International orthopaedics
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The incidence of periprosthetic fractures is inevitably increasing. Sufficient stabilisation and proper screw placement next to large-volume implants remains difficult. Modern locking plates allow polyaxial, thus bicortical, screw placement around a prosthetic stem. This study analysed the biomechanical properties of different screw configurations in a locking plate construct of a periprosthetic femoral fracture model. ⋯ Bicortical screw placement enhances the primary stability in treating periprosthetic femoral fractures. Notably, the mode of failure may limit the salvage options in case of revision surgery.
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Randomized Controlled Trial Comparative Study
Distal locked and unlocked nailing for perthrochanteric fractures--a prospective comparative randomized study.
Intramedullary nailing is widely used in the treatment of stable pertrochanteric fractures. However, it remains controversial whether the distal locking with intramedullary nailing is necessary. ⋯ This study suggests that intramedullary nails without distal locking may be a reliable and acceptable option for treating stable pertrochanteric fractures (AO/OTA 31-A1 and A2) in elderly people. Distal unlocked nails showed subtle advantages in reducing blood loss, operation time, fluoroscopy exposure time, and size of the incision.
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Randomized Controlled Trial
Neither pre-operative education or a minimally invasive procedure have any influence on the recovery time after total hip replacement.
The purpose of this study was to evaluate pre-operative education versus no education and mini-invasive surgery versus standard surgery to reach complete independence. ⋯ Neither pre-operative education nor mini-invasive surgery reduces the time to reach complete functional independence. Mini-invasive surgery significantly reduces blood loss and the need for morphine consumption.
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The purpose of our study was to compare the outcome of radial head fractures (modified Mason type III and IV) treated by open reduction and internal fixation (ORIF) versus radial head arthroplasty (RHA). ⋯ The treatment of closed comminuted radial head fracture (modified Mason type III and IV) with ORIF and RHA demonstrates similar findings despite less surgical time for performing RHA.