Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2010
Comparative StudyThree-dimensional measurement of femoral antetorsion: comparison to a conventional radiological method.
The aim of our study was to produce a 3-D reconstruction of a CT dataset and compare it to the conventional method, with that same dataset, in terms of precision and the influence of femoral positioning. ⋯ 3-D reconstruction enables precise determination of the femoral AT angle, and is independent of femoral positioning as conventional methods seem to be. In clinical practice, 3-D reconstruction may allow a greater understanding of the femoral AT angle post fracture reduction and internal fixation. However, we believe the 3-D method of measuring the AT-angle can potentially optimize the patient's treatment outcome by allowing the orthopaedic surgeon to measure the femoral AT-angle more precisely after femoral fracture reduction.
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Arch Orthop Trauma Surg · Apr 2010
The management of humeral shaft fractures with associated radial nerve palsy: a review of 117 cases.
This single center retrospective study reviews the management and outcomes of 117 consecutive patients with humeral shaft fractures and associated radial nerve palsy (RNP) treated over a 20-year period (1986-2006). A total of 101 fractures were managed conservatively and 16 fractures underwent external fixation for poor bony alignment. Sixteen grade 1 and 2 open fractures underwent wound toileting alone. No patients underwent initial radial nerve exploration or opening of the fracture sites. ⋯ Humeral fractures with associated RNP may be treated expectantly. With low rates of humeral nonunion, 95% spontaneous nerve recovery in closed fractures and 94% in grade 1 and 2 open fractures, one has the opportunity of waiting. If at 10-12 weeks there are no clinical/EMG signs of recovery, then nerve exploration/secondary reconstruction is indicated. Late tendon transfers may also give good/excellent functional results.
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Arch Orthop Trauma Surg · Apr 2010
Impaction bone grafting for acetabular reconstruction: mean 5.5-year results in Japanese patients.
We performed a retrospective outcome study on 23 consecutive acetabular reconstructions involving impaction bone grafting in Japanese patients. ⋯ Acetabular impaction bone grafting is a reproducible technique in which surgeons should strictly follow the recommended technical procedure.
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Arch Orthop Trauma Surg · Apr 2010
Treatment for large skeletal defects by free vascularized fibular graft combined with locking plate.
Reconstruction of large skeletal defects secondary to osteomyelitis or open fracture is a challenging problem. The purpose of this study was to evaluate the results of using free vascularized fibular graft (FVFG) combined with locking plate in the treatment of large skeletal defects from open fracture and infection. ⋯ FVFG combined with locking plate is a viable option for the management of large skeletal defects from open fracture and infection.
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Arch Orthop Trauma Surg · Apr 2010
Effect of limb rotation on radiographic alignment in total knee arthroplasties.
Even in a well-aligned total knee arthroplasty (TKA), limb rotation at the time of radiographic assessment will alter the measurement of alignment. This could influence the radiographic outcome of TKA. The purpose of this study was to evaluate the effect of limb rotation on radiographic alignment after TKA and to establish a re-calculation of this rotation by using existing radiographic landmarks. ⋯ Limb rotation had a highly statistically significant effect on measured anatomic alignment and mechanical angles. A correlation between limb rotation, anatomic mechanical angle, mechanical angles measured at femur and tibia and the femoral component distance ratio was established. As the anatomic mechanical angle and the femoral component distance ratio change linearly in the range of 20 degrees internal and external limb rotation, a calculation of the femoral component distance ratio could be used to re-calculate the limb rotation at the time of radiographic assessment to evaluate the evidence of a long leg radiograph.