Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Dec 2014
Randomized Controlled TrialEfficacy of the assisted self-reduction technique for acute anterior shoulder dislocation.
The "original" traction-free Kocher's method to perform the reduction of shoulder dislocation has been recently reviewed and some authors speculated that it can be self performed by patients under the guide of the physician. In this way, as an "assisted self-reduction" technique, it is also effective and simple to perform. The aim is to study the effectiveness of the assisted self-reduction technique, in comparison to the well known and largely used traction-countertraction method. ⋯ The assisted self-reduction technique is simple, effective and gentle. Physicians on duty in the Emergency Departments should therefore be encouraged to use it.
-
Arch Orthop Trauma Surg · Dec 2014
Comparative StudyHamstring tendon autograft versus LARS artificial ligament for arthroscopic posterior cruciate ligament reconstruction in a long-term follow-up.
Surgical reconstruction has been increasingly recommended for the surgical management of posterior cruciate ligament (PCL) ruptures. While the choice of tissue graft still remains controversial. Currently both hamstring tendon autograft (HTG) and ligament advanced reinforcement system (LARS) artificial ligament are widely used but there are seldom reports on the comparisons of their clinical results. Our study was aimed to assess the effectiveness of these two grafts. ⋯ Similar good clinical results were obtained after PCL reconstruction using hamstring tendon autografts and LARS ligaments. Both LARS ligament and hamstring tendon autograft are ideal grafts for PCL reconstruction.
-
Arch Orthop Trauma Surg · Dec 2014
Direct reduction may need to be considered to avoid postoperative subtype P in patients with an unstable trochanteric fracture: a retrospective study using a multivariate analysis.
It has recently been reported that the cases with an anterior femoral neck cortex posterior to the distal fragment (subtype P) in the lateral view of a postoperative radiograph have a risk of excessive sliding of lag screws compared to those located anterior to the distal fragment (subtype A) or perfectly continuous to the distal fragment (subtype N) following osteosynthesis for the treatment of a trochanteric fracture. The purpose of this study was to investigate factors that influence the postoperative subtype in the lateral view of radiographs. ⋯ The results of this study suggest that direct reduction via a small elevator with a small skin incision or percutaneous intrafocal pinning may be needed in these cases.
-
Arch Orthop Trauma Surg · Dec 2014
Comparative StudyThe effectiveness of skeletal imaging for quality assessment in posterior cruciate ligament reconstruction: reliability and validity of radiographs and computed tomography.
For intra- and postoperative evaluation of precise and anatomic graft tunnel position, radiographs (XR) and computed tomography (CT) scans have been suggested. The purpose of this study was to evaluate the reliability and validity of XR and CT for quality assessment following PCL reconstruction. ⋯ XR and CT represent complementary imaging modalities and both offer considerable accuracy and precision for the determination of femoral and tibial tunnel apertures following PCL reconstruction and can be recommended for intra- and postoperative quality assessment.
-
Arch Orthop Trauma Surg · Dec 2014
Ankle injuries in distal tibial spiral shaft fractures: results from an institutional change in imaging protocol.
Posterior malleolus and other articular ankle injuries are known to concomitantly occur with tibial shaft fractures, especially spiral fractures of the distal one-third diaphysis. Due to our heightened awareness of this combined injury, our department instituted a new preoperative ankle imaging protocol for all distal one-third spiral tibia shaft fractures. The purpose of this study was to evaluate the effectiveness of an imaging protocol involving radiographs, CT and magnetic resonance imaging (MRI) in a distal one-third spiral tibia fracture cohort. ⋯ Concomitant ipsilateral ankle and distal one-third spiral tibial shaft fractures are more common than previously reported. Utilizing a new imaging protocol, we found that the incidence of this combined injury was 84 %. Recognition of the ankle fracture component in this tibial shaft cohort can be important as it may alter the surgical plan and postoperative management.