Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jan 2013
Risk factors for nonunion in 337 displaced midshaft clavicular fractures treated with Knowles pin fixation.
Clavicular fractures account for nearly 10 % of all fractures, and the majority of those fractures involve the midshaft. Historically, these fractures were treated nonoperatively; however, recent data suggest an increased risk of nonunion and symptomatic malunion for displaced, comminuted midshaft clavicular fractures treated conservatively. Surgical intervention via plate osteosynthesis or intramedullary fixation with pins, nails, or screws has been shown to reduce, but not eliminate, this risk. Identification of risk factors predictive of nonunion would improve the overall management of displaced, comminuted midshaft clavicular fractures. ⋯ Nonunion remains a significant complication in the treatment of displaced, comminuted midshaft clavicular fractures even with intramedullary fixation. Use of absorbable suture in place of wire for cerclage fixation and careful selection of treatment strategy in the elderly may reduce the risk for nonunion.
-
Arch Orthop Trauma Surg · Jan 2013
The use of enhanced recovery after surgery (ERAS) principles in Scottish orthopaedic units--an implementation and follow-up at 1 year, 2010-2011: a report from the Musculoskeletal Audit, Scotland.
To establish whether a nationally guided programme can lead to more widespread implementation of enhanced recovery after surgery (ERAS), a well-established optimised care pathway for lower limb arthroplasty. ⋯ A clinically guided and nationally supported process has proven highly successful in achieving a further uptake of enhanced recovery principles after lower limb arthroplasty in Scotland, which has resulted in clinical benefits to patients and reduced length of hospital stay.
-
Arch Orthop Trauma Surg · Jan 2013
Distal radius fracture fixation with volar locking plates and additional bone augmentation in osteoporotic bone: a biomechanical study in a cadaveric model.
Fractures of the distal radius represent the most common fractures in adults. Volar locked plating has become a popular method for treating these fractures, but has been subject to several shortcomings in osteoporotic bone, such as loss of reduction and screw purchase. In order to overcome these shortcomings, cement augmentation has been proposed. ⋯ Cement augmentation improves biomechanical properties in volar plating of the distal radius.
-
Arch Orthop Trauma Surg · Jan 2013
Comparative StudyWhich posterior instrumentation is better for two-level anterior lumbar interbody fusion: translaminar facet screw or pedicle screw?
To determine whether translaminar facet screws can provide stability equivalent to pedicle screws and whether the two posterior instrumentations have the same influence on the adjacent segments in two-level anterior lumbar interbody fusion. ⋯ Translaminar facet screws can provide stability equivalent to pedicle screws, but their influence on the adjacent segments is relatively lower; therefore, we suggest that translaminar facet screws be the choice in the optimal posterior instrumentation in a two-level anterior lumbar interbody fusion.
-
Arch Orthop Trauma Surg · Jan 2013
Comparative StudyLower limb alignment in the frontal plane: analysis from long standing radiographs and computer tomography scout views: an experimental study.
A profound knowledge of physiologic lower limb alignment is essential to understand deformities and to plan surgical correction. The gold standard in radiographic assessment is the long standing radiograph with a forward directed patella. The advantage of computed tomography (CT) is that its cutting-edge image technique can visualize the femur condyles. Study purpose was to determine if the CT-scout view has the potential to replace the standing radiograph. ⋯ No evidence was found clearly excluding the possibility of an exclusive use of the CT-scout view for the analysis of the leg geometry. However, advantages of the long standing radiograph became obvious.