The Orthopedic clinics of North America
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Orthop. Clin. North Am. · Apr 2011
Comparative StudyComparison of fully porous-coated and hybrid hip resurfacing: a minimum 2-year follow-up study.
The purpose of this study was to compare clinical and radiological outcomes of the first 191 fully porous-coated hip resurfacing arthroplasties with 96 hybrid hip resurfacing arthroplasties performed during the same period at a minimum 2-year follow-up to evaluate the initial fixation of uncemented femoral resurfacing components. The results of this study indicate that fully porous-coated femoral resurfacing components can routinely achieve reliable fixation and provide similar initial results as have been achieved with cemented fixation. Long-term results are needed to determine which type of fixation is superior for the femoral hip resurfacing component.
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There has been a significant increase in the prevalence of obesity in the United States over the last 20 years, with the highest percentage in Mississippi. The percentage of obese patients undergoing total hip arthroplasty (THA) appears to be increasing at an even faster rate. Orthopedic surgeons performing hip arthroplasty need to be aware of potential issues to minimize complications associated with this population. This article outlines preoperative and postoperative care and describes current techniques and tools used by surgeons in obese patients to facilitate soft tissue dissection, exposure, implant placement, and closure.
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Orthop. Clin. North Am. · Jan 2011
Comparative StudyPercutaneous treatment of pelvic and acetabular fractures in obese patients.
A body mass index (BMI) greater than 30 is becoming increasingly common in the United States. Surgery for pelvic and acetabular fractures in this population is particularly problematic because conventional treatment often requires large surgical exposures. ⋯ Wound problems and infections are particularly common after open surgery in obese patients, and these increase linearly with the BMI. In this article, we present a small consecutive series over 14 months on obese patients who underwent percutaneous treatment of their pelvic or acetabular fractures.
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Orthop. Clin. North Am. · Apr 2010
ReviewHip resurfacing arthroplasty: a review of the evidence for surgical technique, outcome, and complications.
Hip resurfacing arthroplasty has reemerged as a valid reconstruction option for the osteoarthritic hip. Patient selection is critical for excellent surgical outcomes, especially when compared with total hip arthroplasty. However, concerns regarding surgical technique and postsurgical complications persist. The authors review the evidence for surgical technique, outcomes, and complications related to modern metal-on-metal hip resurfacing arthroplasty.
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Orthop. Clin. North Am. · Apr 2010
ReviewClavicle fractures in 2010: sling/swathe or open reduction and internal fixation?
Clavicle fractures are common, and they comprise close to 3% of all fractures seen in fracture clinics. Midshaft fractures account for approximately 80% of all clavicle fractures and are the focus of this article. In carefully selected cases primary plate fixation of displaced midshaft clavicle fractures improves outcome, results in earlier return to function, and reduces the nonunion and symptomatic malunion rate significantly compared with nonoperative treatment.