Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2013
Impact of tendon suturing on the interference fixation strength of quadrupled hamstring tendon grafts.
Interference screw fixation of soft tissue grafts has been a widely used fixation technique for cruciate ligament reconstruction. Suturing of the graft construct prior to graft fixation has been proposed to increase fixation strength; however, the effect on mechanical properties has not been well characterized. The goal of this study was to determine whether uniform suturing of the tendon graft affects (1) ultimate fixation strength of the hamstring tendon graft and (2) motion of the tendon in the bone tunnel during cyclic loading when comparing sutured grafts vs. unsutured grafts. ⋯ This study confirms that suturing of the graft construct before interference screw fixation may increase ultimate failure load. However, an improvement of structural properties in response to cyclic loading with sub-maximal loads could not be confirmed. Clinicians using interference screw fixation may suture the graft to improve fixation strength; however, suturing does not appear to allow a more aggressive rehabilitation after surgery.
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Arch Orthop Trauma Surg · Aug 2013
Randomized Controlled Trial Multicenter StudySingle-bone intramedullary fixation of unstable both-bone diaphyseal forearm fractures in children leads to increased re-displacement: a multicentre randomised controlled trial.
Both-bone diaphyseal forearm fractures in children can be stabilised without cast by a flexible intramedullary nail in both the radius and the ulna. Adequate results with single-bone fixation combined with a complementary cast are also reported. However, because those results are based on a selection of children, this trial investigates whether single-bone intramedullary fixation, compared with both-bone intramedullary fixation, results in similar pronation and supination in children with an unstable diaphyseal both-bone forearm fracture. ⋯ These results caution against the use of single-bone fixation in all both-bone forearm fractures. This method may lead to increased re-displacement and reduced clinical results.
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Arch Orthop Trauma Surg · Aug 2013
Review Case ReportsFractures of the anatomical neck of the scapula: two cases and review of the literature.
Anatomical neck fractures of the scapula are rare. The authors have found in the literature only four radiologically documented fractures of the anatomical neck of the scapula. Two of them were published by Hardegger et al., the third case was published by Arts and Louette. ⋯ In all six cases, the subacromial space between the acromion and the humeral head was widened. All fractures were operated on via a Judet posterior approach. In five cases, the outcome of the operation was assessed at 3, 5, 12, 21 and 120 months after surgery, three-being rated as excellent or very good, one as good and one as poor.
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Arch Orthop Trauma Surg · Aug 2013
Role of navigated total knee arthroplasty for acute tibial fractures in the elderly.
The role of total knee arthroplasty (TKA) in acute tibial fractures with existing comminution/bone loss, osteoporosis or preexistent arthritis has been described in the literature. Many of these procedures necessitate the use of stems to off-load the component and augments/wedges to avoid overresection and hence restore the joint line. Conventional methods may not be consistently accurate in restoring the desired alignment within 3° of the anatomical axis in this complex scenario. Computer-assisted TKA has been demonstrated to reproducibly and accurately restore the mechanical axis and joint line in primary TKA. Literature review has sparse data on use of navigation in acute TKA. ⋯ Total knee arthroplasty should be considered a treatment option for acute upper tibial fractures in the elderly with coexistent knee arthritis and poor bone stock. Computer-assisted navigation aids in restoration of mechanical axis and component positioning.
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Arch Orthop Trauma Surg · Aug 2013
Multicenter StudyPigmented villo-nodular synovitis and giant-cell tumor of tendon sheaths: a binational retrospective study.
Pigmented villonodular synovitis is rare. Thus, we initiated a retrospective multi-center study regarding symptoms, location, type of disease, type of surgery, number of recurrences, use of adjuvant therapies and functional outcome. ⋯ Prognostic multi-center study, Level III.