Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2017
A patient's perception of their hospital stay influences the functional outcome and satisfaction of total knee arthroplasty.
To assess whether patient satisfaction with their hospital stay influences the early outcome of total knee arthroplasty (TKA). ⋯ A patient's perception of their inpatient hospital experience after surgery is an important modifiable predictor of early functional outcome and satisfaction with TKA.
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Arch Orthop Trauma Surg · May 2017
A cadaveric biomechanical study comparing the ease of femoral nail insertion: 1.0- vs 1.5-m bow designs.
Anatomic fit of intramedullary nails was suggested by previous studies to improve significantly when the nail radius of curvature (ROC) is closer to the average femoral anatomy. However, no attempt has been made to investigate the impact of different ROC designs on the nail insertion process. Therefore, this biomechanical study quantitatively compared the ease of insertion between femoral intramedullary nails with a 1.0-m and a 1.5-m bow radius. ⋯ Compared to PFNA nails, a significant decrease in insertion force and nail deformation was found at the end of insertion for TFNA nails. Results suggest that TFNA having a 1.0-m ROC is easier to insert for the set of femora used in this study compared to PFNA with a 1.5-m ROC.
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Arch Orthop Trauma Surg · May 2017
Observational StudyComparative analysis of locking plate versus hook plate osteosynthesis of Neer type IIB lateral clavicle fractures.
Controversy exists on optimal operative treatment of vertically unstable Neer IIB lateral clavicle fractures. Aim of this study was to analyse and compare clinical and radiological results and complications of locking plate osteosynthesis (LPO) versus hook plate osteosynthesis (HPO) with acromioclavicular joint (ACJ) stabilization. The hypothesis was, that HPO would recreate coracoclavicular stability more effectively and potentially lead to a superior outcome. ⋯ Both HPO and LPO were equally effective in relation to restoration of vertical stability, overall functional outcome and fracture consolidation in treatment of Neer IIB fractures. Contrary to our hypothesis, HPO was not associated with superior recreation of the coracoclavicular distance. Considerable drawbacks of HPO were an inferior ACJ-specific outcome (Taft-Score) and a higher overall complication rate. Level of evidence IV.
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Arch Orthop Trauma Surg · May 2017
Review Meta AnalysisEffectiveness of decompression alone versus decompression plus fusion for lumbar spinal stenosis: a systematic review and meta-analysis.
The debate on efficacy of fusion added to decompression for lumbar spinal stenosis (LSS) is ongoing. No meta-analysis has compared the effectiveness of decompression versus decompression plus fusion in treating patients with LSS. ⋯ The additional fusion in the management of LSS yielded no clinical improvements over decompression alone within a 2-year follow-up period. But fusion resulted in a longer duration of operation, more blood loss, and a higher risk of complications. Therefore, the appropriate surgical protocol for LSS should be discussed further.
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Arch Orthop Trauma Surg · May 2017
Comparative StudySelective laminectomy for cervical spondylotic myelopathy: a comparative analysis with laminoplasty technique.
The purpose of this study was to evaluate the effectiveness of selective laminectomy compared with laminoplasty for patients with multilevel cervical spondylotic myelopathy (CSM) by evaluating the radiological and clinical outcomes. ⋯ Selective posterior laminectomy for the treatment of multilevel CSM showed advantages of shorter operation time and less blood loss, without a significant difference in clinical outcome, when compared with laminoplasty. However, postoperative kyphosis and decreased range of motion were limitations of laminectomy.