Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2022
The base of coracoid process as a reference for glenoid reconstruction in primary or revision reverse shoulder arthroplasty: CT-based anatomical study.
Joint replacement surgery as a treatment for glenohumeral arthritis with glenoid bone loss is challenging. The aim of this study is to offer an anatomical orientation for glenoid reconstruction. ⋯ III.
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Arch Orthop Trauma Surg · Mar 2022
Comparing radial lengthening osteotomy with ulnar shortening osteotomy to treat ulnar impaction syndrome after distal radius fracture malunion.
Distal radius mal-unions often cause radius shortening and ulnar impaction syndrome. The modern treatments of ulnar impaction syndrome following distal radius mal-union are ulnar shortening osteotomy (USO) and distal radius lengthening osteotomy (DRLO). However, there are few studies to compare long-term outcomes of these two treatments. This study compares isolated USO to DRLO for the treatment of ulnar impaction syndrome following distal radius mal-union. ⋯ Although both treatments improved range of motion, grip strength, and VAS for pain, DRLO was found in better reduction of pain and improvement of function. USO is a simpler procedure with a shorter operative time but it has an increased potential to cause subsequent osteoarthritis of the DRUJ as its incongruity of DRUJ after USO especially in reverted inclination. DRLO can be a preferred method for treating USWP in relevant distal radial mal-union.
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The proximal ulna has been comprehensively described in the anatomic literature and imaging studies. However, to the best of our knowledge, the anatomy of the proximal ulna in children has not been fully described in the literature. ⋯ Good understanding of the anatomy of the pediatric proximal ulna will help to increase the knowledge base in pediatric orthopedic surgeons allowing them to provide improved treatment of fractures. Restoration of the correct forearm anatomy should result in superior clinical and functional results.
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Arch Orthop Trauma Surg · Mar 2022
Management of humeral nonunions following failed surgical fixation.
Management of humerus nonunions with previously failed fixation presents a complex problem. There are multiple revision fixation strategies, of which compression plating is a mainstay. The aim of this study was to assess the results of open reduction and direct compression plating without the need for autograft or allograft in the setting of revision humerus open reduction internal fixation. ⋯ The use of humeral shortening osteotomy and compression plating without autograft or allograft is a viable option for management of humeral nonunions which avoids the morbidity associated with autograft harvest. The patients with radial nerve palsy after the index procedure are likely to have a transient radial nerve palsy as well after the revision surgery necessitating proper informed consent prior to the operation.
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Arch Orthop Trauma Surg · Mar 2022
Bicompartmental, medial and patellofemoral knee replacement might be able to maintain unloaded knee kinematics.
Unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) are standard procedures for treating knee joint arthritis. Neither UKA nor TKA seems to be optimally suited for patients with bicompartmental osteoarthritis that affects only the medial and patellofemoral compartments. A bicompartmental knee arthroplasty (BKA) was designed for this patient group. This study aimed to compare the effectiveness of a BKA and TKA in restoring the kinematics of the knee joint. ⋯ Kinematics similar to that of the natural knee can be achieved by BKA under passive conditions. However, no functional advantage of BKA over TKA was detected, which suggests that natural knee kinematics cannot be fully imitated by an arthroplasty yet. Further prospective studies are required to determine the anatomic and design factors that might affect the physiologic kinematics.