Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jan 2013
Review Meta AnalysisVascularized fibular grafts in patients with avascular necrosis of femoral head: a systematic review and meta-analysis.
Vascularized fibular grafting (VFG) has been initiated to treat avascular necrosis of the femoral head (ANFH) since the late 1970s. There are a number of review articles updating the use of VFG to treat the ANFH. None of them applied statistical analysis for combining results from different studies to obtain a quantitative estimate of the overall effect and potential harm of VFG in comparison to other treatment. ⋯ VFG is a justified method that can prevent the ANFH from progressing to collapse, and that can retard or avoid hip replacement, especially in the hips of Steinberg stage I, II, and III.
-
Arch Orthop Trauma Surg · Jan 2013
Comparative StudyBiomechanical comparison of intramedullar versus extramedullar stabilization of intra-articular tibial plateau fractures.
Fractures of the proximal tibia occur very often and are a great challenge for trauma surgeons to stabilize. Although locked nails were developed to stabilize these fractures, this technique has not been sufficiently investigated. The purpose of this study was to biomechanically assess the stability of locked intramedullary nailing compared to locked plating. ⋯ Nailing of proximal tibia fractures leads to a stiffer implant-bone construct than plating. Since no adverse effects were found after nailing it seems to be a good alternative to plating for intra-articular proximal tibia fractures, especially in patients with soft tissue problems.
-
Arch Orthop Trauma Surg · Jan 2013
Outcome of Autologous Matrix Induced Chondrogenesis (AMIC) in cartilage knee surgery: data of the AMIC Registry.
Autologous Matrix-Induced Chondrogenesis (AMIC) is an innovative treatment for localized full-thickness cartilage defects combining the well-known microfracturing with collagen I/III scaffold. The purpose of this analysis was to evaluate the medium-term results of this enhanced microfracture technique for the treatment of chondral lesions of the knee. ⋯ Prognostic study, Level IV.
-
Arch Orthop Trauma Surg · Jan 2013
Core decompression and implantation of bone marrow mononuclear cells with porous hydroxylapatite composite filler for the treatment of osteonecrosis of the femoral head.
Implanted bone marrow mononuclear cells (BMMCs) may promote both osteogenesis and angiogenesis in the femoral head. The aim of this study was to investigate the effectiveness of core decompression and implantation of BMMCs with porous hydroxyapatite bone filler for the treatment of osteonecrosis of the femoral head (ONFH). ⋯ Both core decompression with or without implantation of BMMC are effective treatment for ONFH. However, core decompression with implantation of BMMCs and porous hydroxyapatite bone filler may be a more effective treatment for ONFH.
-
Arch Orthop Trauma Surg · Jan 2013
Review Case ReportsCannulated screw unraveling: a case series and literature-based review of an under-recognized complication.
Partially threaded cannulated screws have enhanced the orthopedic surgeon's ability to fix periarticular fractures. There are many reports of complications and hardware failure during screw removal, but those during fracture fixation are under-reported and under-recognized in the literature. We describe a 21-year-old healthy man with a grade 1 open displaced medial epicondylar humerus fracture. ⋯ We believe that screw unraveling is an under-reported complication of fracture fixation with cannulated screws that should be recognized by the orthopedic community. We found intra-operative fluoroscopy integral to the recognition of the problem in our case and recommend its use in fracture fixation with cannulated screws. We also suggest pre-drilling of cortices, especially when operating on young patients with strong bone.