Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2012
Occult hip and pelvic fractures and accompanying muscle injuries around the hip.
We investigated the incidence of occult hip and pelvic fractures and associated muscle injuries around the hip. ⋯ Occult hip and pelvic fractures were almost equally seen among 113 cases with suspected hip fracture but were negative on plain radiography. Different patterns of associated muscle injuries in cases of occult hip fracture and pelvic fracture suggest that the mechanism of hip fracture and pelvic fracture is possibly different.
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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.
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Arch Orthop Trauma Surg · Jan 2012
Clinical TrialDisplaced femoral neck fractures in the young: significance of posterior comminution and raised intracapsular pressure.
Osteosynthesis in fracture neck of femur (NOF) in young is a universally acceptable procedure. Various factors affect the outcome; with AVN (avascular necrosis) and non-union primarily contributing to adverse results in such patients. To identify factors affecting outcome of displaced fracture NOF, a prospective cohort study was carried out in the setting of a tertiary care centre in developing country. ⋯ Prognosis of displaced fracture NOF is significantly associated significant with posterior comminution and intracapsular pressure difference between fractured and normal side.
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Arch Orthop Trauma Surg · Jan 2012
Case ReportsFree vascularized metacarpal bone graft combined with extended dorsal metacarpal artery flap for phalangeal bone and soft tissue loss: case report.
A 45-year-old man suffered from a complex bone and soft tissue defect of the middle phalanx of his left middle finger after an electric saw injury. Here, we present the patient's clinical and radiological outcomes after reconstruction with a free vascularized metacarpal II bone graft and an extended distally based second dorsal metacarpal artery skin flap (DMCA). To our knowledge, this is the first description of a free vascularized metacarpal bone graft combined with DMCA for distal finger reconstruction.
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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.