Injury
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Infection in megaprostheses remains an unsolved problem, with a rate of occurrence ranging from 5% to 12%. Silver coating of medical devices has recently been proposed to reduce infection rate because of the antibacterial effect of silver. This innovation could be particularly interesting for megaprostheses, but few data have been reported in the literature. ⋯ Silver-coated megaprostheses showed promising results in this series in terms of prevention of infection in a high-risk group of patients, many of whom had a history of infection. No side-effects were detected. The circulating silver levels confirm both the persistence of silver-coating activity after three years and the safety of silver-coated implants. Longer follow-up and larger series are needed.
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Review Multicenter Study
Minimally-invasive treatment of calcaneal fractures: A review of the literature and our experience.
The optimal treatment of calcaneal fractures (CF) is currently controversial and is still under debate. It is well established that conservative treatment of these fractures is associated with poor results. ⋯ ORIF is the most popular technique for these fractures, but it is associated with high rates of wound complications, hardware failure and infections. Several minimally-invasive techniques have been developed recently for the treatment of CF, with the common aim to be as simple, effective and inexpensive as possible and to reduce surgical times, complications and length of hospital stay.
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We present the case of a 39-year-old sportswoman who was involved in a motorcycle accident in 2012. She sustained a complex proximal femoral fracture that involved the neck and trochanteric region. We decided to preserve the natural bone stock and repair the fractures, adopting skeletal traction in the first stage and then implanting an intramedullary nail. Twenty months later the fracture was healed clinically and radiologically and the patient was able to walk and run without pain.
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The purpose of this study was to determine if the triceps-reflecting anconeus pedicle (TRAP) approach combined with the precontoured locking plate can provide acceptable clinical outcomes in the treatment of comminuted distal humerus fracture. ⋯ By retaining the intact olecranon by the TRAP approach, orthopedic surgeon can get adequate surgical exposure for fracture fixation and can use olecranon as a three-dimensional template to restore the articular fragments. The promising results in this study obtain because that precise identification of the triceps muscle allowed the determination of a proper length-tension relationship for triceps reattachment. The combination of triceps tendon repair and anconeous muscle repair ensured the strength of the extensor mechanism. Therefore, the TRAP approach in combination with the usage of the precontoured locking plate can be recommended as the optimal surgical approach for the treatment of comminuted distal humerus fracture.