Zeitschrift für Orthopädie und Unfallchirurgie
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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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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.
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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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Also after bagatelle trauma, some patients can develop a complex regional pain syndrome (CRPS). The limb concerned usually shows a marked temperature difference to the contralateral side. Apart from a doughy swelling, the patient is impaired in particular by burning pain and a restricted range of motion. The objective of the present study was to examine the influence of early thoracic sympathetic nerve blockade on the basis of clinical and quantified blood flow parameters. ⋯ Outpatient CT-assisted temporary sympathetic nerve blockade is an effective and low-complication therapeutic option for the supportive treatment of patients with CRPS.