Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2013
Healing process after rigid plate fixation of humeral shaft fractures revisited.
The purpose of this study was to describe the radiological healing process after open reduction and internal fixation (ORIF) of humeral shaft fractures with plate. ⋯ Both primary and secondary healing processes were observed after rigid plate fixation of OTA 12 A or B humeral shaft fractures. Our study revealed that size of gap, mode of compression, type of fracture could affect the type of healing, and that periosteal callus formation can occur after rigid plate fixation.
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Arch Orthop Trauma Surg · Jun 2013
Design and preliminary biomechanical analysis of artificial cervical joint complex.
To design an artificial cervical joint complex (ACJC) prosthesis for non-fusion reconstruction after cervical subtotal corpectomy, and to evaluate the biomechanical stability, preservation of segment movements and influence on adjacent inter-vertebral movements of this prosthesis. ⋯ After cervical subtotal corpectomy, reconstruction with ACJC prosthesis not only obtained instant stability, but also reserved segment motions effectively, without abnormal gain of mobility at adjacent inter-vertebral spaces.
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Arch Orthop Trauma Surg · Jun 2013
Randomized Controlled Trial Comparative StudyNo difference in mortality between cemented and uncemented hemiprosthesis for elderly patients with cervical hip fracture. A prospective randomized study on 334 patients over 75 years.
Laboratory and human mechanical studies indicated that chemical substances in bone cement had toxic and prothrombotic effects. Impaction of cement added a mechanical trauma to the reaming and broaching procedure and contributed to a substantial local and systemic thrombin generation. Case reports and materials have indicated bone cement as the immediate trigger of cardiorespiratory and vascular dysfunction, occasionally fatal, and described as the bone cement implantation syndrome. In spite of this knowledge, bone cement has gained popularity and is widely used for prosthesis fixation, possibly due to a lack of clinical evidence supporting the basic science indicating bone cement as a mortality risk factor. ⋯ Installation of non-cemented hemiprostheses in elderly with hip fracture may have benefits perioperatively regarding operation time and bleeding, and do not seem to influence 1 year mortality relative to cemented implants.
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Arch Orthop Trauma Surg · Jun 2013
Anterior surgical options for the treatment of cervical spondylotic myelopathy in a long-term follow-up study.
To provide a basis for the choice of anterior surgery procedures in the treatment of cervical spondylotic myelopathy (CSM) through long-term follow-up. ⋯ For CSM with compression coming from the front side, proper anterior decompression based on the specific conditions could directly eliminate the compression. Through long-term follow-up, the effect of decompression became observable.
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Arch Orthop Trauma Surg · Jun 2013
Comparative StudyPosterior interosseus nerve vs. medial cutaneous nerve of the forearm: differences in digital nerve reconstruction.
Digital nerve defects are common in hand trauma and for primary or secondary nerve reconstruction, the autologous nerve graft remains the gold standard. This study compares the regeneration results and donor side morbidity of either the posterior interosseus nerve (PIN) graft or the medial antebrachial cutaneous nerve (MACN) graft. 16 patients (group A, age 43 ± 13 years) with digital nerve defects were treated with a PIN graft and 12 patients (group B, age 40 ± 15 years) received a MACN graft. The average nerve gap was 22 mm in each group. ⋯ Regarding the donor side morbidity, almost all patients complained about a disturbing scar formation and unpleasant paresthesia at the forearm down to the rascetta. Neuroma-associated pain has been detected in 4 cases. Although there has been no significant difference in terms of nerve regeneration, we recommend the use of the PIN graft for digital nerve reconstruction, since harvesting this nerve is fast and easy and without any donor side morbidity compared to the MACN graft.