Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2010
Comparative StudyTreatment of fractures of the fifth metatarsal with the XS-nail retrospective study and comparison with tension-band wiring.
Many different surgical methods and implants for the treatment of fifth metatarsal fractures have been established yet. A high rate of complications, such as nonunion, fragment dislocation, refracture, implant deformation and irritation are widely occurring due to the insufficient ability of the implants to compensate the tension applied to the proximal fragment through the peroneal tendon combined with an impaired blood supply at the fracture zone. Therefore, the search for improved surgical solutions is thoroughly understandable. Thus, we have introduced the XS-nail as an intramedullary nail system that bears the ability to provide a compression to the fracture zone through a grub screw. In this work, we have analyzed the position of the XS-nail in relationship to other methods with special regard to the tension-band wiring. ⋯ Thus, the XS-nail proved to be an effective and technical optimized implant for the treatment of proximal fifth metatarsal fractures that provides a rapid full-weight-bearing mobilization and shows good long-term results.
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Arch Orthop Trauma Surg · Sep 2010
Case ReportsA case of extension loss of great toe due to peroneal nerve compression by an osteochondroma of the proximal fibula.
The authors present a case of extension loss of great toe caused by entrapment neuropathy of a peroneal nerve due to an osteochondroma of the proximal fibula. Plain radiographs revealed no bony abnormality around the foot or ankle, but a sessile exophytic bony growth at the proximal fibula. ⋯ At 3 months postoperatively, normal full extension of the great toe was completely restored. The current case deserves attention in that the only clinical manifestation of peroneal nerve entrapment neuropathy by the osteochondroma at the fibular neck was extension loss of great toe.
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Arch Orthop Trauma Surg · Sep 2010
Comparative StudyInitial load-to-failure and failure analysis in single- and double-row repair techniques for rotator cuff repair.
This experimental study aimed to compare the load-to-failure rate and stiffness of single- versus double-row suture techniques for repairing rotator cuff lesions using two different suture materials. Additionally, the mode of failure of each repair was evaluated. ⋯ A double-row technique combined with arthroscopic Mason-Allen/horizontal mattress stitches provides high initial failure strength and may minimize the risk of the polyethylene sutures cutting through the tendon in rotator cuff repair when a single load force is used.
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Arch Orthop Trauma Surg · Aug 2010
Case ReportsIntraosseous foreign body granuloma in rotator cuff repair with bioabsorbable suture anchor.
Biodegradable implants lead to problems such as cyst formation, soft-tissue inflammation, loose implant fragments or local osteolysis. This report represents the first published case of an intraosseous foreign body granuloma in the humeral head after arthroscopic rotator cuff tear fixation with a poly-L: -lactide (PLLA) suture anchor. A 48-year-old female patient presented with pain in her right shoulder. ⋯ Foreign body granulomas are a well known but rarely described complication that arises after the use of biodegradable suture anchors in shoulder surgery. Every patient presenting with shoulder pain after usage of a biodegradable fixation material should be evaluated closely. Orthopaedic surgeons should be aware of the possibility of delayed foreign body reactions, especially after using PLLA anchors.
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Arch Orthop Trauma Surg · Aug 2010
Double-bundle reconstruction cannot restore intact knee kinematics in the ACL/LCL-deficient knee.
The aim of this study was to evaluate the effect of single-bundle (SB) and anatomic double-bundle (DB) anterior cruciate ligament (ACL) reconstruction on the resulting knee kinematics in a simulated clinical setting with ACL rupture and associated extra-articular damage to the lateral structures. It was hypothesized that anatomic DB ACL reconstruction restores the intact knee kinematics in ACL/LCL-deficient knees, whereas SB ACL reconstruction fails to restore the intact knee kinematics. ⋯ The results of the study did not support our initial hypothesis. Though DB reconstructions were significantly superior to SB reconstruction under simulated KT 1000 test, SB as well as DB reconstruction failed to restore the intact kinematics under simulated pivot shift loads. The clinical relevance of this study is that caution and precise preoperative diagnostics are needed to avoid failure of intra-articular ACL reconstruction if the extra-articular stabilizers are torn.