Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2015
Radiologic healing of lateral femoral wall fragments after intramedullary nail fixation for A3.3 intertrochanteric fractures.
Intramedullary nail fixation is a useful treatment option for A3 intertrochanteric fractures. Occasionally, we have encountered displaced lateral femoral wall (LFW) fragment during surgery with intramedullary nail system. We investigated the postoperative spontaneous reduction of displaced LFW fragments without further fixation and the factors that affected the spontaneous reduction of displaced LFW fragments. ⋯ In intramedullary nailing of A3.3 intertrochanteric fractures, the displaced LFW fragments tend to reduce spontaneously without any additional fixation during the postoperative period. We conclude that no additional fixation is needed for the displaced LFW fragment after surgery with intramedullary nail.
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Arch Orthop Trauma Surg · Oct 2015
Outcome of the treatment of chronic isolated and combined posterolateral corner knee injuries with 2- to 6-year follow-up.
Injuries of the posterolateral corner (PLC) of the knee are rare. They are difficult to diagnose and can cause severe disability. This study presents the 20- to 70-month clinical and radiological outcomes of the anatomical reconstruction technique of LaPrade et al. ⋯ Significant improvement in the objective knee stability scores and clinical outcomes with anatomical reconstruction showed that this technique can be used to treat patients with chronic PLC injured knees. However, longer-term multicentre studies and studies with larger groups comparing multiple techniques are required to determine the best treatment method for PLC injuries.
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Arch Orthop Trauma Surg · Oct 2015
Long-term results after modified Epping procedure for trapeziometacarpal osteoarthritis.
Thumb trapeziometacarpal joint (TMJ) arthritis is among the most common degenerative joint diseases of the hand and predominantly affects patients in their fifth or sixth decade of life. Mid-term results of the most common surgical procedures were inconclusive regarding the superiority of one particular treatment method. This study presents the long-term outcomes of a modified Epping procedure. ⋯ Despite relatively high DASH scores, the overall outcome of the modified Epping procedure is encouraging. Subjective loss of strength is a main complaint among patients, whereas instability is less of concern.
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Arch Orthop Trauma Surg · Oct 2015
Wedge effect following intramedullary hip screw fixation of intertrochanteric proximal femur fracture.
The aim of the current study was to determine whether application of an intramedullary hip screw for definitive management of intertrochanteric fracture was associated with post-operative deformity. Specifically this study investigated whether nail insertion would cause a "wedge effect" of the intertrochanteric fracture manifesting as lateralization of the femoral shaft and varus malalignment. ⋯ Despite attention to detail, the application of an intramedullary hip screw for intertrochanteric fracture has the tendency to lateralize the shaft relative to the head/neck segment (The "wedge effect").
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Anterior cruciate ligament tears are one of the most frequent soft tissue injuries of the knee. A torn anterior cruciate ligament leaves the knee joint unstable and at risk for further damage to other soft tissues manifested as pain, dislocation, and osteoarthritis. A better understanding of the anatomical details of knee joints suffering anterior cruciate ligament tears is needed to understand and develop prediction models for anterior cruciate ligament injury and/or tear. ⋯ Anterior cruciate ligament injury has been shown to be caused by the forces which act on the ligament. These forces can result from hyperextension of the tibia or the internal rotation of tibia. The anatomical parameters of the knee joint (i.e., notch width index, anterior cruciate ligament width and length) have no role in the cause of an injury.