Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Mar 2017
Rehabilitation of Achilles tendon ruptures: is early functional rehabilitation daily routine?
Ruptures of the Achilles tendon are the most common tendon injuries of the lower extremities. Besides the initial operative or non-operative treatment, rehabilitation of patients plays a crucial role for tendon healing and long-term outcome. As only limited evidence is available for optimized rehabilitation regimen and guidelines for the initial (e.g., first 6 weeks) rehabilitation are limited, this study investigated the current rehabilitation concepts after Achilles tendon rupture. ⋯ Our study shows that a huge variability in rehabilitation after Achilles tendon rupture exists. This study shows different strategies in rehabilitation of Achilles tendon ruptures using a convertible vacuum brace system. To improve patient care, further clinical as well as biomechanical studies need to be conducted. This study might serve as basis for prospective randomized controlled trials to optimize rehabilitation for Achilles tendon ruptures.
-
Up to 50% of traumatic sternoclavicular joint (SCJ) dislocations need open reduction and fixation to prevent long-term complications and complaints. We present our preferred surgical approach for acute as well as chronic SCJ dislocations, including their outcome. ⋯ The presented technique allowed simple, effective, and durable repair of the SCJ joint in patients with SCJ dislocations with excellent functional outcomes.
-
Arch Orthop Trauma Surg · Mar 2017
Minimal effect of patella eversion on ligament balancing in cruciate-retaining total knee arthroplasty.
The effect of patellar eversion on ligament laxity measurements is still unclear. The purpose of this study was to investigate the influence of patellar eversion on medial and lateral ligament laxity measurements performed intra-operatively in total knee arthroplasty (TKA). ⋯ Earlier research has shown that ligament laxity must be at least 1-2 mm to cause inferior function after TKA. In the current study, we found that the effect of patellar eversion on ligament laxity measurements is too small to be considered clinically relevant. PROSPECTIVE STUDY EVALUATING THE EFFECT OF PATIENT CHARACTERISTICS: Level II.
-
Arch Orthop Trauma Surg · Mar 2017
3D Computer graphical anatomy study of the femur: a basis for a new nail design.
Current intramedullary nails with a radius of curvature (ROC) of 1500-2000 mm sometimes cause distal anterior cortical encroachment. Furthermore, clinical data indicate that the proximal nail end is too long for some Asian patients. The objective of our study was to develop a comprehensive 3D measurement protocol that measures both the anatomy of the canal and the proximal region. The protocol was used to obtain measurements from Caucasian and Asian (Japanese and Thai) specimens. ⋯ The developed comprehensive anatomical 3D measurement protocol could serve as standardised approach for anthropometric studies in the future. Our data suggest that the ROC of current nail designs should be reduced from between 1500 and 2000 to 1000 mm to achieve an improved fit for the investigated population.
-
Arch Orthop Trauma Surg · Mar 2017
Comparative StudyComparison of transtibial and retrograde outside-in techniques of anterior cruciate ligament reconstruction in terms of graft nature and clinical outcomes: a case control study using 3T MRI.
This study was performed to compare ACL graft maturation and morphologies using MRI between trans-tibial (TT) and retrograde outside-in (OI) techniques, and to compare clinical outcomes between the two groups. ⋯ The OI technique showed a more anteriorly positioned tibial tunnel and a more oblique graft orientation in both sagittal and coronal planes. However, in comparison with the TT group, a significantly higher SNQ value was noticed in the follow-up MRI of the OI group at 6 months, although clinical results of the two groups were not significantly different during at least the 2-year follow-up.