Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2017
Posterior elements disruption with hybrid constructs in AIS patients: is there an impact on proximal junctional kyphosis?
Proximal junctional kyphosis (PJK) is a frequent proximal adjacent segment disease following spinal fusion in adolescent idiopathic scoliosis (AIS) and its rate has been estimated to 28% in the literature. The etiology is multifactorial, and risk factors associated with PJK are controversial. The aim of this study was to demonstrate that the disruption of muscular and bony tissue above the upper instrumented vertebra (UIV) during surgery does not increase the rate of PJK in patients undergoing posterior fusion for adolescent idiopathic scoliosis. ⋯ The disruption of ligamentous and bony tissue proximal to the UIV during the surgery does not increase the rate of PJK. Level of evidence IV.
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Arch Orthop Trauma Surg · May 2017
Functional and patient-reported outcomes of the Swanson metacarpo-phalangeal arthroplasty in the rheumatoid hand.
Replacement of the metacarpo-phalangeal joints (MCPJ) with silastic Swanson's implants can help decrease pain, stiffness and allow for improved function in rheumatoid arthritis (RA). There is a lack of patient reported outcome measure (PROM) studies assessing the efficacy of this procedure in RA. The aim of this study was to report any change in function, pain, stiffness and satisfaction following the Swanson MCPJ replacement using patient reported outcomes in a rheumatoid population. ⋯ Patient satisfaction and functional surrogate markers were overall favourable. Our results support the continued use of Swanson silastic arthoplasty in advanced RA.
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Arch Orthop Trauma Surg · May 2017
Rotator interval closure has no additional effect on shoulder stability compared to Bankart repair alone.
Arthroscopic Bankart repair (ABR) provides satisfactory results for recurrent anterior shoulder instability, but the high recurrence rate post-ABR remain a concern. One of the adjunct procedures proposed to improve ABR results is arthroscopic rotator interval closure (ARIC). This study prospectively evaluated the outcomes of ABRs alone compared to combined ABR + ARIC and identified risk factors related to failure of each procedure. ⋯ Level 2.
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Arch Orthop Trauma Surg · May 2017
A systematic comparison of the closed shoulder reduction techniques.
To identify the optimal technique for closed reduction for shoulder instability, based on success rates, reduction time, complication risks, and pain level. ⋯ For closed reduction of anterior shoulder dislocations, the combined data from the selected studies indicate that scapular manipulation is the most successful and fastest technique, with the shortest mean hospital stay and least pain during reduction. The FARES method seems the best alternative.
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Arch Orthop Trauma Surg · May 2017
Case ReportsFinger reconstruction using induced membrane technique and ulnar pedicled forearm flap: a case report.
Injuries referred to as "rollover hands" are associated with multiple and complex lesions of the dorsal aspect of the hand. We present a case of a multitissular reconstruction following a severe injury of the dorsum of the fingers in a 45-year-old woman. ⋯ Rollover hands are typically a challenge for both the patient and the hand surgeon. The risk of septic complications, as well as the need for several stages of surgical reconstruction, makes the Masquelet technique particularly attractive for the treatment of phalanx bone defects consecutive to rollover injuries.