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Background With the ubiquity of digital radiographs, the use of digital templating for arthroplasty has become commonplace. Although improved accuracy with digital radiographs and magnification markers is assumed, it has not been shown. Questions/PurposesWe wanted to (1) evaluate the accuracy of magnification markers in estimating the magnification of the true hip and (2) determine if the use of magnification markers improves on older techniques of assuming a magnification of 20% for all patients. Methods Between April 2013 and September 2013 we collected 100 AP pelvis radiographs of patients who had a THA prosthesis in situ and a magnification marker placed per the manufacturer's instructions. Radiographs seen during our standard radiographic review process, which met our inclusion criteria (AP pelvic view that included a well-positioned and observed magnification marker, and a prior total hip replacement with a known femoral head size), were included in the analysis. We then used OrthoView TM software program to calculate magnification of the radiograph using the magnification marker (measured magnification) and the femoral head of known size (true magnification). Results The mean true magnification using the femoral head was 21% (SD, 2%). The mean magnification using the marker was 15% (SD, 5%). The 95% CI for the mean difference between the two measurements was 6% to 7% (p \ 0.001). The use of a magnification marker to estimate magnification at the level of the hip using standard radiographic techniques was shown in this study to routinely underestimate the magnification of the radiograph using an arthroplasty femoral head of known diameter as the reference. If we assume a magnification of 20%, this more closely approximated the true magnification routinely. With this assumption, we were within 2% magnification in 64 of the 100 hips and off by 4% or more in only four hips. In contrast, using the magnification marker we were within 2% of true magnification in only 20 hips and were off by 4% or more in 59 hips. Conclusion We found the use of a magnification marker with digital radiographs for preoperative templating to be

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Introduction We retrospectively compared the outcomes of open reduction and internal fixation (ORIF) with volar locking plate versus standard external fixation and percutaneous pinning in treating similar unstable distal radius fractures with a minimum 2-year follow-up. Methods The ORIF group included 41 patients with an average follow-up of 29 months. The external fixation group comprised 14 patients with an average follow-up of 33 months. Average age at presentation was 45 years in the external fixation group and 48 years in the ORIF group. The male/female ratios were 16:25 among the ORIF group and 6:8 in the external fixation group. The two groups were compared for clinical and functional outcomes measured by the disabilities of the arm, shoulder, and hand (DASH) score. Pain scores were similar. Radiographic measurements were also evaluated between groups. Results Final ranges of motion and grip strengths were similar between the two groups. The mean DASH score of the locked volar plate group was 9 compared to 23 for the external fixation group. Radiographically, volar tilt and radial length were significantly better in the patients treated with ORIF. The ORIF group required less therapy visits. No complications occurred in the locked volar plate group whereas two patients had pin tract infections and one had prolonged finger stiffness in the external fixation group. ConclusionLocked volar plating compares favorably to external fixation and pinning for amenable fracture patterns. Whereas grip and range-of-motion data were similar, DASH scores, frequency of rehabilitation, and some radiographic parameters were superior in patients treated with ORIF.

This investigation suggests that up to 5 mm of physiologic motion can occur at the pubic symphysis in asymptomatic individuals, as demonstrated by alternating-single-leg-stance radiographs.

A torn acetabular labrum is a well-documented source of hip pain, but the mechanism of injury is debated because the relationship between the bone morphology and labral tears is poorly understood. We compared hips with and without labral abnormalities to determine the relative incidence of morphologic abnormalities. The study group consisted of patients with a labral tear confirmed by arthroscopy or arthrotomy at the time of open débridement or periacetabular osteotomy. We compared the affected hip with the contralateral, unaffected hip to ascertain signs of hip dysplasia and impingement. We observed differences in the center edge angle, acetabular depth to width index, acetabular index of elevation, femoral head extrusion, lateral and superior subluxation, Sharp's angle, peak to edge distance, and acetabular retroversion. Similar differences occurred in the subgroup analyses. Symptomatic labral tears correlated with abnormal hip morphology as reflected by radiographic measurements of dysplasia and impingement. This relationship occurred in patients with hip dysplasia and patients without obvious femoral head uncovering. Our findings suggest abnormal hip morphology may be a risk factor for labral tears.

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