Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2010
Comparative StudyBiomechanical evaluation of fixation of comminuted olecranon fractures: one-third tubular versus locking compression plating.
New concepts in plate fixation have led to an evolution in plate design for olecranon fractures. The purpose of this study was to compare the stiffness and strength of locking compression plate (LCP) fixation to one-third tubular plate fixation in a cadaveric comminuted olecranon fracture model with a standardised osteotomy. ⋯ Contoured LCP and intramedullary screw fixation can be used as an alternative treatment method for comminuted olecranon fractures as its stiffness and strength were not significantly different from a conventional plating technique.
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Arch Orthop Trauma Surg · Apr 2010
Comparative StudyThree-dimensional measurement of femoral antetorsion: comparison to a conventional radiological method.
The aim of our study was to produce a 3-D reconstruction of a CT dataset and compare it to the conventional method, with that same dataset, in terms of precision and the influence of femoral positioning. ⋯ 3-D reconstruction enables precise determination of the femoral AT angle, and is independent of femoral positioning as conventional methods seem to be. In clinical practice, 3-D reconstruction may allow a greater understanding of the femoral AT angle post fracture reduction and internal fixation. However, we believe the 3-D method of measuring the AT-angle can potentially optimize the patient's treatment outcome by allowing the orthopaedic surgeon to measure the femoral AT-angle more precisely after femoral fracture reduction.
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Arch Orthop Trauma Surg · Apr 2010
The management of humeral shaft fractures with associated radial nerve palsy: a review of 117 cases.
This single center retrospective study reviews the management and outcomes of 117 consecutive patients with humeral shaft fractures and associated radial nerve palsy (RNP) treated over a 20-year period (1986-2006). A total of 101 fractures were managed conservatively and 16 fractures underwent external fixation for poor bony alignment. Sixteen grade 1 and 2 open fractures underwent wound toileting alone. No patients underwent initial radial nerve exploration or opening of the fracture sites. ⋯ Humeral fractures with associated RNP may be treated expectantly. With low rates of humeral nonunion, 95% spontaneous nerve recovery in closed fractures and 94% in grade 1 and 2 open fractures, one has the opportunity of waiting. If at 10-12 weeks there are no clinical/EMG signs of recovery, then nerve exploration/secondary reconstruction is indicated. Late tendon transfers may also give good/excellent functional results.
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Arch Orthop Trauma Surg · Apr 2010
Impaction bone grafting for acetabular reconstruction: mean 5.5-year results in Japanese patients.
We performed a retrospective outcome study on 23 consecutive acetabular reconstructions involving impaction bone grafting in Japanese patients. ⋯ Acetabular impaction bone grafting is a reproducible technique in which surgeons should strictly follow the recommended technical procedure.
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Arch Orthop Trauma Surg · Apr 2010
Treatment for large skeletal defects by free vascularized fibular graft combined with locking plate.
Reconstruction of large skeletal defects secondary to osteomyelitis or open fracture is a challenging problem. The purpose of this study was to evaluate the results of using free vascularized fibular graft (FVFG) combined with locking plate in the treatment of large skeletal defects from open fracture and infection. ⋯ FVFG combined with locking plate is a viable option for the management of large skeletal defects from open fracture and infection.