Injury
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There is no classification for acquired forearm deformities. A clinical-radiographic study was conducted to classify these deformities and evaluate the results. ⋯ Characteristics and locations of post-traumatic deformities were identified. The major location is diaphisary and distal, the elbow is rarely affected. The functional consequence is a limitation in the range of motion of the hand. The best results are achieved with short-term treatment.
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Immediate total hip replacement (THR) in patients with acetabular fractures is controversial because of concerns about high complication rates. The current article is a systematic review of the literature on the use of acute THR for the treatment of acetabular fractures. ⋯ Data reported in the literature indicate that immediate THR can be successful in appropriately selected elderly patients or patients with extensive osteoporosis, combined acetabular and femoral neck fractures or pathological fractures. There is currently a limited evidence base for THR in patients with acetabular fractures; therefore, physicians' practice and expertise are the most useful tools in clinical practice.
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Comparative Study
Insertion of distal locking screws of tibial intramedullary nails: A comparison between the free-hand technique and the SURESHOT™ Distal Targeting System.
Positioning of the distal locking screws of an intramedullary nail is often challenging and time consuming because of difficult localisation of the distal locking holes, potential screw malalignment and nail deformation during insertion. The standard free-hand technique under fluoroscopic control involves considerable radiation exposure of both the patient and the surgical team. In this study, we aimed to compare the free-hand technique with a new system that utilises electromagnetic (EM) tracking data (SURESHOT™ Distal Targeting System) to localise distal locking holes. ⋯ The EM field-generating device significantly reduces distal locking time and, more importantly, significantly decreases duration of exposure to ionising radiation.
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The development of new megaprosthesis for the treatment of large bone defects provides important options to orthopaedic oncologic surgeons for the replacement of skeletal segments, such as the long bones of the upper and lower limbs and the relative joints. We implanted megaprosthesis using either a one-step or two-step technique depending on the patient's condition. The aim of this study was to evaluate retrospectively both clinical and radiological outcomes in patients who underwent lower limb megaprosthesis implant. ⋯ Megaprosthesis provides a valuable opportunity to restore functionality to patients with highly disabling diseases.
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We present the case report of a 40-year-old woman who was HIV-positive in Highly Active Anti-Retroviral Therapy (HAART) and affected by femural pertrochanteric fracture, which was treated by endomedullary nailing. Two years after the surgical operation, the woman developed an aseptic symptomatic osteolysis around the implant. ⋯ Aseptic and septic hardware mobilization, hardware removal, and implant decision in HIV patients with pertrochanteric fractures is discussed. The authors suggest close follow-up and prompt hardware removal, as soon as X-rays demonstrate healing signs, in HIV patients with fracture fixation, if general condition allows.