Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Nov 2012
Randomized Controlled Trial Comparative StudyPrecision of novel radiological methods in relation to resurfacing humeral head implants: assessment by radiostereometric analysis, DXA, and geometrical analysis.
Resurfacing humeral head implants (RHHI) are used to preserve bone stock and restore normal anatomy in the osteoarthritic shoulder joint. The purpose of this study was: (1) to describe the use of novel radiological methods in relation to evaluation of RHHI; (2) to estimate the precision of these methods; and (3) to present preliminary clinical and radiological results at 6 months follow-up after Copeland and Global Cap RHHI. ⋯ Radiostereometric analysis and DXA can be used for evaluation of RHHI, but expectedly with a lower precision as compared to standards of TKA or THA. Geometric analysis of the prosthetic shoulder is precise. We interpret that the early radiological and clinical results of the two RHHI are comparable.
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Arch Orthop Trauma Surg · Nov 2012
Randomized Controlled Trial Comparative StudyPercutaneous distal metatarsal osteotomy versus distal chevron osteotomy for correction of mild-to-moderate hallux valgus deformity.
A lot of procedures were described for managing hallux valgus deformity. Percutaneous metatarsal osteotomies have received increasing recognition in the previous decade. The proposed benefits revolve primarily around the shorter surgical time, lower incidence of complications, and higher patient satisfaction. However, there is insufficient evidence to determine whether this technique is comparable to traditional open approaches. ⋯ The results of this study support the idea that percutaneous distal metatarsal osteotomy yields good functional and radiological result and is associated with a high degree of postoperative patient satisfaction.
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Arch Orthop Trauma Surg · Nov 2012
Case ReportsIs augmentation a possible salvage procedure after lateral migration of the proximal femur nail antirotation?
Failed fracture fixation of proximal femur fractures in the elderly usually results in prosthetic replacement. In case of the proximal femur nail antirotation (PFNA), during lateral blade migration or periimplant fracture at the femoral shaft, the femoral head remains intact and therefore a joint preserving procedure might be performed. However, implant anchorage in the femoral head after the second blade implantation generally results in reduced anchorage in the remaining cancellous bone. Therefore, we hypothesize that in the above mentioned cases augmentation of the PFNA blade could be a treatment option before prosthetic surgery has to be performed. ⋯ Augmentation of simulated blade exchange after lateral blade migration demonstrated a good anchorage. There was superior rotational stability in the revised case and no inferiority during pull out for the investigated specimens. Furthermore, augmentation could compensate for destroyed trabeculae and poor bone stock. It could furthermore be an option when a failed implant has to be replaced by a long PFNA in case of shaft fracture at the tip of the implant to increase anchorage in the femoral head. From a biomechanical point of view, reosteosynthesis and augmentation in selected cases of PFNA revision could be an alternative to initial prosthetic replacement. In the case of cut-out or medial implant protrusion, the suggested salvage technique is not feasible.
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Arch Orthop Trauma Surg · Nov 2012
Anatomical evaluation of the rectus femoris tendon and its related structures.
The purpose of this study was to evaluate the anatomical structure of the quadriceps tendon in detail for use as an anterior cruciate ligament (ACL) graft tendon. ⋯ If the RF tendon only is used as an ACL graft, surgeons should be cautious of the fact that the narrowest point of the RF tendon is located close to the patella. The entire quadriceps tendon is big enough to be used as an ACL graft. However, since the direction of the VL and VI tendons is different, the suitability of the quadriceps tendon as an ACL graft is questionable.
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Arch Orthop Trauma Surg · Nov 2012
Anatomical reconstruction of the medial patellofemoral ligament in children with open growth-plates.
Recurrent lateral patellar dislocation is a common knee injury in the skeletally immature adolescent. In adults, anatomical reconstruction of the medial patellofemoral ligament (MPFL) is recommended, but due to the open physis, operative therapy in children is more challenging. ⋯ This technical note considers the important fact that the femoral insertion is distal to the femoral physis. Since the importance of an anatomical reconstruction respecting the femoral insertion of the ligament has been proven an insertion proximal of the physis has to be strictly avoided.