Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2014
Poor prognosis and complications are common in limb salvage surgery for malignant tumors of the proximal tibia invading the fibula.
Malignant tumors in proximal tibia invading fibula usually have a large tumor volume and are adjacent to the neurovascular bundles. The prognoses and functional outcomes of limb salvage for these patients are uncertain. We, therefore, asked whether patients with limb salvage surgery for malignant tumors in proximal tibia invading fibula had poorer oncological prognosis, higher complication rate, and lower postoperative functional score compared with patients without fibula invasion. ⋯ Patients with limb salvage surgery for malignant tumors in proximal tibia invading fibula had poorer oncological prognosis, higher complication rate, and acceptable postoperative functions compared with patients without fibula invasion.
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Arch Orthop Trauma Surg · Mar 2014
Arthrolysis combined with reconstruction for treatment of terrible triad injury with a poor outcome after surgical as well as conservative intervention.
The treatment of terrible triad injury with a poor outcome after intervention has not been successful thus far. The purpose of this study was to evaluate the efficacy of arthrolysis and reconstruction in the treatment of terrible triad injury with a poor outcome after surgical as well as conservative intervention. ⋯ The combination of open arthrolysis and reconstruction performed at a mean interval of 6-month posttrauma can restore functional mobility in cases of terrible triad injury with a poor outcome after surgical as well as conservative intervention. Thus, it may be an effective alternative for the treatment of the poor outcome terrible triad injury. We recommend early functional rehabilitation with adherence to the guidelines for hinged external fixation.
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Arch Orthop Trauma Surg · Mar 2014
ReviewPrepatellar and olecranon bursitis: literature review and development of a treatment algorithm.
Olecranon bursitis and prepatellar bursitis are common entities, with a minimum annual incidence of 10/100,000, predominantly affecting male patients (80 %) aged 40-60 years. Approximately 1/3 of cases are septic (SB) and 2/3 of cases are non-septic (NSB), with substantial variations in treatment regimens internationally. The aim of the study was the development of a literature review-based treatment algorithm for prepatellar and olecranon bursitis. ⋯ The available evidence did not support the central European concept of immediate bursectomy in cases of SB. A conservative treatment regimen should be pursued, following bursal aspirate-based differentiation between SB and NSB.
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Arch Orthop Trauma Surg · Mar 2014
Multicenter StudyThree-dimensional imaging of children with severe limitation of pronation/supination after a both-bone forearm fracture.
Although both-bone forearm fractures in children may result in severe limitation of forearm rotation, finding the cause remains a diagnostic challenge. This study tries to evaluate the role of rotational malunion, bony impingement and contractures of the interosseous membrane. ⋯ Prospective multicenter study, Level 2.
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Arch Orthop Trauma Surg · Mar 2014
Multicenter Study Clinical TrialLong-term results of the augmented PFNA: a prospective multicenter trial.
Pertrochanteric fractures are increasing and their operative treatment remains under discussion. Failures needing reoperations such as a cut-out are reported to be high and are associated with multiple factors including poor bone quality, poor fracture reduction and improper implant placement. The PFNA(®) with perforated blade offers an option for standardized cement augmentation with a PMMA cement to provide more stability to the fracture fixation. It remains unclear if the augmentation of this implant does any harm in a longer time span. This prospective multicenter study shows clinical and radiological results with this implant with a mean follow-up time of 15 months. ⋯ This study makes us believe that the standardized augmentation of the PFNA with a perforated blade is a safe method to treat pertrochanteric femoral fractures. It leads to good functional results and is not associated with cartilage or bone necrosis.