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            "title": "The frequency and epidemiology of hand and forearm fractures in the United States",
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                    "firstName": "K C",
                    "lastName": "Chung"
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                    "firstName": "S V",
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            "abstractNote": "The purpose of this study was to estimate the frequency and describe the epidemiology of hand and forearm fractures in the United States. We extracted cases with ICD-9-CM diagnostic codes of 813.0 to 817.1 from the 1998 National Hospital Ambulatory Medical Care Survey. In 1998 there were 1,465,874 estimated cases of hand/forearm fractures, accounting for 1.5% of all emergency department cases. Radius and/or ulna fractures comprised the largest proportion of fractures (44%). The most affected age group was 5 to 14 years of age (26%). Private insurance paid for 49% of the cases. Most of the fractures occurred at home (30%); the street/highway was the second most likely fracture location (14%). Accidental falls caused the majority (47%) of fractures. Large database analysis provides important information that can be used to target interventions toward vulnerable populations and to allocate adequate resources for treating upper extremity fractures.",
            "publicationTitle": "The Journal of hand surgery",
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            "date": "Sep 2001",
            "volume": "26",
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            "pages": "908-915",
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            "journalAbbreviation": "J Hand Surg Am",
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            "title": "State-of-the-art treatment of forearm shaft fractures",
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                    "firstName": "Peter P",
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            "abstractNote": "As the treatment of pediatric forearm shaft fractures has changed extensively over the past 30 years, it is worth discussing the current treatment modalities in these fractures. The recommendations are based on an ongoing evaluation of treatment procedures, problems, complications, and final results going back to 1976. Between 1976 and 1985, the 95.9% of fractures that were treated conservatively were tainted with bad functional results because a significant proportion healed with malalignment. The introduction of elastic-stable intramedullary nailing (ESIN) initiated a definitive change and the opportunity to stabilize unstable fractures with a less invasive method. Apart from some technical problems, the functional results of ESIN are very satisfactory. The external fixator is a good treatment for open, comminuted, or special distal dia-metaphyseal fractures in older children and adolescents. Therefore, we currently have a variety of methods to treat forearm shaft fractures in children using primary definitive fracture care (PDFC). The differentiated use of conservative and surgical measures should minimize final functional sequelae. A well-tried algorithm for this fracture region is outlined.",
            "publicationTitle": "Injury",
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            "date": "Feb 2005",
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            "abstractNote": "Of 103 patients who had a fracture of the distal third of the femur that was treated by open reduction and internal fixation with a condylar blade-plate, sixty-two had removal of the plate after the fracture had united. The mean interval between injury and removal of the plate was twenty-six months. Six patients (10 per cent) sustained a refracture that was unrelated to major trauma; the refracture occurred twelve to ninety-three days after removal of the plate. Five of the six refractures occurred through a hole of a supplemental interfragmentary lag-screw. The use of such screws significantly increased the risk of refracture after removal of the hardware (p less than 0.01). The refractures were treated by intramedullary nailing in five patients and by replating in one, and union was achieved in all six patients. Routine removal of a condylar blade-plate after union of a fracture of the distal third of the femur cannot be recommended, especially in the presence of supplemental fixation with interfragmentary screws.",
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            "title": "Internal fixation of diaphyseal fractures of the forearm by interlocking intramedullary nail: short-term results in eighteen patients",
            "creators": [
                {
                    "creatorType": "author",
                    "firstName": "Hong",
                    "lastName": "Gao"
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                    "creatorType": "author",
                    "firstName": "Cong-Feng",
                    "lastName": "Luo"
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                {
                    "creatorType": "author",
                    "firstName": "Chang-Qing",
                    "lastName": "Zhang"
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                    "firstName": "Hui-Peng",
                    "lastName": "Shi"
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                    "firstName": "Cun-Yi",
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                    "firstName": "Bing-Fang",
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            "abstractNote": "OBJECTIVE: This study was designed to evaluate the efficacy of the treatment of diaphyseal fractures of the forearm using the ForeSight forearm interlocking intramedullary nail.\nDESIGN: Retrospective study.\nSETTING: University-affiliated teaching hospital.\nPATIENTS: Eighteen patients with 32 displaced diaphyseal forearm fractures were identified.\nINTERVENTION: All fractures were treated with the ForeSight forearm interlocking intramedullary nail. Eighteen fractures were stabilized with static interlocking technique.\nMAIN OUTCOME MEASURES: The assessment of patients was based on the time to union, the functional recovery, and the incidence of complications. Physical capability was evaluated by using the rating system of Grace and Eversmann. Patient-rated outcome was assessed by completion of the Disability of Arm Shoulder Hand questionnaire (DASH).\nRESULTS: All fractures healed with the index procedure. The average time to union for fractures utilizing a closed technique was 10 weeks; for fractures using an open reduction technique, 15 weeks. The mean pronation was 62 (range, 0-96) degrees, and the mean supination was 80 (range, 0-105) degrees. Compared with the normal arm, the mean loss of rotation of the forearm was 32 (range, 5-162) degrees. Using the rating system of Grace and Eversmann, 13 patients had an excellent or good result, 3 had an acceptable result, and 2 had an unacceptable result. Using the patient-rated functional questionnaire, the mean DASH of 19 (range, 4-72) points at the time of the most recent follow-up indicated a mild-to-moderate impairment. There were 7 postoperative complications. The incidence of complications was 22% (7/32). One cross-union between forearm bones occurred in a patient with a closed head injury and high-energy trauma. Two nondriving end screws of the ulna nail backed out causing wrist pain and had to be removed. There were 4 superficial infections occurring all in the fractures that necessitated an open reduction technique. The overall rate of infection was 12.5% (4/32). Three patients who presented with an open fracture needed a skin graft to cover the open wound.\nCONCLUSIONS: Forearm interlocking intramedullary nailing is an acceptable method to stabilize displaced diaphyseal forearm fractures in adult.",
            "publicationTitle": "Journal of orthopaedic trauma",
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            "date": "Jul 2005",
            "volume": "19",
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            "pages": "384-391",
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            "shortTitle": "Internal fixation of diaphyseal fractures of the forearm by interlocking intramedullary nail",
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            "creatorSummary": "Antabak et al.",
            "parsedDate": "2013-09",
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            "itemType": "journalArticle",
            "title": "Treatment outcomes of both-bone diaphyseal paediatric forearm fractures",
            "creators": [
                {
                    "creatorType": "author",
                    "firstName": "Anko",
                    "lastName": "Antabak"
                },
                {
                    "creatorType": "author",
                    "firstName": "Tomislav",
                    "lastName": "Luetic"
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                {
                    "creatorType": "author",
                    "firstName": "Sjekavica",
                    "lastName": "Ivo"
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                {
                    "creatorType": "author",
                    "firstName": "Robert",
                    "lastName": "Karlo"
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                    "firstName": "Stanko",
                    "lastName": "Cavar"
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                    "firstName": "Marko",
                    "lastName": "Bogovic"
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                    "firstName": "Suzana Srsen",
                    "lastName": "Medacic"
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            ],
            "abstractNote": "AbstractBackground\nElastic-stable intramedullary nailing (ESIN), is an accepted method for stabilization of unstable forearm shaft fractures in children. This study analyzed the radiographic and functional outcomes of intramedullary nailing of forearm diaphyseal fractures in children.\nMaterials and methods\nA retrospective analysis was performed of children with forearm shaft fractures and open epiphyseal plates, treated with ESIN between 2000 and 2012 in our institution. Evaluation of cases was conducted minimum 14 months after osteosynthesis. Clinical results were evaluated according to the criteria developed by Price et al. and Flynn et al.\nResults\nThe study included 88 (42 boys) children. The average age of children at day injury was 10.5 ± 2.59 years (range 4-16), and at the review clinic was 13.4 ± 1.85 years (range 7-18). Forty six (52.3 %) had right forearm and 42 (47.7%) had left fracture respectively. Open reduction was required in 20 (22.7%) children. Primarily surgically were treated 62 (70.5%) children and 26 (29.5%) were operated as a second procedure after failed conservative management. There was one delayed union. Rotational forearm restriction with values between 11 and 20 degrees was present in nine children. Six children developed radial nerve hypoesthesia which eventually resolved with time. After removal of the implant one child sustained a re-fracture. The overall complication rate was 25%. Complete recovery to the original condition was noted in 76 (86.4%) children, eleven children (12.5%) had good and only one (1.1%) had poor outcome.\nConclusion\nOur study suggests that ESIN osteosynthesis for diaphyseal forearm fractures remains a valid technique with very good functional results.",
            "publicationTitle": "Injury",
            "publisher": "",
            "place": "",
            "date": "September 2013",
            "volume": "44, Supplement 3",
            "issue": "",
            "section": "",
            "partNumber": "",
            "partTitle": "",
            "pages": "S11-S15",
            "series": "Orthopaedic Trauma Care: A Croatian Perspective",
            "seriesTitle": "",
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            "journalAbbreviation": "Injury",
            "DOI": "10.1016/S0020-1383(13)70190-6",
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            "tags": [
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                    "tag": "Children",
                    "type": 1
                },
                {
                    "tag": "Forearm fractures",
                    "type": 1
                },
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                    "tag": "Intramedullary nailing",
                    "type": 1
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            "creatorSummary": "Schone",
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        "data": {
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            "version": 5,
            "itemType": "journalArticle",
            "title": "The treatment of forearm fractures with pins.",
            "creators": [
                {
                    "creatorType": "author",
                    "firstName": "Georg",
                    "lastName": "Schone"
                }
            ],
            "abstractNote": "In the case of fractures of the middle one-third of the forearm that are several weeks old, the procedure is as follows. Use a brachial block or general anesthesia. Open the radial fracture by freeing up the fracture site and clearing the medullary canals. About a 4-cm longitudinal incision is made over the dorsal aspect of the radius at the wrist distant from the fracture and between the tendons of the extensor pollicis longus and the extensor carpi radialis longus and brevis. Make a hole in the radius with a small gouge with insertion of the pin to the fracture site and then drive it into the proximal fragment. Then cut the pin off at the right length and set it into the bone with hammer blows to the driver. Remove the driver. Check the reduction of the fracture and closure of the wound. Repeat the procedure on the ulna with the difference that the trephination of the ulna is done proximally. Apply the splint. The fracture site must be protected carefully to avoid angulation. Should this occur, it can be corrected without opening the fracture site because the pins are flexible. We have operated upon four isolated fractures of the ulna, one isolated fracture of the radius, and two fractures of both radius and ulna. I believe that the procedure is simple and practical to perform. Whether and to what extent a similar procedure can be carried out satisfactorily on other bones with larger marrow canals remains to be seen.",
            "publicationTitle": "Clinical orthopaedics and related research",
            "publisher": "",
            "place": "",
            "date": "1913",
            "volume": "",
            "issue": "234",
            "section": "",
            "partNumber": "",
            "partTitle": "",
            "pages": "2-4",
            "series": "",
            "seriesTitle": "",
            "seriesText": "",
            "journalAbbreviation": "Clin. Orthop. Relat. Res.",
            "DOI": "",
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            "url": "",
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            "ISSN": "0009-921X",
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            "shortTitle": "",
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            "callNumber": "",
            "rights": "",
            "extra": "PMID: 3044660",
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                    "type": 1
                },
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            "creatorSummary": "Sinikumpu et al.",
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            "itemType": "journalArticle",
            "title": "The increasing incidence of paediatric diaphyseal both-bone forearm fractures and their internal fixation during the last decade",
            "creators": [
                {
                    "creatorType": "author",
                    "firstName": "Juha-Jaakko",
                    "lastName": "Sinikumpu"
                },
                {
                    "creatorType": "author",
                    "firstName": "Anu",
                    "lastName": "Lautamo"
                },
                {
                    "creatorType": "author",
                    "firstName": "Tytti",
                    "lastName": "Pokka"
                },
                {
                    "creatorType": "author",
                    "firstName": "Willy",
                    "lastName": "Serlo"
                }
            ],
            "abstractNote": "Background\nThe incidence of children's forearm fractures is increasing worldwide. This is different from the declining trend observed in the overall injury rate, and the reason for the increase is not known. Diaphyseal forearm fractures comprise 3–6% of all paediatric fractures, and they offer a challenge to their treatment. The purpose of this study was to evaluate the incidence of diaphyseal both-bone forearm fractures in children during the last decade in Northern Finland. Another objective was to study the background factors, treatment, and re-displacement of these fractures.\nMaterials and methods\nAll 168 children (&lt;16 years) admitted to our paediatric trauma centre due to diaphyseal both-bone forearm fractures during 2000–2009 were included. The type of injury, background factors, radiographics, treatments and re-dislocations were reviewed. The age-related incidence rates were evaluated.\nResults\nThe incidence of diaphyseal both-bone forearm fractures increased 4.4-fold (95% CI 2.0–10.8; P &lt; 0.001) between 2000 (8.2/100 000) and 2009 (35.9/100 000). The increase in the incidence was accelerating (P &lt; 0.001) and the overall increase was 338%. The incidence of surgical treatment for diaphyseal fractures increased 4.2-fold (95% CI 1.9–10.4, P = 0.001), which is in relation to increasing number of fractures. However, internal fixation increased from 13.3% in 2000–2001 to 52.7% in 2008–2009 (P = 0.015), as an alternative to conservative treatment. The re-displacement rate was high (29.9%) amongst the patients with conservative treatment compared to those who were invasively operated (1.4%) (P &lt; 0.001). The mean age of the patients increased by 2.4 years in the study period (P = 0.019). Trampoline was the most important and still increasing reason for the fractures. At the beginning of the study, there were no trampoline-related fracture, but towards the end of the study 30–41% of the fractures were caused by a trampoline injury (P = 0.004).\nConclusions\nThere was an accelerating increase in the incidence of paediatric diaphyseal both-bone forearm fractures during the last decade. Trampoline was the most important and still increasing reason for these fractures. The mean age of the patients was increasing. Increasing proportion of diaphyseal both-bone forearm fractures was treated operatively. Re-displacement was unusual amongst operated cases.",
            "publicationTitle": "Injury",
            "publisher": "",
            "place": "",
            "date": "March 2012",
            "volume": "43",
            "issue": "3",
            "section": "",
            "partNumber": "",
            "partTitle": "",
            "pages": "362-366",
            "series": "",
            "seriesTitle": "",
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            "DOI": "10.1016/j.injury.2011.11.006",
            "citationKey": "",
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                    "tag": "Children and Adolescents",
                    "type": 1
                },
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                    "type": 1
                },
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                    "tag": "INCIDENCE",
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            "title": "Single-bone fixation of paediatric diaphyseal both-bone forearm fractures: A systematic review",
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            "title": "Use of elastic stable intramedullary nailing for treating unstable forearm fractures in children",
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                    "creatorType": "author",
                    "firstName": "Neeraj Kumar",
                    "lastName": "Garg"
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                {
                    "creatorType": "author",
                    "firstName": "Moez S",
                    "lastName": "Ballal"
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                {
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                    "firstName": "Ibrahim A",
                    "lastName": "Malek"
                },
                {
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                    "firstName": "Roshin A",
                    "lastName": "Webster"
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                    "firstName": "Colin E",
                    "lastName": "Bruce"
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            ],
            "abstractNote": "BACKGROUND: The majority of the pediatric diaphyseal forearm fractures are treated with closed reduction and the application of an above elbow cast for a varying period, depending on the age of the child. Some forearm diaphyseal fractures require osteosynthesis mainly because of the presence of an unacceptable angular deformity, fracture instability, presence of an open injury or failure of conservative management in the form of redisplacement in the cast after manipulation.\nMETHODS: We present our experience with elastic stable intramedullary nailing (ESIN) for displaced and unstable pediatric diaphyseal fractures. A consecutive series of 21 patients treated with ESIN between 1997 and 2005 have been reviewed retrospectively. There were 14 boys and 7 girls with a median age of 11.8 years. All fixations were protected in an above elbow plaster cast. Patients were followed up for an average of 12.8 months (Range, 12-21.5 months).\nRESULTS: Clinical and radiologic union was achieved within 13 weeks after the procedure in 19 children. One patient had delayed union of the ulna which finally united at 9 months after operation without any further intervention. Another patient had nonunion of ulna that required autologous bone marrow injection after 1 year before full consolidation occurred. Complications were all modest and transient and eventually all patients achieved a good functional clinical outcome.\nCONCLUSION: We think that the technique has many merits over a more traditional plating technique including a minimally invasive technique, a less time consuming procedure and easier metal work removal. We think that cosmesis is perhaps the most important to our patients because the wounds are small and less conspicuous than the traditional Henry approach for plating which leaves a long unsightly volar forearm scar. We think that ESIN is an attractive treatment option for displaced and unstable diaphyseal forearm fractures in children.",
            "publicationTitle": "The Journal of trauma",
            "publisher": "",
            "place": "",
            "date": "Jul 2008",
            "volume": "65",
            "issue": "1",
            "section": "",
            "partNumber": "",
            "partTitle": "",
            "pages": "109-115",
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            "seriesTitle": "",
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            "PMCID": "",
            "ISSN": "1529-8809",
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            "shortTitle": "",
            "language": "eng",
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            "callNumber": "",
            "rights": "",
            "extra": "PMID: 18580539",
            "tags": [
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                    "tag": "Adolescent",
                    "type": 1
                },
                {
                    "tag": "Bone Nails",
                    "type": 1
                },
                {
                    "tag": "Child",
                    "type": 1
                },
                {
                    "tag": "Child, Preschool",
                    "type": 1
                },
                {
                    "tag": "Cohort Studies",
                    "type": 1
                },
                {
                    "tag": "Diaphyses",
                    "type": 1
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                {
                    "tag": "Elasticity",
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                    "tag": "Equipment Design",
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                    "tag": "Fracture Fixation, Intramedullary",
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                {
                    "tag": "Humans",
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                    "tag": "Male",
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                    "type": 1
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                    "tag": "Recovery of Function",
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                    "type": 1
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                    "tag": "Ulna Fractures",
                    "type": 1
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            "creatorSummary": "Alam et al.",
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            "itemType": "journalArticle",
            "title": "Unstable Fracture of Radius and Ulna Outcome of Intramedullary Kirschner Wire Fixation in Children",
            "creators": [
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                    "creatorType": "author",
                    "firstName": "Waqar",
                    "lastName": "Alam"
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                {
                    "creatorType": "author",
                    "firstName": "Faaiz",
                    "lastName": "Ali Shah"
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                    "creatorType": "author",
                    "firstName": "Zafar",
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                {
                    "creatorType": "author",
                    "firstName": "Zahid",
                    "lastName": "Askar"
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                {
                    "creatorType": "author",
                    "firstName": "Muhammad",
                    "lastName": "Ayaz Khan"
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                    "firstName": "Sikandar",
                    "lastName": "Hayat"
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            ],
            "abstractNote": "Objectives: To know the functional outcome of Intramedullary Kirschner Wire fixation of unstable Radius-Ulna fractures in children. Study Design: Descriptive study. Period: 27/03/2009 to 26/03/2010. Setting: Department of Orthopedic and Trauma, Khyber Teaching Hospital, Peshawar. Patients and Methods: All patients were admitted from OPD . Children less than 16 years with Unstable Radius-Ulna fractures were included in the study. Patients with open fractures and adults with polytrauma were excluded from the study. Unstable Radius-Ulna fractures were treated by Intramedullary Kirschner Wire fixation under general anesthesia and tourniquet control. Follow up till radiological and clinical union was done. K-wires were removed after healing of fractures. Patients were assessed functionally and radiologically and results were graded according to Price et al Criteria. Results: A total of 64 children with unstable radius and ulna fractures were included in the study. The age range was 6 to 15 years with average age of 10.41 years. 47 were male and 17 were female. The average time of radiological union was 7 weeks and K-wires were removed at 8 weeks time. At final assessment there were 47 Excellent, 10 Good and 7 Fair results. Conclusions: Excellent results can be achieved by Intramedullary K-Wires fixation. In children with unstable Radius-Ulna fractures. It should be the method of choice for treating these fractures.",
            "publicationTitle": "Professional Medical Journal",
            "publisher": "",
            "place": "",
            "date": "May 2011",
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            "issue": "2",
            "section": "",
            "partNumber": "",
            "partTitle": "",
            "pages": "323-327",
            "series": "",
            "seriesTitle": "",
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            "url": "http://www.proxy.its.virginia.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=65481556&site=ehost-live",
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                    "type": 1
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                    "tag": "FRACTURE fixation",
                    "type": 1
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                    "tag": "INTRAMEDULLARY fracture fixation",
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                    "tag": "K-Wire fixation",
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                    "tag": "RADIUS (Anatomy) -- Wounds & injuries",
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                    "tag": "ULNA injuries",
                    "type": 1
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                {
                    "tag": "Unstable Radius-Ulna fractures",
                    "type": 1
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            "creatorSummary": "Trlica et al.",
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            "version": 5,
            "itemType": "journalArticle",
            "title": "[True/Flex intramedullary nailing for forearm shaft fractures. Long-term results]",
            "creators": [
                {
                    "creatorType": "author",
                    "firstName": "J",
                    "lastName": "Trlica"
                },
                {
                    "creatorType": "author",
                    "firstName": "I",
                    "lastName": "Počepcov"
                },
                {
                    "creatorType": "author",
                    "firstName": "J",
                    "lastName": "Kočí"
                },
                {
                    "creatorType": "author",
                    "firstName": "M",
                    "lastName": "Frank"
                },
                {
                    "creatorType": "author",
                    "firstName": "T",
                    "lastName": "Holeček"
                },
                {
                    "creatorType": "author",
                    "firstName": "T",
                    "lastName": "Dědek"
                }
            ],
            "abstractNote": "PURPOSE OF THE STUDY: Presentation of technical experience and the clinical and functional results of intramedullary fixation of forearm shaft fractures.\nMATERIAL AND METHODS: Between January 1994 and December 2009, a total of 96 patients with 144 radial and/or ulnar fractures (ulna, 33; radius,15; both, 48) were treated by nailing (True/Flex®). According to the AO classification there were 22-A, 22-B and 22-C type fractures in 39 (41%), 44 (46%) and 13 (13%).cases, respectively. Of these, 82 (85%) were closed (types: 0, 48; I, 33; II, 1) and 14 (15%) were open (types: I, 13; II, 1; III, 0) fractures. Seventy-eight patients (81%) were followed up and their functional outcomes were evaluated according to the criteria of Anderson et al. The average interval between the operation and final follow-up was 28 months (15 to 96 months)\nRESULTS: The average time to surgery was 2.2 days (0 to 25 days). Early complications were recorded in 4% of the patients (1x bursitis olecrani; 1x end cup replacement; 1x bending of nails) and late complications in 15% (5x non-union; 2x delay union; 4x bursitis olecrani; 1x ruptured tendon). Bone healing was achieved in 95% of the cases and took on average 16 weeks (7 to 34 weeks). No infection, refracture or synostosis occurred. Primary loss of reduction was recorded in four cases due to distraction in one, bent nails in two and a wrong size of the implant in one; secondary loss of reduction was found in three cases, with two cases of radius shortening and one 10°malrotation. No primary malrotation was recorded, but secondary loss of alignment was seen in the distal part of the radius and the proximal part of the ulna. Functional results according to the Anderson criteria were excellent and good in 87% of the cases.\nDISCUSSION: Intramedullary mailing provides good stability to mid- and distal-third shaft fractures of the ulna and mid- and proximalthird shaft fractures of the radius, particularly in AO type A and type B fractures. The technical aspects of the method are analysed in detail in this paper.\nCONCLUSIONS: True/Flex® intramedullary nailing, because of its minimally invasive approach and close reduction, allows us to minimise the risk of wound and neurovascular complications, especially in proximal shaft fractures of the radius.",
            "publicationTitle": "Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca",
            "publisher": "",
            "place": "",
            "date": "2012",
            "volume": "79",
            "issue": "4",
            "section": "",
            "partNumber": "",
            "partTitle": "",
            "pages": "347-354",
            "series": "",
            "seriesTitle": "",
            "seriesText": "",
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            "DOI": "",
            "citationKey": "",
            "url": "",
            "accessDate": "",
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            "PMCID": "",
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            "language": "cze",
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            "extra": "PMID: 22980934",
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                    "type": 1
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                    "type": 1
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            "title": "Trends in Fracture Incidence: A Population-Based Study Over 20 Years",
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                    "firstName": "Shreyasee",
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            "abstractNote": "To assess recent trends in fracture incidence from all causes at all skeletal sites, we used the comprehensive (inpatient and outpatient) data resources of the Rochester Epidemiology Project to estimate rates for Olmsted County, MN, USA, residents in 2009 to 2011 compared with similar data from 1989 to 1991. During the 3-year study period, 2009 to 2011, 3549 residents ≥50 years of age experienced 5244 separate fractures. The age- and sex-adjusted (to the 2010 US white population) incidence of any fracture was 2704 per 100,000 person-years (95% confidence interval [CI] 2614 to 2793) and that for all fractures was 4017 per 100,000 (95% CI 3908 to 4127). Fracture incidence increased with age in both sexes, but age-adjusted rates were 49% greater among the women. Overall, comparably adjusted fracture incidence rates increased by 11% (from 3627 to 4017 per 100,000 person-years; p = 0.008) between 1989 to 1991 and 2009 to 2011. This was mainly attributable to a substantial increase in vertebral fractures (+47% for both sexes combined), which was partially offset by a decline in hip fractures (−25%) among the women. There was also a 26% reduction in distal forearm fractures among the women; an increase in distal forearm fractures among men aged 50 years and over was not statistically significant. The dramatic increase in vertebral fractures, seen in both sexes and especially after age 75 years, was attributable in part to incidentally diagnosed vertebral fractures. However, the fall in hip fracture incidence, observed in most age groups, continues the steady decline observed among women in this community since 1950. More generally, these data indicate that the dramatic increases in the incidence of fractures at many skeletal sites that were observed decades ago have now stabilized. © 2014 American Society for Bone and Mineral Research.",
            "publicationTitle": "Journal of Bone and Mineral Research",
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            "date": "March 1, 2014",
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            "pages": "581-589",
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            "title": "Treatment of Forearm Shaft Fractures by Double-Plating",
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            "abstractNote": "A PRELIMINARY REPORTJACK P. SARGENT and WILLIAM A. TEIPNER333 Marsh Avenue, Reno, Nevada 89502Abstract\nTwenty-nine diaphyseal fractures of the forearm in twenty-one patients were treated by the double-plate method with primary bone union in 100 per cent of them. Complications were two refractures after removal of the plates and screws, one minor infections, and two cases of radio-ulnar synostosis. Funtional results in the majority of cases were excellent.\nThe double-plate method provides rigid internal fixation, anatomical restoration of the bone, obviation of external immobilization, and early restoration of function.\nIt is our impressions that, even though the double-plate method is technically difficult, it may have much to offer its the solution of the many problems encountered in the management of forearns fractures in adults.\nCopyright © 1965 by The Journal of Bone and Joint Surgery, Incorporated",
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