Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2007
Randomized Controlled TrialTreatment of type IIIA open fractures of tibial shaft with Ilizarov external fixator versus unreamed tibial nailing.
The aim of this study was to compare the radiographic results and clinical outcome of unreamed tibial nailing (UTN) and Ilizarov external fixation (IEF) for the treatment of type IIIA open fractures of the tibia. ⋯ The results of the current study showed that IEF technique had a notable incidence of pin-tract infection, joint contracture, and shorthening related to treatment of the delayed union. The UTN technique had the disadvantage of a posttraumatic osteomyelitis and delayed union requiring additional surgery. We believe that the decision to use IEF or UTN should be made on a case-by-case basis.
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Arch Orthop Trauma Surg · Oct 2007
Treatment of the humeral shaft nonunion after surgical failure using the Selfdynamisable internal fixator.
A nonunion of the humeral shaft is not a rare condition and is a complication of both nonoperative and operative treatment of the fracture. Several fixation options were used in the nonunion treatment, including various plate techniques, intramedullary nails and external fixator. We applied our Selfdynamisable internal fixator for the treatment of humeral shaft nonunion after surgical failure and evaluated its clinical outcome. ⋯ Selfdynamisable internal fixator with bone graft for the treatment of recalcitrant humeral shaft nonunion provided successful clinical outcome with minimal complications.
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Arch Orthop Trauma Surg · Oct 2007
Case ReportsComplete osseous avulsion of the adductor longus muscle: acute repair with three fiberwire suture anchors.
An acute tear of the adductor longus tendon is a seldom injury. A proximal osseous avulsion of this tendon has never been reported in literature. ⋯ Case report.
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Arch Orthop Trauma Surg · Oct 2007
Review Case ReportsOpen grade III "floating ankle" injuries: a report of eight cases with review of literature.
"Floating ankle" injuries result from high-energy trauma and are usually associated with extensive soft tissue damage. Such rare and complex injuries in the acute phase pose therapeutic dilemma to the treating surgeon. When salvage instead of amputation is preferred, a variety of treatment options are available ranging from open reduction along with minimal internal fixation to external fixation. In this retrospective case series study we report eight patients with open "floating ankle" injuries who had been treated with external fixation with or without internal fixation. ⋯ External fixation with or without internal fixation is an option when salvaging rare injuries like open grade III "floating ankle" injuries. Salvaged patients do suffer a cocktail of crippling disease characterized by psycho-socio-economic and physical disability and result in increased hospital costs. We recommend more prospective studies with long-term follow-up of such complex injuries to identify the indications for salvage and also the criteria for a successful salvage.
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Arch Orthop Trauma Surg · Oct 2007
Rupture of the distal biceps brachii tendon: conservative treatment versus anatomic reinsertion--clinical and radiological evaluation after 2 years.
Distal biceps tendon rupture is a relatively rare injury. It commonly occurs in the dominant extremity of middle-aged men during an excessive eccentric tension as the arm is forced from a flexed position, while it is rarely observed during sport activities. Many techniques, including non-operative and surgical option, have been described for the treatment of a ruptured distal biceps tendon, but there is still considerable controversy about the management of choice. ⋯ Our findings confirm the view that anatomic repair of distal biceps tendon rupture provides consistently good results and early anatomic reconstruction can restore strength and endurance for the elbow.