Eur J Orthop Surg Tr
-
Eur J Orthop Surg Tr · Jan 2013
Factors associated with avascular necrosis of the femoral head and nonunion in patients younger than 65 years with displaced femoral neck fractures treated with reduction and internal fixation.
Few studies have evaluated treatment of displaced femoral neck fractures in patients younger than 65 years, and risk factors for AVN or nonunion have not been clearly delineated within this age range. ⋯ Patients between 53.5 and 65 years presented a higher risk of AVN. A primary arthroplasty should be considered in this subgroup.
-
Eur J Orthop Surg Tr · Jan 2013
Positioning of the patient during shoulder surgery: an inexpensive, safe and easy technique.
The knowledge of shoulder pathology has improved tremendously in the last decades, and shoulder surgery is increasingly performed because of new treatment options and better operative results. Nowadays most surgical shoulder procedures are performed in the sitting or semi-sitting (beach chair) position. Stability of the patient and the ability to flex, extend and rotate the shoulder during surgery are crucial to improve exposure of the surgical field and lower the risk of perioperative complications. ⋯ This position also gives the possibility to provide an excellent radiographic view of the shoulder during operative fracture treatment. Our technique further allows a significant reduction in costs. A surgical table, extra bar, additional arm support and neck support are usually available and can be used in different settings, without the need for a specific shoulder table.
-
Eur J Orthop Surg Tr · Dec 2012
Delayed surgical treatment of displaced midshaft clavicle fracture using Herbert cannulated screw with intramedullary bone graft.
There is an increasing trend towards operative treatment for displaced midshaft clavicle fractures. This retrospective study was performed to assess the outcome of delayed fixation of displaced midshaft clavicle fractures and test the null hypothesis that there is no difference in results between early and delayed surgical treatment for displaced midshaft clavicle fractures. Using the hospital database, two groups of patients who were surgically treated using Herbert cannulated screw for displaced midshaft clavicle fractures were identified. ⋯ The delayed group had significantly more problems with prominent, symptomatic screws that required removal (P = 0.002). There were no significant differences in union time and complication rate. Delayed fixation of displaced midshaft fractures using the Herbert cannulated bone screw and bone graft is effective and provides a good functional outcome that only slightly reduced from that recorded for early fixation.
-
Eur J Orthop Surg Tr · Sep 2004
Correlative analysis of reliability and validity of plain radiology, MOS short-form health survey and surgical examination in making decision for treatment of chronic low back pain patients.
The aim of this study was to determine inter- and intraobserver agreement between spine surgeons and orthopedic radiologists in recognizing distinct degenerative pathology on plain lumbosacral roentgenograms; to estimate the validity (sensitivity and specificity) to make a surgical decision by correlating Short form-36 Health Survey (SF-36) scores and roentgenographic degenerative pathology; and to determine the intra- and interobserver agreement between radiologists, surgeons, and authors in making a surgical decision for treatment on the basis of distinct roentgenographic pathology, SF-36 scores, clinical findings derived from physical examination, or combined. The authors followed three routes to objectively assess the reliability and validity of the surgical decision in chronic low back pain patients: First, 100 consecutive male patients who suffered from low back pain were examined by the authors physically, using imaging techniques (including plain roentgenograms, CT-scan, or/and MRI), and SF-36 survey. Two senior orthopedic radiologists and two senior spine surgeons were asked to read blinded a set of 100 roentgenograms of the lumbar spine in two sessions. ⋯ This investigation showed that distinct degenerative lumbar spinal pathology can be identified on plain roentgenographs with similarly high accuracy by orthopedic, radiologists, and spine surgeons. The sensitivity and specificity of recognizing abnormal and normal roentgenograms using normal and abnormal SF-36 data was low because of the subjective nature of the SF-36 survey. This study additionally concluded that any surgical decision should not be taken on the basis of any roentgenographic pathology or on what the patient says in the SF-36 questionnaire, but on the basis of matched SF-36 scores, roentgenographic and imaging evaluation, and physical examination data.
-
Eur J Orthop Surg Tr · Dec 1996
[Social and professional effects of hip prosthetic replacment on people under 50 years of age].
Although total hip prosthetic replacement is a common surgical procedure, it is not without social and professional consequences. In a certain number of cases, return to occupational activities is not possible. In others, it is difficult. ⋯ It is advisable that they should be accompanied in this step by competent librarians. Compatible occupational activity: Functional rehabilitation will be completed by retraining aiming at recovering stamina and at intensifying physical activities level essentially by play or sports activities. In some cases, retraining in a specialized centre can be considered.