Archives of orthopaedic and trauma surgery
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Fractures of the ankle are fairly common injuries. Open ankle fractures are much less common and associated with severe injuries to surrounding tissues. We have performed a systematic review of the literature concerning the clinical results and complication rates in the treatment of open ankle fractures. ⋯ There is a lack of high quality literature concerning the (operative) treatment of patients with open ankle fractures. Remarkable is that most authors reported satisfactory results after performance of their treatment protocol. Based on the available literature, we formulated guidelines regarding: timing of operative treatment, wound irrigation, the role of internal fixation, wound coverage and closure, the use of antibiotics and additional therapies.
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Arch Orthop Trauma Surg · Nov 2011
Comparative StudyComplete acetabular cup revision versus isolated liner exchange for polyethylene wear and osteolysis without loosening in cementless total hip arthroplasty.
Revision surgery in patients showing polyethylene wear and acetabular osteolysis without visible acetabular cup loosening involves the difficult decision of whether to revise only the liner or both the cup and the liner. The purpose of this study is to compare the outcomes of complete acetabular revision and isolated liner exchange in patients showing wear and osteolysis without loosening. ⋯ We found no differences in acetabular osteolysis progression, fixation failure, or complication between the cup revision and retention groups. Therefore, isolated liner exchange without cup extraction in cases of osteolysis that includes a well-fixed and well-positioned shell could be considered as a viable treatment option.
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Arch Orthop Trauma Surg · Nov 2011
Comparative StudyInternal fixation of dorsally comminuted fractures of the distal part of the radius: a biomechanical analysis of volar plate and intramedullary nail fracture stability.
The purpose of the present study was to carry out biomechanical testing of "new generation" volar plates and an intramedullary nail. ⋯ In this experimental setting, all "new generation" implants for distal radius fractures with the exception of the 2.4 mm-LCP showed identical or higher stability compared to the 3.5 mm-LCP. The 2.4 mm-LCP showed the lowest resistance and this must be taken into consideration when planning postoperative functional therapy.
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Arch Orthop Trauma Surg · Nov 2011
Implant survival and outcome after rotating-hinge total knee revision arthroplasty: a minimum 6-year follow-up.
Data on long-time survival and clinical function of rotating hinge knee prostheses used in revision total knee arthroplasty (TKA) are scarce. ⋯ Our results indicate that revision arthroplasty of the knee with this rotating hinge prosthesis can be performed with satisfactory or good results in an elderly population with severe comorbidities.
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Arch Orthop Trauma Surg · Oct 2011
Comparative StudyComparison of stability in the operative treatment of pelvic injuries in a finite element model.
The comparison of the stability of four surgical methods for the treatment of vertically and rotationally unstable type C pelvic ring injuries. ⋯ The finite element model may be utilized for the comparison of different methods of osteosynthesis for the treatment of injuries described above. Due to several difficulties in investigations performed on cadaver specimens, this model has undoubted utility.