Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2019
Staged internal plate fixation of severe lower extremity fractures that use a temporary external fixator for the initial treatment as an intraoperative retention tool: a technical note.
Staged treatment for severe lower extremity fractures is coming into widespread use, and some reports have described internal fixation (IF) using a temporary external fixator for primary care as an intraoperative retention tool. However, the infection risk with this procedure has not been examined sufficiently. To our knowledge, this article is the first report focusing exclusively on this specific surgical technique. ⋯ In all 19 fractures treated with our set protocol, postoperative infection did not occur. In this regard, however, a goal of definitive IF at the time of initial treatment is essential for this specific procedure. This technique could help orthopaedic trauma surgeons to import a temporary external fixator into the operative field for definitive IF, with less concern regarding risk of infection.
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Arch Orthop Trauma Surg · Jan 2019
Insights into treatment and outcome of fracture-related infection: a systematic literature review.
Standardized guidelines for treatment of fracture-related infection (FRI) are lacking. Worldwide many treatment protocols are used with variable success rates. Awareness on the need of standardized, evidence-based guidelines has increased in recent years. This systematic literature review gives an overview of available diagnostic criteria, classifications, treatment protocols, and related outcome measurements for surgically treated FRI patients. ⋯ This extensive literature review shows a lack of standardized guidelines with respect to diagnosis and treatment of FRI, which mimics the situation for prosthetic joint infection identified many years ago. Internationally accepted guidelines are urgently required to improve the quality of care for patients suffering from this significant complication.
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Arch Orthop Trauma Surg · Jan 2019
Dorsal transosseous reduction and locking plate fixation for articular depressed middle phalangeal base fracture.
An articular depressed fragment at the base of the middle phalanx can be an obstacle to congruent reduction and stable fixation. This study assessed the outcomes of a transosseous reduction technique combined with locking plate fixation for the treatment of articular depressed middle phalangeal base fracture. ⋯ Therapeutic, level IV.
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Arch Orthop Trauma Surg · Jan 2019
Fixation of a modular curved revision stem with a taper of 2° in the femur.
Modular revision stems with a short distal component can prevent the bypassing of the femoral isthmus and hereby theoretically have advantages concerning risk of periprosthetic fractures, breakage of the junction and a technically easier revision procedure. ⋯ The use of combinations of short modular components leads to reproducibly good outcomes in femoral revision with respect to subsidence and loosening.
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Arch Orthop Trauma Surg · Jan 2019
The hamstring/quadriceps ratio is an indicator of function in ACL-deficient, but not in ACL-reconstructed knees.
The purpose of this study was to investigate the isokinetic, eccentric and isometric hamstring/quadriceps (HQ) ratios in patients before and after ACL reconstruction (ACLR) using bone-patellar tendon grafts and to establish the relationships between HQ ratio and knee function. ⋯ Level IV, case series.