Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2006
Case ReportsStabilisation of periprosthetic fractures with angular stable internal fixation: a report of 13 cases.
Periprosthetic fractures of the femur present a challenging surgical problem. The aim of this study was to retrospectively evaluate the outcome of periprosthetic fractures stabilised with an angular stable, less invasive stabilisation system (LISS). ⋯ The cases showed the internal fixator to be effective for the stabilisation of periprosthetic fractures, even in cases of poor bone quality with good functional outcomes. The internal fixator, with the option of minimal invasive application, is the preferred method of osteosynthesis in periprosthetic fractures.
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Arch Orthop Trauma Surg · Mar 2006
Case ReportsMultifocal arterial haemorrhage in a partially stable pelvic fracture after a crush injury: a case report.
Most pelvic haemorrhages are thought to be caused by injury to small arteries or veins in the fractured cancellous pelvic bone or in the surrounding soft-tissues, and only 6-18% of patients with unstable pelvic fractures have haemorrhage from larger arteries. When arterial injuries are present, the majority involve branches of the internal iliac artery with only few published reports of injuries to the external iliac artery or its branches. ⋯ The case describes a rare combination of arterial injuries in a complex pelvic fracture constituting a partially stable pelvic fracture and a dislocated acetabular fracture in a patient with pelvic crush injury and a degloving injury to the trunk. The case also describes the complex nature of these injuries and rarely reported problems related to the treatment of them.
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Arch Orthop Trauma Surg · Mar 2006
Salvage of proximal tibial malunion or nonunion with the use of angled blade plate.
Single buttress plating laterally was sometimes performed by a few orthopedists to treat complex tibial plateau fractures with medial compartment involvement. However, we might encounter cases with medial compartment collapse due to such treatment. The causes of failure, the technique of the revision surgery, and the methods of prevention were investigated retrospectively. The purpose of this study was to report our clinical results of a retrospectively followed series of patients treated with blade plate fixation for proximal tibial metaphyseal nonunions and malunions which were treated with unilateral plating. ⋯ For clinical and biomechanical considerations, single buttress plating laterally was unsuitable for complex tibial plateau fractures with medial compartment involvement due to relatively huge compressive loads on the medial compartment. The stability provided by a few screws of the buttress plate laterally was normally insufficient. An angled blade plate could be a useful armament in the management of metaphyseal nonunion and malunions of the proximal tibia. Its better stabilization could normally provide a high success rate.
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Arch Orthop Trauma Surg · Mar 2006
Case ReportsSigmoid perforation after medial migration of lag screw in gamma nailing.
Medial lag screw migration in Gamma nailing is a rare complication. In an 84-year-old woman, the medial migration of the lag screw into the pelvic was observed 8 weeks after intramedullary osteosynthesis of a trochanteric fracture by Gamma nailing. ⋯ The reason for the retroperitoneal abscess was the undetected sigmoid perforation due to the migrated lag screw. After radical surgical and antibiotic therapy, the complication could be handled with a satisfactory clinical outcome.
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Arch Orthop Trauma Surg · Mar 2006
Applying evidence-based surgery in daily clinical routine: a feasibility study.
Although the word evidence-based medicine (EBM) has gained wide popularity, only a few studies have evaluated how EBM works in clinical practice. ⋯ Time will be the main barrier against the introduction of clinical EBM. It is likely that clinicians reduce EBM to those situations where evidence is likely to be found. Although the impact of EBM on patient-care was limited, the concept of EBM was successfully implemented.