The ideal timing and modality of femur shaft fracture fixation in head-injured patients remains a topic of debate. Several groups advocate the immediate definitive fixation of femur fractures ("early total care"), whereas others support the concept of "damage control orthopaedics" with temporary fracture fixation by means of external fixation and staged, planned conversion to internal fixation....

BACKGROUND Recently, various femoral head fixation devices (HFDs) for trochanteric fractures have become available. However, there are some cases in which femoral head rotation with excessive sliding of the HFD is observed and it is often followed by cutout. The purpose of this study is to compare the ability of the three types of HFDs to prevent femoral head rotation. METHODS Between July 20...

INTERTROCHANTERIC FRACTURES Approximately 50% of intertrochanteric fractures are stable and have minimal or no posteromedial comminution. The remaining 50% are unstable and have posteromedial instability and little resistance to varus deformity.1,4,5 Older rigid devices led to cutout or penetration of the nail as the fracture impacted. In the late 1960s, sliding devices were developed to allow ...

Femoral non-unions are difficult to treat even for the experienced orthopaedic trauma surgeon. If the non-union follows failure of modern stable internal fixation, the complexity of the management is further increased. We report two cases of stiff hypertrophic femoral non-unions after failed locking plate fixation that were successfully treated with a new hexapod circular external fixator. In a...

An analysis of 51 type III open tibial fractures treated by external skeletal fixation is presented. The fractures are subdivided according to the classification of Gustilo, Mendoza and Williams (1984) into types IIIa, IIIb and IIIc. The different prognoses of these fracture subtypes is examined. The use of the Hoffmann and Hughes external fixators in the management of type III open tibial frac...

Between 1993 and 1995, thirty-three patients having 39 fractures caused by missiles fired from a high velocity rifle were reviewed retrospectively between 1 and 3 years after injury and the outcome of treatment assessed. Majority (33 out of 39) were Grade III. Union was achieved in 35 out of 39 fractures, there was deep infection and delayed union in one case each. Non-union occurred in three f...

This study examined the use of a bidirectional, patient-directed orthosis that used the principles of static progressive stress to improve forearm rotation. Thirty-eight patients who had limited pronation and supination motions after injuries and who failed other physical therapy techniques underwent a 30- to 60-minute stretching protocol with the orthosis one to three times per day. The mean a...

BACKGROUND Allergic reactions to the metal head-pins of a head fixation holder are rare. CASE DESCRIPTION A 45-year-old woman was referred to our hospital for the treatment of unruptured cerebral aneurysms. She underwent successful surgical treatment using four head-pins of the Sugita frame. At her first outpatient visit 3 weeks after discharge, redness, sores, and focal hair loss were noted ...

Head motion parameters (translation, rotation) during an event-related functional magnetic resonance imaging experiment of overt picture naming were investigated for two fixation conditions. We compared normal fixation with cushions and belts with the additional use of a bite-bar. Neither mean nor maximum values differed between the two conditions for any of the parameters. By applying the head...