Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2010
War-related infected tibial nonunion with bone and soft-tissue loss treated with bone transport using the Ilizarov method.
This single centre retrospective study reviews the outcomes of 30 war-injured patients with established infected tibial nonunion after sustaining grade IIIB open fractures. Patients were treated by radical bony and soft-tissue resection and bone transport using the Ilizarov bifocal technique, without the use of systemic antibiotics or bone grafting. ⋯ The Ilizarov technique with bone transport continues to be the most versatile, adaptive and effective method of treatment in these complex cases, and can very successfully deal with the associated large soft-tissue and bony defects without the use of routine bone-grafting, systemic antibiotics or soft-tissue flaps.
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Arch Orthop Trauma Surg · Jun 2010
Clinical and radiological outcomes after stabilisation of complex intra-articular fractures of the distal radius with the volar 2.4 mm LCP.
The purpose of the present study is to evaluate the results of the treatment of intra-articular fractures with the volar 2.4 mm LCP with regard to loss of reduction, clinical outcome and complications. ⋯ The treatment of complex intra-articular distal radius fractures with the volar 2.4 mm LCP provides sufficient fixation to prevent clinically significant loss of articular reduction, acceptable patient outcomes and minimal soft tissue complications.
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Arch Orthop Trauma Surg · Jun 2010
Evaluation of the ankle function following reconstruction of the donor defect with a split fibular bone after a vascularized fibular flap transfer.
To validate the hypothesis that the reconstruction of the missing segment of the fibula using a redundant split fibular graft after a vascularized fibular flap transfer may have a better effect on ankle function. ⋯ The reconstruction of the donor site with a split fibular bone graft led only a slight improvement in ankle eversion.
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Arch Orthop Trauma Surg · Jun 2010
Indications and contraindications for vertebroplasty and kyphoplasty.
Vertebral fractures (VF) are a leading cause of morbidity in the elderly. In the past decade, minimally invasive bone augmentation techniques for VF, such as percutaneous vertebroplasty (VP) and kyphoplasty (KP) have become more widespread. According to the literature, both techniques provide significant pain relief. However, KP is more expensive and technically more demanding than VP. The current study surveyed German surgeons who practice percutaneous augmentation to evaluate and compare decisions regarding the implementation of these techniques. Is there a difference in the indications and contraindications of VP and KP compared with the interdisciplinary consensus paper on VP and KP of the German medical association in the treatment of VF? ⋯ Vertebroplasty and kyphoplasty both have roles in the treatment of vertebral fractures. However, we could see differences in the indications for the two percutaneous techniques. Participants of this study found more indications for KP versus VP in cases of painful A1.2 and A3.1 fractures due to osteoporosis, metastasis, and trauma. About half of the respondents reported that VP is indicated for osteoporotic and pathologic A1.1 fractures. This study offers only limited conclusions. Open questionnaires and prospective data from all clinicians performing these procedures should be analyzed to offer more specific information.