Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2013
The incidence of posterior tibial plateau fracture: an investigation of 525 fractures by using a CT-based classification system.
Fractures of the tibial plateau are seen frequently in orthopedic trauma units and traditionally classified based on two-dimension plain radiographs with the Schatzker Classification system, the most popular. This system focuses on fractures involving the medial and lateral plateau but does not comment on fractures that involve the posterior aspect of the tibial plateau. The purpose of this study was to investigate the incidence of posterior tibial plateau fracture and propose a new computed tomography (CT)-based three-column classification system to guide fracture treatment. ⋯ Fractures of the posterior tibial plateau are not uncommon, especially in high-energy trauma. CT imaging is required to appreciate these fracture patterns, and a three-column classification allows for a better understanding of the fracture morphology and the injury mechanism, which guides surgical management.
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Arch Orthop Trauma Surg · Jul 2013
The use of a dual-mobility concept in total hip arthroplasty patients with spastic disorders: no dislocations in a series of ten cases at midterm follow-up.
Total hip arthroplasty (THA) is one of the treatment options in patients with cerebral palsy (CP) with painful osteoarthritis of the hip. However, the risk of dislocation of the prosthesis is higher in patients with CP when compared with physically normal patients. In this retrospective study of ten consecutive cases, we hypothesized that the use of a dual-mobility cup could reduce this risk of dislocation combined with good functional results. ⋯ The use of a dual-mobility cup in THA in patients with CP can lead to favourable results with respect to dislocation and clinical outcome.
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Arch Orthop Trauma Surg · Jul 2013
Return to play following ACL reconstruction: survey among experienced arthroscopic surgeons (AGA instructors).
There is a lack of consensus regarding appropriate criteria attesting patient's unrestricted sports activities after ACL reconstruction. The purpose of this study was to perform a survey among experienced arthroscopic surgeons regarding their return to play guidelines in these patients. ⋯ In conclusion, the majority of surgeons do not consider muscle function, jump tests, alignment tests, and proprioception as relevant return to sports criterion. However, these are two crucial parameters for return to sports.
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Arch Orthop Trauma Surg · Jul 2013
Traumatic and degenerative cartilage lesions: arthroscopic differentiation using near-infrared spectroscopy (NIRS).
Cartilage lesions or defects are the most common finding during knee arthroscopy. During arthroscopy, it is often difficult to differentiate between degenerative and traumatic cartilage lesions. The study aimed to determine the impact of near-infrared spectroscopy (NIRS) on the distinction between traumatic and degenerative cartilage lesions in the medial femoral condyle (MFC). It was hypothesized that NIRS as able to distinguish between traumatic and degenerative cartilage lesions. ⋯ After an injury, cartilage has a normal or nearly normal absorbance on near-infrared-light. Thus, it is possible to distinguish intraoperatively between traumatic and degenerative lesions. In addition, our results demonstrate that evaluating cartilage with NIRS is a dependable method for improving the diagnosis of significant chondral lesions.
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Arch Orthop Trauma Surg · Jul 2013
Intraosseous correction of misdirected cannulated screws and fracture malalignment using a bent tip 2.0 mm guidewire: technique and indications.
Percutaneous pelvic screw placement is a technically demanding procedure. A precise intraosseous pathway must be prepared before screw placement into any osseous fixation pathway of the pelvis. ⋯ This technique also allows for manipulation and reduction of certain malaligned pelvic fractures prior to percutaneous cannulated screw placement. This technique does not substitute for poor surgical technique but is used to optimize the position of percutaneously placed pelvic screws.