Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2012
A "sandwich" method of reconstruction of the medial patellofemoral ligament using a titanium interference screw for patellar instability in skeletally immature patients.
No standard surgical procedure for medial patellofemoral ligament (MPFL) reconstruction exists in skeletally immature patients with patellar instability. This study aimed to evaluate the clinical effectiveness of a novel reconstruction technique for the MPFL in patients with patellar instability because of non-closure of the epiphyseal line. ⋯ The MPFL reconstruction methods, using a double-stranded semitendinosus autograft and sparing the femoral physeal line in non-closure of the epiphyseal line, provide acceptable short-term results for the treatment of patellar instability.
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Arch Orthop Trauma Surg · Aug 2012
Case ReportsTreatment of an open distal tibia fracture with segmental bone loss in combination with a closed proximal tibia fracture: a case report.
The treatment of open distal tibia fractures remains challenging, particularly when the fracture is infected and involves segmental bone loss. We report the case of a 38-year-old man who sustained an open distal tibiofibular fracture with segmental bone loss and a closed proximal tibial fracture. The fractures were initially fixed with a temporary external fixator. ⋯ Bone graft was also used to the distal tibiofibular space to achieve distal tibiofibular synostosis. We describe one treatment option for an infected open fracture of the distal tibia with segmental bone loss that is accompanied by a closed fracture of the proximal tibia. This method can treat two fractures simultaneously.
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Arch Orthop Trauma Surg · Aug 2012
Platelets rich plasma for treatment of chronic plantar fasciitis.
Plantar fasciitis is a common cause of heel pain in adults. Many treatment options exist. Platelets rich plasma (PRP) is derived from autologous blood and contains high concentration of growth factors necessary for tissue healing. The use of PRP in the treatment of plantar fasciitis is a fairly recent and evolving concept. The purpose of our work was to study the effectiveness of PRP treatment for chronic plantar fasciitis. ⋯ Injection of PRP is safe and doesn't affect the biomechanical function of the foot. Our successful early findings with injection of PRP indicate that this may become a very commonly used modality in treating this difficult condition.
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Arch Orthop Trauma Surg · Aug 2012
Core decompression combined with implantation of a demineralised bone matrix for non-traumatic osteonecrosis of the femoral head.
Core decompression is the standard surgical procedure in the treatment of early stage non-traumatic osteonecrosis of the femoral head (ONFH). However, there is still a debate whether decompression in combination with supplementary augmentation by bone grafts, growth factors, or cell implementation is superior to conventional decompression alone. This study evaluated patients after core decompression combined with an augmentation by a demineralised bone matrix, and particularly aimed to report long-term conversion rates to total hip replacement (THR). ⋯ In patients with early- stage femoral head osteonecrosis core decompression combined with the implantation of a demineralised bone matrix leads to a limited, temporary pain relief as seen in core decompression alone. However, long-term results were not encouraging with a high rate of conversion to arthroplasty. Therefore, core decompression with implantation of a demineralised bone matrix may be not appropriate to avoid THR in the long term.
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Arch Orthop Trauma Surg · Aug 2012
Outcomes of total hip replacement in patients with slipped capital femoral epiphysis.
Total hip replacement has been advocated for the treatment of degenerative hip diseases secondary to slipped capital femoral epiphysis; nonetheless, outcomes of this procedure have not been well established. We reviewed the outcomes of modern total hip replacements in patients who suffered from slipped capital femoral epiphysis. ⋯ We recommend total hip replacement for patients who suffer from slipped capital femoral epiphysis because of the satisfactory survival, low complication rate, and the possibility of restoring leg length.