Operative Orthopädie und Traumatologie
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Oper Orthop Traumatol · Apr 2015
Clinical Trial[Corrective arthrodesis of midfoot Charcot neuroosteoarthropathy with internal fixation].
The goal of treatment is a plantigrade, stable, ulcer-free foot which can be addressed with diabetes-adapted insoles and/or DNOAP shoes. ⋯ High rate of surgical complications (e.g., infection, implant failure, non-union, loss of correction, reulceration), in particular, in cases of inadequate indication or insufficient primary stability.
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Oper Orthop Traumatol · Apr 2015
Clinical Trial[Suturing and refixation of the medial collateral ligament in severe acute medial instability of the knee].
Restoration of the medial stability after acute lesion of the medial collateral ligament (MCL) and of the posteromedial complex in case of a high grade instability of the MCL. Stabilization against valgus stress and prevention of an increased posterior drawer in case of a lesion of the posterior oblique ligament (POL). ⋯ Between 2010 and 2013, 34 cases of acute medial instability were treated. According to the injury pattern, some procedures were isolated MCL refixations, while others were combined procedures. While 25 patients showed a concomitant ACL injury, 13 patients had combined PCL and ACL injury. Postoperatively all medial instabilities had improved. Revision surgery was performed in 3 cases due to postoperative arthrofibrosis.
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Oper Orthop Traumatol · Feb 2015
Clinical TrialDouble locking plate fixation of sacral fractures in unstable pelvic ring C-type injuries.
Alternative sacrum fixation with double-plate osteosynthesis in vertical unstable pelvic fractures. The surgical technique allows anatomic reduction and osteosynthesis of the sacrum component. ⋯ A total of 27 patients with vertical unstable pelvic fractures were identified and treated with open reduction and double-plate osteosynthesis. The Iowa pelvic score was rated excellent in 83 % and good in 17 % of cases. One patient developed a nonunion and had to be revised.
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Insertion of a small joint arthroscope into the proximal and distal parts of the distal radioulnar joint (DRUJ) allows visualization of the proximal pouch of the DRUJ, the joint surfaces of the sigmoid notch and the ulnar head, the convexity of the ulnar head and the proximal ulnar-sided surface of the triangular fibrocartilage complex (TFCC). ⋯ Still rarely performed procedure for diagnosis and therapy of ulnar-sided wrist pain. Technically demanding with a flat learning curve and anatomy-related obstacles. A complete view of the joint is not always accessible. Rare complications are injuries of the extensor digiti minimi tendon as well as contusion or sectioning of the transverse branch of the dorsal branch of the ulnar nerve. In distinct cases this procedure offers valuable additional information about the distal radioulnar joint.
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Oper Orthop Traumatol · Dec 2014
[Treatment of periprosthetic femoral fractures after total hip arthroplasty with specially constructed retrograde hollow nails].
Treatment of periprosthetic fractures by implantation of a specially constructed, retrograde hollow nail which fits over the tip of the prosthesis and becomes locked on it. ⋯ From 2004 to 2011 a total of 25 periprosthetic femoral fractures in 25 patients were treated in 2 locations using specially constructed slotted hollow nails. Within the framework of a retrospective study 20 of these patients (16 female and 4 male; average age 77.2 [72-84] years) were clinically and radiologically re-examined on average 19.3 (7-31) months postoperatively. No postoperative bleeding, wound healing disorders and infections. In all patients there was a loading stable consolidation of the fracture in the correct femoral axis, length and rotation with no evidence for radiological signs of loosening of the prosthesis or dislocation of the nails. In one case there was loosening of the prosthesis which had obviously occurred during the operative procedure. After consolidation of the fracture it was necessary to exchange the prosthesis for a long shafted prosthesis. A comparable situation to the preoperative degree of mobility was found in 12 out of the 20 patients, a moderate deterioration in 5 patients, a substantial residual impairment in 2 patients and an improvement of the situation in 1 patient.