Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2009
Bone quality measured by the radiogrammetric parameter "cortical index" and reoperations after locking plate osteosynthesis in patients sustaining proximal humerus fractures.
To analyse the radiogrammetric parameter "cortical index" (CI) and its predictive value for proximal humerus fractures. Furthermore, to investigate the reoperations and the cause of reoperations after locking plate osteosynthesis of displaced proximal humerus fractures. ⋯ The risk for reoperation is independent of the CI even though the CI may be a predictor for proximal humerus fracture. Younger patients should be aware that surgical treatment of proximal humerus fractures might be a two-stage surgery. Regular follow-up visits for older patients during the first postoperative year must be assured.
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Arch Orthop Trauma Surg · Sep 2009
The postoperative patella height: a comparison of additive and subtractive high tibial osteotomy in correcting the genu varum.
Intraligamentary correctional operations like a high tibial osteotomy were performed in genua valga to prevent later medial gonarthrosis especially in younger patients. An unwanted effect of this method seems to be the inferiorization of the patella. This is feared because of the complications in case of subsequent alloarthroplasty. Besides the classical Coventry method as a subtractive osteotomy the hemicallotasis has been established as a sustainable additive procedure. This means a gradual open wedge correction using an external fixateur. ⋯ The results are surprising, contrary was expected. First this can be explained by its gradual, additive correctional property in contrast to the spontaneous correction by the conventional method according to Coventry, second by the postoperative treatment, which allows an early mobilization and active remedial gymnastics, provided an impact resistant osteosynthesis by a fixateur externe is given. In the case of the additive hemicallotasis an intraligamentary osteotomy is recommended. Technically expensive step cuts in order to osteotomize below the tuberositas tibiae are not necessary. Due to the low quota of complications and the small operative expense the continuous distraction is preferential to ad hoc correction. A postoperative patella baja position has not to be afraid in hemicallotasis.
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Arch Orthop Trauma Surg · Sep 2009
Results of open reconstruction of anterior glenoid rim fractures following shoulder dislocation.
The present study evaluates the clinical and radiological outcome following open reconstruction of avulsion fractures of the anterior glenoid rim in traumatic shoulder dislocation. ⋯ Open reconstruction of glenoid rim fractures is a valuable procedure regarding medium-term subjective and objective outcome measures. Recurrent dislocation, glenoid defects and early onset of osteoarthritic degeneration can be avoided.
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Arch Orthop Trauma Surg · Aug 2009
Clinical TrialPercutaneous suturing of the ruptured Achilles tendon with endoscopic control.
A prospective study of modified percutaneous Achilles tendon repair performed between 1999 and 2005 under local infiltration anesthesia is presented; the study evaluated the results of percutaneous repair technique by visualization of the synovia under endoscopic control, followed by early functional postoperative treatment for surgical intervention of acute Achilles tendon ruptures. ⋯ The proposed method offers a reasonable treatment option for acute total Achilles tendon rupture with a low number of complications. The rerupture rate and return to preinjury activities are comparable to open and percutaneous without endoscopic control procedures.
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Arch Orthop Trauma Surg · Aug 2009
Arthroscopic removal of proud metallic suture anchors after Bankart repair.
This study presents an arthroscopic removal technique for proud metallic suture anchor after Bankart repair and analyzes the cause of anchor failures. ⋯ Despite small numbers of patients, a successful removal of proud metal suture anchors was achieved using a large empty suture anchor screw driver, which is a simple and reproducible method to remove a proud metallic suture anchor arthroscopically.