Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Aug 2014
The use of the 95-degree-angled blade plate in femoral nonunion surgery.
The 95-degree-fixed angle blade plate has been in use for decades for both acute femoral fractures and nonunions. Our objective was to examine the results of use by a single surgeon of the 95-degree-angled blade plate in proximal and distal femoral nonunion surgery. ⋯ The 95-degree-angled blade plate is an effective reduction aid and fixation device for aseptic nonunions of the proximal and distal femur with acceptable healing rates with one surgery alone.
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Eur J Orthop Surg Tr · Aug 2014
Hip arthroplasty with the articular surface replacement (ASR) system: survivorship analysis and functional outcomes.
The articular surface replacement (ASR) hip resurfacing system, now withdrawn, has the highest all-cause revision rate (24.2 % at 7 years) compared with other resurfacing brands. We present our experience with the ASR articulation and the implant recall process. ⋯ Our data indicate an overall high revision rate, comparable with recently published studies. Even though most of our revisions were attributed to causes that are not specific to the metal-on-metal articulation, we do expect to find more cases of failures in the future. Therefore, continued close clinical surveillance and laboratory monitoring of these patients is warranted.
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Eur J Orthop Surg Tr · Aug 2014
Risk of acetabular protrusion is low in rheumatoid arthritis patients treated with bipolar hemiarthroplasty for displaced femoral neck fractures without rheumatoid change in hip joints.
The aim of this study was to analyze the radiological outcomes of bipolar hemiarthroplasty after displaced femoral neck fractures of non-arthritic hip joints in rheumatoid arthritis patients. ⋯ We conclude that risk of acetabular protrusion appears to be low in patients of rheumatoid arthritis treated with bipolar hemiarthroplasty for displaced femoral neck fractures of non-arthritic hip joints in the medium term.
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Eur J Orthop Surg Tr · Jul 2014
ReviewTreatment options for vertebral fractures an overview of different philosophies and techniques for vertebral augmentation.
For more than 30 years, minimally invasive surgical procedures have been available to stabilize the fractured vertebrae by cement augmentation leading to significant pain relief, a distinct improvement in quality of life and decreased mortality for patients suffering from osteoporotic vertebral compression fractures. This overview article is designed to provide information on the wide range of augmentation methods previously tested and clinically applied in surgery in an attempt to compile the clinically relevant information on safety and efficacy in the published literature. ⋯ Options for the treatment of vertebral fractures: Reductions in bone density and pathological changes in bone structure are associated with an elevated risk of fractures, which can lead to decisive functional impairment, pain, and a host of further comorbidities. Vertebral augmentation can be considered as an alternative conservative treatment, in order to achieve immediate and lasting pain relief as well as improvement in functional impairment. To achieve greater safety, instrumentation for transpedicular access and incorporation of radiopacifiers in PMMA for vertebroplasty were developed in mid-eighties. Balloon kyphoplasty was introduced in the end nineties, and results of prospective, randomized clinical studies have confirmed the safety and efficacy; the destruction of the remaining native spongiosa structures during balloon expansion is viewed as a disadvantage of this method. The two step method of cavity creation followed by cement delivery known as kyphoplasty has been further refined and developed by and varied by technology/procedural developments. This includes most the radiofrequency kyphoplasty (DFINE Inc., San Jose, CA, USA), in which ultrahigh-viscosity cement is delivered at a controlled delivery rate, following producing a bone sparing size and side specific cavity which minimizes loss of spongiosa, allowing for mechanical stability upon interdigitation of cement into that remaining trabecular bone. This combination has been shown to preserve vertebral structures and reduces the risk of leakages. Finally, systems have been available in which cement augmentation of implants to enhance mechanical stability of the implants or the overall fracture is constructed by load sharing.
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Eur J Orthop Surg Tr · Jul 2014
Surgical site infection after open reduction and internal fixation of tibial plateau fractures.
The aim of this study was to identify risk factors for surgical site infections and to quantify the contribution of independent risk factors to the probability of developing infection after definitive fixation of tibial plateau fractures in adult patients. ⋯ Both open fracture and operative time are independent risks factors for postoperative infection.