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Gunshot wounds to the extremities

Dicpinigaitis, Paul A; Koval, Kenneth J; Tejwani, Nirmal C; Egol, Kenneth A
PMID: 17155923
ISSN: 1936-9719
CID: 72406

Can external fixation maintain reduction after distal radius fractures?

Dicpinigaitis, Paul; Wolinsky, Philip; Hiebert, Rudi; Egol, Kenneth; Koval, Kenneth; Tejwani, Nirmal
BACKGROUND: The purpose of this study was to assess the effectiveness of external fixation and percutaneous pinning in maintaining distal radius fracture reduction over a 6-month period and to identify factors that might predict loss of fracture reduction. METHODS: Seventy cases had complete radiographic evaluation before surgery; at surgery; and at 6-week, 3-month, and 6-month follow-up. Radiographic parameters measured included volar tilt, dorsal displacement, radial inclination, radial height, radial shift, and ulnar variance. RESULTS: Dorsal tilt averaged 17.5 degrees from neutral before surgery; this value was corrected to 0.9 degree at surgery, but then progressed to 4.2 degrees by the 6-month follow-up. At 6-month follow-up, 49% of cases had lost more than 5 degrees of initially reduced volar tilt. However, none of these patients went from an acceptable initial reduction to an unacceptable reduction at 6 months. Initial deformity, patient age, use of bone graft, and duration of external fixation were not predictors of loss of reduction. CONCLUSION: Loss of reduction of volar tilt was seen for a period of up to 6 months after fixation, despite the use of pinning to hold the reduction. No specific predictor of loss of reduction was noted, although there was a trend toward loss of reduction in younger patients
PMID: 15514540
ISSN: 0022-5282
CID: 50280

Gunshot wounds to the lower extremities

Dicpinigaitis, Paul A; Fay, Robert; Egol, Kenneth A; Wolinsky, Phillip; Tejwani, Nirmal; Koval, Kenneth J
In this article, we briefly mention the personal, social, and economic costs of gunshot injuries; describe the science of ballistics and how differences in ballistics affect gunshot wounds and their treatment; and review the general principles involved in managing gunshot injuries. We will summarize the strategies for treating adults with gunshot injuries to specific regions of the lower extremities--the hip, the femur, the knee, the tibia, and the foot
PMID: 12041522
ISSN: 1078-4519
CID: 44650