Zeitschrift für Orthopädie und Unfallchirurgie
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Comparative Study
[Results after replacement of femoral neck prostheses - thrust plate prosthesis (TPP) versus ESKA cut prosthesis].
The aim of this study was to analyse and evaluate comparatively loosening mechanisms, failure frequency, surgical changing strategies and results after replacement of thrust plate prostheses (TPP) and ESKA Cut prostheses. ⋯ In comparison with the usually problem-free changing procedure of the TPP to a standard type stem, the revision surgery of the Cut prosthesis becomes substantially more complex and leads frequently to complications. In view of unacceptable survival rates, the Cut prosthesis does not represent an alternative implant in young patients. Except for the implantation technique, which does not allow a less invasive surgical procedure, the TPP fulfils the requirements of femoral neck prosthesis due to acceptable survival rates and good convertibility.
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Correction of severe tibial deformity due to a non-union of the tibia is best achieved by a slow gradual correction which allows the compromised tissue to adapt. The Taylor spatial frame (TSF) is a hexapod-based ring fixator that allows a simultaneous gradual correction of a multiplanar deformity through a virtual hinge. The aim of this study was to demonstrate the application of the TSF and the clinical outcomes of ten patients with a non-union of the tibia. ⋯ In patients with either a hypertrophic or oligotrophic non-union of the tibia and severe deformity, the TSF is a powerful tool to correct the deformity in a closed manner which preserves the remaining viability of the non-union.
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Comparative Study
[Intraoperative control of pedicle screw position using three-dimensional fluoroscopy. A prospective study in thoracolumbar fractures].
Screw misplacement affects the stability of the internal fixateur and may cause neurovascular complications. However, only a computer tomographic scan can show the exact position of the screws. This study was undertaken to assess the reliability of intraoperative three-dimensional imaging (3-D) to view screw positions. ⋯ Intraoperative imaging by 3-D fluoroscopy can predict very exactly the position of pedicle screws, especially, when a good scan quality is available and the spine section viewed is T 11-L 5. The scan offers the advantage of immediate correction of screw malposition. Thus, computer tomography to control pedicle screw position is dispensable.
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We report the case of an 82-year-old man with a pertrochanteric fracture of the hip and an avulsion of the lesser trochanter. During the third postoperative week after unproblematic correction with a gamma nail, a swelling of the proximal thigh occurred. Angiographs showed a false aneurysm of the deep femoral artery which was treated by suture.
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The aim of this study was to find the correct angle of the needle position for the epidural perineural injection at the lumbar spine without any help by imaging. ⋯ With some training it is possible to perform epidural-perineural injection for sciatica without the help of imaging.