Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2010
Intraoperative three-dimensional fluoroscopy assessment of iliosacral screws and lumbopelvic implants stabilizing fractures of the os sacrum.
Percutaneous iliosacral screw fixation of unstable sacrum fractures has gained popularity since its introduction in the 1990s. The combination with lumbopelvic implants allows the application even in situations of higher instability. Both manual and navigated screw insertion in the sacrum and vertebra bodies shows unchanged relevant malpositions. The current standard to control the screw position is postoperative computed tomography. The study presents the results of assessment of these implants by intraoperative three-dimensional fluoroscopy. ⋯ Intraoperative 3D fluoroscopy is a valuable tool for intraoperative assessment of iliosacral screws and lumbopelvic implants. The technique should help us to detect intraoperative malplacement of the screws more reliably than conventional fluoroscopy and allows an immediate correction of malplaced implants. Therefore, a postoperative computed tomography to control the position of implants is dispensable.
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Arch Orthop Trauma Surg · Nov 2010
Comparative StudyEndoscopic plantar fasciotomy versus extracorporeal shock wave therapy for treatment of chronic plantar fasciitis.
Planter fasciitis is a common cause of heel pain in adults. Many treatment options exist. Most of patients resolve with conservative management. Approximately 10% of patients develop persistent and often disabling symptoms. ⋯ Because of better results with endoscopic release versus the benefits of no complications, no immobilization, and early resumption of full activities with ESWT, we conclude that ESWT is a reasonable earlier line of treatment of chronic plantar fasciitis before EPF.
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Arch Orthop Trauma Surg · Nov 2010
Elastic stabilisation of proximal humeral fractures with a new percutaneous angular stable fixation device (ButtonFix(®)): a preliminary report.
The ButtonFix(®) system represents a new angular stable percutaneous fixation device for stabilisation of fractures of the proximal humerus. The purpose of this study was to present a preliminary report of the radiological and clinical outcome after minimally invasive stabilisation of selected proximal humerus fractures with the ButtonFix(®). ⋯ The ButtonFix(®) system represents a valuable tool in the treatment of proximal humeral fractures with results indicating fewer complications compared to prior percutaneous fixation devices. Moreover, the ButtonFix(®) seems to be able to maintain reduction even in elderly patients with potentially reduced bone mass.
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Arch Orthop Trauma Surg · Oct 2010
Acute postoperative infection with Aeromonas hydrophila after using medical leeches for treatment of venous congestion.
Venous convulsion after reconstructive microsurgery procedures is one major complication a surgeon has to deal with. Today, especially in the field of reconstructive microsurgery, medicinal leech therapy enjoys a renaissance. The potential risks such as infections associated with leech therapy are generally underestimated and not sufficiently discussed in literature. ⋯ We recommend making a considered indication for leech therapy, to diagnose wound infections early and to think about prophylactic antibiotics in patients with leech application.
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Arch Orthop Trauma Surg · Oct 2010
Isolated fractures of the greater trochanter with occult intertrochanteric extension.
Isolated fractures of the greater trochanter (GT) are relatively rare. The diagnosis can be done on routine radiographs, but it is difficult to fully define the geographic extent of these injuries. This study examined the pattern and extent of an injury shown by magnetic resonance imaging (MRI) and radionuclide bone scan (RBS) in patients whose plain radiographs revealed fractures limited to the GT. ⋯ Patients with an isolated fracture of GT can have a broader fracture extending into the ITC region than that diagnosed by standard radiographs. We recommend that all patients presenting with an isolated GT fracture on the plain radiographs should undergo MRI examination.