Archives of orthopaedic and trauma surgery
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In this paper, a case of closed medial subtalar dislocation and accompanying talar head fracture in a 22-year-old man which occurred while walking on a downhill road is reported. Closed reduction under general anesthesia was unsuccessful. The obstacle for closed reduction was determined at surgery for open reduction and internal fixation as buttonholing of the talar head through the extensor retinaculum. At the 26-month follow-up, he was pain-free in his daily activities.
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Arch Orthop Trauma Surg · Dec 2002
The thrust plate prosthesis in patients with aseptic osteonecrosis of the femoral head.
The thrust plate prosthesis (TPP) is an implant with a metaphyseal fixation at the proximal femur that transmits the load forces of the hip onto the femoral neck. The osseous incorporation of the TPP and the adaptation of the bone to this force transmission depend on the bone quality, which is reduced to minor vitality and stability in patients with osteonecrosis of the femoral head. Depending on the etiology of the femoral head necrosis, the TPP might lead to early failures. ⋯ Femoral head necrosis following renal transplantation and extension of the necrotic area into the femoral neck are contraindications for TPP. Excluding these patients, the TPP shows comparable mid-term results to cementless stemmed prostheses and supplies advantages especially for younger patients, because of its metaphyseal, bone-preserving fixation. However, evaluation of the clinical impact of the TPP in comparison with other cementless femoral stem systems requires long-term examinations in the future.