Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2013
Arthroscopically assisted stabilization of chronic AC-joint instabilities in GraftRope™ technique with an additive horizontal tendon augmentation.
A chronic symptomatic acromioclavicular joint (ACJ) instability is a possible consequence of an acute ACJ separation. Besides vertical instability a horizontal component of the instability is common in high-grade ACJ separation and clinically relevant; especially, in chronic cases. A new technique of horizontal biologic ACJ augmentation with a transacromial gracilis tendon loop as an addition to the arthroscopically assisted stabilization with the GraftRope™ device is described and first clinical and sonographical results are shown. ⋯ The arthroscopically assisted stabilization of chronic ACJ instabilities with the GraftRope™ device and an additive horizontal tendon augmentation technique leads to good short-term results with a supplementary horizontal stabilization.
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Arch Orthop Trauma Surg · Jun 2013
Treatment of large posttraumatic tibial bone defects using the Ilizarov method: a subjective outcome assessment.
The treatment of large posttraumatic tibial bone defects using the Ilizarov method was shown to be successful in several studies. These studies, however, typically focus on the radiological and functional outcome using objective parameters only. The aim of the present study was therefore to assess the objective and subjective outcome of a consecutive series of patients with large posttraumatic tibial bone defects using the Ilizarov method. Additionally, it was our goal to assess the physical and mental stress for the patients and their relatives during the long treatment period and the general health status at final follow-up. ⋯ The Ilizarov method is a safe option for the treatment of large posttraumatic tibial bone defects after failure of internal fixation despite the high complication rate. It is essential to comment this to the patients and their relatives prior to the application of the frame increase their compliance with the long and emotionally draining treatment. The Ilizarov method is worth the effort only in patients, who will presumably comply with this treatment option and all of its drawbacks.
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Arch Orthop Trauma Surg · Jun 2013
Uncemented third-generation ceramic-on-ceramic total hip arthroplasty using metal acetabular shell with direct taper locking liner.
The ceramic-on-ceramic (CoC)-bearing couple in total hip arthroplasty (THA) was developed to reduce the wear debris and osteolysis. Although the mechanical strength of third-generation ceramic has improved over previous generations, the risk of osteolysis and ceramic fracture is still an important concern. ⋯ Patients, who received third-generation CoC THA had no detectable wear and osteolysis. One ceramic fracture occurred, and the main reason for revision was dislocation.
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Arch Orthop Trauma Surg · Jun 2013
Coronal plane fractures of the distal humerus involving the capitellum and trochlea treated with open reduction internal fixation.
Coronal plane fractures of the distal humerus involving the capitellum and trochlea are rare. Treatments have evolved from closed reduction to open reduction and internal fixation (ORIF) to achieve a stable joint that allows early mobilization. ⋯ Level IV case series.
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Arch Orthop Trauma Surg · Jun 2013
Technique of anatomical footprint reconstruction of the ACL with oval tunnels and medial portal aimers.
The purpose of this article was to demonstrate an anterior cruciate ligament (ACL) reconstruction technique using oval tunnels. Aim of this single bundle technique is to fit the footprint anatomy of the ACL as closely as possible. TECHNIQUE AND PATIENTS: The presented technique is a single bundle technique using a semitendinosus graft. For femoral tunnel placement, a specific medial portal aimer (Karl Storz, Tuttlingen, Germany) is used. Aiming and drilling of the femoral tunnel are performed via the medial portal. Oval tunnels are created by stepwise dilatation with ovally shaped dilatators. The position of the femoral tunnel is visualized and controlled with the arthroscope via the medial portal. For the tibial tunnel placement, a specific aimer was used as well. With this technique, 24 patients were operated and all intra- and postoperative complications were analyzed prospectively. The tunnel position was documented postoperatively by CT scan. ⋯ Level IV, case series.