Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2013
Randomized Controlled Trial Multicenter StudySingle-bone intramedullary fixation of unstable both-bone diaphyseal forearm fractures in children leads to increased re-displacement: a multicentre randomised controlled trial.
Both-bone diaphyseal forearm fractures in children can be stabilised without cast by a flexible intramedullary nail in both the radius and the ulna. Adequate results with single-bone fixation combined with a complementary cast are also reported. However, because those results are based on a selection of children, this trial investigates whether single-bone intramedullary fixation, compared with both-bone intramedullary fixation, results in similar pronation and supination in children with an unstable diaphyseal both-bone forearm fracture. ⋯ These results caution against the use of single-bone fixation in all both-bone forearm fractures. This method may lead to increased re-displacement and reduced clinical results.
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Arch Orthop Trauma Surg · Aug 2013
Review Case ReportsFractures of the anatomical neck of the scapula: two cases and review of the literature.
Anatomical neck fractures of the scapula are rare. The authors have found in the literature only four radiologically documented fractures of the anatomical neck of the scapula. Two of them were published by Hardegger et al., the third case was published by Arts and Louette. ⋯ In all six cases, the subacromial space between the acromion and the humeral head was widened. All fractures were operated on via a Judet posterior approach. In five cases, the outcome of the operation was assessed at 3, 5, 12, 21 and 120 months after surgery, three-being rated as excellent or very good, one as good and one as poor.
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Arch Orthop Trauma Surg · Aug 2013
Role of navigated total knee arthroplasty for acute tibial fractures in the elderly.
The role of total knee arthroplasty (TKA) in acute tibial fractures with existing comminution/bone loss, osteoporosis or preexistent arthritis has been described in the literature. Many of these procedures necessitate the use of stems to off-load the component and augments/wedges to avoid overresection and hence restore the joint line. Conventional methods may not be consistently accurate in restoring the desired alignment within 3° of the anatomical axis in this complex scenario. Computer-assisted TKA has been demonstrated to reproducibly and accurately restore the mechanical axis and joint line in primary TKA. Literature review has sparse data on use of navigation in acute TKA. ⋯ Total knee arthroplasty should be considered a treatment option for acute upper tibial fractures in the elderly with coexistent knee arthritis and poor bone stock. Computer-assisted navigation aids in restoration of mechanical axis and component positioning.
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Arch Orthop Trauma Surg · Aug 2013
Multicenter StudyPigmented villo-nodular synovitis and giant-cell tumor of tendon sheaths: a binational retrospective study.
Pigmented villonodular synovitis is rare. Thus, we initiated a retrospective multi-center study regarding symptoms, location, type of disease, type of surgery, number of recurrences, use of adjuvant therapies and functional outcome. ⋯ Prognostic multi-center study, Level III.
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Arch Orthop Trauma Surg · Aug 2013
Midterm results after modified Epping procedure for trapeziometacarpal osteoarthritis.
Various surgical procedures have been proposed for the treatment of trapeziometacarpal joint (TMJ) osteoarthritis. Despite an overall satisfactory outcome in most cases, some patients complain about inadequate performance at work, due to instability of the TMJ. We present a cross-sectional study of patients with TMJ arthritis who underwent a modified Epping procedure for increased TMJ stability. ⋯ The great majority of patients who underwent this novel procedure benefited from an unaffected or improved work performance, due to good TMJ stability combined with adequate motion for ADL. Less favorable results were seen in patients with accompanying hand pathologies.