Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Jan 2006
Case ReportsModified Steindler procedure for the treatment of brachial plexus injuries.
A retrospective follow-up study was completed on ten patients who suffered from a brachial plexus injury that was treated with a modified Steindler procedure. The mean postoperative period was 6.8 years. The postoperative elbow joint range of motion was -42 degrees of extension (range -5 degrees to -65 degrees ) and 107 degrees of flexion (range 90 degrees -130 degrees ). ⋯ In the subjective assessment, the patients scored 20 out of 30 points and were able to perform almost all activities with the exception of shoulder elevation. Innervation of the musculocutaneous nerve was evaluated by electromyography and no correlation was seen between preoperative and postoperative amplitude of the biceps brachii by electromyogram. Based on these results, we concluded that a modified Steindler procedure is useful for reconstruction of upper brachial plexus injuries, and recovery of the biceps brachii was difficult to predict by an electromyogram.
-
Arch Orthop Trauma Surg · Jan 2006
Clinical TrialA novel treatment of grade III acromioclavicular joint dislocations with a C-hook implant.
This study evaluates the results of the new surgical treatment of complete acromioclavicular (ac) dislocations using coracoclavicular (cc) fixation with a shape memory metal C-hook implant. ⋯ The new C-hook implant provides accurate anatomical reduction, conserves the articular surfaces and enables fast functional recovery with excellent patient contentment. Technically, the implant is easy to use. Based on this study, the C-hook presents a reliable novel treatment option in surgical ac repair.
-
Arch Orthop Trauma Surg · Jan 2006
Trans-sacral fixation for failed posterior fixation of the pelvic ring.
In the treatment of certain pelvic ring pathologies (non-unions and failure of ilio-sacral screw fixation) trans-sacral fixation (i.e. fixation from iliac wing to the other traversing the body of S1) may be necessary. The purpose of our study was to describe our early experience and describe the surgical technique. ⋯ Initial experience with trans-sacral fixation has proven to be very effective technique to solve the most difficult problems in posterior pelvic ring fixation. We reserve its use to the following indications: nonunion/malunion of the pelvic ring, and sacral fractures.
-
Arch Orthop Trauma Surg · Jan 2006
Case ReportsA new autogenous graft choice in pelvic reconstructions: free vascularized rib (a case report).
Primary or secondary bone tumours are not uncommon in pelvic girdle. In some cases, after radical resection, there is a big bony defect where the prosthesis is not applicable; arthrodesis is the only choice for good functional results. ⋯ In this case report, we focused on easy harvesting and minimal time consumption with free vascularized rib graft to achieve the fusion between the resected segments. Two year follow up showed fusion with good functional result.
-
Arch Orthop Trauma Surg · Dec 2005
The treatment of proximal humeral fractures with intramedullary titanium helix wire by 97 patients.
The displaced proximal humeral fracture continues to be a problem and remains the "unsolved fracture". Many guidelines for surgical treatment of different types of these fractures have been described. A conservative functional therapy is recommended as well as a closed or open reposition and internal fixation. Other authors prefer the primary prosthetic replacement of the displaced humeral head. The purpose of this article is to describe a minimal invasive technique--the intramedullary titanium helix wire--and to analyse results and specific problems of this method compared to other techniques. ⋯ The advantages of the method arising from the results lie in both the simple operation approach without nerve lesions or wound infections, and also in the indirect, intramedullary splinting of the fracture without damage to the surrounding soft parts, while iatrogenic necroses of the humeral head can be avoided.