Orthop Traumatol Sur
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Orthop Traumatol Sur · Jun 2009
Review Case ReportsThigh compartment syndrome after intramedullary femoral nailing: possible femoral nerve block influence on diagnosis timing.
We report a case of anterior thigh compartment syndrome (TCS), which occurred after a closed femoral fracture internal fixation using an intramedullary rod. A 20 ml ropivacaine hydrochloride single-injection femoral block had preceded general anaesthesia to conduct the surgical procedure. The compartment syndrome diagnosis was made the morning after surgery when the level of pain was interpreted as disproportionate to the treated lesion; in addition, compartment pressure measure had increased to 54 mmHg. ⋯ This patient's report raises the question of whether a femoral block may be responsible for delays in diagnosing compartment syndrome, although no series have been published of such occurrences in large numbers. When nerve blocks are used, they should be more analgesic than anaesthetic. Careful patient monitoring remains important.
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Orthop Traumatol Sur · Jun 2009
Distal femur rotational alignment and patellar subluxation: a CT scan in vivo assessment.
Patellofemoral instability following total knee arthroplasty is a very common complication which may result from a defective rotational positioning of the femoral component. However, rotational landmarks for optimal orientation are not unequivocal. Moreover, no proven correlation has yet been established between preexisting rotational malposition and patellofemoral instability occurrence. ⋯ Prospective diagnostic study.
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Orthop Traumatol Sur · Jun 2009
Mobile-bearing insert translational and rotational kinematics in a PCL-retaining total knee arthroplasty.
Total knee prostheses with a mobile-bearing insert were developed to provide nonconstrained joint range of motion while reducing friction forces. The purpose of this study was, based on weightbearing X-rays, to evaluate the mobility of the polyethylene tibial insert in relation to the femoral and tibial components. We studied the results of a cementless total knee arthroplasty (TKA) retaining the posterior cruciate ligament (PCL), with a mobile-bearing platform in rotation and anteroposterior translation (Innex Anterior-Posterior Glide, Zimmer) with a mean 23-month follow-up duration after surgery. ⋯ Level IV. Prospective non-controlled therapeutic study.
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Orthop Traumatol Sur · May 2009
LCS mobile-bearing total knee replacement. A 10-year's follow-up study.
For the last three decades total knee arthroplasty surgery has been facing the renewed choice of using a traditional fixed-bearing design or a mobile-bearing system. A growing number of surgeons have elected to increase their use of mobile-bearing prostheses. We wanted to assess the reliability, in our hospital of this alternative choice. ⋯ Level IV. Therapeutic study.
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Orthop Traumatol Sur · May 2009
ReviewFemoral offset: anatomical concept, definition, assessment, implications for preoperative templating and hip arthroplasty.
BACKGROUND OBJECTIVE: Femoral offset is supposed to influence the results of hip replacement but little is known about the accurate method of measure and the true effect of offset modifications. ⋯ Therefore, femoral offset restoration is essential to improve function and longevity of hip arthroplasty. CT-scan is more accurate than plain radiography to assess femoral offset. Hip resurfacing decreases offset without effect on function. Modular neck and computer assistance may improve intraoperative calculation and reproduction of femoral offset. Increasing offset with a standard cemented design may decrease long-term fixation. Level IV: Retrospective or historical series.