Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2010
Free serratus anterior fascia flap for reconstruction of hand and finger defects.
Reconstruction of the dorsal surface of hand defects requires thin, pliable, well vascularized tissue with a gliding surface for the extensor tendon course. Also defects of the palmar hand and degloved fingers need non-bulky soft tissue for reconstruction. We present a retrospective analysis of nine patients with free serratus anterior fascia flaps used to cover defects of the palmar and dorsal hand and of degloved fingers. ⋯ The free serratus anterior fascia flap has good functional and cosmetic properties and there is low donor-site morbidity. It is an excellent flap for soft-tissue reconstruction combined with extensor tendon reconstruction on the dorsum of the hand. The flap is also very useful for palmar and finger defects.
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Arch Orthop Trauma Surg · Feb 2010
ReviewSimple elbow dislocations: a systematic review of the literature.
To identify if functional treatment is the best available treatment for simple elbow dislocations. ⋯ This review has included data from two trials and three observational comparative studies. Important data were missing from three observational comparative studies and the results from these studies were extracted for this review. No difference was found between surgical treatment of the collateral ligaments and plaster immobilisation of the elbow joint. Better range of movement, less pain, better functional scores, shorter disability and shorter treatment time were seen after functional treatment versus plaster immobilisation.
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Arch Orthop Trauma Surg · Feb 2010
Controlled Clinical TrialThe effects of pre-emptive analgesia with bupivacaine on acute post-laminectomy pain.
This is a prospective, non-randomized, hospital-based, case-controlled, clinical trial to assess the efficacy of perineural infiltration with bupivacaine at the related neural root for acute pain relief after lumbar laminectomy. ⋯ Our data suggests that pre-emptive analgesia via perineural infiltration of bupivacaine is a simple, and effective method for post-operative acute pain relief.
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Arch Orthop Trauma Surg · Feb 2010
A quantitative anatomic study of plate-screw fixation of the acetabular anterior column through an anterior approach.
Screw penetration of the hip joint is a serious complication during plate-screw internal fixation of acetabular anterior column or anterior wall fractures through an anterior approach. The purpose of the cadaveric study is to determine safe paths for screw placement on the anterior column of the acetabulum. ⋯ During the operation of plate-screw fixation of the anterior column on the acetabulum, there are three ways to avoid screw penetration of the hip joint. The first one is to use the long screw. Its entry point is placed as close to pelvic brim as possible, and the entry direction is parallel to the quadrilateral surface. The second one is to use the short screws whose lengths are 14, 12 and 10 mm and locate them in the region between the pelvis brim and 0.5-cm entry point, between 0.5- and 1.0-cm entry point, between 1.0- and 1.5-cm entry point, respectively, regardless of the direction of the screw placement. The third one is to take quadrilateral surface as a reference plane, and adjust the medial angulation of the screw placement according to different target locations, i.e., in the coronal plane ranges from 0 degrees to 10 degrees in the region between pelvis brim and 0.5-cm entry point, 10 degrees-20 degrees in the region between 0.5- and 1.0-cm entry point, and 20 degrees-30 degrees in the region between 1.0- and 1.5-cm entry point.
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For primary uncemented hip arthroplasty, various stem designs are available. The cementless CLS((R)) Spotorno stem has been used for more than 20 years. We re-evaluated a group of patients previously examined for a 10-year follow-up to assess the clinical and radiological stem performance in the long run. ⋯ The CLS((R)) Spotorno stem allows excellent long-term results in cementless hip arthroplasty, leaving only minimal options for substantial improvements. Our findings on progressive stress shielding point towards a more diaphyseal load transfer of the CLS stem.