Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2008
Reconstruction with pasteurized autograft for distal tibial tumor.
Primary malignant tumors of the distal tibia are rare. With advances in various treatment modalities, limb salvage for tumors of the distal tibia has been indicated for selected cases. This study examined whether the results of a pasteurized autologous bone graft are comparable to other reconstruction methods with regard to the graft survival and the functional outcome. ⋯ The reconstruction with a pasteurized autograft is a simple and easily method for treating distal tibial malignancies. Moreover, vascularized fibula transfer might be considered a good ancillary procedure for resolving graft-related complications.
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Arch Orthop Trauma Surg · Feb 2008
Percutaneous antegrade screwing for anterior column fracture of acetabulum with fluoroscopic-based computerized navigation.
Open reduction and internal fixation has been the gold standard for displaced fracture involving weightbearing dome and fractures with intra-articular fragments. However, extensile exposure can lead to complications. Fracture with minimal displacement can be fixed by a minimally invasive method. Percutaneous screwing for an anterior column fracture of acetabulum under conventional 2D fluoroscopy is a demanding technique. With fluoroscopic-based computerized navigation, we can determine the position of a screw real time intra-operatively with less exposure to radiation. We proposed that a fluoroscopy-based computerized navigational system would simplify operation procedures. The purpose of this study is to test the application of the fluoroscopy-based computerized navigational system for anterior column fracture of acetabulum. ⋯ Though the indication for this procedure is limited, we think that there should be potential to apply the screw with less radiation by fluoroscopic-based computerized navigation. Once anatomic reduction can be achieved by the close method in the anterior column fracture of the acetabulum, percutaneous screw fixation under fluoroscopic-based computerized navigation could be a reliable method; however; validating the position of the guide pin and screw by fluoroscopy is suggested.
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Arch Orthop Trauma Surg · Feb 2008
Case ReportsPulp thumb defect reconstruction using a twin neurovascular island flaps: a case report.
In this report, we present the functional and cosmetic results of a case with complete loss of the thumb pulp for which the Chen and Noordhoof techniques has been chosen for reconstruction. A 33-year-old man, artisan, had his right thumb caught in a machine during the work, resulting in a degloving injury in the entire pulp of the distal phalanx of the thumb with all other digits of the right hand intact. The patient was a young man, in good health and non-smoker. ⋯ The patient turned up to work at 10 weeks after surgery. After 2 years, we obtained a good aesthetic result, a sensitivity in the thumb and at the donor site comparable to the other hand and a complete recovery of normal function of the hand. In focal pulp loss of the thumb, the twin neurovascular island flaps suggested by Chen and Noordhoff could be an easy and efficient method to reconstruct soft tissue coverage and sensibility when microsurgical setting and abilities are not available.
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Arch Orthop Trauma Surg · Jan 2008
Case ReportsA primarily overlooked and incorrectly treated Essex-Lopresti injury: what can this lead to?
What result can one expect in treating an Essex-Lopresti lesion--a rare complex combination injury of the forearm consisting of a radial head fracture and a rupture of the interosseous membrane--which failed to be identified at first? ⋯ Years of illness and multiple corrective operations which only serve to limit the collateral damage caused by the wrong therapy strategy and ultimately only lead to restoration of moderate function. The crucial factor is an early diagnosis. Then a radial head prosthesis should first be implanted in an operation in order to prevent an additional proximal migration of the radius and to move the distal radioulnar joint into the proper anatomical position.
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Arch Orthop Trauma Surg · Jan 2008
Case ReportsAnkle stiffness after Bosworth fracture dislocation of the ankle.
The purpose of this study is to review the result of patients with Bosworth fracture dislocation of ankle. ⋯ Early recognition and prompt reduction of the dislocated ankle is important in case of Bosworth fracture dislocation in order to prevent late complication. Closed reduction of dislocated ankle is usually not helpful and repeated attempts may be harmful. Emergency operation of open reduction and internal fixation is usually required to reduce the ankle joint without delay.