Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jun 2013
Comparative StudyPosterior interosseus nerve vs. medial cutaneous nerve of the forearm: differences in digital nerve reconstruction.
Digital nerve defects are common in hand trauma and for primary or secondary nerve reconstruction, the autologous nerve graft remains the gold standard. This study compares the regeneration results and donor side morbidity of either the posterior interosseus nerve (PIN) graft or the medial antebrachial cutaneous nerve (MACN) graft. 16 patients (group A, age 43 ± 13 years) with digital nerve defects were treated with a PIN graft and 12 patients (group B, age 40 ± 15 years) received a MACN graft. The average nerve gap was 22 mm in each group. ⋯ Regarding the donor side morbidity, almost all patients complained about a disturbing scar formation and unpleasant paresthesia at the forearm down to the rascetta. Neuroma-associated pain has been detected in 4 cases. Although there has been no significant difference in terms of nerve regeneration, we recommend the use of the PIN graft for digital nerve reconstruction, since harvesting this nerve is fast and easy and without any donor side morbidity compared to the MACN graft.
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Arch Orthop Trauma Surg · Jun 2013
Design and preliminary biomechanical analysis of artificial cervical joint complex.
To design an artificial cervical joint complex (ACJC) prosthesis for non-fusion reconstruction after cervical subtotal corpectomy, and to evaluate the biomechanical stability, preservation of segment movements and influence on adjacent inter-vertebral movements of this prosthesis. ⋯ After cervical subtotal corpectomy, reconstruction with ACJC prosthesis not only obtained instant stability, but also reserved segment motions effectively, without abnormal gain of mobility at adjacent inter-vertebral spaces.
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Arch Orthop Trauma Surg · Jun 2013
Case ReportsA case of supracondylar humerus fracture with vascular impairment. Open it up?
Supracondylar humerus fracture is one of the most frequent fractures in childhood. A serious complication is an injury to the neurovascular structures which could potentially result in severe functional impairment. We are presenting the case of a 3-year-old girl with a supracondylar humerus fracture in our emergency department and highlight the diagnostic and therapeutic steps in managing this situation. ⋯ As concomitant vascular injuries after supracondylar humerus fractures are rare, it can be difficult to discriminate a pink pulseless hand from a patient with essential vascular injury. Our case also demonstrates the need for short-term reevaluation of the clinical status. When in doubt there should be no hesitation to perform open surgery and vascular repair.
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Arch Orthop Trauma Surg · Jun 2013
Comparative StudyJoint line changes in cruciate-retaining versus posterior-stabilized computer-navigated total knee arthroplasty.
This study compared joint line changes and functional outcomes between cruciate-retaining (CR) and posterior-stabilized (PS) computer-navigated total knee arthroplasties (TKAs). With the increased precision offered by computer navigation, we hypothesized that there should be minimal differences in the joint line changes between the groups and thus no significant differences in the clinical outcomes. ⋯ III.
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Arch Orthop Trauma Surg · Jun 2013
Coronal plane fractures of the distal humerus involving the capitellum and trochlea treated with open reduction internal fixation.
Coronal plane fractures of the distal humerus involving the capitellum and trochlea are rare. Treatments have evolved from closed reduction to open reduction and internal fixation (ORIF) to achieve a stable joint that allows early mobilization. ⋯ Level IV case series.