Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2014
The T-line as an intraoperative landmark for reproducing the native femoral anteversion during hip arthroplasty.
Three-dimensional computed tomographic (CT)-based preoperative planning for total hip arthroplasty (THA) enabled us to evaluate the cut surface of the femoral neck osteotomy. When we planned the stem placement in 20° of anteversion, we noticed that the line connecting the trochanteric fossa and the middle of the medial cortex of the femoral neck (T line) was coincident with the component torsion in many cases. We attempted to evaluate the accuracy of the T line for reproducing the native femoral anteversion during THA comparing it with the midcortical line, the reference guide previously reported by Suh. ⋯ Aligning the stem parallel to the T line on the cut surface provides a good reproduction of the femoral anteversion. The T line can be an useful intraoperative reference guide for the anteversion of the femoral component in THA for patients without severe hip deformity.
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Arch Orthop Trauma Surg · Jun 2014
Gap measurement in posterior-stabilized total knee arthroplasty with or without a trial femoral component.
To investigate the effects of a trial femoral component on the intraoperative joint gap and intraoperative joint gap kinematics throughout the range of knee motion in minimally invasive surgery-total knee arthroplasty (MIS-TKA) with the gap technique. ⋯ The trial femoral component influenced the intraoperative gap measurements, and increased the intraoperative gap difference. The joint gap kinematics with the trial femoral component were not constant throughout the range of knee motion, even if the appropriate joint gaps in extension and flexion were achieved. For acquisition of constant stability throughout the knee motion, the present results should be taken into account by surgeons performing MIS-TKA with the gap technique.
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Arch Orthop Trauma Surg · Jun 2014
Functional outcome and mortality in nonagenarians following hip fracture surgery.
The world's population is ageing and the elderly population itself is growing older. This population shows a high incidence of hip fractures. We performed a retrospective study, reviewing the functional status, postoperative complications and mortality rate of nonagenarians who underwent surgery for hip fracture. ⋯ Nonagenarians have good surgical outcomes after hip fracture surgery with low mortality rate. They should be treated similarly as their younger counterparts in terms of decision for surgery. Potential decline in functional status and rehabilitation options should be shared with the patient and family at an early stage.
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Arch Orthop Trauma Surg · Jun 2014
Case ReportsPosterior resection and fusion of a lumbosacral hemivertebra in a case of dipygus.
Dipygus or pygomelia is an incomplete form of twinning due to the incomplete division of the embryonic disc. This extremely rare condition consists in the presence of an accessory limb that generally inserts into the buttock or perineum. Associated anomalies such as duplication of the genitourinary or the intestinal tract are frequent, and recurrently appear associated with spinal anomalies such as congenital scoliosis due to hemivertebra. We present our experience with a 20-year-old girl, the first and only case of dipygus recorded and treated in Switzerland, who came to us complaining of increasing low back pain along with a progressive congenital scoliosis due to the presence of a hemivertebra between L5 and S1, which was removed in a single stage exclusively through a posterior approach.
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Arch Orthop Trauma Surg · Jun 2014
Simultaneous surgery for chronic lateral ankle instability accompanied by only subchondral bone lesion of talus.
Osteochondral lesion of the talus (OCT) frequently accompanies chronic lateral ankle instability (CLAI). However, it remains unclear whether concomitant OCT and CLAI should be treated surgically at the same time. The purpose was to evaluate the clinical outcome of simultaneous surgery involving stabilization of CLAI and retrograde drilling for only subchondral bone lesion of the talus. ⋯ Simultaneous surgery involving lateral ankle stabilization and retrograde drilling under arthroscopic and fluoroscopic guidance is a promising method for treating CLAI accompanied by only subchondral bone lesion of talus.