Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2017
Three-dimensional motion analysis for validation of shoulder internal rotation.
10% of the points for the Constant-Murley score (CMS) are allocated for the capacity for internal rotation (IR), measured as unassisted active movement of the dorsum of the hand or the thumb to reach different anatomical landmarks. However, there is little information about the validity of this method and no three-dimensional measurement of the degree of IR that is necessary to reach these landmarks. ⋯ Measurement of IR as described in the CMS is a suitable method. However, there was an increase of only 10° in IR between positions 3 and 5, which may be hard to measure with a standard goniometer in clinical practice.
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Arch Orthop Trauma Surg · Jun 2017
Does the tibia component design affect the need for offset stems in revision total knee arthroplasty?
The stem/keel location varies between anatomic and symmetric revision tibial baseplates. The current study investigates the impact of an anatomic versus symmetric stem location on the need for offset couplers in revision total knee arthroplasty. ⋯ The current study suggests that while asymmetric anatomic tibial baseplates have benefits for revisions with minimal bone loss, symmetric tibial baseplates require less offset when larger bone defects are encountered.
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Arch Orthop Trauma Surg · Jun 2017
Case ReportsUnusual cause of the thumb basal joint pain: osteoid osteoma of the trapezium.
The trapezium is rare site of osteoid osteoma development. The diagnostic challenge lies in its rare occurrence, and requires differentiation from various disease entities causing thumb basal joint pain. ⋯ He was initially treated for calcific periarthritis because of concomitant calcifications around the thumb basal joint, but had undiscovered osteoid osteoma. A high index of suspicion to a patient with wrist pain unresponsive to prior treatment is necessary for diagnosis of osteoid osteoma.
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Arch Orthop Trauma Surg · Jun 2017
Impingement of the patellar component against the tibial post after posterior stabilized and constrained TKA: a pilot study.
Patella-post impingement (PPI), contact of the patellar component with the tibial post, occurs during deep knee flexion after posterior stabilized total knee arthroplasty (TKA). PPI can cause anterior knee pain, increased patellar pressure, wear of the polyethylene patellar component and tibial post, and poor range of motion. There have been no reports on the relationship between PPI and tibial post design. The aim of this study was to compare different tibial post designs with regard to PPI incidence. ⋯ This is the first study to analyze the relationship between PPI and the design of tibial post. Our results clearly show that tibial post design and TPC affect PPI. To avoid patellar component and tibial post impingement in deep flexion, appropriate TPC must be achieved during surgery. Improvements in tibial post design, especially in constrained prostheses, are also desirable. This study highlights the potential risk of PPI during deep flexion after TKA.
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Arch Orthop Trauma Surg · Jun 2017
Computer-aided analysis for optimal screw insertion in lateral mass of C1: An anatomical study.
Motion preserving techniques in C1 ring fractures are increasingly used especially in young patients. Therefore, lateral mass screws are inserted in the first vertebra and connected by a rod. The purpose of this study was to determine safe zones regarding the vertebral arteries and the medulla oblongata for optimal lateral mass screw positioning when fusing the C1-ring. ⋯ Screws should be positioned with a slightly converging angle of 16° and a slightly ascending angle of 10°. Due to the required high precision technique intraoperatively multiplanar 2 D or 3 D imaging is recommended to avoid harm to the vertebral artery or the spinal canal.