Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2019
Case ReportsStaged arthrodesis using the Masquelet technique for osteomyelitis of the finger with articular destruction: a report of two cases.
Osteitis of the fingers is a serious infection that needs early diagnosis and appropriate surgical debridement and antibiotic treatment of the infected bone. If the effects of treatments are insufficient, long-term antibiotic treatment and repeated operations could be required. In worst cases, some patients may have to undergo amputation. ⋯ They obtained good infection control and better function of the finger than before the operation. Moreover, there was no recurrence of the infection. The Masquelet technique could be an alternative technique for osteitis with high risk of amputation.
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Arch Orthop Trauma Surg · Jul 2019
Tobacco use predicts poorer clinical outcomes and higher post-operative complication rates after open elbow arthrolysis.
Tobacco use is a worldwide public health problem, and has been found to be a predisposing factor for adverse functional outcomes and increased postoperative complication rates after various orthopedic operations. The purpose of this study was to determine the potential impact of tobacco use on open arthrolysis for post-traumatic elbow stiffness. ⋯ Level III; Retrospective Cohort Design; Therapeutic Study.
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Arch Orthop Trauma Surg · Jul 2019
Decrease surgery time by using an alternative lateral parapatellar approach for tibia shaft fracture nailing.
Medial parapatellar or transpatellar ligament approaches are commonly used for nail osteosynthesis in tibia shaft fractures. The lower leg is normally in a hanging position to allow guide wire insertion and reaming of the tibia. However, this position complicates fracture reduction and retention, as well as image intensification throughout the procedure. A lateral parapatellar approach with the lower leg in a semi-extended, horizontal position has been previously described for proximal tibial fracture fixation. The purpose of the presented study was to share the lateral parapatellar approach technique used in our institution and to analyse its feasibility for tibia shaft fracture fixation when compared to a medial parapatellar and transpatellar incision technique. ⋯ The extra-articular semi-extended tibial nailing technique using a lateral parapatellar approach was associated with a significant decrease in time of surgery, while fluoroscopy time was shorter but not significantly different between the three groups.
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Arch Orthop Trauma Surg · Jun 2019
Standardization of torsional CT measurements of the lower limbs with threshold values for corrective osteotomy.
Re-establishing anatomic rotational alignment of shaft fractures of the lower extremities remains challenging. Clinical evaluation in combination with radiological measurements is important in pre- and post-surgical assessment. Based on computed tomography (CT), a range of reference values for femoral torsion (FT) and tibial torsion (TT) have historically been reported, which require standardization to optimize the significant intra- and inter-observer variability. The aims of this study were (re-)evaluation of the reference FT and TT angles, determination of the normal intra-individual side-to-side torsional differences to aid the surgical decision-making process for reoperation, and development of a novel 3D measurement method for FT. ⋯ The results from this study showed that the maximal side-to-side tolerance in asymptomatic normal adult lower extremities is 12°-13° for FT and 12° for TT, which could be a useful threshold for surgeons as indication for revision surgery (e.g., derotational osteotomy). We developed a new 3D CT method for FT measurement which is similar to 2D and could be used in the future for virtual 3D planning.
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Arch Orthop Trauma Surg · Jun 2019
> 10-year outcome of dislocated radial fractures with concomitant intracarpal lesions as proven by MRI and CT.
To clarify the role of concomitant carpal lesions in dislocated distal radius fractures (DRF), 104 consecutive patients with DRF underwent a preoperative morphological examination using CT and MRI. The study was performed between 2004 and 2006 with the aim of recording all types of concomitant carpal lesions as well as their consequences after 1 year. Carpal lesions of different types were found in all treated cases of dislocated DRF. ⋯ Again, there were no correlations with the primarily recognized carpal lesions [comparable groups 22 vs 22 (identical patients in both follow-ups); lost to follow-up rate 15.4%]. These results suggest that concomitant carpal lesions are primarily prevalent and detectable in (nearly) all dislocated DRF cases. However, with the usual protection of the wrist and the carpus after surgical treatment of DRF, these lesions often do not decompensate or require treatment, even after 10 years.