Acta Orthop Traumato
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Acta Orthop Traumato · Jan 2015
Modified tension band wiring technique for olecranon fractures: where and how should the K-wires be inserted to avoid articular penetration?
Articular penetration of K-wires is a possible complication of the modified tension band wiring technique. However, there is no clear information or evidence regarding the entry point or introduction angle for K-wires to avoid this complication. The aim of this experimental study was to evaluate the effect of varying K-wire insertion points and angles on the risk for articular penetration during modified tension band wiring for olecranon fractures. ⋯ When applying the modified tension band wiring technique to prevent articular penetration, K-wires should be inserted in the first 5 mm from dorsal cortex of the olecranon process at a maximum angle of 20°. Moreover, if the wires are required to be inserted more anteriorly because of the anatomical configuration of the fracture, they should be inserted at a shallow angle in the sagittal plane in relation to the proximal cortex of the ulna.
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Acta Orthop Traumato · Jan 2015
Impact of oxidative stress on early postoperative knee function and muscle injury biochemical markers: Is it possible to create an ischemic preconditioning effect in sequential ischemic surgical procedures?
Simultaneous bilateral total knee arthroplasty (TKA) with prolonged tourniquet time has the potential to trigger ischemia-reperfusion injury, which can adversely affect knee function. Studies suggest that the magnitude of injury is less if it occurs following an ischemic event which takes place in another part of the body, known as ischemic preconditioning (IPC). The purpose of this study was to investigate the impact of oxidative stress on muscle injury and knee function and to elucidate if potential IPC effect can attenuate ischemia-reperfusion injury metabolites and prevent poor functional outcomes in single-stage bilateral TKA. ⋯ The biochemical and functional outcomes can be attributed to potential IPC effect. During bilateral TKA, a 20-minute interval between tourniquets can create IPC effect and attenuate the magnitude of ischemia-reperfusion injury, preserving better functional outcomes.
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Acta Orthop Traumato · Jan 2015
Biomechanical effect of medial cortical support and medial screw support on locking plate fixation in proximal humeral fractures with a medial gap: a finite element analysis.
This finite element analysis aimed to examine the effect of medial cortical support and medial screw support on loads at the implant-bone interface of locking plate fixation of proximal humeral fractures with a medial gap. ⋯ Placement of calcar screws combined with good medial cortical contact in varus in locking plate fixation of proximal humeral fractures with a medial gap may provide optimal stability for the fixation.
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Acta Orthop Traumato · Jan 2015
Early surgery is feasible in patients with hip fractures who are on clopidogrel therapy.
Timing of surgery in hip fracture patients using antiplatelet agents is a controversial issue. Clopidogrel is an antiplatelet drug widely used in the treatment of many diseases. In this study, we aimed to investigate the outcomes of early surgery in hip fracture patients using clopidogrel. ⋯ Surgery should not be postponed in hip fracture patients using clopidogrel.
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Acta Orthop Traumato · Jan 2015
Efficacy of rapid recovery protocol for total knee arthroplasty: a retrospective study.
Our aim was to compare the clinical results and cost-effectiveness of a rapid recovery protocol for total knee arthroplasty (TKA) with a current standard protocol. ⋯ Application of the rapid recovery protocol to patients who underwent TKA reduced costs and infection rates and improved functional results.