Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2017
The biodegradable spacer as a novel treatment modality for massive rotator cuff tears: a prospective study with 5-year follow-up.
The management of massive, irreparable rotator cuff tears (RCT) is challenging and associated with high failure rates. There are no current consensus or definitive guidelines concerning the optimal surgical treatment for this devastating condition. This study was designed to confirm the long-term safety and efficacy of the biodegradable inflatable InSpace™ system in patients with massive reparable or irreparable RCTs. ⋯ We conclude that in this initial cohort, arthroscopic implantation of InSpace™ system represented an effective alternative to the existing arthroscopic procedures in patients with painful massive RCT refractory to conservative management. Further randomized controlled trials comparing the clinical and functional outcomes after implantation of the InSpace™ device are warranted.
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Arch Orthop Trauma Surg · Jan 2017
Do we still need autopsy in times of modern multislice computed tomography?-Missed diagnoses in the emergency room.
In spite of increasing quality of emergency room (ER) assessment in trauma patients and improved accuracy of modern multislice computed tomography (MSCT), the number of potentially missed diagnoses is still controversial. The aim of this study was to compare the initial findings of ER assessment and MSCT to the findings during autopsy in trauma patients not surviving the first 48 h after admission. We hypothesized that autopsy was more accurate than MSCT in diagnosing potentially fatal diagnoses. ⋯ As determined by autopsy, modern multislice computed tomography is an accurate method to diagnose injuries. However, 25% of all diagnoses, and 4.1% of potentially fatal diagnoses are still missed in trauma patients, who deceased within the first 48 h after admission. Therefore, autopsy seems to be necessary to determine potentially missed diagnoses for both academic and medicolegal reasons as well as for quality control.
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Arch Orthop Trauma Surg · Jan 2017
PEEK versus titanium locking plates for proximal humerus fracture fixation: a comparative biomechanical study in two- and three-part fractures.
The high rigidity of metal implants may be a cause of failure after fixation of proximal humerus fractures. Carbon fiber-reinforced polyetheretherketone (PEEK) plates with a modulus similar to human cortical bone may help to overcome this problem. The present study assesses the biomechanical behavior of a PEEK plate compared with a titanium locking plate. ⋯ In this biomechanical study on unstable proximal humerus fractures, fixation with a PEEK plate showed lower fixation strength and increased motion at the bone-implant interface compared with a titanium locking plate.
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Arch Orthop Trauma Surg · Jan 2017
Single minimal incision fasciotomy for the treatment of chronic exertional compartment syndrome: outcomes and complications.
Chronic exertional compartment syndrome (CECS) is a common injury in young athletes, causing pain in the involved leg compartment during strenuous exercise. The gold standard treatment is fasciotomy, but most of the reports on its effectiveness include relatively small cohorts and relatively short follow-up periods. This study reports the long-term results of a large cohort of young athletes who underwent single-incision fasciotomy for CECS. ⋯ Single-incision fasciotomy leads to long-term improvement in the activity level and QOL of patients with CECS.
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Arch Orthop Trauma Surg · Jan 2017
Patient-specific factors influencing the traction forces in hip arthroscopy.
The application of traction in hip arthroscopy is associated with peri-operative complications. Within a therapeutic case series, patient-related factors correlating with high-traction forces during hip arthroscopy and occurring complications should be identified. ⋯ The study revealed several patient-specific risk factors correlating with high-traction forces during hip arthroscopy. With view to potential complications, these patient groups require special attention during surgical treatment as well as in future studies.