Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2015
Incompliance of total hip arthroplasty (THA) patients to limited weight bearing.
Limited weight bearing of the lower extremity is a commonly applied procedure in orthopedic rehabilitation following trauma surgery and joint replacement. The compliance of patients with limited weight bearing after cementless total hip arthroplasty has not yet been surveyed using sensor-loaded insoles. The objective of this study was to investigate foot loadings in patients after THA under the assumption of limited weight bearing. ⋯ Patients following cementless do not comply with limited weight bearing when they are trained by the use of a bathroom scale.
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Arch Orthop Trauma Surg · Feb 2015
Breakage of cephalomedullary nailing in operative treatment of trochanteric and subtrochanteric femoral fractures.
Mechanical breakage of cephalomedullary nail osteosynthesis is a rare complication attributed to delayed fracture union or nonunion. This study presents a series of cases of breakage and secondary lag screw dislocation after cephalomedullary nailing. The aim of this study was to identify factors that contribute to cephalomedullary nail breakage. ⋯ Breakage of cephalomedullary nail osteosynthesis of trochanteric fractures is a severe complication. The results of our study demonstrate that revision surgery provides good clinical and radiological short-term results. Predominately, failures of trochanteric fractures are related to lack of surgeon performance. Therefore, application of the implant requires accurate preoperative planning, advanced surgical experience to evaluate the patient and the fracture classification, and precise surgical technique including attention to detail and anatomical reduction of the fracture fragments.
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Arch Orthop Trauma Surg · Jan 2015
Comparative StudyHigh-flexion posterior-substituting versus cruciate-retaining prosthesis in total knee arthroplasty: functional outcome, range of motion and complication comparison.
Currently, a high-flexion cruciate-retaining knee prosthesis has been designed to allow greater advantage after total knee arthroplasty (TKA). The present study was conducted to compare functional outcome, range of motion (ROM) as well as complications in subjects who underwent either a high-flexion cruciate-retaining (HFCR, Group I) or a high-flexion posterior-substituting (HFPS, Group II) prosthesis TKA. ⋯ Our study demonstrated no advantage of the high-flexion cruciate- retaining TKA over high-flexion posterior-substituting TKA with regard to functional outcome, range of motion as well as complications at short-term follow-up. However, longer follow-up is necessary to confirm whether these results are sustained.
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Arch Orthop Trauma Surg · Jan 2015
Comparative StudyDistal femoral fractures in the elderly: biomechanical analysis of a polyaxial angle-stable locking plate versus a retrograde intramedullary nail in a human cadaveric bone model.
Compromised bone quality and the need for early mobilization still lead to high rates of implant failure in geriatric patients with distal femoral fractures. With the newest generation of polyaxial locking plates and the proven retrograde femoral nails today two minimally invasive surgical procedures have been established. Indications for both procedures overlap. This study attempts to define the strength and failure mode of both surgical procedures. ⋯ Based on our results, no statements regarding the superiority of either of the devices can be made. Even though the load to failure values for both osteosyntheses were much higher than the loads experienced during normal walking; however, because only axial loading was applied, it remains unclear whether both osteosyntheses meet the estimated requirements for postoperative full weight-bearing for an average heavy patient with a distal femoral fracture.
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Arch Orthop Trauma Surg · Jan 2015
Dynamic in vitro analysis of tractile forces of the anterior cruciate ligament (ACL) transplant using patellar and semitendinosus muscle tendon: a cadaver study.
The presented biomechanical study focused on the in vitro analysis of tractile forces working on the anterior cruciate ligament (ACL) and the ACL transplants, respectively, using a semitendinosus and/or patellar tendon during a passive flexion-extension movement (150-0°). ⋯ The tractile forces assessed within the ACL during passive flexion movements between 10 and 90° were not greater than the forces measured in the ACL transplants. Thus, the clinical consequence is that in the early postoperative phase passive mobilization might be performed in this motion range without putting the ACL transplant at risk for damage.