Injury
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In traumatology, we encounter several clinical challenges that involve extensive bone loss primarily related to trauma, conditions that can be treated with autologous grafts. A good alternative is the use of synthetic biomaterials as substitutes. These polymers provide a suitable environment for the growth of new bone and vascular tissue, which are essential for repair. ⋯ Mineralization of sponges did not stimulate bone neoformation, with bone repair being incomplete over the experimental period. In conclusion, mineralization by the addition of hydroxyapatite should be better studied. However, the collagen/chitosan sponges used in this study are suitable to stimulate osteogenesis in cranial defects, although this process is slow and not sufficient to achieve complete bone regeneration over a short period of time.
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Controversy exists regarding optimal primary management of Lisfranc injuries. Whether open reduction internal fixation (ORIF) or primary arthrodesis is superior remains unknown. ⋯ Level III Retrospective Cohort Study.
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Nearly 18,000 individuals suffer from hip fracture in Sweden each year. The choice in operation method for femoral neck fractures has changed over the years as well as the overall management. Functional outcome after hip fracture is affected by several factors and the overall functional level for old people in Sweden has improved over the last decades. ⋯ Although there have been changes in operation methods for hip fractures and the management has developed, our study does not show any effect on functional outcome over a 25-year period. The medical condition of these patients with increasing age seems to counteract efforts to improve the care.
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Proximal femoral fractures are a very common disease which affect elderly patients after low energy trauma, but can also affect the young population as a consequence of high energy trauma. Classification of sub trochanteric fractures has not yet been clearly defined representing a major issue in comparing different treatment techniques among the scientific literature. These fractures are well known by orthopaedic surgeons for intraoperative difficulties in reduction and post-operative high rate of non-unions and malunions. We present two clinical cases, one treated with an intramedullary device and one with an extramedullary device, both failed and revised with open surgery using a condylar angled bladeplate, following AO principles of anatomical reduction and stable fixation.
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The large bone defect treatment is a challenge issue in modern orthopaedic trauma surgery. One of the most used technique is the Masquelet's technique. In this case report we used a modified Masquelet technique to fill a six centimeters bone gap in the proximal femur. ⋯ A year later the fracture had healed uneventfully. The modification of the Masquelet Technique that we have made allows the patient to immediately weight bearing safely, speeding up the functional recovery. Further studies are needed to standardize this type of combined technique.