Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2015
Extra- vs. intramedullary treatment of pertrochanteric fractures: a biomechanical in vitro study comparing dynamic hip screw and intramedullary nail.
Due to the demographic trend, pertrochanteric fractures of the femur will gain increasing importance in the future. Both extra- and intramedullary implants are used with good results in the treatment of these fractures. New, angular stable extramedullary implants promise increased postoperative stability even with unstable fractures. Additional trochanteric plates are intended to prevent secondary impaction, varisation and shortening of the fracture, as well as medialisation of the femoral shaft. The aim of this study was to perform a biomechanical comparison of both procedures regarding their postoperative stability and failure mechanisms. ⋯ Extra- and intramedullary osteosynthesis showed comparable results as regards postoperative stiffness and survival during cyclic testing. Since the failure load of the nail was significantly higher in the tested AO31-A2.3 fracture model, we conclude that intramedullary implants should be preferred in these, unstable, fractures.
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Arch Orthop Trauma Surg · Aug 2015
Image-free navigated coracoclavicular drilling for the repair of acromioclavicular joint dislocation: a cadaver study.
Reconstruction of the coracoclavicular ligament functions to restore anatomic alignment of the clavicle and may improve biomechanical function and clinical outcomes. Improper placement of the coracoclavicular tunnel may inherently weaken the coracoid. The purpose of this study was to evaluate the feasibility and accuracy of navigated image-free placement of K-wires for coracoclavicular tunnel position in comparison to conventional drill guide-based placement. ⋯ Image-free navigated coracoclavicular drilling for the repair of acromioclavicular joint dislocation has higher first-pass accuracy in comparison to conventional drill guide-based placement and, therefore, may enable a precise anatomic position of the drill holes and reduce the risk of an iatrogenic coracoid fracture.
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Arch Orthop Trauma Surg · Aug 2015
Effect of patient position on measurement of patellar height ratio.
Patient position is an important factor which can affect the accuracy of patellar height ratio measurement. Varying degree of knee flexion angles and action of quadriceps muscle while supine or standing positions are the most concerning factors. ⋯ Quadriceps action had a significant influence on the mean values obtained by the MIS, CD, and BP methods. In clinical practice, interpretation for patella alta or patella baja of these measurement methods should be normalized according to the patient position. Varying the degree of knee flexion did not produce clinically important effects in any of the five patellar height measurement methods.
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Arch Orthop Trauma Surg · Jul 2015
The size of tibial footprint of anterior cruciate ligament and association with physical characteristics in Asian females.
The tibial footprint is important for preoperative planning of operative technique and graft selection. Knowledge of tibial footprint in Asians is scant including the relationship between tibial footprint and physical characteristics. The aim of this study was to identify the size of the anterior cruciate ligament (ACL) tibial footprint and the proportion of size <14 mm, and to evaluate the association of tibial footprint with physical characteristics in Asian females. ⋯ Tibial footprint size shows a large variation with a high proportion of <14 mm length. Tibial length can help predict the ACL tibial footprint in the preoperative planning of ACL reconstruction.
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Arch Orthop Trauma Surg · Jul 2015
Randomized Controlled TrialEarly functional outcome of two different orthotic concepts in ankle sprains: a randomized controlled trial.
Purpose of the study was the evaluation of the early functional outcome of patients with an acute ankle sprain treated either with a semirigid, variable, phase-adapted modular ankle orthosis or an invariable orthotic reference device. ⋯ Differences between the two intervention groups were marginal and very small but significant and--regarding Cohen's effect sizes--effective. Especially relating to functional performance, this might be a careful indication that a more effective strategy for promoting a protected, rapid recovery to physical activity after ankle sprains might be achieved by applying a phase-adapted ankle orthosis. Especially in athletic patients, phase-adapted orthosis should be further investigated and considered to ensure fully protected ligament healing as well as to regain early functional recovery.