Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2013
Review Case ReportsProximal radioulnar translocation associated with elbow dislocation and radial neck fracture in child: a case report and review of literature.
Proximal radioulnar translocation with radial neck fracture and elbow dislocation is extremely rare. We report a case of a 5-year-old boy who was presented with elbow dislocation, and proximal radioulnar translocation was diagnosed a day after the injury. ⋯ The patient finally regained full range of elbow motion and forearm rotation. This case had clinical importance in that the reverse instability of the elbow was observed compared with the previous reports.
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Arch Orthop Trauma Surg · Oct 2013
ReviewThe assessment of neutrophil CD64 count as an early warning marker of joint replacement infection.
120,000 hip and knee replacements are performed each year in the UK and more than 1 % of these require revision surgery due to infection. Current diagnostic tests used to diagnose infection of joint replacements, including the current gold standard C-reactive protein, which offers poor specificity when diagnosing infection in the post-operative period. In the post-operative period these tests are unable to differentiate between physiological inflammation and infection of the replacement. ⋯ Data from several studies utilising a flow cytometer support the view that CD64 is firstly, a good marker of systemic infection and secondly, when studied in conjunction with musculoskeletal infections alone, is a sensitive and specific marker of this type of infection. However, meta-analysis of studies in this field concludes that more highly powered studies are needed before definite conclusions can be drawn. Despite this, the studies do portray a strong case for CD64 being the future of diagnosis of post-operative infection.
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Arch Orthop Trauma Surg · Oct 2013
Comparative StudyOperative treatment for volar plate avulsion fractures of the fingers.
We present our experience with 14 volar plate avulsion fractures of the fingers that were treated by excision or internal fixation and discuss the factors affecting the operative techniques and results. Fourteen cases were divided into two groups: the volar plate avulsions with excision (eight cases) and the volar plate avulsions with fixation (six). We compared clinical factors between fracture groups and between fixation methods. ⋯ All fixated fractures healed and the time to union did not differ based on fixation method. The true size of the fracture fragment was larger than expected based on the X-ray and the fragments were usually rotated by pull of the volar plate or ligament. The size and shape of the avulsed fragment might be important factors to determine the treatment method, but the results after operation were not significantly different whether the fragment was excised or fixed.
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Arch Orthop Trauma Surg · Oct 2013
Case ReportsSevere posttraumatic radiocarpal cartilage damage: first report of autologous chondrocyte implantation.
Case report. ⋯ The case presented here demonstrates the first use of autologous chondrocyte implantation for cartilage reconstruction using an in situ polymerizable albumin-hyaluronic acid gel after traumatic cartilage lesion with 4° cartilage damage of the wrist in a 22-year-old non-smoking, active and healthy man. Initial results are promising in terms of mobility, pain and patient outcome. However, further clinical studies have to be performed with larger number of cases.
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Arch Orthop Trauma Surg · Oct 2013
Comparative Study Clinical TrialDoes laminoplasty really improve neurological status in patients with cervical spinal cord injury without bone and disc injury? A prospective study about neurological recovery and early complications.
Cervical spinal cord injury without bone and disc injury in patients with spinal cord compression is a fairly common problem in Japan. Because elderly Japanese population tend to have cervical spinal canal stenosis. However, there has been no consensus in the treatment of these patients. We conducted a prospective study to evaluate treatment outcomes and complications of these patients. ⋯ In the present study, we found no significant difference in paralysis improvement between surgical and conservative treatment, although we observed a higher frequency of complications with surgery.