Zeitschrift für Orthopädie und Unfallchirurgie
-
Comparative Study
[Distal intraarticular humerus fracture in the elderly: prosthesis or osteosynthesis?].
The distal intraarticular fracture of the humerus, even in elderly patients, was treated so far with internal osteosynthesis. Due to the poor bone stock, in association with a complex fracture site, the achieved results may be disappointing. The use of an elbow joint prosthesis may be a solution for these specific problems in elderly patients as long as one takes the features of the prosthesis into account. ⋯ We recommend osteosynthetic management of type B fractures. The appropriate treatment of C-type fractures remains demanding and leads in cases of reduction malalignment with supportive immobilisation to poor results. Here the primarily implanted elbow prosthesis provides a safe solution for a painfree, stable and mobile joint.
-
Comparative Study
[Clinical and radiological results after distal radius fracture: intramedullary locking nail versus volar locking plate osteosynthesis].
Treatment of distal radius fractures with the volar locking plate provides a stable fixation and early postoperative function. However, after intramedullary osteosynthesis systems for long bones had been established an intramedullary locking nail (Targon DR, Aesculap) for treatment of distal radius fractures was developed. Thus, the aim of this study was to compare the outcomes after volar locking plate osteosynthesis (Aptus, Medartis) and intramedullary osteosynthesis (Targon DR nail) for the distal radius. ⋯ The compared osteosynthesis systems achieved equally good functional outcomes after distal radius fractures. However, patients treated with the Targon DR nail showed a superior subjective satisfaction, probably because of the less invasive surgical approach.
-
Femoral neck fractures after seizure are rare. This injury can easily be underdiagnosed due to generalised, musculoskeletal pain after seizure. In case of persisting groin pain and limited range of motion X-rays are indicated. ⋯ After a delayed diagnosis total hip arthroplasty is necessary. As the result of prolonged intra-articular haematoma the incidence of a femoral head necrosis increases. When choosing the implant, an elevated risk of joint dislocation should be considered.
-
The aim of the study was to evaluate the application of a locked internal fixator in complex fractures of the proximal femur, in which the internal fixation with standard implants was not possible due to poor quality of bone or already failed internal fixation in the past. ⋯ The "reversed" locked internal fixator could be a successful alternative implant for stabilisation of proximal femur fractures which could not be fixated by standard implants due to poor bone quality and circulation. It can also be used as a salvage procedure after internal failed fixation in proximal femur fractures.