Acta Orthop Belg
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The purpose of this study is to evaluate radiological, clinical results and complication rates of dual plate fixation for severe metaphyseal comminuted fracture of proximal humerus. 21 patients who have proximal humerus fractures with impaired posteromedial buttress were enrolled. Fractures were treated with dual plate technique using Proximal Humeral Locking plate and Variable Angle Plate. Radiographic results were analyzed based on duration of union. ⋯ Degree of anatomic reduction was good in 17 patients (80.95%), fair in 3 patients (14.28%), and poor in 1 patient (4.77%). One case of impingement, and one case of avascular necrosis were noted. The dual plate technique provides stable fixation and satisfactory clinical and radiological results for severely comminuted metaphyseal fracture of the proximal humerus.
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This study presents the outcomes of patients treated with non-union of femoral neck fractures healed with valgus osteotomy, fixed with a Dynamic Hip Screw (DHS). The study retrospectively evaluated 16 patients who, between 2007 and 2014, developed pseudarthrosis following treatment for a femoral neck fracture and who were treated with DHS-osteosynthesis, after a valgus subtrochanteric osteotomy. Postoperative clinical evaluation of the patients was done? using the Harris Hip Scoring (HHS) system. ⋯ Of the patients who were followed up for a mean duration of 3.1 years (range: 1-5 years), four had 1-cm shortening. No patient developed postoperative AVN of the femoral head. For patients with non-union after femoral neck fracture, DHS-osteosynthesis after valgus osteotomy is a method with a shorter learning curve, which can be successfully performed.
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There is no agreement within literature regarding management of scapula fractures. Our aim was to carry out a systematic review of literature on management of the scapular fractures. Our search across multiple medical databases for studies on the scapular fractures until February 2014 yielded 32 studies. ⋯ Non-operative management scapular body fractures had satisfactory results. The scapular neck fractures displaced <10mm have satisfactory outcome following non-operative management. Operative management of displaced glenoid fossa fractures and scapular neck fractures displaced >10mm lead in a better functional outcome.
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Treatment of segmental bone defects resulting from trauma or infection is extremely difficult. Bone segment transport with distraction osteogenesis and vascularized fibula transfer are the commonest used methods of treatment. Bone transport has problems with docking site. ⋯ The time to union ranged from 4 to 11 months after 2nd stage with mean 7.4 months. In conclusion, induced membrane (Masquelet) technique is a safe, simple and reliable method for treating segmental bone defect. The major complications of this technique include infection and graft resorption.
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Displaced calcaneus fracture often results in severe permanent sequelae and considerably limits the activities of daily living. In this prospective cohort study we present the outcomes of surgical treatment of 137 displaced intra-articular calcaneal fractures, over 8y period. ⋯ According to our experience we could advocate percutaneous reduction and screw fixation as the method of choice for Sanders type IIC tongue- type fractures and modified Palmer approach with screw alone, C-nail, K-wires or alternatively an open plate osteosynthesis in Sanders type IIAB depression fractures. For Sanders Type III fractures, we find ORIF with a plate as the most suitable method and an external fixation supplemented with K-wires for Sanders Type IV.