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Articular Fractures: Does an Anatomic Reduction Really Change the Result?*
J. L. Marsh, MD; J. Buckwalter, MD; R. Gelberman, MD; D. Dirschl, MD; S. Olson, MD; T. Brown, PhD; A. Llinias
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J.L. Marsh, MD
J. Buckwalter, MD
T. Brown, PhD
Departments of Orthopaedics (J.L.M. and J.B.) and Orthopaedic and Biomechanical Engineering (T.B.), The University of Iowa Hospitals and Clinics, 01071 Pappajohn Pavilion, Iowa City, IA 52242. E-mail for J.L. Marsh: j-marsh@uiowa.edu

R. Gelberman, MD
Department of Orthopaedic Surgery, Washington University School of Medicine, One Barnes-Jewish Hospital Plaza, Suite 11300, St. Louis, MO 63110

D. Dirschl, MD
Department of Orthopaedics and Rehabilitation, Oregon Health and Sciences University, 3181 S.W. Sam Jackson Park Road, OP31, Portland, OR 97201

S. Olson, MD
Department of Orthopaedics, Duke University Medical Center, Trent Drive, Orange Zone, Room 5739, Durham, NC 27710

A. Llinias
Department of Orthopaedics and Traumatology, Fundacion Santa Fe de Bogota, Avenida 9 #117-20, Suite 811, Bogota, Colombia

The authors did not receive grants or outside funding in support of their research or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

*This report is based on a symposium presented at the Annual Meeting of the American Orthopaedic Association on June 14, 2001, in Palm Beach, Florida.

J Bone Joint Surg Am, 2002 Jul 01;84(7):1259-1271
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The effects of injury to the articular cartilage sustained during articular fracture and the effect of treatment interventions on joint function and preservation are poorly understood. Surgeons do not have good data on which to base treatment decisions, and widely held beliefs are not always supported by data. Which fractures benefit from surgery to restore the articular surface? To what degree does the articular surface need to be reduced to predict a favorable outcome? How can we accurately assess the amount of displacement? What is the effect of the articular injury compared with residual displacement on the eventual outcome? These questions were addressed at a symposium presented at the Annual Meeting of the American Orthopaedic Association in June 2001. The evidence to answer the question that was raised in the title of the symposium-"Does an anatomic reduction really change the result?"-is not necessarily adequate.
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