Eur J Orthop Surg Tr
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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
The efficacy of multimodal high-volume wound infiltration in primary total knee replacement in facilitating immediate post-operative pain relief and attainment of early rehabilitation milestones.
Inadequate pain relief after lower limb joint replacement surgery has been a well-recognised limiting factor affecting post-operative mobilisation and length of hospital stay. Multimodal local wound infiltration with local anaesthetics, adrenaline and non-steroidal anti-inflammatory agents can lower the opiate intake, reduce the length of stay and enhance early mobilisation in knee replacement patients. A retrospective review of 64 patients undergoing primary total knee replacement was undertaken. ⋯ The patients in the treatment group mobilised around 19 h earlier (p = 0.001). No major post-operative complications were encountered in either group. Wound infiltration is an effective and safe technique that promotes early rehabilitation and discharge of patients following primary total knee replacement.
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Eur J Orthop Surg Tr · Apr 2014
Review Meta Analysis Comparative StudyUnilateral versus bilateral fixation for lumbar spinal fusion: a systemic review and meta-analysis.
The objective of this study was to systematically compare the efficacy and safety of unilateral fixation to bilateral fixation for the lumbar degenerative disease. ⋯ Unilateral fixation seems to be an effective, feasible, and safe procedure in one or two segmental disease when compare with bilateral instrumentation.
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Eur J Orthop Surg Tr · Apr 2014
Management of open infected comminuted tibial fractures using Ilizarov concept.
Bone loss is very common in high energy trauma. It could be treated either by amputation and prosthesis or by reconstruction of both bony and soft tissue structures. The choice of treatment in a given case must be based on the assessment of the local and general condition of the patient such as regional neurovascular supply, and the residual articular and muscular function. Reconstruction may require bone grafts, tibiofibular synostosis, free microvascular soft tissue or bone transplants. The use of Ilizarov concept gives another option for treatment of bone defects. In this study, infected tibial fractures were treated using Ilizarov concept. ⋯ In the management of infected comminuted tibial shaft fractures, bone transport is indicated for the treatment of major bone loss, whereas compression-distraction is suitable only for treating less extensive bone gaps.
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Eur J Orthop Surg Tr · Apr 2014
Randomized Controlled TrialEffect of perioperative parecoxib on postoperative pain and local inflammation factors PGE2 and IL-6 for total knee arthroplasty: a randomized, double-blind, placebo-controlled study.
To assess the efficacy of postoperative pain management and the concentration change of PGE-2 and IL-6 of joint fluid with parecoxib after postoperative total knee arthroplasty. In the study, 100 patients experiencing primary TKA were randomly divided into study group, receiving parecoxib sodium (40 mg) intravenously (IV) at the completion of surgery and once every 12 h for totally 6 times postoperatively, and placebo group, receiving normal saline 2 mL IV at the same time points. Efficacy was assessed by total amount of morphine consumed, pain intensity, range of motion (ROM), the concentration change of PGE-2 and IL-6 of joint fluid, and postoperative nausea and vomiting (PONV) postoperatively. ⋯ The concentration of PGE-2 and IL-6 of joint fluid in study group are significantly lower than that in placebo group (P < 0.01) during 24 h postoperatively. The overall incidence of PONV was low and was not significantly different between the two groups. The present study demonstrated that the perioperative administration of parecoxib after primary TKA resulted in significantly improved postoperative analgesic management as defined by reduction in opioid requirement, lower pain scores and ROM, and significantly lowered local inflammation factors PGE2 and IL-6.