Operative Orthopädie und Traumatologie
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The aim of arthroscopically assisted treatment of tibial plateau fractures is to achieve minimally invasive reduction and internal fixation of the joint fracture of the tibial plateau. Using the arthroscopic procedure, both the approach morbidity and the control of the articular reduction can be optimized. ⋯ Rehabilitation is dependent on the extent of the fracture. In arthroscopically treated fractures, partial weight bearing of 20 kg over a period of 6-12 weeks is usually necessary.
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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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Oper Orthop Traumatol · Oct 2014
Clinical Trial[Correction of posttraumatic lower leg deformities using the Taylor Spatial Frame].
Correction of posttraumatic lower leg deformities using percutaneous osteotomy, external fixation with a ring fixator, and computer-assisted gradual correction with the Taylor Spatial Frame (TSF). ⋯ The correction of posttraumatic lower leg deformities using the TSF was performed in 6 cases. The mean deformity was 15° (12-22°) in the frontal plane and 6° (4-8°) in the sagittal plane. The correction time was 19 days (14-22 days). The deviation between planned and achieved correction was 0-3° in the frontal plane and 0-2° in the sagittal plane. The osseous consolidation of the osteotomy site was carried out in the TSF in 5 cases with a mean external fixation time of 112 days (94-134 days). In one case, the TSF was removed after the correction and the osteotomy site was fixed using an intramedullary nail. Pin site infections were observed in 3 cases. There were no further complications. The treatment goal was achieved in all cases. The examination at final follow-up was performed after 1 year. All patients were able to walk without walking aids and with no pain at that time. They were able to perform all of their activities of the daily life and their leisure activities without limitations.
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Oper Orthop Traumatol · Oct 2014
[Minimally invasive cement augmentation of osteoporotic vertebral compression fractures with the new radiofrequency kyphoplasty].
Minimally invasive cement augmentation of painful osteoporotic vertebral compression fractures in elderly patients. ⋯ In all, 44 patients (29 women, 15 men) with a mean age of 73.5 years with a total of 62 painful osteoporotic vertebral fractures were treated with RF kyphoplasty from May 2009 until July 2010, and followed over a period of 12 months. The mean operating time per patient was 36.2 min, the operating time per vertebra was 25.7 min. All the patients studied experienced an early and persistent significant pain relief even 12 months after therapy (8 ± 1.4 vs. 2.7 ± 1.9) according to the visual analogue pain scale. According to the Oswestry Disability Index (ODI) as a disease-specific disability measure all the patients improved significantly (p < 0.001) in the level of disability after operative treatment (56.2 ± 18.8 vs. 34.5 ± 16.6). Cement leakage was detected in 17 out of 62 (27.4 %) augmented vertebrae, whereas all the patients with cement leakage remained asymptomatic. One patient had subsequent vertebral fractures after a period of 6 months.
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Oper Orthop Traumatol · Oct 2014
Multicenter Study Clinical Trial[Femoral nailing using a helical nail shape (LFN(®))].
Antegrade femoral nailing through a greater trochanteric entry portal avoids damage to the proximal external rotators and to the ramus profundus of the medial femoral circumflex artery, furthermore eases insertion in adipose subjects. However a helical nail shape is necessary for this pathway because bending in two perpendicular planes has to be passed by the nail. ⋯ In a prospective mulicentric study, 227 helical femoral nails were used for antegrade femoral nailing. Follow-up after 12 month was available in 74 %. Surgeons' rating for ease of identifying entry site was excellent or good in 89 %. Functional and radiological results after 12 months do not prove significant benefits over conventional antegrade femoral nails.