International orthopaedics
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Randomized Controlled Trial
Unipolar hemiarthroplasty versus bipolar hemiarthroplasty in patients with displaced femoral neck fractures: a four-year follow-up of a randomised controlled trial.
The treatment of choice for a displaced femoral neck fracture in the most elderly patients is a cemented hemiarthroplasty (HA). The optimal design, unipolar or bipolar head, remains unclear. The possible advantages of a bipolar HA are a better range of motion and less acetabular wear. The aim of this study was to evaluate hip function, health related quality of life (HRQoL), surgical outcome and acetabular erosion in a medium-term follow-up. ⋯ The bipolar HAs seem to result in better HRQoL beyond the first two years after surgery compared to unipolar HAs. Bipolar HAs displayed a later onset of acetabular erosion compared to unipolar HAs.
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Randomized Controlled Trial
Locking versus non-locking neutralization plates for treatment of lateral malleolar fractures: a randomized controlled trial.
The reduction of periosteal compression through the use of a locking plate may minimize disturbances of bone blood supply and may improve the rate of bone union. A single-centre, assessor blinded randomized controlled trial was conducted to compare the clinical effectiveness of a locking plate and a non-locking plate. ⋯ No differences were observed in patients with AO/OTA 44B lateral malleolar fractures undergoing fixation with a locking versus non-locking neutralization plate.
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Comparative Study
A comparative biomechanical study of proximal femoral nail (InterTAN) and proximal femoral nail antirotation for intertrochanteric fractures.
The purpose of this study was to compare the biomechanical strength of the cephalomedullary nail InterTAN in cases of intertrochanteric fractures with the commonly used PFNA. ⋯ Comparison of the treatment of intertrochanteric fractures with InterTAN and PFNA internal fixation showed that the InterTAN yielded improvement relative to the PFNA. InterTAN has a firmer and biomechanically superior performance and is therefore an ideal internal fixation method for treating intertrochanteric fractures. Additional research in osteopenic bone is necessary to comprehensively characterize the effects of the design enhancements of these two implants.
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The safety and efficacy of the novel Limmed® system (locked plate fixation) for immediate full weight-bearing after medial opening wedge high tibial osteotomy (HTO) were evaluated in patients with symptomatic varus gonarthrosis. ⋯ The Limmed® medial opening wedge HTO system represents a novel method of achieving a reliable correction while producing a stable fixation allowing satisfactory stability and bone healing with immediate full weight-bearing.
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The purpose of this study was to evaluate the impact of a preoperative myocardial infarction (MI) on outcomes of inpatient orthopaedic operations. ⋯ A myocardial infarction within six months prior to orthopaedic surgery is not associated with a higher risk of 30-day perioperative cardiac complications; however, it is associated with increased rates of surgical site infection, prolonged ventilator dependence, and longer hospital stay.