A cadaveric model for biomechanical study of fixation methods for AO type C2 fractures of distal radius: design and testing with dorsal plating fixation.

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Prospectively recorded versus medical record-derived spinal cord Injury scores in dogs with intervertebral disk herniation

BACKGROUND : Validated spinal cord injury (SCI) scores have been established for veterinary species but are not uniformly used in practice. HYPOTHESIS/OBJECTIVES : To determine the level of agreement of SCI scores at the time of admission versus those assigned from reconstructed medical records in a population of dogs with intervertebral disk herniation (IVDH). ANIMALS : Eighty-six client-owned dogs with confirmed IVDH. METHODS : Retrospective study. Medical records were reviewed for history, physical examination, neurologic examination, and recorded Modified Frankel score (MFS) and Texas spinal cord injury score (TSCIS) at the time of admission. Three raters, all board-certified neurologists, assigned MFS and TSCIS based on digitized abstracted medical records to each patient. These scores were then compared to the recorded score at the time of admission. RESULTS : Actual agreement for MFS and TSCIS derived from medical records by the 3 raters compared to prospectively derived MFS and TSCIS was 77.9 and 51.2%, respectively. A kappa value of 0.572 (95% CI 0.450, 0.694; P < .001) and an ICC of 0.533 (95% CI 0.410, 0.646; P < .001) were calculated for MFS scores. A kappa value of 0.100 (95% CI 0.000, 0.222; P = .107), and an ICC of 0.503 (95% CI 0.377, 0.620; P < .001) were calculated for TSCIS scores. CONCLUSIONS AND CLINICAL IMPORTANCE : Results showed that SCI scores recorded at the time of admission often do not agree with those retrospectively abstracted from medical records. Agreement was less when using the more complex TSCIS scale and therefore the MFS scale might be more appropriate for use in retrospective studieshttp://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1939-1676hb2013ab201

Biomechanical evaluation of plate osteosynthesis for AO type C2 fracture of the distal radius: A cadaver study

An AO type C2 distal radius fracture was simulated in a cadaver model by creating a metaphyseal defect of 5 mm and an intra-articular defect of 2 mm. Five different methods of plate osteosynthesis were tested biomechanically in each of six fresh cadaveric hands. Biomechanical testing suggested that cement augmented plating plus screws in the distal fragment was the strongest. Dorsal and volar plating plus screws on both sides of the distal fragment had the same effect of restoring stiffness and load transmission pattern as fixation with double plating plus volar screws alone. Fixation with plating plus dorsal screws was significantly weaker than these three methods, and double buttress plating with no screws in the distal fragments was the weakest