Archives of orthopaedic and trauma surgery
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Dwarfism is a challenge in arthroplasty. The anatomical features provide a lot of pitfalls. The aim of this study was to follow-up growth-restricted patients after endoprosthetic treatment. ⋯ Knee arthroplasty can be performed in patients suffering from dwarfism with good clinical benefits. However, survival rates are worse compared to the general population.
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Arch Orthop Trauma Surg · Aug 2015
The effect of postoperative wound infections on functional outcome following intra-articular calcaneal fractures.
High rates of postoperative wound infections (POWI) are reported following the operative treatment of calcaneal fractures. This leads to additional therapy, prolonged hospital stay, burden for patients and increased costs. The primary aim of this study is to evaluate the effect of POWI following the extended lateral approach of displaced intra-articular calcaneal fractures on functional outcome. Secondary aims are assessment of health-related quality of life and patient satisfaction. ⋯ Our results implicate that postoperative wound infection leads lower functional outcome scores following calcaneal fracture surgery, but no statistical significance was reached. In addition, patients do not report significant worse QOL or physical impairment. Overall patient satisfaction measured by a VAS was significantly lower in case of a POWI, reflecting the burden caused by a wound complication.
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Arch Orthop Trauma Surg · Aug 2015
Extra- vs. intramedullary treatment of pertrochanteric fractures: a biomechanical in vitro study comparing dynamic hip screw and intramedullary nail.
Due to the demographic trend, pertrochanteric fractures of the femur will gain increasing importance in the future. Both extra- and intramedullary implants are used with good results in the treatment of these fractures. New, angular stable extramedullary implants promise increased postoperative stability even with unstable fractures. Additional trochanteric plates are intended to prevent secondary impaction, varisation and shortening of the fracture, as well as medialisation of the femoral shaft. The aim of this study was to perform a biomechanical comparison of both procedures regarding their postoperative stability and failure mechanisms. ⋯ Extra- and intramedullary osteosynthesis showed comparable results as regards postoperative stiffness and survival during cyclic testing. Since the failure load of the nail was significantly higher in the tested AO31-A2.3 fracture model, we conclude that intramedullary implants should be preferred in these, unstable, fractures.
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Arch Orthop Trauma Surg · Aug 2015
Image-free navigated coracoclavicular drilling for the repair of acromioclavicular joint dislocation: a cadaver study.
Reconstruction of the coracoclavicular ligament functions to restore anatomic alignment of the clavicle and may improve biomechanical function and clinical outcomes. Improper placement of the coracoclavicular tunnel may inherently weaken the coracoid. The purpose of this study was to evaluate the feasibility and accuracy of navigated image-free placement of K-wires for coracoclavicular tunnel position in comparison to conventional drill guide-based placement. ⋯ Image-free navigated coracoclavicular drilling for the repair of acromioclavicular joint dislocation has higher first-pass accuracy in comparison to conventional drill guide-based placement and, therefore, may enable a precise anatomic position of the drill holes and reduce the risk of an iatrogenic coracoid fracture.
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Arch Orthop Trauma Surg · Aug 2015
Effect of patient position on measurement of patellar height ratio.
Patient position is an important factor which can affect the accuracy of patellar height ratio measurement. Varying degree of knee flexion angles and action of quadriceps muscle while supine or standing positions are the most concerning factors. ⋯ Quadriceps action had a significant influence on the mean values obtained by the MIS, CD, and BP methods. In clinical practice, interpretation for patella alta or patella baja of these measurement methods should be normalized according to the patient position. Varying the degree of knee flexion did not produce clinically important effects in any of the five patellar height measurement methods.