International orthopaedics
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Randomized Controlled Trial Multicenter Study Comparative Study
A prospective, randomised, controlled multicentre study comparing cervical disc replacement with anterior cervical decompression and fusion.
Total cervical artificial disc replacement (TDR) simulates normal disc structure, thus avoiding the drawbacks of anterior cervical decompression and fusion (ACDF). This prospective, randomized, controlled and multicentre study aimed to evaluate clinical and radiographic outcomes by comparing cervical disc replacement using Mobi-C disc prostheses with ACDF. ⋯ Although ACDF may increase the risk of additional surgery, clinical outcomes indicated that both Mobi-C artificial cervical disc replacement and ACDF were reliable. Radiographic data showed that ROM of the cervical spine, FSU angle and treated and adjacent segments were relatively better reconstructed and maintained in the Mobi-C group compared with those in the ACDF group.
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Randomized Controlled Trial
Prospective randomized trial comparing open reduction and internal fixation with minimally invasive reduction and percutaneous fixation in managing displaced intra-articular calcaneal fractures.
Managing displaced intra-articular calcaneal fractures remains controversial. A prospective randomised trial was undertaken to compare open reduction and internal fixation (ORIF) with minimally invasive reduction and percutaneous fixation (MIRPF). ⋯ MIRPF is associated with fewer wound-healing problems, better functional outcome and earlier return to work compared with ORIF.
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Bicondylar tibial plateau fractures involving four articular quadrants are severe and complex injuries, and they remain a challenging problem in orthopaedic trauma. The aim of this study was to introduce a new treatment protocol with dual-incision and multi-plate fixation in the floating supine patient position as well as to report the preliminary clinical results. ⋯ For bicondylar four-quadrant tibial plateau fractures, the treatment protocol of multiple medial-posterior small plates combined with a lateral strong locking plate through dual incisions can provide stable fracture fixation to allow for early stage rehabilitation. Good clinical outcomes can be anticipated.
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The aim of this study was to determine the outcome of surgically-treated periprosthetic femoral fractures with an orthogonal double plate system. ⋯ Based on a small number of cases, we were able to show for the first time that the use of orthogonal double plating is not associated with an increased rate of complications in patients with periprosthetic femoral fractures and stable components. Moreover, orthogonal double plating can be used successfully as a salvage procedure. At the time of follow up, seven out of ten patients were mobile. More cases must be investigated to validate our findings.
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The frequency, type and consequences of errors in orthopaedic and trauma surgery procedures should be analysed. ⋯ Typical patient- and procedure-related errors can be detected by consequent documentation and analysis. It may help to develop sufficient strategies of error prevention. Because of the often-seen time delay, error prevention may help save time and costs.