Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2019
Graft tears after arthroscopic superior capsule reconstruction (ASCR): pattern of failure and its correlation with clinical outcome.
Arthroscopic superior capsule reconstruction (ASCR) using fascia lata autograft is a new surgical technique developed to overcome irreparable rotator cuff tears. There is little information about graft tear after ASCR and its impact on clinical outcome. This study is to investigate the graft tear rate, pattern of failure, and its correlation with clinical outcomes after arthroscopic superior capsule reconstruction (ASCR). ⋯ IV, case series, treatment study.
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Arch Orthop Trauma Surg · Feb 2019
Observational StudyRisk factors of postoperative valgus malalignment in mobile-bearing medial unicompartmental knee arthroplasty.
The aim of this observational study was to investigate the risk factors of postoperative valgus malalignment after mobile-bearing medial unicompartmental knee arthroplasty (UKA). ⋯ Preoperative smaller LDFA, FTFA, larger MPTA and less medial tibial cut thickness were significantly associated with postoperative valgus malalignment in mobile-bearing UKA.
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Arch Orthop Trauma Surg · Feb 2019
Treatment of scaphoid waist nonunion by one, two headless compression screws or plate with or without additional extracorporeal shockwave therapy.
Scaphoid nonunion remains challenging for hand surgeons. Several treatment options are available such as: non-vascularized or vascularized bone grafting, with or without additional stabilization. In the last few decades, extracorporeal shockwave therapy (ESWT) has become an established procedure for treating delayed and nonunions. Purpose of this retrospective follow-up study was (a) to investigate union rate and clinical outcome of the different implants [either one/two headless compression screws (HCS) or a plate] and (b) union rate and clinical outcome using only surgery, or a combination of surgery and ESWT. ⋯ Stabilization of scaphoid waist nonunions with two HCS or plate showed higher union rates than a stabilization using only one HCS. In addition, ESWT combined with a nonvascularized bone graft from the iliac crest seems a suitable option for treating scaphoid nonunions.
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Arch Orthop Trauma Surg · Feb 2019
Factors influencing the accuracy of iliosacral screw insertion using 3D fluoroscopic navigation.
The purpose of the present study was to determine which factors affect the positional accuracy of iliosacral screws inserted using 3D fluoroscopic navigation. Specifically, we asked: (1) does the screw insertion angle in the coronal and axial planes affect the positional accuracy of iliosacral screw insertion using 3D fluoroscopic navigation? (2) Is the positional accuracy of iliosacral screw insertion using 3D fluoroscopic navigation affected by the type of screw (transsacral versus standard iliosacral), site of screw insertion (S1 versus S2), patient position (supine versus prone), presence of a dysmorphic sacrum, or AO/OTA classification (type B versus C)? ⋯ Level IV, therapeutic study.
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Arch Orthop Trauma Surg · Feb 2019
Three-dimensional kinematics of the flexor pollicis longus tendon in relation to the position of the FPL plate and distal radius width.
The standard therapy of intra-articular and extra-articular distal radius fractures consists of open reduction and stabilization using palmar osteosynthesis with an angularly stable plate. The integrity of the flexor pollicis longus tendon (FPLT) may be mechanically affected by the plate, with rupture rates between 1 and 12% reported in the literature, occurring during a postoperative time period from 4 to 120 months. The aim of this study was to investigate the position of the tendon in relation to the distal edge of the plate using high-resolution ultrasonic imaging. ⋯ The results show that the indentation of the Medartis® APTUS® FPL plate reduces the tendon-plate contact and ideally even prevents it entirely. In particular, ulnar positioning of the plate lowers the risk of tendon-plate contact. If the FPLT touches the plate, the tendon pulls into the plate indentation, thus lowering the contact. Consequently, the Soong criteria are not applicable when a FPL plate is used.