Musculoskeletal surgery
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Musculoskeletal surgery · Aug 2012
Comparative StudyA comparison of intramedullary nailing and plate-screw fixation in the treatment for ipsilateral fracture of the hip and femoral shaft.
We compared the outcomes of intramedullary nailing with plate-screw fixation in the treatment for ipsilateral fracture of the hip and femoral shaft. A retrospective study. Level 1 Trauma. ⋯ Although Group I had more nonunions, delayed unions, and revision operations than Group II, the total union time was similar for both groups. Intramedullary nailing was found to be superior to screw-plate fixation due to improved functional bearing, increased rate of union, stability, and mechanical solidity. The reconstruction nail method is an acceptable alternative treatment for ipsilateral hip and femoral shaft fractures.
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Musculoskeletal surgery · Jun 2012
ReviewCoronal fractures of the medial femoral condyle: a series of 6 cases and review of literature.
Isolated coronal fracture of medial femoral condyle with intact lateral femoral condyle is extremely rare. We present our experience with such 6 cases of coronal fractures of medial femoral condyle. We reviewed all case records of cases of coronal fractures of femoral condyle which presented to our centre from Jan 2000 to Jun 2009. ⋯ A high index of suspicion is necessary for early diagnosis especially in cases of undisplaced fractures. Being intra-articular, the ideal management includes open reduction and internal fixation. Medial or antero-medial approach with antero-posterior screws is the preferred method for fixation.
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This study examines 32 patients operated for radial head fractures, mean age 48.7 years (range 26-76 years), Mason type II in 25 cases and Mason type III with 3 main fragments in 7 cases. Fractures were surgically reduced and fixed with Herbert's (12 cases) or Osteomed (20 cases) cannulated screws. The latter have a head that is <1 mm high and are only threaded distally. ⋯ We believe that fixation can be carried out with screws alone, which are less invasive, and that the screw heads should preferably be completely buried, to avoid stiffness in prono-supination. In addition, suturing of the annular ligament and the joint capsule is made easier by the reduced invasiveness of screws. Screw treatment is effective in non-comminuted fractures of the radial head.
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Musculoskeletal surgery · Dec 2011
Treatment of humeral shaft fractures with antegrade intramedullary locking nail.
Antegrade interlocked humeral nailing for stabilization of humeral fractures was introduced many years ago, and studies on this method in the orthopedic literature have shown mixed results. The purpose of this investigation was to document the clinical outcome and complications associated with the use of an antegrade intramedullary nail (T2, Stryker) for the humeral fractures. Between 2005 and 2008, 52 fractures of the humeral shaft were treated operatively with this intramedullary nail in our department. ⋯ Antegrade humeral nailing is a valid therapeutic option for stabilization of humeral shaft fractures. By strictly adhering to the operation technique, the number and the severity of complications can be reduced. When good fracture alignment and stability are obtained, uneventful bone healing with good functional results is the rule.
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Musculoskeletal surgery · Aug 2011
Case ReportsA technique for treating patello-femoral instability in immature patients: the tibial tubercle periosteum transfer.
Patello-femoral problems are frequently encountered in knee clinic. The most important role of the patella is to increase the quadriceps efficiency, although this function could be altered in the patello-femoral instability. Active stability of the patello-femoral joint is provided by the surrounding muscles and ligaments, passive stability is provided by the bony and cartilage structures. ⋯ Every time should be performed careful radiological preoperative investigations (radiographs and computed tomography) involving an expert musculoskeletal radiologist. Surgical procedures may be divided into those that address the soft tissues (muscles and ligaments), generally on the immature skeletal, and those that effect bony changes, generally on the mature skeletal; sometimes, it is necessary to combine soft-tissue and bony procedures. In this report, the authors describe a tibial tubercle periosteum transfer technique for patello-femoral instability in immature patients, which may potentially improve clinical results in very young symptomatic patients with patello-femoral instability.