Operative Orthopädie und Traumatologie
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Oper Orthop Traumatol · Jun 2009
Clinical Trial[Endoscopic decompression of the ulnar nerve in cubital tunnel syndrome].
Long endoscopic in situ decompression of the ulnar nerve in cubital tunnel syndrome (sulcus ulnaris syndrome) with direct visualization and minimal incision. ⋯ 52 patients were operated using this method. 53% felt an immediate improvement right after surgery. 47 patients (90%) were available for reexamination after 8 months. Two-point discrimination, grip and pinch strength, and nerve conduction velocity had improved significantly to normal levels. Results, measured with the modified Bishop Rating System, were excellent in 66%, good in 32%, and fair in 2%. There were no poor results. Patients with advanced stages of disease also achieved good results.
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Oper Orthop Traumatol · Mar 2009
Comparative Study[Direct posterior approach for the treatment of posteromedial tibial head fractures].
Direct posterior approach requiring minimal soft-tissue dissection for the treatment of posteromedial tibial head fractures. ⋯ From 2001 to 2007, twelve patients (nine female, three male) with "medial split fractures" were treated via the direct posterior approach. Four patients had isolated "medial split fractures", seven patients bicondylar fractures of the tibial plateau, and one patient a four-part fracture. Six of our patients had acute injuries which were primarily treated at the authors' institution. The other six patients presented with malunited fractures or insufficient internal fixation (average 8.4 weeks, 3.5-24 weeks old). In all cases the fracture could be addressed by the described posterior approach. Sufficient reposition and restoration of anatomy could be achieved in all patients.
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Oper Orthop Traumatol · Mar 2009
[Subligamentous transfer of the extensor digitorum brevis tendon for medial malalignment of the lesser toes].
Realignment of medially deviated lesser toes II-IV via subligamentous transfer of the extensor digitorum brevis tendon to treat painful toe disorders. ⋯ 23 of 32 patients with flexible medial malalignment of the lesser toes II and/or III were followed up after a mean of 19 months. Medial malalignment could be reduced markedly (preoperatively 28 degrees, postoperatively 6 degrees). Four patients treated with the tendon transfer alone developed a recurrent deformity with dorsal subluxation at the metatarsophalangeal joint level. These patients revealed a concomitant hallux valgus deformity of >30 degrees. Six patients with an additional metatarsal shortening presented with floating toes. Although all patients were able to stand on tiptoes, the active range of toe motion was decreased. Radiologically, joint congruency was improved. 18 patients revealed a congruent joint, and five patients presented with a medial subluxation of the proximal phalanx.
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Oper Orthop Traumatol · Dec 2008
[Percutaneous fusion technique on the thoracolumbar spine with the Expedium LIS].
Fusion can be done from the thoracic spine up to the sacrum. A cannulated Expedium screw as well as the rod can be placed percutaneously. This minimally invasive approach creates only a minor muscular trauma. ⋯ From 2005 to 2006, 72 patients (45 female, 27 male) with a mean age of 44 years (35-73 years) were treated using this technique. Follow-up examinations were performed 3, 6, 12, and 24 months after surgery. The mean follow-up was 14 months (3-24 months). Fusion rate was evaluated by computed tomography scan or X-ray. Implant-related complications were not observed.
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Oper Orthop Traumatol · Oct 2008
Clinical Trial[Surgical treatment of fractures of the distal tibia in adolescents].
Injury to the epiphyseal cartilage during the period of growth plate closure in adolescence results in specific stereotyped injury patterns due to the change in biomechanics. According to the number of fragments, fractures of the distal tibia can be categorized into so-called two-plane and triplane I and II fractures. Since these fractures are involving the joint, the most important aspect for further therapy is the reconstruction of the joint surface. As the growth plate has already begun to close at this stage, relevant growth disturbances are unlikely. ⋯ While short-term results are generally good, data on long-term outcome and possible development of arthrosis is still insufficient.