Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2012
Two-stage surgical management using posterior instrumentation, anterior debridement and allografting for tuberculosis of the lower lumbar spine in children of elementary school age: minimum 3-year follow-up of 14 patients.
Various surgical methods have been described for the management of lumbar tuberculous spondylitis in the literature. However, there were few reports on the two-stage surgical treatment of lumbar tuberculosis in children of elementary school age. We present a retrospective clinical study of 14 patients with lumbar and lumbosacral tuberculous spondylitis treated by two-stage surgery (first stage: posterior instrumentation; second stage: anterior debridement and allografting). The purpose is to determine the clinical efficacy of such surgical treatment for lumbar tuberculosis in children. ⋯ Two-stage (posterior and anterior) surgery is a safe and effective procedure for the patient of elementary school age suffering from lumbar and lumbosacral tuberculous spondylitis, especially for the patients in poor general condition. The procedure has the advantage of minor surgical invasion, effective kyphosis correction and less complications.
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Arch Orthop Trauma Surg · Sep 2012
Biomechanical effect of graded minimal-invasive decompression procedures on lumbar spinal stability.
Decompression surgery represents the standard operative treatment for lumbar spinal stenosis, but this procedure is often combined with fusion surgery. It is still discussed whether minimal-invasive decompression procedures are sufficient and if they compromise spinal stability as well. The aim of this study was to analyze the effects of different minimal-invasive decompression procedures on the range of motion (ROM) of the decompressed and adjacent segments under preload conditions. ⋯ The results support minimal-invasive procedures for the preservation of spinal stability. Therefore, surgeons can determine which grade of decompression procedure can be performed in the individual patient without requiring additional fusion to maintain spinal stability.
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Arch Orthop Trauma Surg · Sep 2012
A new pathway to classification of complex hand injuries: a clinical pilot testing using a new method of assessment.
All existing classifications, which are based on the severity of hand injuries, are being referred to facets of variety of hand injuries in general. A clear picture of all consequences of hand injuries would be apparent, if any kind of injury mechanism and occurrence of an injury would be identified and academically captured. Predictions regarding return to the former occupation and rehabilitation time would be possible with further study; 102 patients with different hand injuries were engaged in a pilot project using a specifically designed assessment sheet to achieve this purpose in the framework of a retrospective clinical testing within 1 year. ⋯ Furthermore, the mean DASH equivalents of one category were compared to the mean Hand Injury Severity Scoring (HISS) scores in order to get an initial idea of information on the degree of severity. A first impression of the potential of this assessment sheet has been obtained with regard to the above. With further study, we could evaluate the assessment sheet and try to create a classification of the grade of severity as well as prognostic values like return to the former occupation and rehabilitation time.
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Arch Orthop Trauma Surg · Sep 2012
Effect of depressive symptoms on perceived disability in patients with chronic shoulder pain.
Psychological distress may be an important determinant of perceived disability in patients with chronic musculoskeletal disorders. We evaluated the relationship between depressive symptoms and perceived disability in patients with chronic shoulder pain and quantified the contribution made by depression to perceived disability. ⋯ Level 2, prospective cohort study, prognostic study.
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Arch Orthop Trauma Surg · Sep 2012
Functional outcome of limb salvage surgery with mega-endoprosthetic reconstruction for bone tumors.
The use of a mega-endoprosthesis has become the method of choice for reconstruction after bone tumors. In this study, we sought to determine the functional outcome and complications associated with mega-endoprosthesis. ⋯ Mega-endoprosthetic reconstruction in limb salvage provides good functional outcome in patients with bone tumors.