Operative Orthopädie und Traumatologie
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Oper Orthop Traumatol · Aug 2007
The Targon PH nail as an internal fixator for unstable fractures of the proximal humerus.
Exercise-stable internal fixation of unstable fractures of the proximal humerus. ⋯ From December 2000 to spring 2004, 133 patients (average age: 74.9 years) with 137 unstable proximal humeral fractures were treated surgically. 97 patients with 99 operated shoulders were followed up for at least 7 months. The patients' average age at follow-up was 74.9 +/- 13.6 years (20-102 years). A Constant Score of 60.0 +/- 16.8 points was achieved and 84.8 +/- 19.4% and 84.0 +/- 15.5% on the age- and gender-related as well as side-related Constant Scores.
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Reduction and fixation of displaced fractures of the humeral head by percutaneous methods. Early functional postoperative management. ⋯ 200 patients (78 men, 122 women) were followed up at least 2 years (24-81 months) postoperatively. The average age was 61.6 years (14-103 years). The average Constant Score for four-part fractures was 87%. 24% of the patients had to be operated on a second time (shortening of the wires or reosteosyntheses). In 8.5% secondary change of management was necessary. In 3% clinically relevant avascular head necrosis occurred, and pseudarthrosis in 3%.
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Oper Orthop Traumatol · Aug 2007
Total hip arthroplasty by a minimally invasive, direct anterior approach.
Implantation of a total hip replacement device through a direct anterior approach to the hip joint with minimal trauma to adjacent tissue. ⋯ 116 consecutive hips in 111 patients were operated on between August 2004 and December 2005. 17 patients were excluded due to fracture or severe dysplasia (Crowe 3 and 4). Mean age was 62.5 years (range, 46-84 years), mean BMI amounted to 23.1 kg/m(2) (range, 18.1-37.7 kg/m(2)). The implantation of a total hip replacement device could be accomplished safely in all patients. No severe intraoperative complication requiring a change of the planned procedure or any additional surgical measures was noted. Mean surgical time was 79 min (45-150 min). The operative time was decreasing gradually during the study period. The mean preoperative Japanese Orthopaedic Association (JOA) score of 47.2 points (range, 18-63 points) improved to 92.3 points (range, 67-100 points) at 3 months postoperatively (p < 0.001) and 94.2 (range, 72-100 months) at the latest follow-up at an average of 17 months (range, 9-26 months).