Eur J Orthop Surg Tr
-
Eur J Orthop Surg Tr · Jul 2013
Latissimus dorsi flap coverage of soft tissue defect following below-knee amputation: emphasis on flap design and recipient vessels.
High-energy trauma to the lower extremity often results in amputation of the limb. For maximal preservation of limb length during amputation, free tissue transfer is often necessary. In this study, we report our experience of stump coverage using latissimus dorsi musculocutaneous flaps with an emphasis on flap design and recipient vessels. ⋯ In flap design, the width of the skin paddle must match the anteroposterior diameter of the defect at the stump. The latissimus dorsi muscle must sufficiently wrap the bony stump for padding. We recommend using the anterior tibial artery as a recipient vessel in primary cases, and the descending geniculate artery in secondary cases.
-
Eur J Orthop Surg Tr · Jul 2013
Modified retrograde percutaneous intramedullary multiple Kirschner wire fixation for treatment of unstable displaced metacarpal neck and shaft fractures.
The purpose of this prospective study was to evaluate the functional and radiographic outcomes of our new surgical technique, retrograde percutaneous intramedullary multiple Kirschner wire (K-wire) fixation, for the treatment of unstable displaced metacarpal neck or shaft fractures. Between March 2005 and April 2010, 56 consecutive patients with 65 metacarpal fractures were treated with closed reduction and retrograde intramedullary fixation with at least 2 K-wires. The average follow-up duration was 13 months. ⋯ The average shortening was corrected significantly to 1 mm (SD, 2) in neck fractures and to -1 mm (SD, 2) in shaft fractures postoperatively. Based on our experience, our retrograde intramedullary K-wire fixation technique is an acceptable alternative modality for the treatment of unstable displaced metacarpal fractures. This straightforward technique can facilitate early hand mobilization, correct the deformity, and provide good clinical and radiographic outcomes.
-
Eur J Orthop Surg Tr · Jul 2013
Is there a stable vertebral height restoration with the new radiofrequency kyphoplasty? A clinical and radiological study.
The aim of this study is to evaluate whether radiofrequency kyphoplasty can restore vertebral body height in osteoporotic vertebral fractures and whether restoration of vertebral height correlates with decreased pain. ⋯ Radiofrequency kyphoplasty achieves rapid and lasting improvement in clinical symptoms. There was stable restoration of vertebral body height with a mean cement volume of 3.0 ml ± 0.6. There was no correlation between restoration of vertebral body height and pain relief.
-
Eur J Orthop Surg Tr · Jul 2013
Relationship between postoperative axial symptoms and the rotational angle of the cervical spine after laminoplasty.
An axial symptom is one of the postoperative problems after cervical laminoplasty. The range of motion (ROM) of the cervical spine decreases after laminoplasty. It is speculated that the reduction in neck ROM is one of the causes of axial symptoms. However, most reports have focused on ROM of the cervical spine in flexion and extension, and few papers describe the rotational motion after surgery. It is impossible to assess the rotational motion in plain X-rays. This study was undertaken for the following two purposes: (1) to compare segmental rotational angles of the cervical spine between control subjects and patients with cervical laminoplasty ; (2) to analyze the relationship between postoperative axial symptoms and the range of cervical rotational angle after laminoplasty. ⋯ Reduction of the rotational angle in the cervical spine was clearly observed in patients with cervical laminoplasty, compared to that in the controls. The marked reduction might be related to the axial symptoms after laminoplasty.
-
Eur J Orthop Surg Tr · May 2013
Comparative StudyComparison of therapeutic outcomes of periprosthetic femoral fracture between treatments employing locking and conventional plates.
Locking plate is considered biomechanically advantageous for porotic bone, compared with conventional plate. However, clinical evaluations of locking and conventional plates for periprosthetic femoral fracture are still controversial. Thus, we investigated the usefulness of a locking plate compared with the conventional plate for treatment for this fracture. ⋯ We cannot suggest the usefulness of locking plate for periprosthetic femoral fracture. However, functional training was performed in the same rehabilitation schedule in our comparative study. Considering the angle stability of the locking plate, weight may be loaded on the locking plate, earlier than that on the conventional plate, which may be an advantage of the locking plate.