Operative Orthopädie und Traumatologie
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Oper Orthop Traumatol · Mar 2010
[Minimally Invasive Acromioclavicular Joint Reconstruction (MINAR)].
Reduction and retention of an acromioclavicular (AC) joint dislocation with a button/suture augmentation cerclage (Flip tack, Karl Storz, Tuttlingen, Germany). ⋯ 23 patients with an acute luxation of the AC joint were operated with a minimally invasive coracoclavicular cerclage (five patients with Rockwood type III and 18 patients with Rockwood type V). Mean operative time was 28.6 min. Perior postoperative complications such as nerve and vascular injuries, thoracic injuries, infection, thrombosis, and embolism did not occur. The mean Constant Score was 94.1 points (73-100 points) after a mean of 23.3 months (18-28 months). In two cases, a slight loss of reposition of less than half of the clavicle width in comparison with the contralateral side was observed.
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Oper Orthop Traumatol · Mar 2010
[A modified posterolateral approach for the treatment of tibial plateau fractures].
Open reduction and internal fixation of posterolateral tibial plateau fractures. ⋯ In a period of 2 years, seven patients with posterolateral tibial plateau fractures received open reduction and internal fixation by using the modified posterolateral approach. The patients were examined at follow-up between 12 and 24 months after surgery. Six patients were free of pain with full range of motion and stable knee joints. Radiologically, a good fracture reduction was achieved in six cases. In one patient with a posterolateral comminuted dislocation fracture, a small fracture step and a gap could be observed. No approach-related complications were found.
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Oper Orthop Traumatol · Dec 2009
Clinical Trial[The surgical treatment of chronic extension deficits of the knee].
Restoration of full knee extension in patients with chronic extension deficits, especially in posttraumatic and postoperative cases. ⋯ 121 patients underwent anterior and posterior arthrolysis between 1990 and 2000. 86 of these patients could be included in this study. The average follow-up was 4.6 years (1-10 years). The extension deficit before surgery averaged 20 degrees compared with the opposite side. At follow-up, the average extension had increased by 17 degrees , no patient had more than 5 degrees of flexion contracture. The Lysholm Score was 84 postoperatively. The Tegner Activity Scale increased from 1.9 to 4.0 after arthrolysis. In the AOSSM Subjective Outcome Score, 35 patients showed excellent and 60 good results. 14 patients were satisfied after surgery and nine were not. Three patients required revision surgery (two synovial fistulas, one hematoma).
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Oper Orthop Traumatol · Dec 2009
Clinical TrialLess invasive plate osteosynthesis in humeral shaft fractures.
Stable internal fixation of the humeral shaft by less invasive percutaneous plate insertion using two separate (proximal and distal) incisions, indirect reduction by closed manipulation and fixation to preserve the soft tissue and blood supply at the fracture zone. Early mobilization of the shoulder and elbow to ensure a good functional outcome. ⋯ Between January 2003 and January 2006, 23 patients were operated on using the less invasive plate osteosynthesis technique. The minimum follow-up period of 12 months was completed in 20 patients. The mean healing time was 14.6 weeks, defined as three of four cortices having stable bridging callus. In one patient with delayed union, healing was observed after 28 weeks. Functional outcomes were evaluated using the Constant Score and the Hospital for Special Surgery (HSS) Score. 19 patients had good to excellent elbow function with a mean HSS Score of 93.5 points. All patients achieved satisfactory shoulder function with a mean Constant Score of 85.8 points compared to 90.6 on the healthy side. Complications observed were one paresthesia of lateral cutaneous nerve of forearm (no radial nerve injury) and one loosening of the LCP (Locking Compression Plate) screws due to technical error.
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Oper Orthop Traumatol · Dec 2009
Clinical Trial[Surgical principles and clinical experiences with the DUROM hip resurfacing system using a lateral approach].
Objective Bone-preserving hip resurfacing in young and active patients using a soft-tissue-sparing, modified transgluteal, lateral approach. ⋯ Analysis involved the pre- and postoperative functions of 72 patients with a total of 82 prostheses and a mean durability time of 29.2 +/- 11 months based on the Harris Hip Score (HHS), the modified UCLA (University of California, Los Angeles) activity index, and the Merle d'Aubigné Score. Postoperatively, prosthetic angle and femoral offset as well as periprosthetic signs of loosening/lytic areas were assessed by means of radiology and compared with the preoperative CCD angle and femoral offset. Compared to the preoperative evaluation, follow-up yielded a significant increase in the average HHS values (94 +/- 4.6 vs. 40.1 +/- 7 points), the modified UCLA activity index (8.9 +/- 2.6 vs. 4.6 +/- 2.2), and the Merle d'Aubigné Score (17.9 +/- 1.9 vs. 7.3 +/- 2.4; p < or = 0.05). In 98.8%, a solid osteointegration of the cup and femoral components was observed. The average deviation of the physiological CCD angle (136.6 degrees +/- 3.6 degrees ) from the postoperative angle of the prosthesis (142.6 degrees +/- 4.9 degrees ) was 6 degrees +/- 2.8 degrees . The postoperative femoral offset was reduced by an average of 2.3 mm compared to the preoperative offset. During clinical follow-up n = 2 prostheses (2.5%) required revision (one femoral neck fracture; one periarticular ossification [Brooker III]).