Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2013
Case ReportsThe use of a structural free iliac crest autograft for the treatment of acetabular fractures.
Bone and cartilage deficits in the posterior acetabular wall are severe complications resulting from the unsuccessful management or delayed treatment of acetabular fracture. This potentially disastrous condition cannot be treated reliably with the use of reconstruction plates and screws alone. Therefore, this technical report describes a modified anatomical reconstruction method that uses a structural iliac crest autograft and an acetabular tridimensional memory alloy fixation system (ATMFS) to treat late-stage deficits in the posterior wall of the acetabulum. This paper also describes a clinical study of 22 patients with an average of 6.3 years follow-up to evaluate the clinical outcomes of this method. ⋯ The use of a modified iliac crest grafting and ATMFS fixation, as a biological method to reconstruct the acetabulum anatomically may offer better congruence of the joint surface and may ensure good hip joint stability during early postoperative exercise. The medium to long-term results of this method are encouraging.
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Arch Orthop Trauma Surg · Jun 2013
Revision total hip replacement with a cemented long femoral component: minimum 9-year follow-up results.
Surgical revision after failed total hip replacement is a technically challenging procedure. The aim of this study was to analyze the long-term results of revision total hip replacement using a cemented long femoral component and identify factors that influence the results. ⋯ The quality of cementation was identified as a significant risk factor for further loosening. Revision total hip replacement using a cemented long femoral component yielded satisfactory long-term results in this series.
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Arch Orthop Trauma Surg · Jun 2013
Case ReportsA case of supracondylar humerus fracture with vascular impairment. Open it up?
Supracondylar humerus fracture is one of the most frequent fractures in childhood. A serious complication is an injury to the neurovascular structures which could potentially result in severe functional impairment. We are presenting the case of a 3-year-old girl with a supracondylar humerus fracture in our emergency department and highlight the diagnostic and therapeutic steps in managing this situation. ⋯ As concomitant vascular injuries after supracondylar humerus fractures are rare, it can be difficult to discriminate a pink pulseless hand from a patient with essential vascular injury. Our case also demonstrates the need for short-term reevaluation of the clinical status. When in doubt there should be no hesitation to perform open surgery and vascular repair.
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Arch Orthop Trauma Surg · Jun 2013
Arthroscopically assisted stabilization of chronic AC-joint instabilities in GraftRope™ technique with an additive horizontal tendon augmentation.
A chronic symptomatic acromioclavicular joint (ACJ) instability is a possible consequence of an acute ACJ separation. Besides vertical instability a horizontal component of the instability is common in high-grade ACJ separation and clinically relevant; especially, in chronic cases. A new technique of horizontal biologic ACJ augmentation with a transacromial gracilis tendon loop as an addition to the arthroscopically assisted stabilization with the GraftRope™ device is described and first clinical and sonographical results are shown. ⋯ The arthroscopically assisted stabilization of chronic ACJ instabilities with the GraftRope™ device and an additive horizontal tendon augmentation technique leads to good short-term results with a supplementary horizontal stabilization.
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Arch Orthop Trauma Surg · Jun 2013
Treatment of large posttraumatic tibial bone defects using the Ilizarov method: a subjective outcome assessment.
The treatment of large posttraumatic tibial bone defects using the Ilizarov method was shown to be successful in several studies. These studies, however, typically focus on the radiological and functional outcome using objective parameters only. The aim of the present study was therefore to assess the objective and subjective outcome of a consecutive series of patients with large posttraumatic tibial bone defects using the Ilizarov method. Additionally, it was our goal to assess the physical and mental stress for the patients and their relatives during the long treatment period and the general health status at final follow-up. ⋯ The Ilizarov method is a safe option for the treatment of large posttraumatic tibial bone defects after failure of internal fixation despite the high complication rate. It is essential to comment this to the patients and their relatives prior to the application of the frame increase their compliance with the long and emotionally draining treatment. The Ilizarov method is worth the effort only in patients, who will presumably comply with this treatment option and all of its drawbacks.