Zeitschrift für Orthopädie und Unfallchirurgie
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Randomized Controlled Trial Comparative Study
[Intramedullary osteosynthesis in fractures of the mid-third of the clavicle in sports traumatology].
In Germany, non-operative treatment using a figure of eight dressing is the most common method for managing fractures of the mid-third of the clavicle. This treatment is chosen preferably even in cases of dislocated fractures. The described procedures of open osteosynthesis are characterised by a huge access trauma. Up to date literature shows the advantages of intramedullary pin osteosynthesis, which can be considered as a minimally invasive procedure. In this study we compare the results of pin-osteosynthesis with the non-operative treatment in athletes. ⋯ The intramedullary titanium pin osteosynthesis is a promising alternative with better results. Up to date literature and our own results prove the advantages of this minimally invasive osteosynthesis. This procedure allows sports activities to be resumed soon after the operation. As intramedullary pin osteosynthesis is an ideal operation of fractures of the middle third of the clavicle, this comparatively easy procedure with few complications should be more widespread.
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Periprosthetic fractures in cases without prior loosening of the stem can be treated with open reduction and internal fixation, but cases with preexisting loosening and/or bone defects present specific challenges to the surgeon. The keys to the success of intramedullary stabilization of femoral fractures--reconstruction of length, axis and rotation rather than meticulous reduction of the fragments and minimal impact on fragment vascularization by the surgical approach--can be transferred to the treatment of periprosthetic fractures. ⋯ In conclusion, combined application of the principles of intramedullary nailing and of uncemented total hip replacement by use of the distally interlocked Bicontact revision stem enables successful treatment of periprosthetic femoral fractures.
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The aim of the study was the evaluation of the medium- to long-term results of the cementless Bicontact SD hip arthroplasty, which was designed specially for narrow femoral medullary cavities. ⋯ The clinical and radiological results confirmed the proximal fixation concept in dysplastic femurs and narrow medullary cavities.