Operative Orthopädie und Traumatologie
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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 · 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 · 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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Oper Orthop Traumatol · Dec 2014
[The talus stop screw arthroereisis for flexible juvenile pes planovalgus].
Pain relief by realignment of the hindfoot and blocking excessive pronation through insertion of a screw into the lateral aspect of the calcaneus in juvenile pes planovalgus. ⋯ Between 2002 and 2011, the technique was used in 35 children (68 feet; mean age 10 years). Complications were peroneal spasms, overcorrections, wound healing problems and local tenderness. Tarsometatarsal and calcaneal pitch angle improved significantly. The procedure is a reliable method for the correction of flexible juvenile flatfeet allowing "growth adjustment" of the subtalar joint.
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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.