Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2012
Influence of trabecular microstructure and cortical index on the complexity of proximal humeral fractures.
Poor bone quality increases the susceptibility to fractures of the proximal humerus. It is unclear whether local trabecular and cortical measures influence the severity of fracture patterns. The goal of this study was to assess parameters of trabecular and cortical bone properties and to compare these parameters with the severity of fractures and biomechanical testing. ⋯ In our study population local trabecular bone structure and cortical index could not predict the severity of proximal humeral fractures in the elderly. Complex fractures do not necessarily imply lower bone quality compared to simple fractures.
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Arch Orthop Trauma Surg · Apr 2012
Case ReportsUnexpected injury of the orthopaedic surgeon: a case report of a hammer splinter.
Sharps injuries have become one of the most important occupational injuries and they are common during surgery, with rates between 1.7 and 6.9% of all surgical procedures. This case report, however, revealed an extremely rare and unexpected condition, which could not be prevented by the reasonable safety precautions against injury. Closed reduction and closed intramedullary fixation was planned for the patient with humeral shaft fracture. ⋯ Sharps injuries continue to be a serious concern for all healthcare workers. In some studies however, reporting of sharps injuries by healthcare workers remains a problem with reporting levels cited as low as 15% and as high as 90% (Kerr H-L, Stewart N Ann R Coll Surg Engl 91:430-432, [6]). Guo et al. pointed out the most recent sharps injuries at work, and syringe needles was by far the most important items causing injuries, followed by glass products, suture needles, and intravenous catheters.
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Arch Orthop Trauma Surg · Mar 2012
Review Comparative StudyTotal hip arthroplasty: to cement or not to cement the acetabular socket? A critical review of the literature.
The optimal method for acetabular socket fixation remains controversial. We present a critical analysis of the current evidence from a systemic literature review of comparative studies, long-term case series, prior literature reviews, meta-analysis, and national arthroplasty registry data for cemented and uncemented acetabular components to determine the respective survivorship rates, overall risk of re-operation, dislocation rates, and wear-related complications. Using contemporary techniques, both cemented and uncemented sockets can yield good long-term results, but our evaluation suggests that the overall/all cause re-operation risk is lower for cemented fixation. Until and unless crosslinked polyethylene (PE) liners or alternative bearings can prove to yield superior outcome in the future, the cemented PE cup remains the gold standard, in all age groups, by which every acetabular component should be compared.
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Arch Orthop Trauma Surg · Mar 2012
Comparative StudyInterdisciplinary inter-observer agreement and accuracy of MR imaging of the shoulder with arthroscopic correlation.
Differences between radiologists and orthopaedic surgeons in the interpretation of MR images of the shoulder joint are experienced in daily clinical practice. This study set out to evaluate the inter-observer agreement between radiologists and orthopaedic surgeons in assessing pathology on MR imaging of the shoulder joint. Also, we determined the accuracy of the observers with arthroscopy as the standard of reference. ⋯ The orthopaedic surgeon and radiologists differed in their interpretation of what defines a Bankart lesion and what defines a ligamentous lesion. The orthopaedic surgeon was significantly more accurate in assessing impingement.