Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2011
Locked posterior shoulder dislocation: treatment options and clinical outcomes.
Posterior dislocation of the shoulder is a rare injury and often misdiagnosed during the initial presentation to a physician. Misdiagnosis is due to a lack of clear clinical signs compared to anterior dislocation and inappropriate radiographs. In contrast to anterior dislocations, the humeral head defect accounts for recurrent instability. Depending on the size of the defect and the duration of dislocation, different treatment options include elevation of the defect, bone grafting, McLaughlin procedure, rotation osteotomy or arthroplasty. ⋯ Although locked posterior shoulder dislocation is uncommon and often initially misdiagnosed, satisfying results can be achieved by different surgical treatment options. Early diagnosis by detailed clinical examination and sufficient radiographic evaluation with true anterior-posterior and axillary views is essential to improve clinical results. Levl of evidence: IV.
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Arch Orthop Trauma Surg · Aug 2011
Extracorporeal shockwave therapy shows chondroprotective effects in osteoarthritic rat knee.
This study investigated the effects of extracorporeal shockwave therapy (ESWT) on the subchondral bone and articular cartilage in the initiation of osteoarthritis of the knee in rats. ⋯ Extracorporeal shockwave therapy shows chondroprotective effect associated with improvement in subchondral bone remodeling in the initiation of ACLT OA knee model in rats.
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Arch Orthop Trauma Surg · Aug 2011
Clinical TrialArthroscopic repair of type II superior labrum anterior posterior (SLAP) lesions in patients over the age of 45 years: a prospective study.
Superior labrum anterior posterior (SLAP) lesions are a well-defined cause of shoulder pain and disability and may occur in conjunction with rotator cuff tears. This study was designed to prospectively evaluate the minimum 2 year results of arthroscopic repair of type II SLAP lesions in patients over the age of 45 years with and without rotator cuff tears. ⋯ The arthroscopic repair of symptomatic type II SLAP lesions yields favorable outcomes in patients over 45 years of age and the presence of accompanying rotator cuff tears has a negative effect on the results.
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Arch Orthop Trauma Surg · Aug 2011
Arthritis predicting factors in distal intraarticular radius fractures.
Intra-articular malunion with step off and gap formation is claimed to be crucial for radiocarpal degeneration. In addition to well-defined intraarticular malunion, the shape of the distal radius is important for unaffected wrist function. In typical intra-articular fracture patterns with a dorsoulnar and palmar ulnar fragment, alterations of the shape of the articular surface, in a kind of a cavity, without obvious step off can be observed. The aim of the present study is to determine the residual articular deformity following intra-articular radius fractures and to analyze their impact on the final clinical and radiological outcome. ⋯ ORIF leads to predictable results in the restoration of length and form of the distal radius. Increasing the articular cavity depth should be avoided to prevent degenerative arthritis at the radiocarpal joint at long-term follow-up visits.
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Arch Orthop Trauma Surg · Aug 2011
Comparative StudyStructural properties of a new fixation strategy in double bundle ACL reconstruction: the MiniShim.
Double-bundle reconstruction of the ACL has become the focus of scientific and clinical interest in the last years. However, there is still a discussion about the most appropriate technique for graft fixation. Both, extracortical fixation systems like the Endobutton and aperture fixation by interference screws have advantages as well as disadvantages. Aim of this study was to analyze the biomechanical properties of a new small wedge shaped implant (MiniShim, Karl Storz, Germany) for the fixation of a soft tissue graft in double bundle ACL reconstruction and to compare it to an aperture fixation by interference screw and an extracortical fixation. ⋯ Hybrid fixation using the MiniShim provides biomechanical properties strong enough to withstand the forces occurring during rehabilitation and comparable to the fixation strength provided by interference screw. While fixation by MiniShim alone does not provide sufficient fixation strength in double bundle ACL reconstruction, hybridfixation using a cortical fixation by FlippTack is an alternative to aperture fixation by interference screw concerning primary stability.