Eur J Orthop Surg Tr
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To discuss when and how to operate on thoracic and lumbar spine fractures. ⋯ Progressive neurological deficits and/or mechanical instability of the spine are absolute indications for early surgical treatment. Younger patients with high-energy spinal trauma, unstable fractures and neurological deficits should be treated surgically in order to provide optimum conditions for neurologic recovery, early mobilization and possibly ambulation. Most cases can be adequately operated through a posterior only surgical approach; an anterior or combined approach is usually indicated for burst and thoracic spine fractures. Postoperative complications, more common infection and neurological deterioration may occur. Elderly, neurologically intact patients with low-energy, stable spinal fractures without marked spinal deformity may be successfully treated conservatively. Most of these patients will do well; however, follow-up for progressive posttraumatic deformity is required.
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Eur J Orthop Surg Tr · May 2014
Surgical treatment of lateral Hoffa fracture with a locking plate through the lateral approach.
The goal of this study is to determine the efficacy of the surgical treatment of lateral Hoffa fracture with a locking plate and cannulated or lag screws through the lateral approach. ⋯ Fixation with a locking plate and cannulated or lag screws for lateral Hoffa fracture seemed to be effective and reliable. The lateral approach had advantages for reduction and fixation of lateral Hoffa fracture during operation.
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Eur J Orthop Surg Tr · May 2014
Influencing factors of functional result and bone union in tibiotalocalcaneal arthrodesis with intramedullary locking nail: a retrospective series of 30 cases.
Initially considered as an established salvage procedure for tibiotalocalcaneal arthrodesis (TTCA), intramedullary nailing indications have expanded as evidenced in recent literature. We have tried to identify factors influencing functional result and bone union. ⋯ Retrograde intramedullary nailing in TTCA is an effective technique, which allows good clinical results even in case of septic history of the patient. Fusion rate and functional results were not significantly influenced by any of the factors examined in this study.
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Eur J Orthop Surg Tr · May 2014
Randomized Controlled Trial Comparative StudyPercutaneous versus open repair of acute Achilles tendon ruptures.
Controversy exists regarding the optimal treatment for acute Achilles tendon ruptures. Conservative and surgical treatments have been reported with variable results and complications rates. The purpose of this study is to compare the postoperative clinical and functional results of percutaneous versus open repair of acute Achilles tendon ruptures. ⋯ The present study showed similarly successful clinical and functional results after both open and percutaneous repair of acute Achilles tendon ruptures are similar. Cosmetic appearance is superior in the group of patients who had a percutaneous treatment.
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Eur J Orthop Surg Tr · May 2014
Comparative StudyAntibiotic-associated complications following lower limb arthroplasty: a comparison of two prophylactic regimes.
As part of a wider drive to reduce Clostridium difficile rates (CDAD), our trust switched from cefuroxime to gentamicin and flucloxacillin prophylaxis for joint replacement surgery. Anecdotal evidence suggested that we were seeing an increased incidence of acute kidney injury (AKI) following elective total hip replacement (THR) and total knee replacement (TKR) since this change. The aim of this study was to compare rates of AKI and post-operative infection between the two antibiotic regimes. ⋯ Gentamicin with flucloxacillin is comparable with cefuroxime in rates of SSI and RTT but is associated with a significant increase in AKI. AKI is associated with additional morbidity and mortality. This association should be considered when choosing a suitable prophylactic regime.