Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2009
Case ReportsSafety of atlantoaxial fusion using laminar and transarticular screws combined with an atlas hook in a patient with unilateral vertebral artery occlusion (case report).
A disadvantage of transarticular and C2 pedicle screws is vertebral artery (VA) injury as a result of screw misplacement. If unilateral occlusion of the VA is present, VA injury of the dominant side will cause fatal complications as a result of collateral flow insufficiency. Several authors have recently reported the usefulness of C2 laminar screws because of their safety on VA injury. We used transarticular and C2 laminar screws combined with the atlas hook in a patient with C1-2 instability and unilateral VA occlusion, in order to reduce the risk of further VA injury. ⋯ Transarticular and C2 laminar screws fixation combined with the atlas hook in a patient with unilateral VA occlusion is a useful technique, in order to reduce the risk of further VA injury.
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Arch Orthop Trauma Surg · Jan 2009
Fibula and tibia fusion with cancellous allograft vitalised with autologous bone marrow: first results for infected tibial non-union.
Autogenous bone grafting has been used in reconstructing bone defects and in stimulating fracture healing, producing high healing rates in the treatment of infected tibial non-unions. A novel therapeutic alternative is now available known as "vitalised allograft", a cancellous bone graft procured from femoral heads from living human donors and "vitalised" through the injection of autologous bone marrow. The aim of this study is to summarise the initial results of the fibula and tibia fusion using vitalised cancellous allograft in the treatment of infected tibial non-unions. ⋯ Fibula and tibia fusion with allogenic cancellous bone grafting, vitalised through autogenic bone marrow, could well become an innovative treatment option for infected tibial non-unions. We need, however, to analyse a higher number of cases over a longer follow-up period in order to assess more accurately recurrent infections and re-fractures.
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Arch Orthop Trauma Surg · Jan 2009
Case ReportsOncosurgical and reconstructive concepts in the treatment of soft tissue sarcomas: a retrospective analysis.
Patients with soft tissue sarcomas are initially treated in community hospitals and in the private practice setting in the majority of cases. Thus, this disease entity is initially treated by surgeons with limited experience and expertise regarding the complex and demanding therapeutic regimen necessary to address this distinct group of malignancies. ⋯ Based on our data favorable oncological outcomes with satisfactory functional results and limb preservation are achievable if oncological principles for resection are respected and reconstruction is performed according to plastic surgical principles.
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Arch Orthop Trauma Surg · Jan 2009
Biomechanical and functional analysis of the pins and rubbers tractions system for treatment of proximal interphalangeal joint fracture dislocations.
Dynamic external fixation systems are considered as optimal devices for treatment of fracture dislocations of the proximal interphalangeal joint (PiP). The pins and rubbers traction system (PRTS) is cheap, easy to assemble and comfortable and allows early mobilization of the affected digit. We investigated the influence of different wire positions and rubber strength and provided a follow-up of five consecutively treated patients. ⋯ The PRTS allows for efficient treatment of intraarticular fractures with PiP involvement. Although standardized positioning of the wires is important, proximal position of the retraction only increased forces for 30 degrees flexion.