Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2013
Planned preservation surgery for soft tissue sarcomas adjacent to critical structures.
Whether to preserve or sacrifice critical structures (bone, major vessels and major nerves) adjacent to soft tissue sarcomas is still controversial. Referring to characteristic imaging and intraoperative findings, we perform planned preservation surgery for these critical structures. The aim of this study was to investigate the clinical outcome of soft tissue sarcomas adjacent to critical structures and to validate this procedure. ⋯ When soft tissue sarcomas are located adjacent to bone or major vessels, by meticulously detaching the periosteum or neurovascular sheath referring to characteristic imaging and intraoperative findings, a histologically negative surgical margin can be achieved in the majority, allowing avoidance of postoperative radiotherapy. Planned preservation surgery provided no significant adverse effect on survival or local recurrence rates, validating this procedure.
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Arch Orthop Trauma Surg · Apr 2013
Outcome after proximal femoral fractures during primary total hip replacement by the direct anterior approach.
The literature suggests that intraoperative fractures of the greater trochanter and the metaphysis are increased with uncemented stems and the direct anterior approach. This study aims to determine the incidence and assess the functional and radiological outcome after such fractures. ⋯ The intraoperative fracture risk in this series of THR through a direct anterior approach was 2.7 %. Trochanteric fractures do heal without primary fixation. Metaphyseal fractures heal well if immediately stabilized with a cerclage.
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Arch Orthop Trauma Surg · Apr 2013
Avulsion fracture and complete rupture of the thumb radial collateral ligament.
Acute grade III tears of the radial collateral ligament (RCL) of the thumb as well as certain bony avulsion fractures receive early surgical repair at our institution. The aim of this study was to evaluate if patients would benefit from this treatment algorithm at long-term. ⋯ This retrospective analysis indicates that early surgical repair in severe RCL injuries is associated with unrestricted ROM, persistent joint stability, and subjective patient satisfaction. This data suggest that surgical treatment in certain RCL injuries might be a feasible therapeutic option in order to avoid chronic instability.
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Arch Orthop Trauma Surg · Apr 2013
Benign lytic lesions of the femoral neck: mid-term results of extended curettage and sartorius muscle pedicle bone grafting.
Benign lytic lesions of bone encompass a group of neoplastic or developmental disorders of human skeleton. They may involve different sites with varied clinical presentation and pattern of aggressiveness for which the treatment strategy needs to be tailored accordingly. Planning a treatment protocol for a lytic lesion in the femoral neck is a matter of concern for the operating surgeon with due consideration to the risks involved. ⋯ Sartorius muscle pedicle bone grafting using anterior approach is a good and reliable option in patients presenting with benign lytic lesion in the neck of femur.
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Arch Orthop Trauma Surg · Apr 2013
Meniscus suture provides better clinical and biomechanical results at 1-year follow-up than meniscectomy.
Surgery of meniscus tear results in limitation of function. The aim of study was functional assessment of knee 1 year after surgery with two techniques in cases of the medial meniscus tear followed by the same supervised rehabilitation. ⋯ Results suggest worse functional effects when meniscectomy is applied which implies modification of the rehabilitative methods in a postoperative period.