxillary anterior teeth. Read More

Craniomaxillofac Trauma Reconstr 2015 Jun 31;8(2):94-9. Epub 2014 Oct 31.

Gradute School of Maxillo-facial Surgery, University of Bari, Bari, Italy.

In this article, authors report the different steps of development and clinical validation of MatrixMANDIBLE Subcondylar Plates (Synthes, Soletta, Switzerland), a specialized osteosynthesis system developed by Synthes during the past 4 years. Between 2009 and 2013, a total of 62 patients were treated for subcondylar and condylar neck fractures via a preauricular or retromandibular/transparotid approach. The MatrixMANDIBLE Subcondylar Plates System consists of a Trapezoidal Plate, a three-dimensional (3D) 4-hole 1. Read More

Magn Reson Imaging Clin N Am 2014 Nov 28;22(4):765-86. Epub 2014 Aug 28.

Radiology Service, VA San Diego Healthcare System, 3350 La Jolla Village Drive, San Diego, CA 92161, USA; Department of Radiology, University of California San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103, USA.

Magnetic resonance (MR) imaging is an established modality for the evaluation of musculoskeletal structures, including the knee. Metallic implants are increasingly used and techniques to minimize artifacts are continuously improving. This article reviews the general principles behind the effects of metal on MR imaging, various MR imaging techniques that are available or have been recently described in the literature, and abnormalities that can be encountered during MR imaging of patients related to knee arthroplasty, hardware after internal fixation, or hardware used for soft tissue fixation. Read More

Arch Plast Surg 2014 Nov 3;41(6):679-85. Epub 2014 Nov 3.

Department of Plastic and Reconstructive Surgery, Konkuk University School of Medicine, Chungju, Korea.

Background: Frontal sinus fractures, particularly anterior sinus fractures, are relatively common facial fractures. Many agree on the general principles of frontal fracture management; however, the optimal methods of reduction are still controversial. In this article, we suggest a simple reduction method using a subbrow incision as a treatment for isolated anterior sinus fractures. Read More

Methods Mol Biol 2014 ;1180:81-109

Department of Pathology, HMR 311, Keck School of Medicine, University of Southern California, 2011 Zonal Avenue, 90033, Los Angeles, CA, USA,

The extent to which data from immunohistochemical (IHC) staining are useful is critically dependent not only upon the proper performance and control of the method but also upon appropriate interpretation. A decade ago an individual pathologist may have nurtured a reasonable expectation of achieving a comprehensive understanding of the IHC literature across the whole field of pathology. Today such an expectation is clearly unreasonable with a simple Medline search of the IHC literature postdating the general adoption of antigen retrieval (arbitrarily 1996), yielding more than 100,000 "relevant" articles. Read More

Rozhl Chir 2014 May;93(5):292-6

A patient with pelvic injury, especially if the injury is part of multiple trauma, must be initially treated in accordance with the principles of Advanced Trauma Life Support®. The authors define the indications of procedures corresponding to damage control surgery with regard to pelvic injury, and also to the timing of and performing the individual internal fixation techniques in pelvic fracture. A multidisciplinary approach with the individual treatment procedures reflecting the general condition of the injured patient is a key to favourable outcome. Read More

Best Pract Res Clin Rheumatol 2013 Dec;27(6):757-69

Department for Trauma Surgery and Sports Medicine, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. Electronic address:

The number of osteoporotic fractures is still increasing and the overall management of these multimorbid patients is demanding. Surgical management of these fractures is challenging due to often comminuted fractures and poor purchase of implants. New implants and some with add-on possibilities such as standardized cement augmentation have been developed to address these problems. Read More

Orthop Traumatol Surg Res 2014 Feb 20;100(1):75-83. Epub 2014 Jan 20.

Centre de Traumatologie et d'orthopédie, 67400 Illkirch-Grafenstaden, France.

The Gamma Nail is the latest advance in the treatment of trochanteric fractures based on intramedullary nailing principles during closed procedures. Its design is based on Küntscher's Y-nail and locking intramedullary (IM) nails. This paper reports the results from the first-ever series of 121 patients operated between 1988 and 1990. Read More

J Spinal Disord Tech 2014 Dec;27(8):423-30

Department of Orthopedics, Yancheng First People's Hospital, Jiangsu Province, China.

Study Design: There are no accurate guidelines on the operative treatment of ankylosing spondylitis (AS)-related thoracolumbar stress fractures. For this reason, we categorized such bone fractures into 2 types: vertebral body type and intervertebral space type, according to the damage mechanism, cross-section spot, and iconography, and devised a targeted surgical plan based on the characteristics of each fracture type.

Objective: To investigate the types and surgical treatment of thoracolumbar stress fractures in AS. Read More

Br Med Bull 2013 19;106:179-91. Epub 2012 Dec 19.

Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London, UK.

Introduction: This review aims to provide information on the time athletes will take to resume sports activity following ankle fractures.

Sources Of Data: We systematically searched Medline (PubMED), EMBASE, CINHAL, Cochrane, Sports Discus and Google scholar databases using the combined keywords 'ankle fractures', 'ankle injuries', 'athletes', 'sports', 'return to sport', 'recovery', 'operative fixation', 'pinning', 'return to activity' to identify articles published in English, Spanish, French, Portuguese and Italian.

Areas Of Agreement: Seven retrospective studies fulfilled our inclusion criteria. Read More

J Craniofac Surg 2012 May;23(3):859-62

Division of Plastic & Reconstructive Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Zygomatic arch fractures are common injuries, occurring in isolation in 5% of all patients with facial fractures and in 10% of patients with any fracture to the zygomaticomaxillary complex. Isolated noncomminuted depressed zygomatic arch fractures are easily treated with the minimally invasive Gillies approach, which most often provides long-term stability. However, zygomatic arch fractures often occur in conjunction with zygomaticomaxillary complex, Le Fort, calvarial, and naso-orbitoethmoid fractures. Read More

Orthopedics 2012 Mar 7;35(3):e448-52. Epub 2012 Mar 7.

The Ohio State University College of Medicine, Columbus, Ohio, USA.

This article describes the cases of 3 patients who were treated for impending pathologic fractures with intramedullary stabilization who developed soft tissue tumor recurrence along the surgical tract site postoperatively, with confirmed histologic diagnoses consistent with each of their prior-known metastatic primaries. This sequela of treatment can lead to additional surgical procedures, longer recovery, and a delay in further systemic treatment, which negatively affects patient outcomes and survival. This can occur despite the use of adjuvant radiation therapy to the surgical site. Read More

Instr Course Lect 2012 ;61:19-25

Department of Orthopaedics, Indiana University School of Medicine, Indianapolis, IN, USA.

Although definitive fixation of anterior pelvic ring injuries is usually referred to an orthopaedic trauma surgeon or a surgeon proficient in pelvic surgery, all orthopaedic surgeons should be familiar with the initial management and resuscitation of patients with high-energy pelvic ring injuries. The initial treatment may be limited to sheet or binder application in the emergency department to allow transfer of the patient to a trauma center or the application of an external fixator by an on-call surgeon, even though that surgeon may not be responsible for definitive fixation. It is important to understand the general principles and approaches used at the time of definitive surgery because decisions made by the initial treating physician may affect (or limit) the ability of the orthopaedic traumatologist to provide definitive care. Read More

Unfallchirurg 2011 Dec;114(12):1122-7

Klinik für Traumatologie, Universitätsspital Basel, Spitalstraße 21, CH-4031, Basel, Schweiz.

Fractures of the acetabulum after low-energy trauma in geriatric patients suffering from osteoporosis are increasing in number and significance due to demographic changes. The results of current therapeutic principles though tend to be poor in this population, while risk and treatment-related morbidity of surgical or conservative approaches are substantial.The treatment of geriatric patients can be challenging, not only because of their often complex medical history. Read More

J Craniofac Surg 2011 Jul;22(4):1190-5

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.

The treatment of pediatric facial fractures, although similar to that of adults, requires a separate and thorough understanding of the unique developmental issues inherent to this age group. The contribution of several of these factors allows for a large portion of these injuries to be managed more conservatively; however, operative indications still exist. The optimal form of management in these situations must balance the risks of impacting dentition or future skeletal growth versus obtaining acceptable stability and reduction for healing. Read More

J Craniofac Surg 2010 Jul;21(4):1051-3

Division of Plastic Surgery, Baylor College of Medicine, Houston, Texas, USA.

Facial fractures are common problems encountered by the plastic surgeon. Although ubiquitous in nature, their optimal treatment requires precise knowledge of the most recent evidence-based and technologically advanced recommendations. This article discusses a variety of contemporary issues regarding facial fractures, including physical and radiologic diagnosis, treatment pearls and caveats, and the role of various synthetic materials and plating technologies for optimal facial fracture fixation. Read More

Acta Chir Orthop Traumatol Cech 2010 Feb;77(1):32-8

Klinika detské chirurgie a traumatologie 3. LF UK, Fakultní Thomayerova nemocnice, Praha.

Purpose Of The Study: In this retrospective study we analyse the methods of Monteggia lesion (ML) treatment in children used in our department. Based on the results we propose several general principals for the therapy of this complex injury to the forearm in agrowing skeleton.

Material: The group included patients with the diagnosis of acute ML treated at our department in the 2003-2007 period. Read More

Injury 2009 Nov 23;40(11):1231-6. Epub 2009 Sep 23.

Department of Trauma and Orthopaedics, Academic Unit, Clarendon Wing, Leeds General Infirmary, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom.

Although reamed intramedullary nailing has long been considered a safe procedure, pulmonary complications have been reported in some groups of patients. Concerns over fat embolisation, adult respiratory distress syndrome (ARDS), and sudden intraoperative death have prompted some authors to question whether the benefits of reaming are outweighed by its potential adverse effects to the patient. In response to these complications, recent evaluations have focused on alternative systems that reduce intramedullary pressure during reaming. Read More

Injury 2009 Nov 22;40(11):1204-6. Epub 2009 Jul 22.

Department of Trauma and Orthopaedics, Maidstone General Hospital, Kent, UK.

Fixation of ankle syndesmosis injury with a fibre-wire tightrope has previously been reported. Early clinical results indicate that it can remain in situ indefinitely without complications. We are the first to report complications with the use of this device. Read More

Injury 2009 Nov 2;40(11):1167-71. Epub 2009 Jul 2.

Wansbeck General Hospital, Northumberland, United Kingdom.

Osteopetrosis is a metabolic disorder with diminished bone resorption due to osteoclastic abnormality. It causes hard and brittle marble bone which fractures easily. Most of these fractures can be treated conservatively. Read More

Arch Orthop Trauma Surg 2009 Jun 24;129(6):827-32. Epub 2008 Dec 24.

Department of Spine Surgery, Manipal Hospital, Bangalore, Karnataka, India.

Introduction: Nonunion of pertrochanteric fracture is rare and its occurrence especially without prior surgical intervention has been hardly ever reported. Hence there is not much literature describing the best way to treat them. Nonunion of pertrochanteric fracture collapses in to varus by virtue of deforming action of muscles and thus deranging the biomechanics of the hip and indirectly preventing fracture union further. Read More

Spine (Phila Pa 1976) 2008 Jun;33(13):1497-500

Department of Trauma and Orthopedic Surgery, University of Witten/Herdecke, Cologne Merheim Medical Center, Ostmerheimerstrasse 200, 51109 Cologne, Germany.

Study Design: A technical report of fluoroscopy guided placement of augmented iliosacral screws in osteoporotic insufficiency fractures of the sacrum.

Objective: To describe a combined approach of navigated iliosacral screw placement and screw augmentation as an option for osteosynthesis of sacral insufficiency fractures in the elderly.

Summary Of Background Data: The incidence of sacral insufficiency fractures is increasing. Read More

Rev Chir Orthop Reparatrice Appar Mot 2008 Feb 20;94(1):26-36. Epub 2008 Feb 20.

Service de traumatologie, hôpital universitaire de Strasbourg, CHU de Hautepierre, 1, avenue Molière, 67098 Strasbourg cedex, France.

Purpose Of The Study: We report a consecutive prospective series of femoral fractures on previous implants. The purpose was to assess treatment with locking compression plates and total weight-bearing.

Material And Method: From June 2002 to December 2005, we treated 21 patients (16 women, five men) for fractures on previous implants: total hip arthroplasty (n=11), total knee arthroplasty (n=1), unicompartmental prosthesis (n=1), gamma nail (n=4), hip screw (n=1). Read More

Spine J 2008 Mar-Apr;8(2):385-90. Epub 2007 Jan 2.

Aristotelian University of Thessaloniki, G. Papanikolaou Hospital, Exohi, TK 57010, Thessaloniki, Greece.

Background Context: Primary epitheliod hemangioendotheliomas of the lumbar spine are extremely rare tumors with an unpredictable clinical course.

Purpose: To present a case of primary lumbar epithelioid hemangioendothelioma and its treatment protocol.

Study Design/setting: A tertiary Spinal Unit. Read More

Injury 2007 Jun 30;38(6):669-87. Epub 2007 Apr 30.

Department of Trauma & Orthopaedic Surgery, Academic Unit, School of Medicine, University of Leeds, Clarendon Wing, Leeds General Infirmary, Great George Street, Leeds, United Kingdom.

Periprosthetic femoral fractures (PFF) are increasing as a result of changes in population demographics and the increase in the number of total hip replacements performed. The overall incidence has been reported to range from 0.1% to 6% of all total hip arthroplasties. Read More

ANZ J Surg 2006 May;76(5):290-4

Department of Orthopaedics, Liverpool Hospital, Liverpool, New South Wales, Australia.

Background: A variety of devices have been used in the treatment of supracondylar femoral fractures. The condylar blade plate relies on the principles of open reduction, absolute stability and interfragmentary compression to achieve union. The technique of retrograde nailing uses indirect reduction of the metaphyseal fracture component, offering relative stability and a less invasive approach. Read More

Injury 2006 Aug;37(8):755-62

Department of Orthopaedic Surgery, Trauma Service, Singapore General Hospital, Outram Road, Singapore 169608, Singapore.

Objective: Intertrochanteric hip fractures are very common and early mobilisation correlates with a better outcome. The ideal surgical procedure should protect the soft tissue envelope, thereby preserving blood supply and reducing blood loss. Furthermore, occupational exposure to fluoroscopy that is used in hip fracture fixation remains a concern amongst orthopaedic surgeons. Read More

Arch Orthop Trauma Surg 2005 Oct 22;125(8):571-4. Epub 2005 Oct 22.

Department of General Surgery, St. Lucas Andreas Hospital, Jan Tooropstraat 164, 1061 AE, Amsterdam, The Netherlands.

A 56-year-old female patient suffered a bimalleolar ankle fracture with an additional proximal fibular fracture. This is an unusual fracture type, seldom reported in literature. It was operatively treated by open reduction and internal fixation of the lateral malleolar fracture. Read More

Osteoporos Int 2005 Mar 3;16 Suppl 2:S54-64. Epub 2004 Nov 3.

AO Development Institute, Davos, Switzerland.

Osteoporotic changes start in cancellous bone due to the underlying pathophysiology. Consequently, the metaphyses are at a higher risk of "osteoporotic" fracture than the diaphysis. Furthermore, implant purchase to fix these fractures is also affected by the poor bone quality. Read More

Injury 2003 Nov;34 Suppl 2:B31-42

Klinik für Traumaand Sportmedizin, Wilhelminspital Wien, Austria.

The basic principles of an internal fixation procedure using a conventional plate and screw system (compression method) are direct, anatomical reduction and stable internal fixation of the fracture. Wide exposure of the bone is usually necessary to gain access to and provide good visibility of the fracture zone to allow reduction and plate fixation to be performed. This procedure requires pre-contouring of the plate to match the anatomy of the bone. Read More

J Craniofac Surg 2002 Nov;13(6):726-37; discussion 738

Bobby R. Alford Department of Otolaryngology-Head & Neck Surgery and Communicative Sciences, Baylor College of Medicine, Houston, Texas, U.S.A.

Orbital skeletal injuries are frequently associated with other significant injuries and require a substantial surgical effort to correct. The use of a unified classification of orbital injury may better predict the surgical effort required to correct such injuries and help with future comparisons of results. In an attempt to summarize the principles of reconstruction of the orbital skeleton following trauma and introduce a unified classification system for orbital injuries, a retrospective review of all consecutive orbital reconstructions in a tertiary care teaching hospital was conducted. Read More

Hand Clin 2002 Feb;18(1):55-63

Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusets General Hospital, Harvard Medical School, ACC 525, 15 Parkman Street, Boston, MA 02114, USA.

Recognition of the pattern of an elbow fracture-dislocation allows immediate knowledge of the treatment principles, pitfalls, and prognosis of the injury. Specific techniques for each injury component increase the surgeon's ability to restore stability to the elbow. When complications are anticipated and avoided or addressed expediently, it is possible to restore elbow function in spite of the complexity of these injuries. Read More

Orthopade 2001 Sep;30(9):627-34

Klinik für orthopädische Chirurgie, Universitätsspital AMC, Meibergdreef 9, Postbus 22660, 1100 DD Amsterdam Z-O, Niederlande.

Nonunions and malunions around the elbow are often due to incorrect initial treatment of a fracture. We have to differentiate between nonunions and malunion of adults and children. There are general principles for the treatment of nonunions and malunions of the distal humerus. Read More

J Oral Maxillofac Surg 1999 Jul;57(7):777-82; discussion 782-3

Division of Maxillofacial Surgery, University of Turin, Italy.

Purpose: This article gives a general description of the incidence, causes, and complexity of maxillofacial fractures in the elderly and discusses whether modification is required in assessment, surgical indications, and techniques in such cases.

Patients And Methods: A retrospective clinical and radiologic study evaluated 222 patients older than 60 years of age (mean age, 70.3) hospitalized with maxillofacial trauma over the period 1987 to 1996 in the Division of Maxillofacial Surgery, University of Turin. Read More

J Biol Phys 1999 Jun;25(2-3):177-92

Dept. Biophysics, Biological Faculty, Moscow State University, Vorobjevy Gory, Moscow, 119899 Russia; Tel.

Principles of regulation on different levels of photosynthetic apparatus are discussed. Mathematical models of isolated photosynthetic reaction centers and general system of energy transduction in chloroplast are developed. A general approach to model these complex metabolic systems is suggested. Read More