Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2012
Underneath the cerclage: an ex vivo study on the cerclage-bone interface mechanics.
Cerclages regain interest due to a rising number of periprosthetic fractures. The contact distribution at the circumferential cerclage-bone interface is still unknown. Local interface pressure depends on the amount of contact area. Cortical damage at the interface would provoke cerclage loosening. Therefore, the contact area, the bone pressure along the interface and the cortical resistance underneath loaded cerclages were determined in an ex vivo model. ⋯ Point contact fixation of the cerclages installs non-loaded, spanned zones where the periosteum is not compressed, rendering a strangulation of the blood supply unlikely. Cortical bone withstands static concentric pressure produced by the cerclage. Cortical groove formation is attributed to instability under functional load and not to weakness of the cortex itself.
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Arch Orthop Trauma Surg · Oct 2012
The impact of coagulopathy on the outcome of traumatic epidural hematoma.
To evaluate the impact of trauma-associated coagulation disorders on the neurological outcome in patients with traumatic epidural hematoma undergoing surgical or non-surgical treatment. A retrospective analysis was performed using prospectively collected data in a consecutive patient series from a level 1 trauma center. ⋯ Poor outcome after traumatic epidural hematoma was associated with coagulopathy. Progression of epidural hematoma volume was not associated with coagulopathy or with poor neurological outcome. Prospective studies are needed to confirm these results.
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Arch Orthop Trauma Surg · Oct 2012
Arthroscopic double-loaded single-row repair in chronic traumatic anterior shoulder dislocation.
We evaluated the clinical results of arthroscopic double-loaded single-row repair for chronic anterior shoulder dislocation. ⋯ Arthroscopic double-loaded single-row repair using suture anchors, containing two sutures in chronic anterior shoulder dislocation, is a reliable procedure with respect to recurrence rate, range of motion, and shoulder function.
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Arch Orthop Trauma Surg · Oct 2012
Treatment of high hip dislocation with a cementless stem combined with a shortening osteotomy.
The purpose of this study was to review the clinical and radiographic outcomes and report the major complications in a group of hips with Crowe type IV developmental dysplasia that underwent reconstruction with a cementless total hip arthroplasty and a transverse subtrochanteric shortening osteotomy fixed with locking compression plate and screws. ⋯ Cementless total hip arthroplasty combined with subtrochanteric osteotomy for the treatment of patients with Crowe Group IV developmental dysplasia of the hip is an effective technique to reduce the hip to its original acetabular location and restore the rotational deformities. Plate and screw fixation is a viable option for a secure and stable fixation of femoral stem after subtrochanteric osteotomy.
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Arch Orthop Trauma Surg · Oct 2012
Impaction bone grafting for femoral revision hip arthroplasty with Exeter Universal stem in Japan.
The purpose of the present study was to analyze the retrospective clinical and radiographic results of femoral revision arthroplasties with impaction bone grafting performed by experienced Japanese surgeons. ⋯ The present study showed encouraging mid-term results of impaction bone grafting for femoral revision arthroplasty by experienced surgeons in Japan. Aggressive augmentation of segmental defects and attenuated femoral shafts prevents massive stem subsidence and periprosthetic fracture.