Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2014
Failure modes for total ankle arthroplasty: a statistical analysis of the Norwegian Arthroplasty Register.
It is imperative to understand the most common failure modes of total ankle arthroplasty (TAA) to appropriately allocate the resources, healthcare costs, enhancing surgical treatment methods, and improve design and longevity of the implant. The objective of this study was to investigate the primary mode or modes of failure (Loose talar component, loose tibial component, dislocation, instability, misalignment, deep infection, Fracture (near implant), Pain, defect polyethylene (PE), other, and missing information) of TAA implants, so these failure mode/modes can be targeted for future improvement. ⋯ Since there is no statistical evidence showing which failure mode contributes most to revision surgeries, it is concluded that more information/data is needed to further investigate failure modes in ankle arthroplasties. Since the numbers of such surgeries are increasing, sufficient data should become available in time.
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Arch Orthop Trauma Surg · Sep 2014
Review Meta Analysis Comparative StudyDoes immobilization after arthroscopic rotator cuff repair increase tendon healing? A systematic review and meta-analysis.
To determine whether immobilization after arthroscopic rotator cuff repair improved tendon healing compared with early passive motion. ⋯ Level II; systematic review of levels I and II studies.
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Arch Orthop Trauma Surg · Sep 2014
Case Reports Clinical TrialPercutaneous cerclage wiring followed by intramedullary nailing for subtrochanteric femoral fractures: a technical note with clinical results.
Although intramedullary nailing is an ideal treatment for subtrochanteric femoral fractures, it is technically challenging in fractures extending into the nail entry area and/or involving the lesser trochanter. Although the application of circumferential wire may facilitate reduction in these situations, its use remains controversial due to possible blood supply disturbances to underlying bone. In the present study, we evaluated complex subtrochanteric fractures treated by percutaneous cerclage wiring followed by intramedullary (IM) nailing for anatomical fracture reduction and union. ⋯ Temporary reduction by percutaneous wiring offers a means of satisfactory nailing in difficult subtrochanteric femoral fractures, and affords anatomical reconstruction and favorable bony union.
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Arch Orthop Trauma Surg · Sep 2014
Clinical TrialArthroscopic assessment of medial malleolar reduction.
Ankle fractures treated with open reduction internal fixation are fixed in an effort to reestablish anatomic bony alignment and avoid a malunion, thereby diminishing the risk of post-traumatic arthritis. For a medial malleolar fracture, an articular step-off is likely more related to the risk of post-traumatic arthritis than is a cortical step-off. However, the external cortical alignment is often used to judge the adequacy of reduction, as the articular component of the fracture is not as readily visualized. Arthroscopy has been used in various articular fractures as an aid to diagnosis and treatment. The current study prospectively assessed both the quality of medial malleolar reduction on the articular side using arthroscopy and the adequacy of using cortical cues to guide the articular reduction. ⋯ The cortical reduction of the medial malleolus often matched up with the articular reduction. However, in some patients, impaction of the medial malleolus made it so that the two did not match up. There are some cases in which extra-articular cues are insufficient to evaluate for intra-articular reduction.