Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2013
ReviewAbsorbable and non-absorbable cement augmentation in fixation of intertrochanteric femur fractures: systematic review of the literature.
We conducted a systematic review of the literature on the use of both resorbable and non-resorbable cement as an adjunct to internal fixation of intertrochanteric hip fractures. Two reviewers independently assessed the methodological quality and extracted relevant data from each included study. In cases in which the outcomes data were similar between studies, data were pooled and analyzed. ⋯ However, radiographic parameters (mean lag screw sliding distance and varus deformity) were better in the augmentation group. In terms of complications, failure to use augmentation with a sliding hip screw device in five studies led to 10.8-fold higher likelihood of construct failure (p < 0.01). Augmentation of intertrochanteric femur fractures with polymethyl methacrylate or calcium-phosphate may provide benefits in terms of radiographic parameters and complication rates; however, more stringent research methodology is necessary to determine the extent of the benefit.
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Arch Orthop Trauma Surg · Apr 2013
The efficacy of patellar decompression for improving anterior knee pain following total knee arthroplasty without patellar resurfacing.
Anterior knee pain remains common following total knee arthroplasty (TKA). In this study, we evaluated the efficacy of patellar decompression via drilling for the treatment of anterior knee pain following TKA without patellar resurfacing. ⋯ As we observed significantly lower rates of anterior knee pain and no patellar complications following patellar decompression via drilling in TKA without patellar resurfacing, we recommend performing patellar decompression in cases of total knee replacement without patellar resurfacing.
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Arch Orthop Trauma Surg · Apr 2013
Endoscopically assisted nerve decompression of rare nerve compression syndromes at the upper extremity.
Besides carpal tunnel and cubital tunnel syndrome, other nerve compression or constriction syndromes exist at the upper extremity. This study was performed to evaluate and summarize our initial experience with endoscopically assisted decompression. ⋯ Endoscopically assisted decompression in rare compression syndrome of the upper extremity is highly appreciated by patients and provides excellent functional results. This minimally invasive surgical technique will likely be further described in future clinical studies.
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Arch Orthop Trauma Surg · Apr 2013
Lateral cortical notching in specific cases of delayed unions or nonunions after intertrochanteric and reversed fractures.
Stabilization of both intertrochanteric and reversed trochanteric fractures is commonly performed by proximal femoral nailing. However, biomechanics significantly differ between these two fracture types. ⋯ Dynamization is part of the general treatment concept for delayed union and nonunion after intramedullary fracture fixation. Normally it is performed by removal of interlocking screws or by occupying a 'dynamic' interlocking hole. We can show, however, that some types of inter- and reversed trochanteric fractures develop a characteristic kind of nonunion at the level of the lesser trochanter. This condition causes pain while walking and includes the risk of implant failure due to material fatigue. In these cases dynamization may be blocked by the cortex of the distal fragment directly contacting the prominent lag screw or its sleeve. We describe a procedure we call "lateral notching", which is needed to make distal conventional dynamization effective and to allow for bone healing.
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Arch Orthop Trauma Surg · Apr 2013
Factors affecting the outcome of osteochondral autografting (mosaicplasty) in articular cartilage defects of the knee joint: retrospective analysis of 152 cases.
The purpose of this retrospective study was to evaluate the results and prognostic factors affecting the outcome of osteochondral autografting (mosaicplasty) in articular cartilage defects of the knee joint. ⋯ Mosaicplasty is an effective technique for the treatment of articular cartilage defects of the knee joint which restores the joint function in a short period of follow-up. Furthermore, age, lesion size, localization, and concomitant surgical interventions are major factors affecting the final outcome. The final knee score deteriorates as the age of the patient and size of the lesion increases. Furthermore, concomitant surgical interventions and lesions located on the medial femoral condyle have a negative effect on the final knee score.