Archives of orthopaedic and trauma surgery
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Subtalar instability is thought to be one of the possible causes for chronic functional instability of the foot and ankle. The purpose of this study was to determine the extent of ligament injury that is followed by subtalar instability and to depict consecutive pathologic joint motion. ⋯ The calcaneofibular ligament plays a key role in lateral stabilisation of the subtalar joint. Therefore, ligaments of the subtalar joint should be included in surgical repair.
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Arch Orthop Trauma Surg · Mar 2010
Quantification of rotator cuff tear geometry: the repair ratio as a guide for surgical repair in crescent and U-shaped tears.
Surgical repair of symptomatic, retracted rotator cuff tears unresponsive to non-operative treatments requires closure of the tear without undue tension and reattaching the torn tendon to its former insertion site. In this study, the length of the torn tendon edge was hypothesized to be longer than the length of the humeral insertion site. The objective of this study was to quantify the discrepancy in length of the torn tendon edge and the length of the avulsed humeral insertion site. ⋯ As only the length of the torn tendon edge equal to the length of the avulsed humeral insertion site can be repaired to bone, a repair ratio more than one precludes a simple repair and an additional repair technique such as margin convergence would be necessary for the remaining unapproximated torn tendon edge in rotator cuff tears. Repair ratio may aid in selection of the surgical repair technique of these rotator cuff tears.
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Arch Orthop Trauma Surg · Mar 2010
Case ReportsOsteonecrosis of the lateral femoral condyle following anterior cruciate ligament reconstruction: is bone bruising a risk factor?
Osteonecrosis of the knee is extremely rare following anterior cruciate ligament (ACL) reconstruction surgery. We report a case of osteonecrosis of the lateral femoral condyle in a patient after ACL reconstruction. The osteonecrotic lesion occurred in the same area as a large bone bruise, which was sustained at the time of the initial injury. We hypothesize that the combination of bone bruising and femoral tunnel drilling for ACL reconstruction may have compromised the overall vascularity of the articular cartilage and the subchondral bone, thereby resulting in osteonecrosis.
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Arch Orthop Trauma Surg · Feb 2010
Multicenter StudyWhat determines length of stay after total hip and knee arthroplasty? A nationwide study in Denmark.
The goal of this study was (1) to identify logistical and clinical areas of importance for length of stay (LOS) by identifying departments with short and long LOS and to evaluate their set-up; and (2) to evaluate patient satisfaction in relation to LOS. ⋯ Nationwide implementation of fast-track THA and TKA would result in a significant decrease in the needed number of hospital beds with similar or better outcome for the patients. Implementation of updated logistical and clinical features is expected to increase rehabilitation and reduce LOS with similar or improved patient satisfaction. These results support the implementation of fast-track total hip- and knee arthroplasty.
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Total femoral replacement after massive resection of bone and soft tissue sarcoma of the thigh can restore femoral integrity and allow patients to resume ambulation, albeit at a compromised level. This compromised functional capacity is superior to that achieved after hip disarticulation. Most reports of total femoral replacements are isolated case studies. Only few reported series have been identified. ⋯ Endoprosthetic femoral replacement is a reliable mean to restore mechanical and functional results after extensive resection of the femur.