Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2015
Outcome of the treatment of chronic isolated and combined posterolateral corner knee injuries with 2- to 6-year follow-up.
Injuries of the posterolateral corner (PLC) of the knee are rare. They are difficult to diagnose and can cause severe disability. This study presents the 20- to 70-month clinical and radiological outcomes of the anatomical reconstruction technique of LaPrade et al. ⋯ Significant improvement in the objective knee stability scores and clinical outcomes with anatomical reconstruction showed that this technique can be used to treat patients with chronic PLC injured knees. However, longer-term multicentre studies and studies with larger groups comparing multiple techniques are required to determine the best treatment method for PLC injuries.
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Arch Orthop Trauma Surg · Oct 2015
Long-term results after modified Epping procedure for trapeziometacarpal osteoarthritis.
Thumb trapeziometacarpal joint (TMJ) arthritis is among the most common degenerative joint diseases of the hand and predominantly affects patients in their fifth or sixth decade of life. Mid-term results of the most common surgical procedures were inconclusive regarding the superiority of one particular treatment method. This study presents the long-term outcomes of a modified Epping procedure. ⋯ Despite relatively high DASH scores, the overall outcome of the modified Epping procedure is encouraging. Subjective loss of strength is a main complaint among patients, whereas instability is less of concern.
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Arch Orthop Trauma Surg · Oct 2015
Wedge effect following intramedullary hip screw fixation of intertrochanteric proximal femur fracture.
The aim of the current study was to determine whether application of an intramedullary hip screw for definitive management of intertrochanteric fracture was associated with post-operative deformity. Specifically this study investigated whether nail insertion would cause a "wedge effect" of the intertrochanteric fracture manifesting as lateralization of the femoral shaft and varus malalignment. ⋯ Despite attention to detail, the application of an intramedullary hip screw for intertrochanteric fracture has the tendency to lateralize the shaft relative to the head/neck segment (The "wedge effect").
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Anterior cruciate ligament tears are one of the most frequent soft tissue injuries of the knee. A torn anterior cruciate ligament leaves the knee joint unstable and at risk for further damage to other soft tissues manifested as pain, dislocation, and osteoarthritis. A better understanding of the anatomical details of knee joints suffering anterior cruciate ligament tears is needed to understand and develop prediction models for anterior cruciate ligament injury and/or tear. ⋯ Anterior cruciate ligament injury has been shown to be caused by the forces which act on the ligament. These forces can result from hyperextension of the tibia or the internal rotation of tibia. The anatomical parameters of the knee joint (i.e., notch width index, anterior cruciate ligament width and length) have no role in the cause of an injury.
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Arch Orthop Trauma Surg · Oct 2015
Clinical TrialInterference screw for fixation of FDL transfer in the treatment of adult acquired flat foot deformity stage II.
Flexor digitorum longus transfer and medial displacement calcaneal osteotomy have shown favourable results in the treatment of adult acquired flat foot deformity stage 2. Little is known about the resorbable interference screw for tendon fixation and postoperative patient satisfaction though. Moreover possible changes of radiographic parameters at final follow-up, possible implant-associated complications and differences concerning clinical results at final follow-up to other studies using bone tunnel techniques for fixation of the FDL tendon were investigated. ⋯ We conclude that interference screw fixation for FDL transfer is a safe and promising operative technique, allowing a smaller skin incision without disrupting the normal interconnections at the knot of Henry, while achieving very high patient satisfaction and improving postoperative function as well as relieving pain. This method is technically easy to perform, has a low complication risk and we, therefore, recommend this fixation technique in patients with adult acquired flatfoot deformity stage 2.