Clinical orthopaedics and related research
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Clin. Orthop. Relat. Res. · Aug 1994
Acetabular fracture fixation via a modified Stoppa limited intrapelvic approach. Description of operative technique and preliminary treatment results.
Between March 1991 and December 1992 the authors surgically treated 55 acetabular fractures using a modified Stoppa anterior intrapelvic extensile approach. Indications for utilization of this approach included displaced anterior column or wall fractures, transverse fractures, T shaped fractures, both column fractures and anterior column or wall fractures associated with a posterior hemitransverse component. The approach involves a transverse skin incision 2 cm above the pubic symphysis followed by a midline split of the rectus abdominis. ⋯ Clinical results were excellent (47%), good (42%), fair (9%) and poor (2%). The modified Stoppa incision offers the experienced trauma surgeon a new approach for fixation of displaced acetabular fractures. The approach offers improved reduction and fixation possibilities and may decrease the rate of complications associated with extrapelvic or extensile approaches.
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Clin. Orthop. Relat. Res. · Aug 1994
Heterotopic ossification prophylaxis following operative treatment of acetabular fracture.
Eighty seven patients with 88 fractures were retrospectively reviewed to assess the effect of postoperative prophylaxis on the formation of heterotopic ossification (HO). Sixty eight patients with 69 acetabular fractures were followed for an average of 21 months (range, 3-98 months). The grade of HO was assessed using the Brooker classification system. ⋯ There was no significant difference between 13 patients who were not treated prophylactically and 18 indomethacin treated patients stabilized through the Kocher-Langenbeck approach. Only one of 11 patients had HO (Grade I) following an ilioinguinal approach. Postoperative radiation therapy, with or without indomethacin, resulted in three patients with Grade 0 HO (all radiated 1-4 days post surgery), one with Grade II (radiated postoperative Day 8), and one with Grade III HO (significant delay in surgery with preoperative Grade III HO of the hip).(ABSTRACT TRUNCATED AT 250 WORDS)
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Clin. Orthop. Relat. Res. · Jul 1994
Randomized Controlled Trial Clinical TrialInterscalene block for pain relief after shoulder surgery. A prospective randomized study.
A prospective randomized study undertaken in 30 patients who underwent outpatient decompressive acromioplasty demonstrated the efficacy and safety of interscalene block post-operatively. Interscalene block improved the postoperative condition and well being of these patients. Their use decreased the hospitalization rate. There were no complications or side effects.
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Clin. Orthop. Relat. Res. · Jun 1994
Case ReportsMedial subtalar dislocation associated with fracture of the posterior process of the talus. A case report.
A 27 year-old man was involved in a high-energy-impact motor-vehicle accident and sustained multiple injuries including a medial subtalar fracture dislocation. The dislocation of the subtalar joint was reduced by closed means, but a large, comminuted, displaced posterior process fracture remained. Open reduction and internal fixation through a posteromedial approach with mobilization of the neurovascular bundle was used to restore congruity to the subtalar joint.