Orthop Traumatol Sur
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Orthop Traumatol Sur · Jun 2015
Tokuhashi score and other prognostic factors in 260 patients with surgery for vertebral metastases.
Metastatic disease of the spine is an increasingly common public health problem. Surgery should be an integral component of the overall cancer treatment plan and, importantly, must neither delay not jeopardize any of the other components. The prognosis governs the choice of the surgical strategy. Tokuhashi et al. developed a prognostic score in 1990, then revised it in 2000 and 2005. Here, our objective was to evaluate the performance of the Tokuhashi score in a cohort of 260 patients and to look for other variables that might improve preoperative outcome prediction. ⋯ Our cohort study supports the validity and reproducibility of the Tokuhashi score. Our finding that shorter time to metastasis diagnosis and age ≥ 70 years were also significantly associated with survival in our population invites further efforts to improve and update the Tokuhashi score.
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Orthop Traumatol Sur · Jun 2015
Prone and direct posterior approach for management of posterior column tibial plateau fractures.
The three-column fixation concept is becoming popular in orthopedic practice. Posterior column fracture is an uncommon type of tibial plateau fracture. The supine position for the surgical approach is familiar to most surgeons; however, it is difficult to achieve good reduction and fixation in posterior column fracture. ⋯ The prone position and direct posterior approach has great advantages in terms of reduction and stable fixation, yielding good results.