Operative Orthopädie und Traumatologie
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Oper Orthop Traumatol · Dec 2019
Fluoroscopically guided acetabular posterior column screw fixation via an anterior approach.
Safe posterior column screw fixation via an anterior approach under two-dimensional fluoroscopic control. ⋯ In a series of 100 pelvic CT scans, the mean posterior angle of the ideal posterior column screw trajectory was 28.0° (range 11.1-46.2°) to the coronal plane and the mean medial angle was 21.6° (range 8.0-35.0°) to the sagittal plane. The maximum screw length was 106.3 mm (range 82.1-135.0 mm). Twelve patients were included in this study: 10 ACPHF and 2 transverse fractures. The residual maximum displacement of the posterior column fracture component in the postoperative CT scan was 1.4 mm (0-4 mm). There was one intraarticular screw penetration and one perforation of the cortical bone in the transition zone between the posterior column and the sciatic tuber without neurological impairment.
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Oper Orthop Traumatol · Dec 2019
Preoperative planning and safe intraoperative placement of iliosacral screws under fluoroscopic control.
Preoperative planning of the starting point and safe trajectory for iliosacral screw (SI screw) fixation using CT scans for safe and accurate fluoroscopically controlled percutaneous SI screw placement. ⋯ Fifty-nine screws were placed in 34 patients using the described technique. There were 2 cases of screw malpositioning (anatomical landmarks inadequately identified and fluoroscopically controlled SI screw fixation should thus not have been performed at all; in a case with sacral dysmorphism, preoperative planning suggested a posterior and/or caudal S1 starting point, respectively, but intraoperatively, selection of a different starting point and screw trajectory resulted in screw malpositioning with iatrogenic L5 nerve palsy).
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Oper Orthop Traumatol · Apr 2019
ReviewMinimally invasive internal fixation of calcaneal fractures or subtalar joint arthrodesis using the Calcanail®.
A minimally invasive technique to prevent soft tissue problems using a calcaneal nail (Calcanail®, FH Orthopedics, Heimsbrunn, France) for calcaneal fractures or in subtalar joint arthrodesis is described. ⋯ Preliminary results of 69 cases from three surgical centers have already been published. From 2013-2017, the technique was used in 48 of our own patients (42 calcaneal fracture reduction and fixation; 6 for subtalar joint arthrodesis). Mean postoperative hospital stay was 7 days for fracture reduction without any need of additional operations. During follow-up, 6 implant removals and 2 secondary subtalar fusions were noticed. All 6 cases of subtalar joint arthrodesis were planned in posttraumatic subtalar osteoarthritis.
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Thorough and profound debridement for acute bite injuries while sparing nerves, vessels and tendons. ⋯ Of 142 bite injuries that were treated and retrospectively evaluated, 46% were caused by dogs and 32% by cats. Patients were on average 44 years old; 55% of all dog bites affected women, but 67% of all cat bites. In 48% of the cases, general anesthesia was necessary. The postoperative infection rate was 6.3%.
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Oper Orthop Traumatol · Dec 2017
[Locked retrograde fibula nail for the surgical treatment of unstable ankle fractures].
Minimally invasive surgical stabilization of ankle fractures allowing postoperative full weight bearing. ⋯ In 34 patients who were treated with a retrograde fibula nail, a 6-month follow-up was possible in 18 patients. Osseous consolidation was achieved without any soft tissue complications or infections in all 18 cases. The patients regained their preoperative level of mobility (Parker Mobility Score 4.2 preoperative vs 4.3 postoperative).