Journal of orthopaedic surgery (Hong Kong)
-
J Orthop Surg (Hong Kong) · Sep 2019
Posterior wall acetabular fracture fixation: A mechanical analysis of fixation methods.
Stable, anatomical fixation of acetabular fractures gives the best chance of successful outcome, while penetration of the acetabular articular surface with screws is associated with poor outcomes. Spring plates are an alternative to interfragmentary lag screws when penetration is a concern. A mechanical study comparing fracture stability and construct stiffness of three fixation methods for posterior wall acetabular fractures with transverse comminutions was performed. ⋯ The rim plate was the stiffest construct 10,962 N/mm, followed by the spring plate model 5637 N/mm and the buttress plate model 4882 N/mm. Based on data obtained in this study, where possible a rim plate with interfragmentary lag screws should be used for isolated posterior wall fractures as this is the stiffest and most stable construct. When this method is not possible, spring plate fixation is a safe and a superior alternative to a posterior buttress plate method.
-
J Orthop Surg (Hong Kong) · Sep 2019
Categorization of single cuneiform fractures and investigation of related injuries: A 10-year retrospective study.
The purpose of this study was to define the fracture type and investigate the injuries related to single medial, intermediate, or lateral cuneiform fracture. ⋯ 4.
-
J Orthop Surg (Hong Kong) · May 2019
Uncemented extensive porous titanium-coated long femoral stem prostheses are effective in treatment of Vancouver type B2 periprosthetic femoral fractures: A retrospective mid- to long-term follow-up study.
The aim of this study was to evaluate the mid- to long-term outcomes of revision surgery for Vancouver type B2 periprosthetic femoral fractures (PFFs) after total hip arthroplasty using an uncemented extensive porous titanium-coated long femoral stem prosthesis (solution prosthesis) with or without cortical strut allograft. ⋯ Revision surgery using the solution prosthesis with or without cortical strut allograft is effective in treating Vancouver type B2 PFFs, with satisfactory mid- and long-term clinical and radiological outcomes.
-
J Orthop Surg (Hong Kong) · May 2019
Case ReportsAn aneurysmal bone cyst at T1 treated with bone grafts containing calcitonin and methylprednisolone.
Aneurysmal bone cysts (ABCs) rarely trigger pathological fractures. Various surgical and nonsurgical treatments have been reported for this condition. Herein, we present the examination findings and treatment for a 15-year-old girl who initially presented with adolescent idiopathic scoliosis and mild back pain, but subsequently experienced severe back pain. ⋯ At 3 years post-surgery, there was no ABC recurrence and only mild back pain persisted. To our knowledge, this is the first report of open surgery (curettage and fixation) with local intralesional administration of calcitonin and mPSL for an ABC-induced pathological spinal fracture. We believe that this treatment is an effective option for ABCs associated with a pathological spinal fracture.
-
J Orthop Surg (Hong Kong) · May 2019
A modified tarsal sinus approach for intra-articular calcaneal fractures.
Plate fixation using traditional lateral L-shape approach for intra-articular calcaneal fractures is complicated by 30% of wound complications, and the lateral small incision techniques with a tarsal sinus approach cannot sufficiently address all the fragments. A modified tarsal sinus approach with combined advantages of traditional lateral L-shape and tarsal sinus approaches for the treatment of intra-articular calcaneal fractures was developed. ⋯ The modified tarsal sinus approach in the treatment of Sander's type II and III calcaneal fractures allowed adequate reduction and rigid fixation with low incidence of wound complications. Compared to sinus tarsi approach, this technique required shorter learning curve and was more easily mastered by young orthopedic surgeons. Thus, it was worthy of application clinically.