Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Sep 2008
Case ReportsTwo-stage decompression for combined epiconus and cauda equina syndrome due to multilevel spinal canal stenosis of the thoracolumbar spine: a case report.
A case of combined epiconus and cauda equina syndrome due to multilevel spinal canal stenosis of the thoracolumbar spine is reported. ⋯ Combined epiconus and cauda equina syndrome due to multilevel spinal canal stenosis was treated by combined two-stage anterior and posterior decompression. In this case, multilevel decompression via anterior and posterior approaches was necessary to relieve the symptoms.
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Arch Orthop Trauma Surg · Sep 2008
Randomized Controlled TrialTiming of thoracolomber spine stabilization in trauma patients; impact on neurological outcome and clinical course. A real prospective (rct) randomized controlled study.
Optimal timing of stabilization for spinal injuries is discussed controversially. The goal of this study is to investigate the neurological recovery and its influencing factors in thoracolumbar spine fractures after surgical decompression and stabilization within 8 h of spinal cord injury versus surgery which is performed between 3 and 15 days. ⋯ Early surgery may improve neurological recovery and decrease hospitalization time and also additional systemic complications in patients with thoracolumbar spinal cord injuries. Thus early stabilization of thoracolumbar spine fractures within 8 h after trauma appears to be favorable.
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Arch Orthop Trauma Surg · Sep 2008
Case ReportsThe reverse shoulder prosthesis for primary and secondary treatment of proximal humeral fractures: a case report.
Humeral head fractures are very common among elderly people, often requiring shoulder arthroplasty. One requirement for good function after shoulder arthroplasty is an intact or at least reparable rotator cuff. In patients with multifractured and or osteoporotic tuberosities, refixation leads to the potential risk of redislocation and resorption of the tuberosities or coexisting irreparable rotator cuff tears lead to a high failure rate after implantation of traditional fracture prosthesis, whereas the reverse shoulder arthroplasty may provide better outcome. ⋯ The primary or secondary implantation of the reverse shoulder prosthesis in proximal humeral fractures has to be planned carefully, since long-term results are still lacking and treatment options after failed reverse shoulder arthroplasty are few. Generally, primary implantation of traditional fracture prosthesis is indicated in most cases of humeral head fractures; but in carefully selected cases primary reverse shoulder arthroplasty may be superior and lead to better outcome. Therefore, future research should be conducted to find criteria where the reverse shoulder arthroplasty is indicated as first line treatment of proximal humeral head fractures in elderly patients.
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Arch Orthop Trauma Surg · Sep 2008
Distraction osteogenesis of the femur using conventional monolateral external fixator.
The author has developed a new simple technique of distraction osteogenesis using conventional monolateral external fixator for femoral lengthening. The primary purpose of the present study was to evaluate the results of treatment with this new technique of femoral lengthening and also to evaluate the effect of preoperative and intraoperative variables on the outcome of distraction osteogenesis in general. ⋯ The newly presented technique of distraction osteogenesis is a useful and cost-effective method for femoral lengthening. Increased lengthenings produced a better healing index but might associate with complications. Younger age was associated with better bone healing but age had no effect on complication rate. Level of osteotomy, acute deformity correction had no effect on healing index and rate of complications.
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Arch Orthop Trauma Surg · Aug 2008
Osteo-fasciocutaneous parascapular flap transfer for reconstruction of the first ray of the foot.
Severe bone and soft tissue defects of the first metatarsal bone after trauma, tumor resection or osteomyelitis are challenging to treat. Partial amputation of the foot may be the consequence. However, due to its significance for gait, salvage of the first ray should be considered, whenever possible. One option for bone and soft tissue reconstruction, therefore, might be an osteo-fasciocutaneous parascapular flap transfer. ⋯ The osteo- fasciocutaneous flap proved to be very versatile and safe for foot reconstruction due to its favorable vascular anatomy. In all patients (partial), amputation of the foot could be avoided.