Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2020
Conventional instruments are more accurate for measuring the depth of the tibial cut than computer-assisted surgery in total knee arthroplasty: a prospective study.
The most commonly used tool for implant positioning are conventional instruments (CI) followed by computer-assisted surgery (CAS). A number of studies have investigated the cutting error of the tibial component when CAS is used, but most of them were focused on the cutting angles. The accuracy of CAS to determine the depth of the cut has not received much attention, even though implications are similar or worse, than with an angle mismatch. ⋯ The results of this study suggest that the tibial cut depth, measured by the navigation, does not match the actual bony cuts performed, even if a perfect cut was achieved in both sagittal and coronal plane. Surgeons should be aware of the measurement error in the navigation system and potentially add an additional step for verifying the achieved depth of the cut.
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Arch Orthop Trauma Surg · Jun 2020
Clinical and radiological results of the vascularized medial femoral condyle graft for scaphoid non-union.
This study evaluated the use of a free vascularized bone graft with and without cartilage from the medial femoral condyle (MFC) in patients with recalcitrant scaphoid non-union, with a special focus on union rates and the osteochondral graft for proximal pole destruction. ⋯ The vascularized medial femoral bone graft leads to a good functional outcome in the treatment of scaphoid non-unions. The graft provides adequate blood supply and structural stability to the scaphoid. A proximal pole destruction can be replaced using an osteochondral graft with promising short-term results preventing carpal osteoarthritis and collapse.
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Arch Orthop Trauma Surg · May 2020
ReviewSalvage procedure after malunited distal radius fractures and management of pain and stiffness.
Indications for surgical treatment of distal radius fractures (DRF) remain controversial in the literature, especially in elderly patients. Complication rates after operatively treated DRF are low and well documented. ⋯ If conservative treatment fails then salvage procedures are necessary. This review summarizes the therapeutic options available to treat degenerative osteoarthritis after malunited distal radius fractures, regardless of the initial operative or conservative treatment.
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Arch Orthop Trauma Surg · May 2020
ReviewIndications, surgical approach, reduction, and stabilization techniques of distal radius fractures.
Distal Radius fractures (DRF) are one of the most common injuries in the upper extremity and incidence is expected to rise due to a growing elderly population. The complex decision to treat patients operatively or conservatively depends on a large variety of parameters which have to be considered. No unanimous consensus has been reached yet, which operative approach and fixation technique would produce the best postoperative functional results with lowest complication rates. This article addresses the available evidence for indications, approaches, reduction, and fixation techniques in treating DRF.
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Arch Orthop Trauma Surg · May 2020
ReviewRehabilitation after distal radius fractures: is there a need for immobilization and physiotherapy?
Although the literature generally agrees that displaced distal radius fractures require surgery, no single consensus exists concerning the length of immobilization and type of post-operative physiotherapeutic rehabilitation program. Palmar locking plate fixation represents a very stable fixation of the distal radius, and was assessed biomechanically in various studies. ⋯ One reason might be due to the pain caused during active wrist mobilization in the early post-operative stages or secondly to protect the osteosynthesis in the early healing stages preventing secondary loss of reduction. This article addresses the biomechanical principles, current available evidence for early mobilization/immobilization and impact of physiotherapy after operatively treated distal radius fractures.