Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2016
Tibiocalcaneal arthrodesis as a limb salvage procedure for complex hindfoot deformities.
Tibiocalcaneal (TC) arthrodesis is a limb salvage method for patients with severe deformities combined with necrosis and/or luxation of the talus. The aim of this study was to examine the clinical and radiological outcome of TC arthrodesis. ⋯ TC arthrodesis is a promising and effective method for the treatment of severe ankle deformities with talus luxation. It allows patient's return to mobility with good to excellent patient satisfaction.
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Arch Orthop Trauma Surg · Apr 2016
ReviewVascular complications in plating of the proximal femur: review.
Plating of the proximal femur represents a standard fixation method in orthopedic and trauma surgery. Vascular lesions are uncommon but potentially life-threatening. With the increasing number of hip surgery also more of these complications have to be anticipated. The purpose of this study was to evaluate the most common types and locations of vascular lesions after plating of the proximal femur as well as the most important causes. ⋯ Vascular compromise in plate osteosynthesis of the proximal femur affects significantly more often the DFA system and represents most often PA. As the majority of cases revealed iatrogenic origin, a thorough surgical technique and awareness can help to avoid these complications.
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Arch Orthop Trauma Surg · Apr 2016
Comparative StudyFour-corner fusion: comparison of patient satisfaction and functional outcome of conventional K-wire technique vs. a new locking plate.
Four-corner fusion is a standard procedure for advanced carpal collapse. Several operative techniques and numerous implants for osseous fixation have been described. Recently, a specially designed locking plate (Aptus©, Medartis, Basel, Switzerland) was introduced. The purpose of this study was to compare functional results after osseous fixation using K-wires (standard of care, SOC) with four-corner fusion and locking plate fixation. ⋯ Both techniques for four-corner fusion have similar healing rates. Using the more expensive locking implant avoids a second operation for K-wire removal, but no statistical differences were detected in functional outcome as well as in patient satisfaction when compared to SOC.
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Arch Orthop Trauma Surg · Apr 2016
Two-stage revision arthroplasty for periprosthetic joint infections: What is the value of cultures and white cell count in synovial fluid and CRP in serum before second stage reimplantation?
Besides CRP in serum, white cell counts and cultures of synovial fluid are routinely used to detect periprosthetic joint infections. But the sensitivities of these parameters do vary from 12 to 100 %. In two stage revision arthroplasty before the second stage surgeons have to decide if reimplantation is justified. Therefore, we investigated the value of cultures and white cell count from the synovial fluid with a polymethyl methacrylate spacer in place and CRP in serum before reimplantation to detect persistent infection in a standardized setting. ⋯ Cultures from synovial fluid and white blood count in synovial fluid and CRP seem to be uncertain parameters to exclude persistent infection. We do not recommend joint aspiration before reimplantation anymore. Further research is necessary to find other markers to confirm or exclude persistent infection.
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Arch Orthop Trauma Surg · Apr 2016
Systemic antibiotic therapy does not significantly improve outcome in a rat model of implant-associated osteomyelitis induced by Methicillin susceptible Staphylococcus aureus.
Treatment of implant-associated osteomyelitis regularly involves the use of systemic antibiotics in addition to surgical intervention. However, it remains unclear if perioperative systemic application of bactericide substances can improve overall outcome in models of severe intramedullary infection. The present study investigated the use of systemic gentamicin in addition to a controlled local release from a highly lipophilic gentamicinpalmitate compound while the previous study showed efficacy of sole antibiotic implant-coating. ⋯ Systemic perioperative and implant-associated application of antibiotics were both comparably effective to treat implant-associated infections whereas the combined antibiotic therapy further reduced systemic signs of infection time dependent.