Objective: Traction achieved using an intraoperative femoral fracture reduction device (IFFRD) was compared with that observed using a traction table (TT) for closed reduction of trochanteric fractures and cephalomedullary nail fixation. Design: Prospective cohort study. Setting: Level 1 trauma center. Patients: One hundred forty-one eligible patients with 141 fractures (Orthopaedic Trauma Association type 31-A1, n = 28; A2, n = 75; and A3, n = 38 cases) were randomized to the IFFRD (n = 73) or TT (n = 68) group. Intervention: The IFFRD was used while the patient was placed on a normal radiolucent operation table with 25-30 degrees elevation of the injured side to allow for antero-posterior and lateral fluoroscopic examination and facilitate entry-point guide wire insertion. Main Outcome Measures: Patient demographics, operative and fluoroscopy duration, quality of fracture reduction, and radiological bone union time were recorded. Results: Patient demographics were similar between groups. Duration of patient positioning was longer in the TT group (P < 0.05); duration of fluoroscopy, fracture reduction, and time to union were comparable. Conclusions: An IFFRD used with a normal radiolucent operation table decreased patient positioning time, with efficacy comparable to the TT approach for closed reduction of trochanteric fractures.
To evaluate the biomechanical and clinical results of modified separate vertical wiring technique (SVW) for inferior pole patellar fracture repair we conducted a finite element biomechanical study using 2 fixation methods and evaluated a clinical series of eleven patients. The modified SVW technique was an effective, safe and simple method that can provide stable fixation for early exercise with excellent functional results in fixing inferior pole patella fractures.
The purpose of this study is to describe a surgical technique for intramedullary fixation and minimally invasive clampassisted reduction with selective cerclage wiring for the management of combined ipsilateral femoral neck and subtrochanteric fractures and to present the clinical outcomes in 17 patients after treatment using this technique.