Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2019
Meta AnalysisIsolated trochleoplasty for recurrent patellar dislocation has lower outcome and higher residual instability compared with combined MPFL and trochleoplasty: a systematic review.
To identify the efficacy of isolated trochleoplasty (TP) as an independent treatment for severe trochlear dysplasia compared with TP combined with medial patellofemoral ligament (MPFL) reconstruction. ⋯ Trochleoplasty is a useful and reliable surgical technique to improve patellofemoral instability in patients with a dysplastic trochlea. However, it as isolated treatment for patients has lower outcome and higher residual instability compared with combined MPFL and trochleoplasty.
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Arch Orthop Trauma Surg · Nov 2019
The PRECICE magnetic IM compression nail for long bone nonunions: a preliminary report.
The magnetic intramedullary (IM) compression nail is capable of providing sustained compression for the treatment of nonunions of long bones. This ability was previously only possible with the use of external fixation. We asked the following questions: How effective is the IM compression nail at achieving union? How do we know when adequate compression has been attained? Which types of nonunions are good candidates for this treatment? ⋯ The IM compression nail was successful at applying compression, preventing deformity, and obtaining union in all diaphyseal and in distal tibia metaphyseal nonunions. Signs of active compression are bending of the locking bolts and failure of the nail to shorten. Proximal tibia metaphyseal nonunion may not be suited for this treatment.
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Arch Orthop Trauma Surg · Nov 2019
Randomized Controlled TrialProspective randomized comparison of early versus newer-generation vertebral access devices for kyphoplasty.
Kyphoplasty is an established method of treating osteoporotic vertebral body compression fractures. In recent years, several techniques to enhance the efficiency and outcomes of this surgery have been developed and implemented in clinical practice. In the present study, we assess the impact of two new access instruments on overall operation time and the administered dose area product in comparison with the standard access instrument used in our clinical practice. The two newer comparator devices have been designed with the intention of streamlining intraoperative workflow by omitting several procedural steps. ⋯ Although use of the two newer-generation access instruments were designed to involve fewer unique steps per operation, their use was not associated with reduction in surgical duration, irradiation time or dose area product administered compared with the older, established vertebral access device. Care should be taken to evaluate the impact of new instruments on key surgery-related parameters such as surgical duration and radiation exposure and claims made about new instruments should be assessed a structured fashion.
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Arch Orthop Trauma Surg · Nov 2019
Randomized Controlled Trial Comparative StudyComparison of intraoperative radiation exposure with and without use of distal targeting device: a randomized control study.
When locking intramedullary nails, inserting the distal interlocking screw accurately and quickly with less radiation exposure is very important. The purpose of this randomized control study was to compare radiation exposure and accuracy of distal locking screws between free-hand fluoroscopic guidance and the use of a distal targeting system (DTS). ⋯ The attempt number of image intensifier during the insertion of two distal locking screws was significantly reduced with DTS compared with that with free hand fluoroscopic guidance. Angle between distal locking screws and nail was also more accurate using DTS.
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Arch Orthop Trauma Surg · Nov 2019
Comparative StudyThermal damage of osteocytes during pig bone drilling: an in vivo comparative study of currently available and modified drills.
The Gekkou-drill® is an industrial drill that is highly efficient due to reduced cutting resistance resulting from its characteristic drill point shape. In this experiment, we compared the degree of thermal damage to bone tissue caused by conventional medical drills and these same drills with Gekkou modifications. ⋯ Gekkou-modified medical drills shortened drilling times despite low thrust force, and histopathological assessment demonstrated a significant reduction in osteocyte damage.