Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2012
Comparative Study Clinical TrialHook plate fixation for acromioclavicular joint separations restores coracoclavicular distance more accurately than PDS augmentation, however presents with a high rate of acromial osteolysis.
Hook plate fixation of acromioclavicular (AC) joint separations carries the disadvantage of compulsory implant removal, occasional implant fatigue and secondary loss of reduction. This study compares the clinical and radiological outcome of a new polyaxial angular stable hook plate (HP) with absorbable polydioxansulfate (PDS) sling. ⋯ Hook plate fixation employing a polyaxial angular stable plate finally restores the coracoclavicular distance more accurately than augmentation with a PDS sling. Although in HP group no implant failure occurred, major disadvantages are initial overcorrection and acromial osteolysis. Both have no influence on final functional results.
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Arch Orthop Trauma Surg · Jan 2012
Comparative StudyComparison between conservative and surgical treatment in Perthes disease.
The purpose of this study was to compare the results of conservative and surgical treatment in a homogeneous group constituted by patients between 6 and 8 years of age at onset of the Perthes disease with Herring B involvement. ⋯ Non-surgical treatment with a brace is a reliable alternative to surgical treatment in Perthes disease between 6 and 8 years of age at onset with Herring B involvement. However, we could not know whether the good results were influenced by the brace or stemmed from having good prognosis of these patients.
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Arch Orthop Trauma Surg · Jan 2012
Randomized Controlled Trial Comparative StudyClinical outcome after Chevron-Akin double osteotomy versus isolated Chevron procedure: a prospective matched group analysis.
Hallux valgus is a frequent condition of the forefoot, resulting in cosmetic deformity and pain. Chevron osteotomy (CO) is widely employed for the treatment of hallux valgus. Chevron-Akin double osteotomy (CAO) was previously described and superiority over an isolated Chevron procedure was assumed. The objective of this study was to compare the short-to-middle term outcomes of CO and CAO. ⋯ These findings indicate that Chevron-Akin double osteotomy is a save and practicable procedure for the treatment of mild-to-moderate hallux valgus. Superiority of combined Chevron-Akin procedure over an isolated Chevron osteotomy might be limited to distinct clinical settings, but should not be generally assumed.
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Arch Orthop Trauma Surg · Jan 2012
Randomized Controlled Trial Comparative StudyClosed suction drainage with or without re-transfusion of filtered shed blood does not offer advantages in primary non-cemented total hip replacement using a direct anterior approach.
Wondering if the use of drains allowing re-transfusion of shed blood as opposed to closed suction drains or no drains would improve quality of care to patients undergoing simple non-cemented primary total hip replacement (THR) using a direct anterior approach, a three-arm prospective randomized study was conducted. ⋯ The possibility to re-transfuse drained blood was not an argument for using drains and, accepting more thigh swelling, we stop to use drains in simple non-cemented primary THR using the direct anterior approach.
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Arch Orthop Trauma Surg · Jan 2012
Randomized Controlled TrialReactionary haemorrhage reduction with adrenaline infiltration in proximal tibial osteotomy: a randomized clinical study of safety and efficacy.
In corrective osteotomy, wound closure is undertaken with or without deflation of the tourniquet. Hypoxia from the tourniquet causes vasodilatation associated with reactionary haemorrhage and reduced haemoglobin concentration and possibly increased blood transfusion rate. Reactionary haemorrhage and related transfusion need can be reduced through vasoconstriction from adrenaline infiltration. ⋯ In conclusion, wound infiltration with adrenaline was effective in reducing the extent of reactionary haemorrhage and post-operative drop in haemoglobin concentration. There was no significant difference in the transfusion rates in both groups.