Eur J Orthop Surg Tr
-
Eur J Orthop Surg Tr · Jan 2017
Management of scaphoid nonunions with vascularized bone grafts from the distal radius: mid- to long-term follow-up.
Scaphoid nonunion represents a challenging problem that leads to disability if neglected. Vascularized bone grafts are proposed to augment the local biology and increase the likelihood of union but long-term outcomes are sparse. In this work, we present the mid- to long-term outcome of 140 scaphoid nonunions managed with vascularized bone grafts from the distal radius. ⋯ The presence of arthritis preoperatively was associated with progression of arthritic changes after 10 years. Treatment of scaphoid nonunions with vascularized bone grafts from distal radius reliably led to highest rate of bone healing with good mid- to long-term outcomes. Enhancement of the local biology and reconstitution of scaphoid and carpal height resulted in improved function mostly in early interventions.
-
Eur J Orthop Surg Tr · Jan 2017
Influence of sagittal plane malpositioning of the patella on anterior knee pain after tibia intramedullary nailing.
Anterior knee pain (AKP) is one of the most common complications after tibia intramedullary surgery. We evaluated changes in patellar tendon length after tibia intramedullary nailing surgery using a transtendinous approach and assessed the importance of nail position in relation to the anterior tibial cortex and joint line. ⋯ Level 3 (Case control study).
-
Eur J Orthop Surg Tr · Jan 2017
Review Meta AnalysisMeta-analysis of epidural analgesia versus peripheral nerve blockade after total knee joint replacement.
Postoperative pain after major knee surgery can be severe. Our aim was to compare the outcomes of epidural analgesia and peripheral nerve blockade (PNB) in patients undergoing total knee joint replacement (TKR). Moreover, we aimed to compare outcomes of adductor canal block (ACB) with those of femoral nerve block (FNB) after TKR. ⋯ PNB is as effective as epidural analgesia for postoperative pain management in patients undergoing TKR. Moreover, it is associated with significantly lower postoperative complications. ACB appears to be an effective PNB with similar analgesic effect to FNB after TKR. Future RCTs may provide better evidence regarding knee range of motion, length of hospital stay, and neurological complications.
-
Eur J Orthop Surg Tr · Jan 2017
Ilizarov fixation for the treatment of scaphoid nonunion: a novel approach.
To evaluate the safety and efficacy of the Ilizarov fine-wire compression/distraction technique in the treatment of scaphoid nonunion (SNU), without the use of bone graft. ⋯ In these selected patients, this technique safely achieved bony union without the need to open the SNU site and without the requirement of bone graft.
-
Eur J Orthop Surg Tr · Jan 2017
Risk factors for mortality in geriatric hip fractures: a compressional study of different surgical procedures in 785 consecutive patients.
Only a little is known about whether type of surgical intervention has an effect on mortality of these patients. Our primary objective was to assess whether different type of surgical procedures has an effect on mortality among elderly patients with hip fracture. A secondary objective was to examine factors that are related to mortality in our patient population. Our hypothesis is that type of surgical procedure, especially external fixation, should have an influence on mortality outcomes. ⋯ Transfusion requirement, ASA grade 4 and having more than two comorbidities are risk factors for mortality in geriatric hip fractures. Type of surgical intervention and fracture type had similar mortality rates in our patient population.