Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2013
Comparative StudyMultiple drilling compared with standard core decompression for avascular necrosis of the femoral head in sickle cell disease patients.
Sickle cell disease (SCD) is the most common cause of avascular necrosis of femoral head (ANFH) in childhood. Advances in medical treatment led to improved life expectancy of such patients. SCD-related ANFH frequently progress to total collapse of the femoral head necessitating hip replacement. However, SCD patient are at more risk of intra- and post-operative complications and suboptimal outcome of total hip arthroplasty. Hence, it is imperative to preserve the femoral head as long as possible. ⋯ While multiple drilling is safer and less invasive than single coring in SCD, there is no statistically significant difference in outcome or complication rate between both procedures done for ANFH in patients with SCD.
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Arch Orthop Trauma Surg · May 2013
The effect of rotational deformity on patellofemoral parameters following the treatment of femoral shaft fracture.
The purpose of this study was to investigate the effect of rotational deformities on patellofemoral alignment using the dynamic magnetic resonance imaging method on patients whose femur fractures were treated with intramedullary locking nails. ⋯ The results of this study revealed that more than 10° of external rotation deformity could cause a detoriation in the patellofemoral scores. Anatomic reduction of the fracture site should be performed as soon as possible and external rotational deformities should especially be avoided in order to prevent patellofemoral malalignment.
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Arch Orthop Trauma Surg · May 2013
Minimally invasive plate osteosynthesis for humeral shaft fracture: a reproducible technique with the assistance of an external fixator.
Minimally invasive plate osteosynthesis (MIPO) has become a popular option for treatment of humeral shaft fractures. However, indirect reduction might risk unpromising results, with mal-alignment/mal-union or nonunion. The purpose of this study was to describe a reproducible MIPO technique that used an external fixator during the procedure as a tool for reduction and maintenance, and to assess the outcomes in patients with humeral shaft fracture. ⋯ Surgical treatment of humeral shaft fractures with external fixator-assisted reduction and MIPO resulted in excellent reductions and high union rates.
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Arch Orthop Trauma Surg · May 2013
Comparative StudyRadio-lunate arthrodesis in rheumatoid arthritis: outcome and techniques.
The wrist is one of the most affected joints in rheumatoid arthritis. The purpose of this retrospective study was to assess clinical, functional and radiographic results of radio-lunate arthrodesis. Two different operation and fixation techniques are compared and detailed outcome after this intervention is presented. ⋯ Due to high patient satisfaction and functional outcome, radio-lunate wrist arthrodesis can be recommended independent of fixation method.
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Arch Orthop Trauma Surg · May 2013
Comparative StudyLocking versus standard screw fixation for acetabular cups: is there a difference?
Total hip replacement has been established as a valid treatment option for displaced subcapital fractures. However, insufficient primary fixation may be the reason for early loosening in these osteoporotic patients. Primary fixation of the cup is usually achieved by press-fit fixation that can be enhanced using screws. Locking the screws into their respective cups may seem to improve the primary fixation of the construct, as locked plates proved superior fixation for osteoporotic fractures. ⋯ These experimental results indicate that acetabular screws enhance primary cup fixation. This may become significant in conditions where the acetabular bone stock is suboptimal, such as when performing total hip arthroplasty after displaced subcapital fractures. However, there is no superiority for locked screws over standard screw fixation.