Acta Orthop Belg
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Non-union of osteoporotic vertebra fractures are a seldom entity. However, when back pain persists in the course of conservatively treated osteoporotic vertebra fractures, a non-union should be considered. We thus sought to validate our diagnostic algorithm in patients with known osteoporotic vertebra fractures presenting persistent back pain and advert to the diagnosis and treatment of vertebral non-unions. ⋯ Non-union of osteoporotic vertebra fractures must be considered when symptoms outlast conservative treatment. In these cases, plain lateral fulcrum radiographs are a simple and effective adjunct to the conventional diagnostic methods. Surgical stabilization then proves to be the effective treatment of choice.
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This study was designed to evaluate the effectiveness of the treatment of infected tibial nonunion by bone transport using the Ilizarov external fixator. We retrospectively reviewed 66 patients with infected tibial nonunion treated by bone transport using the Ilizarov external fixator. Our study included 62 males and 4 females with a mean of age 37.06 years. The average length of the bone defects after radical debridement was 6.27 cm (range 3-13 cm). The mean follow-up after removal of the apparatus was 25.91 months (18-46 months). 6 patients were lost to follow-up. All the patients achieved bone union and no recurrence of infection was observed. The mean external fixation index was 1.38 months/cm (range 1.15-1.58 months/cm). According to Association for the Study and Application of the Method of Ilizarov (ASAMI) classification, bone results were excellent in 44, good in 15, fair in 5 and poor in 2; functional results were excellent in 24, good in 26, fair in 10 and no poor. ⋯ Our study and the current evidence suggested that Ilizarov methods in the treatment of infected tibial nonunion acquired satisfied effects in bone results and functional results. Radical debridement is the key step to control bone infection.
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Comparative Study
Treatment of distal femur fractures with locking plates: Comparison of periprosthetic fractures above total knee arthroplasty and non-periprosthetic fractures.
The purpose of the present study was to compare the results and plate fit of periprosthetic and non-periprosthetic distal femur fractures fixed with locking plates. Twenty-one periprosthetic fractures above a TKA and 27 non-periprosthetic fractures were retrospectively reviewed. The primary healing rate, bone union time, clinical and radiographic results, complications, and additional surgeries were compared between the two groups. ⋯ The incidence of overall complication and additional surgeries did not differ (3/21 vs. 5/27, 1/21 vs. 4/27). Plate fit trouble was observed more frequently in periprosthetic fractures (10/21 vs. 1/27, p = 0.004). Fixation of distal femur fractures with locking plates provided satisfactory results with a low risk of complications and additional surgeries in both periprosthetic and non-periprosthetic fractures.
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Comparative Study
Three metal-on-metal hip replacement devices from the same manufacturer--a short- to mid-term survival.
The aim of this retrospective study was to evaluate short- to mid-term results of three different metal-on-metal hip devices from the same manufacturer. A total of 329 hip operations were performed in a single academic unit between 2004 and 2010 using either Birmingham hip resurfacing or Synergy--Birmingham and Synergy--R3 total hip arthroplasty. The overall survival rate at the end of the follow-up time for Birmingham hip resurfacing was 88%, for Synergy--Birmingham total hip arthroplasty 95%, and for Synergy--R3 total hip arthroplasty 81% (p = 0.036). ⋯ Head sizes > 50 mm had lower revision rates compared to smaller ones. Synergy--R3 had a poor survival already at short-term. The mid-term survival of Birmingham hip resurfacing arthroplasty was inferior compared to previous studies.
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This study assessed the readability and quality of websites related to; total hip replacement, total knee replacement and anterior cruciate ligament reconstruction using validated instruments. 225 websites were analyzed from Google, Yahoo and Bing. Readability was assessed using the Flesch Reading Ease Score and Flesch-Kincaid grade level. ⋯ There was a wide variation in quality scores between websites and the information relating to the three procedures was inconsistent and generally of poor quality. Given the deficit in information it is important Orthopaedic surgeons provide patients with high quality, readable information or direct them to an appropriate source.