Journal of orthopaedic surgery and research
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Metastatic lesions localized in the periacetabular area cause troublesome pain and reduced mobility of the patients. Radiotherapy effectively decreases pain, yet it does not restore the ability to load the joint. Surgical treatment involving resection of metastatic lesions and joint reconstruction using bone grafts is burdened with a high rate of complications. Modular tumor prostheses are being increasingly used. In some cases, it is possible to strengthen the acetabular roof with bone cement using vertebroplasty kits. The aim of the study was to demonstrate various methods of treatment of metastatic lesions localized in the periacetabular area together with the analysis of their results and effectiveness. ⋯ Strengthening of the acetabular roof with bone cement in a specific group of patients is an adequate method of treatment which decreases pain and allows for loading the affected limb while walking. Internal hemipelvectomy combined with LUMiC prosthesis implantation makes it possible for the patients to walk using crutches and significantly reduces pain.
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Comparative Study
Quantification of cephalomedullary nail fit in the femur using 3D computer modelling: a comparison between 1.0 and 1.5m bow designs.
The radius of curvature (ROC) misfit of cephalomedullary nails during anterograde nailing can lead to complications such as distal anterior cortical encroachment. This study quantified the anatomical fit of a new nail with 1.0-m ROC (TFN-ADVANCED(™) Proximal Femoral Nailing System [TFNA]) compared with a nail with 1.5-m ROC (Gamma3 Long Nail R1.5 [Gamma3]). ⋯ The 1.0-m ROC TFNA nail resulted in better fit than the 1.5-m ROC Gamma3 nail. Clinical trials and case studies should be conducted in the future to verify if these findings would also result in clinical improvements.
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There have been many reports on posterior hemivertebra resection. However, there were few articles in very young cases. This is a clinical retrospective study to evaluate the complications and efficacy of posterior hemivertebra resection in very young cases. ⋯ Posterior hemivertebra resection with transpedicular instrumentation is a safe and effective procedure in very young congenital scoliosis cases. Earlier surgeries can achieve short fusion and save more mobile segments. However, complications associated with implants and spinal growth still remain major concerns.
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Limited-incision total hip arthroplasty (THA) preserves hip abductors, posterior capsule, and external rotators potentially diminishing dislocation risk. However, potential complications also exist, such as component malposition. Specific implants have been manufactured that enhance compatibility with this technique, while preserving metaphyseal bone; however, little data exists documenting early complications and component position. The purpose was to evaluate primary THA using a curved, bone-sparing stem inserted through the anterior approach with respect to component alignment and early complications. ⋯ Although the technique with this implant and approach is promising, it does not appear to offer important advantages over standard techniques. However, the findings merit further, long-term study.