Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Aug 2019
Negative prognostic factors in surgical treatment for trimalleolar fractures.
Trimalleolar fractures are a common injury of the ankle that require surgical treatment to obtain an anatomic reduction of both malleoli and stabilization of the syndesmosis. This study aims to report the outcomes of surgical treatment for trimalleolar fractures, identifying the risk factors determining a worse result. ⋯ Surgical treatment for trimalleolar fractures needs accurate preoperative planning. Age over 61 years, BMI > 40, ASA > 1, type C fracture, and fracture dislocation were considered as negative prognostic fractures.
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Eur J Orthop Surg Tr · Aug 2019
Case ReportsSemitendinosus autograft augmentation after bilateral patellar tendon re-rupture: a case report and technique note.
Acute bilateral patellar tendon rupture is a rare occurrence, especially in young patients in the absence of comorbidities. We describe a case of bilateral patellar tendon re-rupture in a young patient without predisposing factors. Further, we explain a technique for autograft augmented patellar tendon repair with bidirectional fixation using an ipsilateral semitendinosus graft in transosseous patellar and tibia bone tunnels. ⋯ This is the first case describing a new fixation technique after bilateral patellar tendon re-rupture. The use of semitendinosus autograft for reconstruction of the patellar tendon after re-rupture is a viable and effective option.
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Eur J Orthop Surg Tr · Aug 2019
Wave changes in intraoperative transcranial motor-evoked potentials during posterior decompression and dekyphotic corrective fusion with instrumentation for thoracic ossification of the posterior longitudinal ligament.
A prospective clinical study of amplitudes of intraoperative transcranial motor-evoked potentials (TcMEPs) was performed in patients undergoing surgery for the posterior longitudinal ligament of thoracic spine (T-OPLL). ⋯ AH muscles were particularly useful for functional assessment of corticospinal conduction. High BMI, positive PST, modified McCormick scale IV, and low preoperative JOA score were associated with low rates of amplitude appearance. Amplitude deteriorations occurred throughout surgery, except during rod placement, and speedy rigid rod placement is important.