International orthopaedics
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Claviculectomy is a rare and poorly described event in the surgical therapy of diseases of the clavicle. We present a case series and functional results of patients who underwent total claviculectomy. ⋯ The surgical technique described for total claviculectomy, along with the insertion of local antibiotic beads, was able to eliminate infection in every case. Good functional results and a low complication rates were observed. For good functional results and the permanent elimination of infection, adjacent joints have to be addressed, the periosteal tube should be preserved and early functional treatment is essential.
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Revision internal fixation for femoral-neck nonunion is a challenging procedure. Treatment options are osteotomy, osteosynthesis using various implants and grafting techniques (muscle pedicle, vascularised or nonvascularised fibular graft) or arthroplasty. The objective of this article is to report the outcome of revision internal fixation using an angle blade plate and autogenous fibular graft in symptomatic aseptic femoral-neck nonunion. ⋯ Angle blade plate provides rigid stability and offloads any shearing force over the fibular graft when used for revision internal fixation in aseptic femoral-neck nonunion. Thus, the fibular graft only serves the purpose of osteogenesis and stimulates the surrounding host cells to promote healing at the nonunion site. We recommend the angle blade plate and autogenous fibular graft as a viable option for hip-joint salvage in revision internal fixation of aseptic femoral-neck nonunion.
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We evaluated the usefulness of percutaneous reduction and leverage fixation using K-wires in children with radial neck fractures. ⋯ Percutaneous reduction and leverage fixation using K-wires in children with radial neck fractures is a recommended surgical treatment that can achieve recovery of normal radial angulation and elbow motion.
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To investigate the correction effectiveness, incidence rate of distal adding on, and post-operative spinal balance in Lenke 3C and 6C AIS treated with extensive fusion using posterior pedicle screw-only constructs. ⋯ In Lenke 3C and 6C scoliosis, extensive fusion can produce satisfactory corrections from the perspectives of both Cobb angle and vertebral translation and rarely causes significant distal adding-on, global imbalance or trunk shift.
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Patellar height is an important factor in patellar tracking and alters the force of the patellofemoral joint reaction. Several methods for measuring patellar height ratio have been described, with no single method recognised as a gold standard. This study developed a new measurement method using a distal femoral reference, where the normal values of measurement are unaffected by varying angles of knee flexion. ⋯ The new patellar height ratio measurement method proved to be accurate and reproducible for evaluating a normal population. This method offered the benefit of using the distal femur as a reference landmark, and, thus, the resulting measurements were not altered by varying degrees of knee flexion.