Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jul 2011
Tendon transfers for drop foot correction: long-term results including quality of life assessment, and dynamometric and pedobarographic measurements.
Drop foot deformity is a common problem with severe restrictions in quality of life and impairment of daily activities. A technique of posterior tibial tendon transfer through the interosseus membrane and fixation to the anterior tibial and the long peroneal tendon "Bridle procedure" (stirrup-plasty) offers a physiological alternative to surgical correction. ⋯ Fusion of the transposed posterior tibial, anterior tibial and the peroneus longus tendon prevents drop foot deformity sufficiently. The stirrup mechanism, in combination with tenodesis of the toe extensors, provides a balanced foot and avoids equinovarus and cavus deformity without immobilizing the ankle joint. Improvements in quality of life parameters justify the risk of the operative procedure for the patient.
-
Arch Orthop Trauma Surg · Jul 2011
Arthroscopically assisted percutaneous osteosynthesis of displaced transverse patellar fractures with figure-eight wiring through paired cannulated screws.
For treatment of displaced transverse patellar fractures, open reduction and internal fixation is the standard reconstructive method. The role of percutaneous osteosynthesis is still unclear and worth of further investigation. Our hypothesis is that satisfactory reduction and rigid fixation is possible for the treatment of displaced transverse patellar fractures with some percutaneous techniques. Here, we present and evaluate a minimally invasive technique for these patellar fractures. ⋯ Under the control of arthroscopy and fluoroscopy, we successfully treated 21 displaced transverse patellar fractures by percutaneously osteosynthesis. This is a safe and reproducible method for transverse patellar fractures. However, it is not indicated for severely comminuted fractures.
-
Arch Orthop Trauma Surg · Jul 2011
Direction of the oblique medial malleolar osteotomy for exposure of the talus.
A medial malleolar osteotomy is often indicated for operative exposure of posteromedial osteochondral defects and fractures of the talus. To obtain a congruent joint surface after refixation, the oblique osteotomy should be directed perpendicularly to the articular surface of the tibia at the intersection between the tibial plafond and medial malleolus. The purpose of this study was to determine this perpendicular direction in relation to the longitudinal tibial axis for use during surgery. ⋯ A medial malleolar osteotomy directed at a mean 30° relative to the tibial axis enters the joint perpendicularly to the tibial cartilage, and will likely result in a congruent joint surface after reduction.
-
Arch Orthop Trauma Surg · Jul 2011
A single incision surgical new anterior technique for forequarter amputation.
Conventionally described standard techniques of forequarter amputation may not be suitable for patients presenting with neglected or maltreated very large tumors of the proximal humerus. ⋯ This technique is safe, easy, less time consuming, involves small single incision in supine position, has better wound healing and can be used for both small and large tumors of proximal humerus with or without involvement of axillary vessels. Although there was no local recurrence for last 24 months but a long term follow-up is required to comment on its actual rate.
-
Arch Orthop Trauma Surg · Jun 2011
Comparative StudyBiomechanical analysis of bicortical versus unicortical locked plating of mid-clavicular fractures.
Operative fixation of displaced mid-shaft clavicle fractures has been shown to improve the functional outcomes and decrease the likelihood of non-union; however, little is known about the need for locking screws versus traditional screws. We, therefore, evaluated the strength of unicortical locked plating versus traditional bicortical non-locking fixation methods. ⋯ Unicortical fixation using pre-contoured plates and locking screws has a similar biomechanical profile compared to gold standard non-locked bicortical screws in cyclic axial compression and axial load to failure. Non-locking constructs were stiffer under rotational testing. This technique may provide a suitable biomechanical environment for bony healing. This may also improve the safety of clavicle plating by protecting infraclavicular structures from injury during drilling or screw penetration as it obviates the need for bicortical fixation.