Eur J Orthop Surg Tr
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Eur J Orthop Surg Tr · Aug 2013
Modifiable factors delaying early discharge following primary joint arthroplasty.
Recent NHS reforms have incentivised reduction in length of stay, with the UK department of health expecting health trusts to reduce bed days and ultimately reduce overall costs. The aim of this study was to identify avoidable causes for protracted hospital admission following total hip arthroplasty (THA) or total knee arthroplasty (TKA) within a fast-track unit. ⋯ Delayed discharge can never be totally prevented. This unit aims to develop improvement in social work provision, with a greater focus on pre-admission discharge planning to reduce the number of delayed discharges and ultimately reduce the cost burden of joint replacement surgery. It is not conducive with the ethos of fast-track arthroplasty to only identify social circumstances upon admission.
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Eur J Orthop Surg Tr · Jul 2013
Review Case ReportsSurgical treatment of high-grade dysplastic spondylolisthesis using intraoperative electrophysiological monitoring: report of two cases and review of the literature.
Treatment of high-grade dysplastic spondylolisthesis in adolescents remains challenging. Surgical treatment of spondylolisthesis has been recommended in adolescents with pain refractory to conservative treatment, slippage progression, or severe slippage on presentation. Controversy exists as to the optimal surgical approach for high-grade spondylolisthesis. ⋯ A postoperative radiogram showed reduction of the slippage, and computed tomogram showed bone union between L5 and S1 vertebral body. This report describes 2 cases of surgical treatment using intraoperative electrophysiological monitoring with transcranial electric motor evoked potentials and continuous spontaneous electromyography for patients with high-grade dysplastic spondylolisthesis in adolescence. We successfully perform the surgery without any neurological deficit using intraoperative electrophysiological monitoring.
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Eur J Orthop Surg Tr · Jul 2013
Comparative StudyIntramedullary nailing versus percutaneous locked plating of distal extra-articular tibial fractures: a retrospective study.
The aim of this study is to compare distal tibial fractures (4-10 cm proximal to the plafond) treated by intramedullary nailing with those treated by percutaneous locked plating and to assess the clinical and radiographic results, complication rates, and the need for secondary procedures. Thirty-six patients received percutaneous locked plate treatment and 25 patients received intramedullary nail treatment. The results obtained from these two treatment methods were assessed by comparing infection rates, starting time for wight-bearing, local implant irritation, union and malunion rates and along with secondary procedures. ⋯ The time to full weight bearing was shorter in the intramedullary nail group. There was no significant statistical difference in malunion and nonunion rates between the two groups. The need for secondary procedures was more common in group receiving the percutaneous locked plate treatment and the time to full weight bearing was shorter in the intramedullary nail group.
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Eur J Orthop Surg Tr · Jul 2013
Comparative StudyTraumatic and non-traumatic isolated horizontal meniscal tears of the knee in patients less than 40 years of age.
The aim of this study is to analyze the characteristics of isolated horizontal meniscal tears in young patients and compared traumatic and non-traumatic isolated horizontal meniscal tear without other type of meniscal tear. ⋯ Isolated horizontal meniscal tears in young patients predominantly involved non-dominant knees and medial meniscus. Anterior aspect of medial meniscus was more frequently involved in traumatic group. Meniscal cysts were more frequently showed in non-traumatic group.
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Eur J Orthop Surg Tr · Jul 2013
ReviewDynamic cervical plate versus static cervical plate in the anterior cervical discectomy and fusion: a systematic review.
This study performs a systematic review to compare the functional outcomes and complications between the dynamic cervical plate and static cervical plate in patients with the anterior cervical discectomy and fusion (ACDF). The common static cervical plates have been widely used in the ACDF. It can successfully increase the fusion rate and decrease the surgery failure. Recently, the dynamic plate has been identified as another safe and efficient option for the better fusion rate by promoting load sharing across the construct. However, the proposed benefits have been largely theoretical, and there is considerable controversy as to which plate is a better option for reconstruction after ACDF. ⋯ The clinical outcome was similar in ACDF for one-level fusion patients, although the hardware failure rate was higher in ACDF with static plates.