Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association
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The purpose of this study was to evaluate the outcome of open severe comminuted tibial plateau fractures treated with minimal internal fixation and circular external fixation frames. ⋯ This technique provided acceptable results for open severe comminuted fractures of the tibial plateau without comminuted posterior wall fractures. The most significant disadvantage of the technique is insufficient anatomical reduction and loss of reduction in comminuted posterior wall fractures in the coronal plane. This technique should be combined with a minimally invasive internal fixation method to prevent loss of reduction in open severe comminuted and irreducible tibial plateau fractures.
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The manner of measuring the outcome of cervical myelopathy must be patient-oriented and have sufficient reliability and validity. The current Japanese Orthopaedic Association (JOA) scoring system for cervical myelopathy is widely used but has not met this requirement. The first- and second-round surveys established 24 items for inclusion on a new questionnaire for cervical myelopathy. The purpose of this study (the third-round survey A) was to confirm the reproducibility of patient responses to the selected questions. ⋯ The newly developed JOA Cervical Myelopathy Evaluation Questionnaire was proven to have sufficient reliability.
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Closing-opening correction (COC) osteotomy is a useful procedure for severe angular kyphosis. However, there is no previous research on the reconstructed vertebrae with kyphotic malalignment in the presence of osteoporosis. Finite-element (FE) analysis was performed to estimate the biomechanical stress with both osteoporotic grades and corrective kyphotic angles during COC osteotomy for osteoporotic angular kyphosis. ⋯ Lack of correction in osteoporotic kyphosis leads to an increase in CPS. This biomechanical study proved the advantage of correcting the kyphotic angle to as close as possible to physiological alignment in the thoracolumbar spine, especially in patients with high-grade osteoporosis.