Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2012
Cervical lateral mass screw fixation without fluoroscopic control: analysis of risk factors for complications associated with screw insertion.
To examine the outcome of cervical lateral mass screw fixation focusing on analysis of the risk factors for screw-related complications. ⋯ In the analysis of potential risk factors for violation of the VA foramen as well as FV during screw insertion, the former incidence was significantly related to the screw trajectory angle (lack of lateral angulation) in the axial plane, while the latter incidence was related to a poor screw trajectory angle in the sagittal plane.
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Arch Orthop Trauma Surg · Jul 2012
Comparative StudySequencing-based detection of drug-resistant Mycobacterium tuberculosis in patients with spinal tuberculosis.
Traditionally, bacterial cultures serve as the gold standard for the detection of drug resistance and can provide evidence for directing the treatment of tuberculosis. However, this method has a low positive rate and is time consuming, which significantly limits its wide application. Thus, in the present study, the genes associated with drug resistance were amplified and sequenced to determine the presence of drug-resistant mutations in Mycobacterium tuberculosis. In addition, to find a more sensitive, specific, rapid, and simple method for the detection of drug-resistant bacteria, this method was compared with traditional bacterial culture. ⋯ These results indicated that PCR and DNA sequencing are rapid, sensitive, and specific methods for the detection of drug-resistant genes of M. tuberculosis in patients with spinal tuberculosis. This method may provide critical evidence for the clinical treatment of tuberculosis when it is applied in combination with bacterial culture.
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Arch Orthop Trauma Surg · Jul 2012
7-year follow-up after open reduction and internal screw fixation in Bennett fractures.
Bennett fractures are unstable, and, with inadequate treatment, lead to osteoarthritis, weakness and loss of function of the first carpometacarpal joint. This study focuses on long-term functional and radiological outcomes after open reduction and internal fixation. ⋯ Good clinical results could be observed, if successful reduction of the fracture was achieved and maintained. However, there was no correlation between the accuracy of the fracture reduction considering a gap and step <2 mm and the development of arthritis.
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Arch Orthop Trauma Surg · Jul 2012
Total hip replacement in patients with history of illicit injecting drug use.
A history of illicit injecting drug use makes indication of total hip arthroplasty (THA) in patients with end stage hip osteoarthritis difficult, as the risk of infection with colonized strains is multiplied if the patient continues to inject or inhale illicit drugs. ⋯ We use this unacceptable high failure rate as evidence when counseling patients and their health care professionals about the appropriate treatment of osteoarthritis in patients with a history of illicit drug use. Furthermore, we support the request of hair analysis for drugs documenting abstinence of at least 1 year before indicating THA.
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Arch Orthop Trauma Surg · Jul 2012
Functional and clinical outcome of total shoulder arthroplasty with oversized glenoid.
The Epoca-Reconstruction-(Reco)®-Glenoid has been developed to treat patients with cuff-tear-arthropathy. The glenoid component of this system has a hemispheric shape that canopies the humeral head. This design is believed to provide a stable fulcrum and restore normal deltoid function. The purpose of this study was to analyse strengths and disadvantages of the Epoca-Reco®-Glenoid in cuff-tear-arthropathy patients. Changes in functional outcome using Constant-Murley-Scoring(CMS), CMS sub-scoring parameters and radiological outcome were analysed. For this purpose, a classification for radiologic lucency was proposed. Diverging results, influencing factors and alternative treatment options have been discussed to analyse weaknesses and enhance future development of this arthroplastic model. ⋯ The semi-constraint reconstruction glenoid prosthesis model in cuff-tear-arthropathy patients significantly improves shoulder function, however, it yields controversial results, with satisfactory results in male and poor results in female patients. Revision rate of the female cohort and loosening of the glenoid component in this short-term follow-up is of concern. Further investigations taking BMD, osteopenic conditions and influence of surface area in smaller individuals into consideration are recommended, to determine whether this is the underlying cause of the inferior results in females.