Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Feb 2017
Choice of surgical approach for capitellar fractures based on pathoanatomy of fractures: outcomes of surgical management.
The understanding of the anatomic configuration of the fractures of the capitellum has enhanced in the last few years, and the classification of these fractures continues to evolve. It is essential to tailor the surgical approaches to these fractures based on the state-of-the-art classifications. Thirty-three patients with fractures of the capitellum were included in this retrospective study. ⋯ Correct choice of surgical approach facilitates the accuracy of reduction and fixation of these difficult fractures. It also helps to minimize the requirement of two-incision approach. Anterolateral approach is an excellent approach for Dubberley 2A and 3A fractures.
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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.
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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).
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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.
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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.