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    Do Cerclage Cables Delay the Time to Bone Union in Patients with an Unstable Humeral Shaft Fracture Treated with Intramedullary Nails?
    Yonsei Med J 2017 Jul;58(4):837-841
    Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Korea.
    Purpose: To evaluate the time to bone union after open reduction and internal fixation with cerclage cables followed by intramedullary nailing (IMN) for unstable humeral shaft fractures.

    Materials And Methods: Patients with a humeral shaft fracture treated by IMN were enrolled. One group of patients was treated via open reduction and internal fixation with cables followed by IMN (cable group; n=32), while the other group was treated with a conventional closed IMN (non-cable group; n=64). Read More

    Anatomic Structures at Risk When Utilizing an Intramedullary Nail for Distal Fibular Fractures: A Cadaveric Study.
    Foot Ankle Int 2017 May 1:1071100717709572. Epub 2017 May 1.
    3 Orthopedic Foot and Ankle Center, Westerville, OH, USA.
    Background: Retrograde intramedullary fibular nail fixation is being utilized with increasing frequency, particularly in patients at higher risk of wound complications. The purpose of this anatomic study was to assess the relative risk to nearby anatomic structures when implanting a contemporary retrograde locked intramedullary fibular nail.

    Methods: Ten human cadaveric lower extremities were instrumented with a fibular nail. Read More

    Proximal Femoral Shortening After Cephalomedullary Nail Insertion for Intertrochanteric Fractures.
    J Orthop Trauma 2017 Jun;31(6):311-315
    *Department of Orthopedic Surgery, Assaf Harofeh Medical Center, Zerifin, Israel;†Faculty of Health Sciences, Ben-Gurion University of the Negev, Department of Orthopedic Surgery, Barzilai Medical Center Campus, Ashkelon, Israel; and‡Department of Orthopedic Surgery, Hadassah Medical Center, Jerusalem, Israel.
    Objective: To assess the incidence of proximal femoral shortening (PFS) and its effect on the patient outcomes when intertrochanteric fractures were treated with a cephalomedullary nail (CMN).

    Design: Retrospective cohort study.

    Settings: Level II trauma center. Read More

    Which Orthopaedic Patients Are Infected with Gram-negative Non-fermenting Rods?
    J Bone Jt Infect 2017 15;2(2):73-76. Epub 2017 Jan 15.
    Orthopaedic Surgery Service.
    Background : 1(st) and 2(nd) generation cephalosporins used for perioperative prophylaxis in orthopaedic surgery do not cover non-fermenting Gram-negative rods (NFR). Methods: Epidemiological cohort study of adult patients operated for orthopedic infections between 2004 and 2014 with perioperative cefuroxim or vancomycin prophylaxis. Exclusion of polyneuropathic ischemic foot infections and septic bursitis cases. Read More

    Penetrating Craniomaxillofacial Injury Caused by a Pneumatic Nail Gun.
    Craniomaxillofac Trauma Reconstr 2017 Jun 27;10(2):159-161. Epub 2016 Jun 27.
    Division of Plastic, Maxillofacial and Oral Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina.
    Craniomaxillofacial injuries can be complex, requiring a multidisciplinary approach. The primary survey is always the first step in trauma management prior to proceeding with further evaluation and treatment. A 26-year-old man presented with a penetrating nail gun injury through the oral and nasal cavities. Read More

    Complications in Treatment of 31-A Fractures with Trochanteric Gamma Nail (TGN) Versus Gamma3 Nail (G3N) - A Review of 217 Cases.
    Open Orthop J 2016 10;10:389-395. Epub 2016 Aug 10.
    Department of Orthopaedics & Traumatology, University of Lübeck, Germany.
    Introduction: The aim of this study was to clinically evaluate two generations of intramedullary gamma-nail used in the treatment of 31-A femur fractures.

    Materials And Methods: In two consecutive series, 117 trochanteric gamma nails (TGN) and 100 Gamma3 nails (G3N) were implanted for the treatment of inter- and subtrochanteric fractures between 2009 and 2011. Clinical and radiological follow-up examinations were assessed. Read More

    Microbiological analysis of acute infections of the nail fold on the basis of bait thread test.
    Postepy Dermatol Alergol 2017 Apr 13;34(2):110-115. Epub 2017 Apr 13.
    Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland.
    Introduction: An acute infection of the nail fold, called paronychia, is a common clinical problem. The basis for the implementation of the treatment is the result of microbiological examination. Due to the rapid and painful course of infection, usually an empirical antimicrobial treatment prior to obtaining microbiological test results is introduced. Read More

    Ipsilateral proximal and shaft femoral fractures.
    Chin J Traumatol 2017 Apr 19. Epub 2017 Apr 19.
    Department of Orthopaedic and Traumatology Surgery, Cotonou Teaching Hospital, Jericho Cotonou, Benin.
    Purpose: To study the management and evaluate anatomical and functional outcomes of patients with ipsilateral proximal and shaft femoral fractures.

    Methods: A retrospective, descriptive and analytic study lasted for ten years and a half ranging from January 1, 2005 to June 30, 2015. The following parameters were studied: epidemiology, fracture characteristics, therapeutic, anatomical and functional outcomes. Read More

    Learning Curve and Clinical Outcomes of Performing Surgery with the InterTan Intramedullary Nail in Treating Femoral Intertrochanteric Fractures.
    Biomed Res Int 2017 19;2017:6781070. Epub 2017 Apr 19.
    Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, No. 109 Xue Yuan Xi Road, Wenzhou, Zhejiang 325000, China.
    Purpose. The purpose of this study is to evaluate the learning curve of performing surgery with the InterTan intramedullary nail in treating femoral intertrochanteric fractures, to provide valuable information and experience for surgeons who decide to learn a new procedure. Methods. Read More

    Biomechanical evaluation of straight antegrade nailing in proximal humeral fractures: the rationale of the "proximal anchoring point".
    Int Orthop 2017 May 11. Epub 2017 May 11.
    The Steadman Clinic, 181 West Meadow Drive, Suite 400, Vail, CO, 81657, USA.
    Purpose: Varus failure is one of the most common failure modes following surgical treatment of proximal humeral fractures. Straight antegrade nails (SAN) theoretically provide increased stability by anchoring to the densest zone of the proximal humerus (subchondral zone) with the end of the nail. The aim of this study was to biomechanically investigate the characteristics of this "proximal anchoring point" (PAP). Read More

    Damage control and intramedullary nailing for long bone fractures in polytrauma patients.
    Injury 2017 Jun 7;48 Suppl 1:S7-S9. Epub 2017 May 7.
    Department of Trauma Surgery and Emergency Medicine; Nc017, Erasmus MC, University Medical, Center Rotterdam, P.O. Box 2040, Rotterdam, 3000 CA, The Netherlands. Electronic address:
    The early fracture treatment in patients with multiple injuries should be focused on damage control. The fracture type and its location, local soft tissue condition as well as the patient's physiological condition shall determine the time and type of fracture treatment. Prevention of local and systemic complications must be immediately considered and included in the treatment planning. Read More

    Individualized Plastic Reconstruction Strategy for Patients With Ectodermal Dysplasia Syndrome.
    Ann Plast Surg 2017 Jun;78(6):684-691
    From the *Department of Plastic and Cosmetic Surgery, Gansu Provincial Hospital, Lanzhou; †Department of Plastic & Reconstructive Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai; and ‡Plastic Surgery Hospital (Institute), Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, P.R. China.
    Ectodermal dysplasia syndrome is a hereditary disease of ectodermal origin. Appearances of nail dystrophy, alopecia or hypotrichosis, saddle nose deformity, and palmoplantar hyperkeratosis are usually associated with a lack of sweat glands as well as partial or complete absence of teeth. These manifestations are usually corrected only with oral rehabilitation by mounting dentures. Read More

    NUTRITIONAL ASPECTS AND THE USE OF NUTRITIONAL SUPPLEMENTS BY WOMEN WHO UNDERWENT GASTRIC BYPASS.
    Arq Bras Cir Dig 2017 Jan-Mar;30(1):11-13
    Clínica Baretta, Curitiba, PR, Brazil.
    Background:: Bariatric surgery is deemed one of the most effective procedures for the treatment of obesity and it aims at the reduction and maintenance of weight loss in long term, as the control of the related comorbidities.

    Aim:: Quantify the occurrence of alterations of the gastrointestinal tract, suggestive signs of nutritional deficiencies and the use of supplements in a group of women undergoing bariatric surgery.

    Methods:: The sample consisted of women aged 20-65 years submitted to Roux-en-Y gastric bypass with monitoring equal to or higher than 24 months. Read More

    Controlled Compression Nailing for At Risk Humeral Shaft Fractures.
    J Orthop Trauma 2017 Jun;31 Suppl 6:S25-S28
    *Department of Orthopaedic Surgery, Saint Louis University School of Medicine, St. Louis, MO; and †Department of Orthopaedics and Sports Medicine, USF Health Morsani College of Medicine.
    Compression techniques seem to be the primary factor in determining the success of both plating and nailing techniques for the management of acute fractures and for delayed and nonunion management of these fractures. An intramedullary nail that can provide continual compression (like a plate) and mechanical manipulation of the callous throughout the course of treatment is an ideal device that provides all the advantages of plating and nailing and avoids the noted limitations of both. The UNYTE compression humeral nail is based on the PRECICE intramedullary limb lengthening system. Read More

    Practical Aspects of Posttrauma Reconstruction With an Intramedullary Lengthening Nail.
    J Orthop Trauma 2017 Jun;31 Suppl 2:S20-S24
    Department of Orthopaedic Surgery and Rehabilitation, Loyola University Medical Center, Maywood, IL.
    Limb equalization using the Ilizarov method has evolved and adapted the use of internal lengthening devices. One of the newest devices, termed "PRECICE," is a magnetically controlled telescoping nail. Complications such as pin site infection and skin irritation are eliminated. Read More

    Adult Posttraumatic Reconstruction Using a Magnetic Internal Lengthening Nail.
    J Orthop Trauma 2017 Jun;31 Suppl 2:S14-S19
    Limb Lengthening and Complex Reconstruction Service, Hospital for Special Surgery; Weill Cornell Medicine, Cornell University, New York, NY.
    A new generation of internal lengthening nail is now available that has reliable remote-controlled mechanisms. This allows accurate and well-controlled distraction rate and rhythm, and early clinical results have been very positive. In this article, 2 posttraumatic cases are presented that illustrate deformity correction and lengthening using the internal lengthening nail. Read More

    Transitioning to an Intramedullary Lengthening and Compression Nail.
    J Orthop Trauma 2017 Jun;31 Suppl 2:S7-S13
    Department of Orthopaedic Surgery, Weill Medical College of Cornell University, Hospital for Special Surgery, New York, NY.
    The magnetic intramedullary lengthening nail is an innovative technology that allows for creative ways to treat difficult problems. The lengthening option has revolutionized femur fracture management with bone loss and malunion therapy. The compression version of this nail has provided a gradual method to compress nonunions and difficult fractures that may obviate the need for many current uses of external fixation. Read More

    The Evolution of Remote-Controlled Intramedullary Lengthening and Compression Nails.
    J Orthop Trauma 2017 Jun;31 Suppl 2:S2-S6
    Department of Orthopaedic Surgery, School of Medicine, University of California, Irvine, Orange, CA.
    The operative elongation of limbs has long been a goal of orthopaedic surgeons. Indeed, the very first external skeletal fixators, although designed for stabilization of displaced fractures, were also used to overcome the posttrauma shortening that so commonly accompanies fracture deformities. Read More

    Insertion-related pain with intramedullary nailing.
    Injury 2017 Jun 5;48 Suppl 1:S18-S21. Epub 2017 May 5.
    Department of Orthopaedics & Sports Medicine, Indiana University Health Methodist Hospital, Indianapolis, IN, USA.
    The use of intramedullary nails for the treatment of long bone fractures has become increasingly frequent over the last decade with gradually expanding indications and technological advances. Improved biomechanics relative to plates and less direct fracture exposure are some of the potential benefits of intramedullary nails. However, persistent insertion-related pain is common and may limit satisfactory long term outcomes. Read More

    Trochanteric Entry for Femoral Lengthening Nails in Children: Is It Safe?
    J Pediatr Orthop 2017 Jun;37(4):258-264
    International Center for Limb Lengthening, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, Baltimore, MD.
    Background: Antegrade intramedullary (IM) nailing for skeletally immature femur fractures can damage the capital femoral epiphysis blood supply, leading to avascular necrosis (AVN) of the femoral head. Reported AVN rates are 2% for piriformis entry and 1.4% for trochanteric entry. Read More

    Undisturbed local bone formation capacity in patients with atypical femoral fractures: a case series.
    Osteoporos Int 2017 May 4. Epub 2017 May 4.
    Department of Orthopedic Surgery, Gävle hospital, SE-80 324, Gävle, Sweden.
    We excised the fracture site in 8 patients with incomplete atypical femoral fractures by drilling an 11-mm-diameter hole. New bone formation could be seen in the hole within a normal time frame. Delayed healing of these fractures might be unrelated to an impaired capacity to form bone. Read More

    Does provisional plating of closed tibia fractures have higher complication rates?
    J Orthop Trauma 2017 Apr 27. Epub 2017 Apr 27.
    1Department of Orthopaedic Surgery, University of Utah School of Medicine, Salt Lake City, UT 2Department of Orthopedic Surgery, Harborview Medical Center, University of Washington, Seattle WA 3Department of Orthopedic Surgery, University of California - Irvine, Orange, CA.
    Objectives: To compare infection and nonunion rates following provisional plating (PP) with standard reduction (SR) techniques for closed tibia fractures treated with an intramedullary nail.

    Design: Retrospective comparative studySetting: Level 1 academic trauma centerPatients/Participants: Of the 348 closed tibia fractures (AO/OTA 42) treated with intramedullary nail from January 2007 through June 2015, 231 (40 PP and 191 SR) patients met inclusion/exclusion criteria.

    Intervention: Patients received either a provisional plate or a standard reduction prior to intramedullary nail placement MAIN OUTCOME MEASUREMENT:: Infection and nonunion RESULTS:: The PP cohort had a significantly higher proportion of high energy injury mechanism and a significantly higher proportion of diabetes than the SR cohort. Read More

    Complications of Distal Phalanx Fractures in Children.
    J Hand Surg Am 2017 Apr 29. Epub 2017 Apr 29.
    Section of Hand Surgery, Children's Mercy Hospitals and Clinics, Kansas City, MO. Electronic address:
    Purpose: To determine whether the incidence of complications varies between among types of distal phalangeal fractures in a pediatric population.

    Methods: We retrospectively reviewed the medical records and radiographs of patients seen in the pediatric hand surgery clinic from 2011 to 2012 with a diagnosis of distal phalanx fracture. Patients were identified by International Classification of Diseases-Ninth Revision code (816. Read More

    Intramedullary Nailing for Atypical Femoral Fracture with Excessive Anterolateral Bowing.
    J Bone Joint Surg Am 2017 May;99(9):726-735
    1Department of Orthopedic Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Gangnam-Gu, Seoul, South Korea 2Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, South Korea 3Department of Orthopedic Surgery, The Second Hospital of Jilin University, Changchun, People's Republic of China.
    Background: Intramedullary nailing is the treatment of choice for atypical femoral fractures. However, several problems, such as iatrogenic fracture and medial gap opening, can occur during intramedullary nailing when atypical femoral fractures are associated with excessive anterolateral bowing. To overcome these problems, we have developed a new grading system for anterolateral femoral bowing and a new technique for intramedullary nailing. Read More

    Treatment of pathological fractures of the long bones.
    EFORT Open Rev 2016 May 13;1(5):136-145. Epub 2017 Mar 13.
    Department of Orthopaedics, Leiden University Medical Centre, The Netherlands.
    Bone metastases of the long bones often lead to pain and pathological fractures. Local treatment consists of radiotherapy or surgery. Treatment strategies are strongly based on the risk of the fracture and expected survival. Read More

    Cerclage-wiring through a mini-open approach to assist reduction of subtrochanteric fractures treated with cephalomedullary fixation: surgical technique.
    J Orthop Trauma 2017 Apr 25. Epub 2017 Apr 25.
    1Department of Traumatology and Orthopaedic Surgery. Lucus Augusti University Hospital. Lugo. Spain. 2Trauma Unit, Department of Traumatology and Orthopaedic Surgery. 12 de Octubre University Hospital. Madrid. Spain.
    In spite of advances in the management of subtrochanteric fractures, in particular the use of cephalomedullary nails, surgical results still remain poorer than other fractures of the proximal femur. Good reduction is key for satisfactory outcomes. Several methods of reduction have been described; recently, good rates of union with open reduction techniques using clamps and wires have been described. Read More

    How High Can You Go?: Retrograde Nailing of Proximal Femur Fractures.
    J Surg Orthop Adv 2017 ;26(1):33-39
    Department of Orthopaedic Surgery, Naval Medical Center San Diego, San Diego, California.
    There are no data-supported recommendations on how proximal is too proximal for retrograde nailing (RGN). At six level 1 trauma centers, patients with femur fractures within the proximal one-third of the femur treated with RGN were included. This article describes a proximal segment capture ratio (PSCR) and nail segment capture ratio to evaluate RGN of proximal fractures. Read More

    The role of the intramedullary implant in limb lengthening.
    Injury 2017 Jun 24;48 Suppl 1:S52-S58. Epub 2017 Apr 24.
    The Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK.
    Limb lengthening is now an accepted practice in orthopaedic surgery. The principles of distraction osteogenesis have become well established with the use of external fixators, utilizing both monolateral and ring fixators. Corticotomy technique, frame stability, lengthening rate and rhythm all contribute to the formation of bone regenerate and tissues. Read More

    Intramedullary nail fixation of non-traditional fractures: Clavicle, forearm, fibula.
    Injury 2017 Jun 25;48 Suppl 1:S41-S46. Epub 2017 Apr 25.
    Division of Orthopaedics, Department of Surgery, Western University, London, Canada. Electronic address:
    Locked intramedullary fixation is a well-established technique for managing long-bone fractures. While intramedullary nail fixation of diaphyseal fractures in the femur, tibia, and humerus is well established, the same is not true for other fractures. Surgical fixations of clavicle, forearm and ankle are traditionally treated with plate and screw fixation. Read More

    Complications of intramedullary nailing-Evolution of treatment.
    Injury 2017 Jun 24;48 Suppl 1:S59-S63. Epub 2017 Apr 24.
    Department of Trauma, Hand and Reconstructive Surgery, University Hospital Münster, Münster, Germany.
    Intramedullary nailing of diaphyseal long bone fractures is a standard procedure in today's trauma and orthopedic surgery due to the numerous advantages (e.g. minimal invasive, limited soft tissue damage, load stability). Read More

    Malalignment in intramedullary nailing. How to achieve and to maintain correct reduction?
    Injury 2017 Jun 24;48 Suppl 1:S30-S34. Epub 2017 Apr 24.
    Department of Orthopaedic Surgery and Traumatology, Hospital Costa del Sol, University of Malaga, Malaga, Autovia A-7 Km. 187, 29603 Marbella, Spain.
    Intramedullary nailing has become the standard for the treatment of long bones diaphyseal fractures. Modern techniques of locking have further enlarged the primary indications to more proximal and distal fractures relying upon a former correct alignment. Nevertheless, residual deformities are not rare as once the nail has left the narrow diaphyseal canal and comes into the wider metaphysis, it may follow an unwished trajectory. Read More

    [Retrograde intramedullary nail fixation for Charcot neuroarthropathy].
    Acta Ortop Mex 2016 Sep-Oct;30(5):223-230
    Instituto Nacional de Rehabilitación «Luis Guillermo Ibarra Ibarra». Calzada México-Xochimilco Núm. 289, Col. Arenal de Guadalupe, CP 14389, Del. Tlalpan, Ciudad de México.
    Charcot arthropathy is defined as an articular degenerative, chronic, progressive disease that affects one or more peripheral joints, develops as a result of a failure in the normal sensory perception (pain and proprioception) in the innervation of joints located in the foot and ankle, is characterized by destructive bone lesions without the presence of infection. Neuropathy is directly associated with diabetes mellitus type 1 and 2. Surgery is indicated when there is severe involvement of soft tissue, foot joints are unstable, at the presence of chronic or recurrent ulcers or when the foot and ankle can not fit to a normal shoe, and had limitation to perform activities of daily living. Read More

    Lengthening of the humerus with intramedullary lengthening nails-preliminary report.
    Strategies Trauma Limb Reconstr 2017 Apr 24. Epub 2017 Apr 24.
    3D-Surgery, Department of General, Trauma and Reconstructive Surgery, Munich University Hospital LMU, Germany, Nußbaumstraße 20, 80336, Munich, Germany.
    Distraction osteogenesis of the humerus with fully implantable lengthening is now possible since the diameter of the available nails was reduced to 10 mm and below. We report on the first intramedullary lengthening cases of the humerus with two different lengthening devices (FITBONE and PRECICE). Two different approaches and implantation techniques were used. Read More

    Treatment of shepherd's crook deformity in patients with polyostotic fibrous dysplasia using a new type of custom made retrograde intramedullary nail: a technical note.
    J Child Orthop 2017 ;11(1):64-70
    Department of Paediatric Orthopaedics, The Royal Children's Hospital, Victoria, Australia.
    Aims: The severe form of coxa vara, the 'shepherd's crook deformity', is always a consequence of a locally extensive form of polyostotic fibrous dysplasia (or McCune-Albright syndrome). Treatment of this deformity is a challenge. The soft bone does not tolerate any implant that depends on the stability of the cortical bone (like plates or external fixators). Read More

    Removal of the Distal Aspect of a Broken Tibial Nail.
    Am J Orthop (Belle Mead NJ) 2017 Mar/Apr;46(2):E112-E115
    Department of Orthopaedic Surgery, Warren Alpert School of Medicine, Brown University, Providence, RI.
    Nail breakage is a known complication of intramedullary nail (IMN) fixation of tibial fractures. Several case reports have described unique methods used to facilitate removal of broken IMNs. In this article, we describe an efficient technique for extracting broken tibial IMNs-a technique that can be used before attempting more invasive extraction methods. Read More

    Comparison of Short vs Long Anti-rotation in Treating Trochanteric Fractures.
    Malays Orthop J 2016 Mar;10(1):22-28
    Department of Orthopaedics, Wishaw General Hospital, Scotland, United Kingdom.
    Introduction: A comparative evaluation of the surgical treatment and outcome of patients with pertrochanteric fractures treated with short versus long proximal femoral nail antirotation. Materials and methods: A retrospective review was conducted of patients with pertrochanteric fractures treated between January 2011 and June 2012. In all 80 patients were enrolled in the study, of which 40 were treated with short PFNA and the remaining with long PFNA. Read More

    Comparative outcome of PFNA, Gamma nails, PCCP, Medoff plate, LISS and dynamic hip screws for fixation in elderly trochanteric fractures: a systematic review and network meta-analysis of randomized controlled trials.
    Eur J Orthop Surg Traumatol 2017 Apr 22. Epub 2017 Apr 22.
    Sport and Orthopedic Center, Samitivej Hospital, Bangkok, Thailand.
    The ideal implant for the treatment of an unstable intertrochanteric femoral fracture is still a matter of discussion. The aim of this systematic review is to conduct a network meta-analysis of randomized controlled trials (RCTs) comparing clinical outcomes between dynamic hip screws (DHS), Medoff sliding plating, percutaneous compression plating (PCCP), proximal femoral nails (PFN), Gamma nails and less invasive stabilization system fixation in femoral trochanteric fractures in the elderly. These clinical outcomes consist of total intra-operative time, intra-operative fluoroscopy time, intra-operative blood loss, blood component transfusion, length of hospital stay, postoperative general complications, wound complications, late complications and reoperation rates. Read More

    Prospective randomized study comparing two cephalomedullary nails for elderly intertrochanteric fractures: Zimmer natural nail versus proximal femoral nail antirotation II.
    Injury 2017 Apr 13. Epub 2017 Apr 13.
    Department of Orthopedic Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, South Korea. Electronic address:
    Objectives: Although both clinical and biomechanical studies suggest that cephalomedullary implants have a mechanical advantage over extramedullary implants, a high rate of complications or implant failure remains in elderly patients with osteoporosis. In an attempt to address some of these challenges, new implants with improved designs named proximal femoral nail antirotation II (PFNA II) and Zimmer natural nail (ZNN) were developed for elderly patients. Although the PFNA II reportedly has good clinical outcomes, it is unclear which implant achieves better safety and efficacy for treating intertrochanteric hip fractures. Read More

    Emerging U.S. National Trends in the Treatment of Pediatric Supracondylar Humeral Fractures.
    J Bone Joint Surg Am 2017 Apr;99(8):681-687
    1Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, Iowa 2The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
    Background: Understanding national trends in the treatment of pediatric supracondylar humeral fractures will provide important insight into variations in regional treatment and identify areas for improving value and quality in care delivery in the U.S.

    Methods: U. Read More

    Comparison of Anesthetic Administration According to Method of Hip Surgery.
    Eurasian J Med 2017 Feb 25;49(1):26-29. Epub 2017 Jan 25.
    Clinic of Orthopaedic Surgery and Traumatology, Okmeydanı Training and Research Hospital, İstanbul, Turkey.
    Objective: The aim of this study is to compare total hip prosthesis (THP), partial hip prosthesis (PHP), and proximal femoral nail (PFN) patients in terms of the chosen anesthetic method.

    Methods: A total of 850 patients who underwent hip surgery were divided into 3 groups according to the operation type: PHP (n=281), PFN (n=393), and THP (n=176). The type of anesthesia administered, interventions during anesthesia, and complications were retrospectively evaluated. Read More

    [Diagnosis and treatment for the basicervical fractures of the trochanteric region].
    Beijing Da Xue Xue Bao 2017 Apr;49(2):246-251
    Department of Orthopaedic Surgery, Peking University Third Hospital, Beijing 100191, China.
    Objective: To evaluate the rate of basicervical fractures and document their diagnosis and treatment.

    Methods: From January 2005 to May 2016, 28 basicervical fractures of the 832 trochanteric fractures were collected and evaluated. The patients were treated with multiple screws, dynamic hip screw (DHS), intramedullary nail. Read More

    A novel smart navigation system for intramedullary nailing in orthopedic surgery.
    PLoS One 2017 17;12(4):e0174407. Epub 2017 Apr 17.
    Department of Orthopedic Surgery, Kyungpook National University Hospital, Daegu, Korea.
    This paper proposes a novel smart surgical navigation system for intramedullary nailing in orthopedic surgery. Using a handle-integrated laser guidance module, the system can target a drill insertion point onto skin, indicating an accurate target position to perpendicularly access an invisible distal hole. The proposed handle-integration-based fixation of the laser guidance module precisely defines the relative position of the module with respect to the distal hole. Read More

    Semiextended approach for intramedullary nailing via a patellar eversion technique for tibial-shaft fractures: Evaluation of the patellofemoral joint.
    Injury 2017 Jun 25;48(6):1264-1268. Epub 2017 Mar 25.
    Fujigaoka Hospital, Showa University School of Medicine, 2-23-4-402 Kodai, Miyamae-ku, Yokohama, Kawasaki 216-0007, Japan.
    Intramedullary nail fixation is a common treatment for tibial-shaft fractures, and it offers a better functional prognosis than other conservative treatments. Currently, the primary approach employed during intramedullary nail insertion is the semiextended position is the suprapatellar approach, which involves a vertical incision of the quadriceps tendon Damage to the patellofemoral joint cartilage has been highlighted as a drawback associated with this approach. To avoid this issue, we perform surgery using the patellar eversion technique and a soft sleeve. Read More

    Pediatric Femoral Shaft Fractures: A Multicenter Review of the AAOS Clinical Practice Guidelines Before and After 2009.
    J Pediatr Orthop 2017 Apr 10. Epub 2017 Apr 10.
    *Department of Orthopedic Surgery, Le Bonheur Children's Hospital, University of Tennessee-Campbell Clinic, Memphis, TN †Harvard Combined Orthopaedic Residency, Boston, MA ‡Children's Hospital of Colorado Orthopedics Institute, University of Colorado, Aurora, CO §Children's Hospital of Los Angeles, Los Angeles, CA.
    Background: To determine if the AAOS clinical practice guidelines (CPG) for the treatment of pediatric femoral shaft fractures (2009) changed treatment, we analyzed pediatric femoral shaft fractures at 4 high-volume, geographically separated, level-1 pediatric trauma centers over a 10-year period (2004 to 2013).

    Methods: Consecutive series of pediatric femoral shaft fractures (ages, birth to 18 y) treated at the 4 centers were reviewed. Treatment methods were analyzed by age and treatment method for each center and in aggregate. Read More

    IM Nail Fixation of Atypical Femur Fractures with Bone Marrow Aspirate Concentrate Leads to Faster Union: A Case Control Study.
    J Orthop Trauma 2017 Apr 7. Epub 2017 Apr 7.
    1Mount Sinai Hospital, Department of Orthopaedic Surgery, 5 E 98th St, New York, NY 10029 2Columbia University Medical Center, Department of Orthopaedic Surgery, 622 W 168th St, PH11-Center, New York, NY 10032 3Elmhurst Hospital Center, Department of Orthopaedic Surgery, 79-01 Broadway, Elmhurst NY 11373.
    Objectives: High rates of implant failure and nonunion in atypical femur fractures (AFF) have been reported. The aim of this study was to evaluate bone marrow aspirate concentrate (BMAC) use in the treatment of AFF.

    Design: Retrospective Case Control SETTING:: Level 1 Trauma Center PATIENTS:: Complete AFF, defined according to American Society of Bone and Mineral Research (ASBMR) criteria, from September 2009 to April 2015 with minimum 1 year follow up. Read More

    Intramedullary nail versus volar locking plate fixation for the treatment of extra-articular or simple intra-articular distal radius fractures: systematic review and meta-analysis.
    Int Orthop 2017 Apr 7. Epub 2017 Apr 7.
    Department of Orthopaedic Surgery, The Third Hospital of Hebei Medical University, NO. 139 Ziqiang Road, Shijiazhuang, Hebei, 050051, People's Republic of China.
    Aims: This study aims to compare the outcomes of intramedullary nail (IMN) and volar locking plate (VLP) fixation for treatment of extra-articular or simple intra-articular distal radius fractures.

    Methods: PubMed, Embase, Medline and Cochrane Collaboration Central databases were searched for studies that compared the results of IMN and VLP fixation for the treatment of distal radius fractures up to March 2016. Stata 11. Read More

    Surgical Treatment of Subungual Squamous Cell Carcinoma by Wide Excision of the Nail Unit and Skin Graft Reconstruction: An Evaluation of Treatment Efficiency and Outcomes.
    JAMA Dermatol 2017 May;153(5):442-448
    Department of Dermatology, Centre Hospitalier Lyon Sud, Pierre-Bénite, France2Health Department, Université Claude Bernard Lyon 1, Lyon, France3Lyons Cancer Research Center, Lyon, France.
    Importance: The best surgical treatment modalities for subungual squamous cell carcinoma (SUSCC) without bone invasion need to be determined. The limited available data on Mohs micrographic surgery do not demonstrate its use as a standard procedure. A previous study in a limited series of patients has shown that wide surgical excision of the nail unit was associated with a low rate of recurrence. Read More

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