Orthopaedic surgery
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Orthopaedic surgery · Nov 2013
Case ReportsIs webbing (pterygia) a constant feature in patients with Escobar syndrome?
We describe two unrelated patients aged 9 and 12 years. The first patient presented with multiple congenital contractures not associated with webbing (pterygia). ⋯ Both patients manifested the typical facial features suggestive of Escobar syndrome. The aim of this paper is twofold: first, to illustrate that the absence of popliteal webbing is not a sufficient reason to exclude Escobar syndrome in patients with multiple contractures and second, dysmorphic facial features and the presence of certain radiological abnormalities might be considered baseline diagnostic tools in favor of this syndromic entity.
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Orthopaedic surgery · Nov 2013
Biomechanical assessment of unilateral pedicle screws plus contralateral transfacetopedicular screws after transforaminal lumbar interbody fusion with two cages.
To assess the biomechanical stability of unilateral pedicle screws (UPS) plus contralateral transfacetopedicular screws (TFPS) after transforaminal lumbar interbody fusion (TLIF) with two cages. ⋯ Because the UPS construct provides the least stability, especially during lateral bending and rotation, it should be used prudently. After TLIF with two cages, UPS plus TFPS provides stability comparable to that of TLIF with BPS. It is thus an acceptable option in minimally invasive surgery.
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Anterior lumbar interbody fusion (ALIF) has become a widely recognized surgical technique for degenerative pathology of the lumbar spine. Spinal fusion has evolved dramatically ever since the first successful internal fixation by Hadra in 1891 who used a posterior approach to wire adjacent cervical vertebrae in the treatment of fracture-dislocation. ⋯ Despite being an established treatment modality, current indications of ALIF are yet to be clearly defined in the literature. This article discusses the current literature on indications on ALIF surgery.
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Orthopaedic surgery · Aug 2013
Locking plate fixation of periprosthetic femur fractures with and without cerclage wires.
The number of patients requiring knee and hip arthroplasty has been steadily increasing, and periprosthetic fractures are on the rise. Locking plates are the most common treatment for periprosthetic fractures, but the use of cerclage wires with locking plate fixation has been controversial. ⋯ Cerclage wires used with locking plate fixation successfully treats periprosthetic fractures of the femur with faster time to union, less complication, and fewer revisions.
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Orthopaedic surgery · Aug 2013
Case ReportsPure closed posteromedial dislocation of the tibiotalar joint without fracture.
Pure tibiotalar dislocation without an associated fracture is an extremely rare injury. We present three cases of closed posteromedial tibiotalar dislocation without any associated fractures to the foot, ankle, or leg. All patients were treated conservatively with immediate closed reduction under general or local anaesthesia and immobilised in a short leg cast for six weeks without weight-bearing resulting in a satisfactory outcome at the final follow-up. A review of the literature is also presented in this paper.