Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2017
Femoral neck fracture osteosynthesis by the biplane double-supported screw fixation method (BDSF) reduces the risk of fixation failure: clinical outcomes in 207 patients.
Osteosynthesis of femoral neck fractures is related up to 46% rate of complications. The novel method of biplane double-supported screw fixation (BDSF; Filipov's method) offers better stability using three medially diverging cannulated screws with two of them buttressed on the calcar. Biomechanically, the most effective component is the distal screw placed at steeper angle and supported on a large area along the distal and posterior cortex of the femoral neck following its spiral anterior curve. Thereby, BDSF achieves the strongest possible distal-posterior cortical support for the fixation construct, which allows for immediate full weight-bearing. The aim of this study was to evaluate the outcomes from the first 5-year period of BDSF clinical application. ⋯ By providing additional cortical support, the novel BDSF method enhances femoral neck fracture fixation strength.
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Arch Orthop Trauma Surg · Jun 2017
ReviewTreatment and outcome with traumatic lesions of the olecranon and prepatellar bursa: a literature review apropos a retrospective analysis including 552 cases.
Traumatic lesions of the olecranon bursa (OB) and prepatellar bursa (PB) are injuries commonly seen in orthopaedic trauma units. These injuries are associated with a high rate of complications. At present, only little is known about the incidence, complication rate, and treatment approaches in patients with acute open bursae. ⋯ Traumatic lesions of the OB and PB are associated with a high risk of complications. Prophylactic antibiotic therapy can potentially reduce the risk of infection and the need for revision surgery.
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Arch Orthop Trauma Surg · Jun 2017
Using an anatomically preshaped low-profile locking plate system leads to reliable results in comminuted radial head fractures.
For comminuted and displaced fractures of the radial head open reduction and internal fixation (ORIF) is recommended nowadays as the treatment of choice. Due to the development of locking plates the possibilities of ORIF in complex fracture types were extended. The purpose of this retrospective survey therefore was to review the preliminary subjective and objective results in patients treated by anatomically preshaped locked plating. A reliable fracture healing for these recently introduced plating devices was hypothesized. ⋯ The treatment of comminuted radial head fractures using anatomically preshaped locking radial head plates represents a reliable and safe surgical approach, leading to good to excellent functional results. Being aware of the importance of the radial head for elbow stability, open reduction and internal fixation should be preferred prior to radial head resection or replacement in complex radial head fractures. Further trials with a higher number of patients are needed to confirm the advantages of preshaped radial head plates.
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Arch Orthop Trauma Surg · Jun 2017
Three-dimensional motion analysis for validation of shoulder internal rotation.
10% of the points for the Constant-Murley score (CMS) are allocated for the capacity for internal rotation (IR), measured as unassisted active movement of the dorsum of the hand or the thumb to reach different anatomical landmarks. However, there is little information about the validity of this method and no three-dimensional measurement of the degree of IR that is necessary to reach these landmarks. ⋯ Measurement of IR as described in the CMS is a suitable method. However, there was an increase of only 10° in IR between positions 3 and 5, which may be hard to measure with a standard goniometer in clinical practice.
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Arch Orthop Trauma Surg · Jun 2017
Case ReportsUnusual cause of the thumb basal joint pain: osteoid osteoma of the trapezium.
The trapezium is rare site of osteoid osteoma development. The diagnostic challenge lies in its rare occurrence, and requires differentiation from various disease entities causing thumb basal joint pain. ⋯ He was initially treated for calcific periarthritis because of concomitant calcifications around the thumb basal joint, but had undiscovered osteoid osteoma. A high index of suspicion to a patient with wrist pain unresponsive to prior treatment is necessary for diagnosis of osteoid osteoma.