The Orthopedic clinics of North America
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Orthop. Clin. North Am. · Jul 2005
Review Comparative StudyStandard and minimally invasive approaches to the spine.
With the advent of minimally invasive surgical approaches to the spine, the ability to adequately expose the desired anatomic structures while minimizing the disadvantages of excessive soft tissue stripping, dissection, and prolonged retraction has become increasingly popular. A minimally invasive one- or two-level posterior exposure of the spine is now safely attainable with the latest minimal-access systems that exploit the biomechanics of an adjustable blade retractor. As the clinical use of these developing systems escalates, more outcomes data will become available to determine the safety and value of these minimally invasive procedures.
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Orthop. Clin. North Am. · Apr 2005
Review Comparative StudyComplications associated with hip resurfacing arthroplasty.
Hip resurfacing arthroplasty is an old orthopedic concept that has undergone a resurgence of interest in the past decade. Because of the rapid increase in the number of procedures being performed, previously recognized complications have begun to recur. This article focuses on complications that are related to the hip resurfacing procedure such as femoral neck fractures, avascular necrosis, raised metal ion levels, and sound initial and durable long-term fixation of an all-metal monoblock cobalt/chrome acetabular component. Dislocation rates after resurfacing and other complications are briefly discussed.
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Orthop. Clin. North Am. · Oct 2004
Review Comparative StudyTrochanteric osteotomy for acetabular fractures and proximal femur fractures.
Anatomic reconstruction of the articular surface is a primary goal of internal fixation of fractures of the hip joint. The quality of the reduction correlates with long-term outcomes. ⋯ Ganz et al described a technique of trochanteric osteotomy combined with a Kocher-Langenbeck approach that allows direct visualization of the joint without the risk for avascular necrosis of the femoral head. This article reviews the indications of this approach in the treatment of fractures around the hip joint.
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Orthop. Clin. North Am. · Oct 2004
Review Comparative StudyThe role of pelvic angiography in evaluation and management of pelvic trauma.
Controversy exists about the indications and optimal timing of angiography in hemodynamically unstable patients with severe pelvic fractures. Recommendations from published studies are limited by small numbers of patients. In this article the recommended indications, timing, and drawbacks to angiography are reviewed.
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Orthop. Clin. North Am. · Oct 2004
Review Comparative StudySoft tissue injuries associated with pelvic fractures.
Significant soft tissue injuries often occur as part of high-energy injuries to the pelvis. These soft tissue injuries must be recognized and considered when implementing a treatment plan if complications are to be minimized. ⋯ Closed pelvic and acetabular fractures also may include soft tissue injury that requires special consideration. Careful evaluation and management of the soft tissues aids in determining appropriate techniques for reduction and fixation of the associated fractures.