Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2015
Case ReportsRecommendations for fracture management in patients with osteopetrosis: case report.
Osteopetrosis is caused by general increase in bone density and obliteration of the medullary canal. Fractures are a frequent complication and their management is considered a challenge due to increased resistance to reaming and screw positioning; reduction maneuvers have to be done more carefully to avoid intraoperative fractures, and there is an increased risk of drill breakage. There is also a higher risk of infection and malunion, which increases the incidence of surgical revisions in this population. ⋯ Fracture fixation in patients with osteopetrosis requires strategies to overcome the technical difficulties found during the procedure. Preoperative planning must include the availability of multiple metal drill bits, electric drills, and bone substitutes, having in mind drilling techniques, drilling speed, and temperature control. Patients should be closely followed to evidence any complications such as infections and malunions.
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Arch Orthop Trauma Surg · Mar 2015
Case ReportsBilateral nonunion of the sacrum in a long-term paraplegic patient treated with trans-sacral bar and spinopelvic fixation.
The incidence of fragility fractures of the pelvis is sharply increasing in accordance with growing life expectancy in developed countries. Numerous conditions may compromise bone density and quality, and paraplegia due to spinal cord injury is one of them. ⋯ The patient was treated with trans-sacral bar and spinopelvic fixation. Rapid relief from pain and functional recovery was achieved with complete bone healing 1 year after the operation.
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Arch Orthop Trauma Surg · Mar 2015
The application of atlantoaxial screw and rod fixation in revision operations for postoperative re-dislocation in children.
We evaluate the feasibility, safety, and efficacy of atlantoaxial screw and rod fixation for revision operations in the treatment of re-dislocation after atlantoaxial operations in children. ⋯ If a revision operation is required, atlantoaxial screw-rod fixation is a safe and effective method. Because the anatomical structure is complicated in revision operation patients, CAD-RP technology could guide the the procedures of exposure and screw placement.
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Arch Orthop Trauma Surg · Mar 2015
Comparative StudyClinical results of using minimally invasive long plate osteosynthesis versus conventional approach for extensive comminuted metadiaphyseal fractures of the radius.
The minimally invasive plate osteosynthesis (MIPO) technique has been introduced recently. The extensive comminuted fractures of the distal radial metaphysis with diaphyseal involvement are probably good indications for MIPO technique because of less extensive dissection and soft-tissue stripping. The purpose of this retrospective study was to compare the clinical results of MIPO technique to those of conventional open reduction in extensive metadiaphyseal fractures of distal radius. ⋯ MIPO is capable of achieving functional results as good as those of conventional open reduction, with a higher satisfaction scale, smaller incision, and shorter operative time. When MIPO intervention is planned, concurrent distal ulnar fracture or DRUJ injury should be repaired first, thus facilitating subsequent indirect reduction. For treating intra-articular fractures, anatomical reduction of the articular surface is more important, and the MIPO technique described here is not recommended.
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Arch Orthop Trauma Surg · Mar 2015
Restoration of the anatomic position during a meniscal allograft transplantation using pre-existing landmarks.
Accurate sizing and positioning of a meniscal allograft is an important factor for successful outcomes of meniscal allograft transplantation. The objectives of this study were (1) to search a proper rotational landmark, (2) to determine the sagittal slope of meniscus, and, thus (3) to determine the meniscal positioning. ⋯ Line between patellar tendon and tibial spine was a good reference line for a meniscal rotation in the medial meniscus. Among previously introduced reference lines, LMLD showed approximity with a true meniscal rotation. The slope between tibial insertion and mid-portion was significantly different in the lateral meniscus.