Archives of orthopaedic and trauma surgery
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The most common implants for treating unstable femoral neck fractures are sliding constructs, which allow postoperative collapse. Successful healing, typically, is a malunion with a shortened femoral neck. Functional sequelae resulting from altered femoral neck biomechanics have been increasingly reported. Re-operation rate due to nonunion, avascular necrosis, hardware cut-out and prominence is high with this treatment modality. We evaluated the outcomes of patients with femoral neck fractures treated with stable calcar pivot reduction, intraoperative compression across the fracture, and stabilization with length-stable implants. ⋯ IV, retrospective with historical controls.
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Arch Orthop Trauma Surg · Dec 2010
Case ReportsC2 translaminar screw as the optimal choice for atlantoaxial dislocation with C2-C3 congenital fusion.
The entry point and trajectory are very important for transarticular screw (TAS) and C2 pedicle screw (PDS) plantation. When the physical size is not large enough for the screw passing through, an accurate entry point is the most important point for successful screw insertion without vertebral artery (VA) injury and spinal cord injury. Once the laminas of C2 and C3 are fused, the normal anatomic mark might disappear and the insertion point would be hard to find. As a result, the complication of TAS or PDS implantation increases rapidly. We used C2 translaminar screws (TLSs) with C1 lateral mass screws as the optimal fixation for atlantoaxial dislocation in order to reduce the risk of VA injury and spinal cord injury. ⋯ TLSs combined with C1 lateral mass screws might be a useful technique for patients with atlantoaxial dislocation and C2-C3 fusion, especially with small size of C2 isthmus. Also, the fusion of posterior elements between C2 and C3 might be a relative contraindication for TAS fixation.
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Arch Orthop Trauma Surg · Dec 2010
Serum metal ion levels after second-generation metal-on-metal total hip arthroplasty.
Metal-on-metal bearings for total hip arthroplasty are increasing in popularity. However, metal ion toxicity, metal hypersensitivity, and metal carcinogenicity are the causes concern for patients with metal-on-metal hip replacement. We investigated serum levels of cobalt and chromium ions in patients with successfully implanted second-generation metal-on-metal total hip arthroplasty (THA) using PINNACLE-A (DePuy, Warsaw, IN, USA). ⋯ Patients with metal-on-metal THA had higher circulating levels of metal ions than before arthroplasty at 3 months, with no additional significant increases at 1 year in this study.
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Arch Orthop Trauma Surg · Nov 2010
Comparative StudyPercutaneous cervical nucleoplasty and percutaneous cervical discectomy treatments of the contained cervical disc herniation.
There were no studies in literature to compare the clinical outcomes of percutaneous nucleoplasty (PCN) and percutaneous cervical discectomy (PCD) in contained cervical disc herniation. ⋯ PCN and PCD treatments of contained cervical disc herniation show good outcomes and there was no difference in the stability of cervical spine. PCN and PCD are safe, minimally invasive, and no differences were observed between the methods in clinical outcome.