Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · May 2018
Use of fully threaded cannulated screws decreases femoral neck shortening after fixation of femoral neck fractures.
Femoral neck fractures (FNF) are becoming increasingly common as population ages. Nondisplaced fractures are commonly treated by cancellous, parallel placed, partially threaded cannulated screws (PTS). This allows controlled fracture impaction. However, sliding implants can lead to femoral neck shortening (FNS) that has been shown to be correlated with reduced quality of life and impaired gait pattern. Recently, in our institution we have changed the fixation of FNF to fully threaded screws (FTS) with or without an additional partially threaded screw in order to minimize this phenomenon. The aim of this study was to compare the FNS in patients treated with FTS as compared with our historical controls treated with PTS. ⋯ This study proves that use of FTS improves the radiographic results following FNF fixation using cannulated screws.
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Arch Orthop Trauma Surg · May 2018
Management of periprosthetic shoulder infections with the use of a permanent articulating antibiotic spacer.
Management of periprosthetic shoulder infections (PSIs) still remains challenging. We conducted a retrospective case study to assess the outcomes of definitive articulating antibiotic spacer implantation in a cohort of elderly, low-demanding patients. We hypothesized that in patients with low functional demands seeking pain relief with chronic PSIs, treatment with a definitive articulating antibiotic spacer would lead to satisfying results concerning eradication of the infection, improvement of pain, and improving shoulder function. ⋯ Case series, Level IV.
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Arch Orthop Trauma Surg · May 2018
The effect of humeral-fenestration diameter in Outerbridge-Kashiwagi arthroplasty on failure load of the distal humerus: a cadaveric biomechanical study.
Outerbridge-Kashiwagi ulnohumeral arthroplasty is an effective method in treating elbow osteoarthritis; however, distal humerus fracture after surgery can become a critical issue. A previous biomechanical study has shown that the failure load of the distal humerus decreases after a fenestration, but the size of the fenestration hole has not yet been discussed. ⋯ The failure load of distal humeri did not differ significantly after fenestration of 12 or 15 mm. The clinical relevance is that as the risk of distal humerus fracture is not exacerbated, a larger-size fenestration hole could be of help to improve the effectiveness of this surgical procedure.
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Arch Orthop Trauma Surg · May 2018
Intra-ligamentary autologous conditioned plasma and healing response to treat partial ACL ruptures.
Conservative treatment of partial ACL ruptures is associated with a high failure rate, and often patients undergo ACL reconstruction. ACL preservation by trephination of the ACL origin and application of Autologous Conditioned Plasma (ACP) seems to be an intriguing new treatment option to favour ACL tissue healing and avoid traditional reconstruction. The aim of this study was to describe the mid-term outcomes of this new ACL preserving technique. ⋯ ACL stump trephination and concomitant intra-ligamentary application of ACP revealed promising results at mid-term follow-up to treat partial ACL lesions.
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Arch Orthop Trauma Surg · May 2018
Gradual fibular transfer by ilizarov external fixator in post-traumatic and post-infection large tibial bone defects.
Several reconstructive procedures have been used in management of large tibial bone defects including bone graft, bone transport (distraction osteogenesis) using various external fixators, and vascularized bone graft. Each of these procedures has its limitations and complications. The study describes gradual medial fibular transfer using Ilizarov external fixators in management of patients with large tibial defect, either following infection or trauma. ⋯ Gradual fibular transfer by Ilizarov external fixator is a reliable technique in management of post-traumatic and post-infection large tibial bone defects with good clinical outcome, and with few complications.