Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Nov 2007
The use of hamstrings in anterior cruciate ligament reconstruction in patients over 40 years.
Anterior cruciate ligament reconstruction is an increasingly established method even in patients over 40 years old. Recent studies with regard to this procedure used BTB transplants. We did a retrospective follow-up examination on over-40-year-old patients with anterior cruciate ligament reconstruction using hamstring transplants and compared them to a younger control group. Our hypothesis is that functional outcome after ACL-reconstruction is comparable in patients under and over 40 years of age. ⋯ The predominantly good results and a high level of patient satisfaction show that anterior cruciate ligament reconstruction is justified even in over-40-year-old patients with persistend subjective symptomatic anterior knee instability. The indication for reconstruction should be based on individual factors such as level of activity or subjective feeling of instability rather than on a dogmatic age limit. Advanced arthrotic changes compared to the healthy side, might be due to a too long period of preoperative decision making.
-
Arch Orthop Trauma Surg · Nov 2007
Endoscopically assisted release for exertional compartment syndromes of the lower leg.
Endoscopic treatment of intractable chronic anterior and lateral exertional compartment syndromes of the lower leg in athletes is reported anecdotically only in six patients. ⋯ This study confirms feasibility of endoscopic release for chronic exertional compartment syndromes of the lower leg on a larger scale. At least for the deep posterior compartment its safety and effectiveness cannot be recommended without stint as results are inferior as compared to data obtained from literature for open surgery. To avoid vascular complications, especially during deep posterior compartment fasciotomy it is most important to perform the procedure without tourniquet.
-
Arch Orthop Trauma Surg · Oct 2007
Randomized Controlled TrialTreatment of type IIIA open fractures of tibial shaft with Ilizarov external fixator versus unreamed tibial nailing.
The aim of this study was to compare the radiographic results and clinical outcome of unreamed tibial nailing (UTN) and Ilizarov external fixation (IEF) for the treatment of type IIIA open fractures of the tibia. ⋯ The results of the current study showed that IEF technique had a notable incidence of pin-tract infection, joint contracture, and shorthening related to treatment of the delayed union. The UTN technique had the disadvantage of a posttraumatic osteomyelitis and delayed union requiring additional surgery. We believe that the decision to use IEF or UTN should be made on a case-by-case basis.
-
Arch Orthop Trauma Surg · Oct 2007
Treatment of the humeral shaft nonunion after surgical failure using the Selfdynamisable internal fixator.
A nonunion of the humeral shaft is not a rare condition and is a complication of both nonoperative and operative treatment of the fracture. Several fixation options were used in the nonunion treatment, including various plate techniques, intramedullary nails and external fixator. We applied our Selfdynamisable internal fixator for the treatment of humeral shaft nonunion after surgical failure and evaluated its clinical outcome. ⋯ Selfdynamisable internal fixator with bone graft for the treatment of recalcitrant humeral shaft nonunion provided successful clinical outcome with minimal complications.
-
Arch Orthop Trauma Surg · Oct 2007
Case ReportsComplete osseous avulsion of the adductor longus muscle: acute repair with three fiberwire suture anchors.
An acute tear of the adductor longus tendon is a seldom injury. A proximal osseous avulsion of this tendon has never been reported in literature. ⋯ Case report.