Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2014
Treatment of periprosthetic femur fractures around a well-fixed hip arthroplasty implant: span the whole bone.
Periprosthetic femur fractures are a growing problem in the geriatric population. This study examines Vancouver B1 periprosthetic femur fractures treated with open reduction internal fixation using a laterally based plate. Outcomes using plates which spanned the length of the femur to the level of the femoral condyles were compared to those which did not. The hypothesis was that spanning internal fixation would result in a decreased rate of refracture and subsequent reoperation. ⋯ In this series, fixation for periprosthetic femur fractures around a well-fixed arthroplasty stem which spans the length of the femur to the level of the femoral condyles is associated with a decreased rate of nonunion and refracture. By decreasing the rate of refracture and nonunion, spanning fixation decreases the morbidity and mortality associated with additional surgery in a fragile geriatric population.
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Arch Orthop Trauma Surg · Jan 2014
The effects of femoral component design on the patello-femoral joint in a PS total knee arthroplasty.
Anterior knee pain following TKA performed utilizing the PFC Sigma system still represents a cause of failure. The purpose of this study was to evaluate whether or not a recent change in the femoral design (PFC Sigma PS) had a positive impact on the patello-femoral complication rate. ⋯ Although the PFC Sigma PS system provides good and predictable results for tricompartmental arthritis of the knee, anterior mechanism complications still represent a reason for dissatisfaction in a substantial group of patients.
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Arch Orthop Trauma Surg · Jan 2014
Randomized Controlled Trial Comparative StudyMinimal invasive and computer-assisted total knee replacement compared with the minimal invasive technique: a prospective, randomized trial with short-term outcomes.
Up to now, no prospective, randomized comparisons between minimal invasive and computer-assisted total knee arthroplasty (MICA-TKA), and minimal invasive technique (MI-TKA) has been documented to evaluate not only clinical, but also radiologic results of the MICA-TKA. This prospective, randomized study was performed to compare the short-term results of MICA-TKA with minimal invasive technique MI-TKA for 6-month follow-up. ⋯ Better alignment and similarity of good clinical results at short-term follow-up may provide subjects who receive MICA-TKA with long-term endurance of their implants. Further studies on longer-term outcomes and functional improvements are required to validate these possibilities.
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Tumors and tumor-like lesions in or around the median nerve are uncommon causes of carpal tunnel syndrome (CTS). The purpose of the present study is to highlight the diagnostic approach and point out the profile of patients with CTS and potential underlying pathology. ⋯ Although rare, the surgeon should include in the differential diagnosis of CTS the unusual cause of tumors and tumor-like lesions, especially when the patients' profile is not typical (young, male, no repetitive stress or manual labor). In addition, the presence of a palpable mass at the distal forearm or palm dictates the need for imaging studies. The extent, location and aggressiveness of the mass will determine the approach and type of procedure.
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Arch Orthop Trauma Surg · Jan 2014
Review Comparative StudyLaminoplasty versus skip laminectomy for the treatment of multilevel cervical spondylotic myelopathy: a systematic review.
Laminoplasty and skip laminectomy are two specific posterior surgical approaches for multilevel cervical spondylotic myelopathy. The objective of this study was to perform a systematic review comparing the clinical results and complications of laminoplasty and skip laminectomy in the treatment of multilevel cervical spondylotic myelopathy. ⋯ Based on the results above, the skip laminectomy group presented better outcomes in a variety of aspects: ROM % (post/pre), complication rate, surgical trauma, etc. However, as limited study samples were included in the paper, a claim of superiority of the two approaches could not be justified. Further studies are required on the comparison between laminoplasty and skip laminectomy.