Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Jul 2013
Dislocated intra-articular femoral head fracture associated with fracture-dislocation of the hip and acetabulum: report of 12 cases and technical notes on surgical intervention.
This report describes case series of the femoral head fractures associated with fracture-dislocation of the hip joint to evaluate the mid- and long-term outcomes and to highlight the surgical technique of fixation of the femoral head from the posterior trochanteric flip osteotomy approach. Twelve patients (6 men and 6 women) with dislocated femoral head fractures (mean age at the time of injury, 56 years; range, 23-80) were followed up for mean period of 9.7 years (range, 5-20). All dislocations were reduced within less than 6 h after the injury. ⋯ The latter patient sustained Pipkin type IV and developed osteoarthritis 1 year after surgery and consequently required total hip arthroplasty. We conclude that small fragment of the femoral head less than 1 cm can be removed, while larger fragments should be fixed by bioabsorbable screws or pins in all types of femoral head fractures. In Pipkin type IV fractures, surgeons should always take anatomical reduction in the acetabulum into consideration during surgery.
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Eur J Orthop Surg Tr · Jul 2013
Management of Vancouver type B2 and B3 femoral periprosthetic fractures using an uncemented extensively porous-coated long femoral stem prosthesis.
The purpose of this study was to evaluate the clinical results of femoral revision using an uncemented extensively porous-coated long femoral stems with or without onlay strut allografts in the treatment of Vancouver type B2 and B3 periprosthetic femoral fractures. ⋯ An uncemented extensively porous-coated long femoral stem together with or without onlay strut allografts provides a good fracture stability that promotes fracture healing and offers a successful solution for the management of Vancouver type B2 and B3 femoral periprosthetic fractures.
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Eur J Orthop Surg Tr · Jul 2013
Correction of post-traumatic thoracolumbar kyphosis using pedicle subtraction osteotomy.
The aim of this study was to retrospectively analyze and evaluate the effect of treatment employing pedicle subtraction osteotomy for chronic, posttraumatic thoracolumbar kyphosis. This study included 19 patients, 11 males and 8 females, with chronic, posttraumatic thoracolumbar kyphosis. Pre-operative kyphosis ranged from 31° to 63°. ⋯ No significant loss of correction was observed (loss of 1.7°), and solid fusion was achieved in all 19 patients. A single-stage posterior pedicle subtraction osteotomy is a safe and effective procedure for correction of posttraumatic thoracolumbar kyphosis. Using this technique, it is possible to safely obtain no greater than 55° of correction at a single level.
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Eur J Orthop Surg Tr · Jul 2013
Latissimus dorsi flap coverage of soft tissue defect following below-knee amputation: emphasis on flap design and recipient vessels.
High-energy trauma to the lower extremity often results in amputation of the limb. For maximal preservation of limb length during amputation, free tissue transfer is often necessary. In this study, we report our experience of stump coverage using latissimus dorsi musculocutaneous flaps with an emphasis on flap design and recipient vessels. ⋯ In flap design, the width of the skin paddle must match the anteroposterior diameter of the defect at the stump. The latissimus dorsi muscle must sufficiently wrap the bony stump for padding. We recommend using the anterior tibial artery as a recipient vessel in primary cases, and the descending geniculate artery in secondary cases.
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Eur J Orthop Surg Tr · Jul 2013
Modified retrograde percutaneous intramedullary multiple Kirschner wire fixation for treatment of unstable displaced metacarpal neck and shaft fractures.
The purpose of this prospective study was to evaluate the functional and radiographic outcomes of our new surgical technique, retrograde percutaneous intramedullary multiple Kirschner wire (K-wire) fixation, for the treatment of unstable displaced metacarpal neck or shaft fractures. Between March 2005 and April 2010, 56 consecutive patients with 65 metacarpal fractures were treated with closed reduction and retrograde intramedullary fixation with at least 2 K-wires. The average follow-up duration was 13 months. ⋯ The average shortening was corrected significantly to 1 mm (SD, 2) in neck fractures and to -1 mm (SD, 2) in shaft fractures postoperatively. Based on our experience, our retrograde intramedullary K-wire fixation technique is an acceptable alternative modality for the treatment of unstable displaced metacarpal fractures. This straightforward technique can facilitate early hand mobilization, correct the deformity, and provide good clinical and radiographic outcomes.