Operative Orthopädie und Traumatologie
-
Oper Orthop Traumatol · Apr 2012
Clinical Trial[Anatomical double-bundle reconstruction of the medial patellofemoral ligament with a gracilis autograft].
Elimination of patellofemoral instability by reconstruction of the medial patellofemoral ligament (MPFL) with a gracilis autograft. ⋯ The method presented in this manuscript was performed on 32 patients with recurring patellar luxation; 27 patients were available for clinical assessment at 1 year postoperatively. There were no recorded events of reluxation; the Kujala score increased on average from 61 points preoperatively to 93 points postoperatively.
-
Oper Orthop Traumatol · Feb 2012
Plate fixation of proximal humerus fractures using the minimally invasive anterolateral delta split approach.
Minimally invasive plate osteosynthesis of proximal humerus fractures via an anterolateral delta split approach. ⋯ In a prospective evaluation from 2003-2006, 29 patients (8 male and 21 female) with a mean age of 64 years (16-91 years) were analyzed. The mean follow-up time was 12 months (6-32 months). The operation was accomplished in 75 min (55-155 min) with an image intensifier time of 160 s (48-807 s). All fractures healed in a timely manner. The median Constant score reached 78 points (28-93 points). In one case (3%), clinical evidence of a lesion of the anterior branch of the axillary nerve was found.
-
Oper Orthop Traumatol · Feb 2012
Case Reports[Soft tissue reconstruction with a temporoparietal fascial flap (TPFF)].
Soft tissue reconstruction with a temporoparietal fascial flap (TPFF). ⋯ The TPFF was utilized for soft tissue reconstruction in 8 patients. A pedicled TPFF was used in 2 patients. Mean time to healing was 16.3 days. Mean follow-up was 13.4 months. Successful reconstructive results with satisfactory functional and aesthetic appearance were obtained in all patients. Complications were encountered in 3 patients and included alopecia at the donor site and iatrogenic injury to the frontal branch of the facial nerve. Vascular compromise was observed in the early postoperative period in a third patient. However, operative revision resulted in successful flap salvage.
-
Oper Orthop Traumatol · Feb 2012
[Augmented posterior instrumentation for the treatment of osteoporotic vertebral body fractures].
Reduction and stabilization of osteoporotic vertebral body fractures using posterior short-segment instrumentation. Cement augmentation of the pedicle screws in order to improve the screw’s holding power in osteoporotic bone and to reduce postoperative loss of reduction. Quick and painless postoperative mobilization without further bracing. ⋯ Between July 2008 and December 2009, 10 patients with osteoporotic vertebral body fractures of the thoracic and lumbar spine were treated with cement-augmented posterior instrumentation. The mean age was 65.8 years (range 35–94 years). There were six type A (2 A1 and 4 A3 lesions) and four type B lesions (1 B1, 1 B2, and 2 B3 lesions) according to Magerl. Indications for cement augmentation of the pedicle screws were the patients’ age (4 patients), osteoporosis with t scores < − 2.5 (2 patients), poor intraoperative screw hold (2 patients), and revision surgery after loosening of pedicle screws (2 patients). Cement leakage was observed in 5 patients with no further clinical relevance. Loosening of cement augmented pedicle screws occurred in 1 patient with a consecutive loss of reduction of 10°. There was no need to remove any of the cement-augmented screws in the first 24 months.
-
Oper Orthop Traumatol · Feb 2012
[Kapandji-Sauvé procedure with distal radioulnar fusion and segmental resection of the ulna].
The Kapandji-Sauvé procedure aims at improvement of rotation in the distal radioulnar joint and reduction of pain. Cases of ulnar impaction syndrome can also be corrected during the same procedure. ⋯ In 75 patients, the Kapandji-Sauvé procedure was performed between 1990 and 2003. Failure was observed in one patient with a bony regeneration between the resected ulnar segment. In 3 cases, a nonunion of the radioulnar joint was found. After revision with bone grafting, bony consolidation of the joint was identified in all cases. In 2 cases, there were problems with the proximal ulnar stump, whereby this was corrected in one case by resection of a ball-type callus. In the other case, painful ulna-snapping was reduced by shortening of the ulna. In earlier follow-up with 45 patients and later long-turn follow-up, ranging from 3-12 years, not only were significant improvement of forearm rotation and reduction of pain observed, but also good patient satisfaction was found.