Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2008
Mismatch between PFNa and medullary canal causing difficulty in nailing of the pertrochanteric fractures.
The proximal femoral nail (PFN) and the proximal femoral nail anti-rotation (PFNA) have been successfully used in the management of osteoporotic pertrochanteric fractures. Although many studies have described the geometrical mismatch between the antecurvation of the femur and the contemporary intramedullay nails, technical difficulties related to the mismatch between the femoral bowing and the PFN/PFNA at the time of nailing have rarely been discussed in the literature. We have experienced a technical difficulty related to the mismatch between the medullary canal and the PFN/PFNA. We describe the complications related with the mismatch and the technical pitfalls and some technical tips to avoid this problem are also described.
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Arch Orthop Trauma Surg · Dec 2008
Comparative StudyPrimary total hip arthroplasty with a flattened press-fit acetabular component in osteoarthritis and inflammatory arthritis: a prospective study on 416 hips with 6-10 years follow-up.
A flattened cup was designed to create a more physiological load transfer to the pelvic bone compared to hemispherical cups, and to allow more bone contact compared to low-profile' spherical cups. To investigate these theoretical advantages and the potential influence of the quality of the acetabular bone, a clinical study was performed in patients with osteoarthritis (OA) and inflammatory arthritis (IA). The aims of the study were (1) to evaluate the fixation of the cup, postoperatively and later when osseous integration should have taken place, (2) to assess perioperative complications such as acetabular fractures and (3) to monitor the polar gap, a potential risk factor for osteolysis. ⋯ This study shows that the flattened press-fit acetabular component creates adequate initial mechanical stability to allow osseous integration and that the cup can be safely used in both OA and IA patients. However, after 6-10 years, in the IA group failure of the cup due to aseptic loosening occurred once and failure due to osteolysis occurred three times, while these type of failures did not occur in the OA group.
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Arch Orthop Trauma Surg · Dec 2008
Case ReportsNonunion of distal radius fracture and distal radioulnar joint injury: a modified Sauvé-Kapandji procedure with a cubitus proradius transposition as autograft.
The Sauvé-Kapandji (SK) procedure is indicated in distal radius nonunion or malunion and distal radioulnar joint (DRUJ) instability. It can also be used to treat the rheumatoid wrist with severe degenerative changes in the DRUJ. The main objective is to allow a pain-free range of movement. ⋯ After 1 year of follow-up, the distal radius fracture has healed and the wrist is pain-free with a complete range of movement in flexion-extension and pronation-supination. The main indication for the SK procedure is post-traumatic positive ulnar variance and associated ulnocarpal impaction. The cubitus proradius bone graft transposition is an interesting technical note that makes this case a challenge for skilled orthopedic hand surgeons.