Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2014
Review Observational StudyFactors associated with complex regional pain syndrome type I in patients with surgically treated distal radius fracture.
Wrist fracture is considered a typical initiating trauma for complex regional pain syndrome type I (CRPS I). However, few studies have comprehensively evaluated factors associated with the occurrence of CRPS I after the surgical treatment of a distal radius fracture (DRF). This study evaluates the factors influencing the occurrence of CRPS I after the surgical treatment of a DRF. ⋯ High energy injuries, severe fractures, and the female gender contribute to the development of CRPS I after the surgical treatment of DRF. The results have important implications for physicians who wish to identify patients at high risk for CRPS I after operative fixation for DRF and instigate treatment accordingly.
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Arch Orthop Trauma Surg · Dec 2014
Randomized Controlled TrialEfficacy of the assisted self-reduction technique for acute anterior shoulder dislocation.
The "original" traction-free Kocher's method to perform the reduction of shoulder dislocation has been recently reviewed and some authors speculated that it can be self performed by patients under the guide of the physician. In this way, as an "assisted self-reduction" technique, it is also effective and simple to perform. The aim is to study the effectiveness of the assisted self-reduction technique, in comparison to the well known and largely used traction-countertraction method. ⋯ The assisted self-reduction technique is simple, effective and gentle. Physicians on duty in the Emergency Departments should therefore be encouraged to use it.
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Arch Orthop Trauma Surg · Dec 2014
Conversion of hemi into reverse shoulder arthroplasty: implant design limitations.
Cranial migration of shoulder hemiarthroplasties due to rotator cuff insufficiency typically requires conversion into a reverse total shoulder arthroplasty. This study was conducted to analyze differences between the height and offset of six implants designed to enable conversion of a hemiarthroplasty into a reverse system. ⋯ Due to the modular stem, the system of Implantcast can be converted in a reverse system with the least changes in height and offset. For the other manufacturers it does not seem possible to convert a hemiprosthesis to a reversed prosthesis without accepting additional tension of the deltoid muscle. Further experimental studies have to analyze the changes in deltoid abduction moments after conversion of a hemi- into a reversed prosthesis.
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Arch Orthop Trauma Surg · Dec 2014
Comparative StudyThe effectiveness of skeletal imaging for quality assessment in posterior cruciate ligament reconstruction: reliability and validity of radiographs and computed tomography.
For intra- and postoperative evaluation of precise and anatomic graft tunnel position, radiographs (XR) and computed tomography (CT) scans have been suggested. The purpose of this study was to evaluate the reliability and validity of XR and CT for quality assessment following PCL reconstruction. ⋯ XR and CT represent complementary imaging modalities and both offer considerable accuracy and precision for the determination of femoral and tibial tunnel apertures following PCL reconstruction and can be recommended for intra- and postoperative quality assessment.
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Arch Orthop Trauma Surg · Dec 2014
Ankle injuries in distal tibial spiral shaft fractures: results from an institutional change in imaging protocol.
Posterior malleolus and other articular ankle injuries are known to concomitantly occur with tibial shaft fractures, especially spiral fractures of the distal one-third diaphysis. Due to our heightened awareness of this combined injury, our department instituted a new preoperative ankle imaging protocol for all distal one-third spiral tibia shaft fractures. The purpose of this study was to evaluate the effectiveness of an imaging protocol involving radiographs, CT and magnetic resonance imaging (MRI) in a distal one-third spiral tibia fracture cohort. ⋯ Concomitant ipsilateral ankle and distal one-third spiral tibial shaft fractures are more common than previously reported. Utilizing a new imaging protocol, we found that the incidence of this combined injury was 84 %. Recognition of the ankle fracture component in this tibial shaft cohort can be important as it may alter the surgical plan and postoperative management.