Patella fracture fixation remains a significant challenge for orthopedic surgeons. Although tension band fixation allows for reliable osseous union, especially in simple fracture patterns, it still presents several problems. Plate fixation of patella fractures is a method that allows for more rigid stabilization and earlier mobilization. At the authors' level 1 trauma center, one fellowship-tra...

In a prospective trial, 10 patients underwent inter-fragmentary screws and external fixation for unilateral tibial shaft fractures. Anatomical reduction was achieved in all cases and uncomplicated bone union occurred in nine patients with a mean time to union of 122 (SD 20) days. One patient had delayed union and the fracture malunited. A 20% pin tract sepsis rate was encountered. The high risk...

Purpose: Most clavicular fractures can be healed by conservative treatment, although there are many factors that influence healing. The aim of the present study was to analyze factors that influence (i) bone union of midshaft fractures of the clavicle treated conservatively and (ii) bone functioning, after union. The long-term goal was to determine which treatments are adequate. Materials and M...

Background To assess the effectiveness of a novel locked intramedullary device in the treatment of acute clavicle shaft fractures. Description of methods Patients admitted with midshaft clavicle fractures were assessed to determine whether operative fixation of the fracture was required. Indications for surgery were: midshaft clavicle fractures with 100% displacement; more than 1.5 cm of shorte...

Fifty-six patients with ununited intracapsular fractures of the femoral neck were treated by internal fixation and muscle-pedicle bone grafting. All had some absorption of the femoral neck, and many had avascular necrosis of the femoral head. At operation the sclerosed surfaces of the fractures were freshened, the avascular femoral head was decompressed and the muscle-pedicle graft was fixed wi...

We report the use of Grosse-Kempf reamed intramedullary nailing in the treatment of 41 Gustilo type II and III open tibial fractures. The union times and infection rates were similar to those previously reported for similar fractures treated by external skeletal fixation, but the incidence of malunion was less and fewer required bone grafting. The role of exchange nailing is discussed and a tre...

BACKGROUND Despite extensive literature supporting the use of computerized tomography (CT) scans in evaluating scaphoid fractures, there has not been a consensus on the methodology for defining and quantifying union. The purpose of this study was to test the inter-observer reliability of two methods of quantifying scaphoid union. METHODS The CT scans of 50 non-operatively treated scaphoid fra...

OBJECTIVE The purpose of this study is to report the union rate and time to union for acute non-displaced scaphoid waist fractures treated with a short arm thumb spica cast. METHODS A database was searched (2006-2013) to identify acute undisplaced scaphoid waist fractures. Cases that were not given a trial of casting were excluded (n=33). X-rays, CT scans and health records for each patient w...

BACKGROUND Standard treatment of diaphyseal fractures of the forearm is open reduction and fixation using dynamic compression plates (DCP) and screws. This technique uses screw placement in all 6 or more of the plate holes except the hole over the fracture line. We hypothesized that DCP with selective 4-screw bicortical placement can provide adequate fixation for these fractures. OBJECTIVES T...