Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2010
Effect of limb rotation on radiographic alignment in total knee arthroplasties.
Even in a well-aligned total knee arthroplasty (TKA), limb rotation at the time of radiographic assessment will alter the measurement of alignment. This could influence the radiographic outcome of TKA. The purpose of this study was to evaluate the effect of limb rotation on radiographic alignment after TKA and to establish a re-calculation of this rotation by using existing radiographic landmarks. ⋯ Limb rotation had a highly statistically significant effect on measured anatomic alignment and mechanical angles. A correlation between limb rotation, anatomic mechanical angle, mechanical angles measured at femur and tibia and the femoral component distance ratio was established. As the anatomic mechanical angle and the femoral component distance ratio change linearly in the range of 20 degrees internal and external limb rotation, a calculation of the femoral component distance ratio could be used to re-calculate the limb rotation at the time of radiographic assessment to evaluate the evidence of a long leg radiograph.
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Arch Orthop Trauma Surg · Apr 2010
Valgus osteotomy combined with intramedullary nail for Shepherd's crook deformity in fibrous dysplasia: 14 femurs with a minimum of 4 years follow-up.
To investigate the effectiveness of valgus osteotomy combined with intramedullary nail in treatment of Shepherd's crook deformity of fibrous dysplasia. ⋯ The valgus osteotomy can correct Shepherd's crook deformity, prevent recurrent fracture, and restore alignment, thus improve functioning of limb. The intramedullary nail with neck cross pinning should be the first consideration of internal fixation. Massive impaction allograft is the key technique to improve full incorporation of allograft and to prevent pathological fracture.
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Two men visited our Emergency Room because of a water-ski-accident. At physical examination, there was hematoma at the upper leg with loss of strength at extension of the hip and flexion of the knee. Both patients had a palpable gap just distal of the ischial tuberosity. ⋯ After treatment consisted of brace for 4 weeks after operation. Both patients returned to their pre-operatively sports, though at a lower level. Surgical treatment of a complete proximal rupture of the hamstrings is recommended in case of sportive patients.
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Arch Orthop Trauma Surg · Mar 2010
Randomized Controlled TrialThe effect of intraarticular combinations of tramadol and ropivacaine with ketamine on postoperative pain after arthroscopic meniscectomy.
The purpose of this prospective randomized study was to evaluate the effects of intraarticular combinations of tramadol and ropivacaine with ketamine in postoperative pain control of patients undergoing arthroscopic meniscectomy. ⋯ Administration of intraarticular tramadol-ketamine combination was found to be more effective in decreasing postoperative daily analgesic consumption.
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Arch Orthop Trauma Surg · Mar 2010
Analgesia requirements after interscalene block for shoulder arthroscopy: the 5 days following surgery.
Excellent initial post-operative analgesia for patients undergoing arthroscopic shoulder surgery can be provided with a single-shot interscalene brachial plexus block. However there have been concerns that when the block wears off, patients may experience pain and this may occur at home. Some investigators have advocated the use of continuous ambulatory local anaesthetic infusions following hospital discharge. We prospectively studied pain scores, analgesic requirements and satisfaction of patients at home in the first 5 days following arthroscopic shoulder surgery to see whether continuous infusion would be of benefit. ⋯ Post-operative continuous ambulatory local anaesthetic infusions may not be justified following this intermediate magnitude of surgery.