Operative Orthopädie und Traumatologie
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Flexor tendon repair by direct suture, providing tendon function and mechanical properties and allowing postoperative active extension and flexion. ⋯ The clinical outcome studies after repair of zone II flexor tendon injuries using a multiple-strand suture technique describe 69-96% excellent and good results.
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Oper Orthop Traumatol · Mar 2008
[Transpatellar refixation of acute quadriceps tendon ruptures close to the proximal patella pole using FiberWire].
Reconstruction of the extensor mechanism of the knee joint by stable suture of the quadriceps tendon. Early functional treatment. ⋯ Early diagnosis, timely surgical repair and early functional treatment are important for the outcome of quadriceps tendon ruptures. With the presented method, ruptures close to the upper patella pole can be treated. The majority of quadriceps tendon ruptures takes place in this area since the avascular zone found here predisposes to degenerative changes.
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Oper Orthop Traumatol · Dec 2007
Total hip replacement through a minimally invasive, anterolateral approach with the patient supine.
Early postoperative mobilization and restoration of pain-free joint function by implantation of a total hip replacement through a standardized, minimally invasive approach regardless of the type of implant with the patient in the supine position. ⋯ two postoperative periprosthetic fractures. No periarticular ossifications > Brooker II. No hematoma requiring revision. No neurologic deficits.
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Oper Orthop Traumatol · Dec 2007
[Implantation technique for the CUT-type femoral neck endoprosthesis].
Total hip replacement with maximum preservation of femoral neck. Restoration of pain-free joint function. ⋯ From 2002 to 2006, 49 uncemented CUT prostheses were implanted in 36 patients. Average age was 45.1 years (20-60 years). Inpatient stay amounted to 10.8 days and operating time to 74 min. Average blood loss through drainage was 795 ml, an average of 297 ml transfused back. Transfusion was necessary in ten patients. There were no cases of postoperative infection, nerve lesion, or hip dislocation. Patients were examined preoperatively and followed up at 6 weeks and 1 year. Harris Hip Score improved from 46.1 points preoperatively to 81.6 points at 6 weeks and 95.7 points at 1 year. Average leg length discrepancy of 0.7 cm (minimum -0.8, maximum 2.2 cm) was determined radiologically in 31 of 49 patients. It became necessary to replace two of the 49 stems due to aseptic loosening, in the first case at 19 months (femoral head osteonecrosis, lupus erythematosus, and taking cortisone), and in the second case 3 years after implantation (steroid-induced femoral head necrosis related to Crohn's disease and azathioprine [Imurek] therapy). One cone and head component had to be revised 1 month after implantation due to impingement syndrome. One ceramic head fractured 2.5 years after implantation so that cone and head required revision. The overall follow-up time was 37 months on average (minimum 12, maximum 55 months).
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Oper Orthop Traumatol · Oct 2007
Comparative StudyRadiology of adolescent slipped capital femoral epiphysis: measurement of epiphyseal angles and diagnosis.
AIMS OF DIAGNOSTIC RADIOGRAPHY: Visualization of the proximal femur in two clearly defined projections. Radiologic and morphological diagnosis of slipped capital femoral epiphysis. Evaluation of the stability of the femoral epiphysis: chronic slippage or acute interruption of continuity between the femoral epiphysis and the femoral neck metaphysis. Radiometric measurement of the spatial deformity of the femoral epiphysis. Measurement of the projected epiphyseal angle on the radiograph as the basis for possible conversion into anatomically correct angles at the proximal femur. Preoperative planning of therapeutic surgical procedures. ⋯ For slight to moderate slippage, the difference between the epiphyseal dislocation angle obtained from the radiographs (as projected in two planes) compared with the anatomic, i.e., real dislocation angle at the proximal femur is generally relatively minor. Conversion of the projected angle to the real angle is not essential in these cases (if in doubt, see Table 1). For more severe dislocations, the differences between the projected and real angles are far more apparent. Table 1 facilitates conversion of the epiphyseal dislocation angles taken from the radiograph into anatomically correct dislocation angles at the proximal femur. Conversion to real angles, especially for preoperative planning of complex corrective surgery, is indicated for more severe deformities of the femoral epiphysis. Conversion into real (anatomic) angles is indicated for exact prognostic evaluation of prearthrotic deformities.