Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2011
Anterior interosseous nerve syndrome: retrospective analysis of 14 patients.
The anterior interosseous nerve (AIN) is a only motor nerve innervating the deep muscles of the forearm. Its compression is rare. We present a retrospective analysis of 14 patients with an AIN syndrome with a variety of clinical manifestations who underwent operative and conservative treatment. ⋯ AIN syndrome can have different clinical manifestations. If no signs of spontaneous recovery appear within 12 weeks, operative treatment should be performed.
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Arch Orthop Trauma Surg · Nov 2011
Autologous bone cylinder transplantation with cannulated screw re-stabilisation: a new treatment option for delayed fracture healing of the femoral neck.
Delayed fracture healing and non-unions of the femoral neck after lag screw osteosynthesis occur particularly in multiply injured young patients, and then surgical revision is often required. Currently no evidence-based treatment guidelines exist and therapeutic options include both hip arthroplasties and femoral head-maintaining operations. Here we report on young patients with delayed fracture healing of the femoral neck. Patients underwent revision surgery by autologous bone cylinder transplantation with mechanical re-stabilisation by cannulated lag screws. ⋯ These data show that in this difficult-to-treat subset of young patients with delayed fracture healing of the femoral neck, autologous bone cylinder transplantation with mechanical re-stabilisation should be considered as a promising surgical revision strategy before hip arthroplasty.
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Fractures of the ankle are fairly common injuries. Open ankle fractures are much less common and associated with severe injuries to surrounding tissues. We have performed a systematic review of the literature concerning the clinical results and complication rates in the treatment of open ankle fractures. ⋯ There is a lack of high quality literature concerning the (operative) treatment of patients with open ankle fractures. Remarkable is that most authors reported satisfactory results after performance of their treatment protocol. Based on the available literature, we formulated guidelines regarding: timing of operative treatment, wound irrigation, the role of internal fixation, wound coverage and closure, the use of antibiotics and additional therapies.
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Arch Orthop Trauma Surg · Nov 2011
Comparative StudyComplete acetabular cup revision versus isolated liner exchange for polyethylene wear and osteolysis without loosening in cementless total hip arthroplasty.
Revision surgery in patients showing polyethylene wear and acetabular osteolysis without visible acetabular cup loosening involves the difficult decision of whether to revise only the liner or both the cup and the liner. The purpose of this study is to compare the outcomes of complete acetabular revision and isolated liner exchange in patients showing wear and osteolysis without loosening. ⋯ We found no differences in acetabular osteolysis progression, fixation failure, or complication between the cup revision and retention groups. Therefore, isolated liner exchange without cup extraction in cases of osteolysis that includes a well-fixed and well-positioned shell could be considered as a viable treatment option.
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Arch Orthop Trauma Surg · Nov 2011
Comparative StudyInternal fixation of dorsally comminuted fractures of the distal part of the radius: a biomechanical analysis of volar plate and intramedullary nail fracture stability.
The purpose of the present study was to carry out biomechanical testing of "new generation" volar plates and an intramedullary nail. ⋯ In this experimental setting, all "new generation" implants for distal radius fractures with the exception of the 2.4 mm-LCP showed identical or higher stability compared to the 3.5 mm-LCP. The 2.4 mm-LCP showed the lowest resistance and this must be taken into consideration when planning postoperative functional therapy.