Journal of Database Reviews

Comments summarizing SIGN’s reviews of cases from the surgical database.

Proximal Tibia Fractures – Reduction and Stabilization

The literature has many articles about reduction of proximal tibia fractures. These include using blocking screws, provisional plating and suprapatella approach( the fracture is reamed and the nail is introduced above the patella to enter the bone entrance of the tibia) SIGN surgeons have solved the problem of reduction of the proximal tibia by using the figure 4 position as shown in the...

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Complications Resulting In Instrument Damage

Complications resulting in instrument damage: striking the cutting edges of instruments such as reamers, step drills and drill bits. These nicks cause the cutting edges to heat up during use and become dull. All of us have felt a hot drillbit after we remove it. Allowing the drillbit to spin rapidly without advancing in the bone. The drillbit will heat up and become dull not removing the bone...

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Aspects of the SIGN Technique

During travel I have a chance to think about different aspects of SIGN technique. We are grateful to our friends in Vietnam and Laos for their hospitality during recent trip. Points to ponder During reaming, sometimes the reamer does not advance. Reason – the canal is oval and the reamer may be out of the track reamed by previous reamers. The surgeon should feel the reamer reaming the canal...

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Two Proximal Interlocking Screws vs. One

Fractures in the proximal femur if treated by antegrade approach should be stabilized by two interlocking screws in the proximal fragment. Reason the gluteus medius and minimus cause the proximal fragment to abduct. The piriformis, gemellus  superior and inferior cause the proximal fragment to externally rotate. The psoas, which may be detached  by a fracture through the lesser trochanter, is a...

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