Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2011
Comparative StudyStructural properties of a new fixation strategy in double bundle ACL reconstruction: the MiniShim.
Double-bundle reconstruction of the ACL has become the focus of scientific and clinical interest in the last years. However, there is still a discussion about the most appropriate technique for graft fixation. Both, extracortical fixation systems like the Endobutton and aperture fixation by interference screws have advantages as well as disadvantages. Aim of this study was to analyze the biomechanical properties of a new small wedge shaped implant (MiniShim, Karl Storz, Germany) for the fixation of a soft tissue graft in double bundle ACL reconstruction and to compare it to an aperture fixation by interference screw and an extracortical fixation. ⋯ Hybrid fixation using the MiniShim provides biomechanical properties strong enough to withstand the forces occurring during rehabilitation and comparable to the fixation strength provided by interference screw. While fixation by MiniShim alone does not provide sufficient fixation strength in double bundle ACL reconstruction, hybridfixation using a cortical fixation by FlippTack is an alternative to aperture fixation by interference screw concerning primary stability.
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Arch Orthop Trauma Surg · Aug 2011
Case ReportsA novel technique for reconstruction of the medial patellofemoral ligament in skeletally immature patients.
Habitual or recurrent dislocation of the patella in the skeletally immature patient is a particularly demanding problem since the etiology is frequently multifactorial. The surgical techniques successfully performed in adults with patellar instability may risk injury to an open growth plate if applied to children. We present a technique that preserves femoral and patellar insertion anatomy of medial patellofemoral ligament (MPFL) using a free semitendinosus autograft together with tenodesis to the adductor magnus tendon without damaging open physis on the patellar attachment of MPFL. ⋯ Aftercare includes immobilization of the joint limited to 30° flexion using an above-knee splint for 2 weeks. No recurrent dislocation was observed in three patients (4 knees) at a mean follow-up time of 17.7 months. Both range of motion and radiological finding were restored to normal limits.
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Arch Orthop Trauma Surg · Aug 2011
Calcium phosphate bone cement: a possible alternative to autologous bone graft. A radiological and biomechanical comparison in rat tibial bone.
Donor site morbidity is a problem after autologous bone transplantation. An injectable CaP bone cement indicates properties similar to bone. ⋯ The injectable CaP bone cement confirms its similarities to bone, implying that it can be used as an adjunct to secure bone fragments and as a possible alternative to autologous bone transplantation in clinical practice.
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Arch Orthop Trauma Surg · Jul 2011
Treatment of lower extremity long bone nonunion with expandable intramedullary nailing and autologous bone grafting.
Nonunion of long bones in lower limbs is a common complication of orthopedic trauma that can be extremely debilitating. This retrospective study describes our experience using expandable intramedullary nails and autologous bone grafting in treating lower limb long bone nonunion with bone defects. ⋯ The use of expandable intramedullary nails and autologous bone grafts was an effective method for repair of nonunion of lower limb fractures combining with bone defects with minimal complications.
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Arch Orthop Trauma Surg · Jul 2011
Case ReportsAn unusual Monteggia type I equivalent fracture: a case report.
We report an unusual case of a type I Monteggia equivalent lesion in a 6-year-old girl consisting of fracture of the ulnar diaphysis and fracture of the neck of the radius without dislocation of the radial head. Manual reduction and immobilization in a plaster cast were performed. At 10 years of follow-up, the patient had regained full flexion and extension of the elbow, and nearly full pronation and supination. In the literature, this lesion has been reported only in two paediatric patients indicating that this is an extremely rare trauma.