International orthopaedics
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Due to increasing life expectancy we see a rising number of joint replacements. Along with the proximal prosthesis in the femur, more and more people have a second implant on the distal ipsilateral side. This might be a retrograde nail or a locking plate to treat distal femur fractures or a constrained knee prosthesis in the case of severe arthrosis. All these constructs can lead to fractures between the implants. The goal of this study was to evaluate the risk of stress risers for interprosthetic fractures of the femur. ⋯ The highest risk for a fracture in the femur with an existing hip prosthesis comes with a retrograde nail. A distal locking plate for the treatment of supracondylar fractures leads to a higher required fracture force. The implantation of a constrained knee prosthesis that is not loosened on the ipsilateral side does not increase the risk for a fracture.
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Although the predictive value of Böhler's angle on outcome remains subject of debate, the initial angle at the time of trauma still guides treatment. Changes in Böhler's angle during follow-up are frequently reported following surgical treatment of displaced intra-articular calcaneal fractures (DIACF). The aim of the present study was to determine the changes in Böhler's angle as a measure of secondary fracture displacement following conservative management of DIACF. ⋯ The conservative treatment of displaced intra-articular calcaneal fractures is still a viable option, yet a significant secondary displacement in time should be taken into account, as reflected in a decrease of Böhler's angle of 11° up to one year following trauma.
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The purpose of this paper is to review our experience and study the feasibility and clinical results of one-stage total knee arthroplasty (TKA) for patients with osteoarthritis of the knee with extra-articular deformity. ⋯ One-stage TKA is a technically difficult but effective treatment for patients with osteoarthritis of the knee and extra-articular deformity. If feasible we recommend TKA with intra-articular bone resection and soft tissue balancing.
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Hemiarthroplasty (HA) is an established treatment for femoral neck fractures of the elderly. Several surgical approaches are currently used including dorsal and transgluteal. It is still unclear whether one approach may be advantageous. We compared early complication rates after dorsal and transgluteal approaches. ⋯ The rate of early surgical complications after dorsal and transgluteal approaches is not significantly different. However, the dorsal approach predisposed to dislocation, whereas the transgluteal approach predisposed to haematoma.
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The objective of this study was to evaluate the morphological characteristics of Schatzker type IV tibial plateau fractures. ⋯ The direction and location of Schatzker type IV fractures are highly variable. Proper operative approach and fixation method should be selected based on the morphological characteristics of individual medial plateau fractures.