Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2015
Lessons learned from treating patients with unstable multifragmentary fractures of the proximal humerus by minimal invasive plate osteosynthesis.
The authors present clinical and radiographic results of minimal invasive plate osteosynthesis (MIPO) for three- or four-part fractures of the proximal humerus. ⋯ The MIPO technique provides reliable radiologic and functional outcomes for three- and four-part proximal humeral fractures. Our results might support the use of MIPO for treating unstable multi fragmentary fractures of proximal humerus such as three- or four-part fractures to decrease osteonecrosis of humeral head.
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Arch Orthop Trauma Surg · Feb 2015
Determining scaphoid waist fracture union by conventional radiographic examination: an analysis of reliability and validity.
Conventional radiographic imaging is the first imaging tool of choice in scaphoid fractures. The majority of undisplaced scaphoid waist fractures unite after 6 weeks of cast immobilization. We hypothesized that conventional radiographic imaging at 6 weeks after injury can both accurately and reliably predict union in undisplaced scaphoid waist fractures. ⋯ Conventional radiographic imaging is accurate and moderately reliable in diagnosing union, and reliable but inaccurate in diagnosing nonunion of scaphoid waist fractures at 6 weeks follow-up.
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Arch Orthop Trauma Surg · Feb 2015
Low preoperative Constant score is a negative predictive factor for postoperative proprioception after total shoulder arthroplasty in osteoarthritis.
Shoulder proprioception in patients with glenohumeral osteoarthritis and the effect of total shoulder arthroplasty (TSA) on proprioception have been evaluated previously. Measuring proprioception with an active angle reproduction (AAR) test, proprioception remained unchanged or deteriorated in a short follow-up period after shoulder replacement. Therefore, the purpose of this prospective study was to evaluate the influence of the preoperative Constant score (CS) on postoperative proprioceptive outcome after TSA in patients with primary osteoarthritis to address the question of whether the preoperative state of shoulder function influences postoperative proprioceptive outcome. ⋯ In conclusion, a low preoperative CS is a negative predictive factor for postoperative proprioception after TSA. We should keep that in mind when determining the best timepoint for shoulder replacement in patients with glenohumeral osteoarthritis.
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Arch Orthop Trauma Surg · Feb 2015
Minimal invasive posterior total hip arthroplasty: are 6 weeks of hip precautions really necessary?
Postoperative hip dislocations have been reported in 0.5 to 10.6 % of patients after primary posterolateral total hip arthroplasty (THA). Hip precautions are currently recommended for 6 weeks postoperatively to reduce early dislocation and facilitate healing of the posterior soft tissue repair. ⋯ Shortening the time of posterolateral hip precautions from 6 to 4 weeks after surgery does not increase the risk of postoperative dislocation.
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Arch Orthop Trauma Surg · Feb 2015
Insertion of the Ascension PyroCarbon PIP total joint in 152 human cadaver fingers: analysis of implant positions and malpositions.
The Ascension PyroCarbon proximal interphalangeal (PIP) total joint is used in osteoarthritis of the PIP finger joint. No systematic study of the positioning of this prosthesis and its relation to proximal and middle phalanx morphology has yet been reported. ⋯ The current design of the Ascension PyroCarbon PIP total joint can lead to malpositioning that we attribute to its incomplete accommodation of the morphology of the proximal and middle phalanx, the surgical challenges the design poses, or both acting together.