Musculoskeletal surgery
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Musculoskeletal surgery · Apr 2019
Meta AnalysisReconstruction of failed acetabular component in the presence of severe acetabular bone loss: a systematic review.
Acetabular revision especially in the presence of severe bone loss is challenging. There is a paucity of literature critiquing contemporary techniques of revision acetabular reconstruction and their outcomes. The purpose of this study was to systematically review the literature and to report clinical outcomes and survival of contemporary acetabular revision arthroplasty techniques (tantalum metal shells, uncemented revision jumbo shells, reinforced cages and rings, oblong shells and custom-made triflange constructs). ⋯ The most common postoperative complication reported in all groups was dislocation. This review confirms successful acetabular reconstructions using diverse techniques depending on the type of bone loss and highlights key features and outcomes of different techniques. In particular, oblong cups and tantalum shells have successful survivorship.
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Musculoskeletal surgery · Apr 2019
Tibial pilon fractures treated with hybrid external fixator: analysis of 75 cases.
The treatment of tibial pilon fractures is a surgical challenge due to the particular anatomical and vascular characteristics of this area, and the severity of the injury that can compromise soft tissues. Nowadays there is no gold-standard treatment for these fractures. ⋯ According to the recent literature, we think that the best treatment for non-articular fracture is the internal osteosynthesis within 6 h or after 6 days from trauma. In articular fractures, the elective treatment is the two-step management. In complicated articular fractures (Tscherne > 2, open, comminuted type III) is highly indicated the external fixation combined with minimal internal synthesis.
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Musculoskeletal surgery · Oct 2018
Review Case ReportsAnnular ligament reconstruction in chronic Monteggia fracture-dislocations in the adult population: indications and surgical technique.
Chronic Monteggia fracture is defined as dislocation of the radial head that is still present 4 weeks after injury. The cause may reside in residual ulnar deformity after internal fixation, in failure of annular ligament healing, or both. This situation may lead to elbow pain, decreased motion, neurologic problems and valgus deformity. ⋯ ALR has been advocated to address radial head instability both combined with ulna osteotomy and as a single procedure, with several surgical techniques described and controversial results reported. A modified Bell Tawse surgical technique resulted to be effective in the presented case. ALR seems to be indicated in chronic Monteggia fractures with normal bony alignment, without conclusive evidence on a preferable surgical technique.
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Musculoskeletal surgery · Oct 2018
Comparative StudyComparison of CFR-PEEK and conventional titanium locking plates for proximal humeral fractures: a retrospective controlled study of patient outcomes.
Metal plates are the fixation devices used most frequently to proximal humeral fractures (PHFs). However, in recent years carbon fiber-reinforced polyetheretherketone (CFR-PEEK) plates have become increasingly common. This study compares the clinical and radiographic outcomes of 42 Neer three- and four-part PHFs treated with CFR-PEEK or metal (titanium) plates. ⋯ CFR-PEEK plates provide a viable alternative to conventional titanium plates in PHFs, ensuring similar clinical outcomes and a lower rate of tuberosity resorption, but they involve higher stress shielding under the plate.