Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2015
Minimal invasive posterior total hip arthroplasty: are 6 weeks of hip precautions really necessary?
Postoperative hip dislocations have been reported in 0.5 to 10.6 % of patients after primary posterolateral total hip arthroplasty (THA). Hip precautions are currently recommended for 6 weeks postoperatively to reduce early dislocation and facilitate healing of the posterior soft tissue repair. ⋯ Shortening the time of posterolateral hip precautions from 6 to 4 weeks after surgery does not increase the risk of postoperative dislocation.
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Arch Orthop Trauma Surg · Feb 2015
Breakage of cephalomedullary nailing in operative treatment of trochanteric and subtrochanteric femoral fractures.
Mechanical breakage of cephalomedullary nail osteosynthesis is a rare complication attributed to delayed fracture union or nonunion. This study presents a series of cases of breakage and secondary lag screw dislocation after cephalomedullary nailing. The aim of this study was to identify factors that contribute to cephalomedullary nail breakage. ⋯ Breakage of cephalomedullary nail osteosynthesis of trochanteric fractures is a severe complication. The results of our study demonstrate that revision surgery provides good clinical and radiological short-term results. Predominately, failures of trochanteric fractures are related to lack of surgeon performance. Therefore, application of the implant requires accurate preoperative planning, advanced surgical experience to evaluate the patient and the fracture classification, and precise surgical technique including attention to detail and anatomical reduction of the fracture fragments.
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Arch Orthop Trauma Surg · Feb 2015
Insertion of the Ascension PyroCarbon PIP total joint in 152 human cadaver fingers: analysis of implant positions and malpositions.
The Ascension PyroCarbon proximal interphalangeal (PIP) total joint is used in osteoarthritis of the PIP finger joint. No systematic study of the positioning of this prosthesis and its relation to proximal and middle phalanx morphology has yet been reported. ⋯ The current design of the Ascension PyroCarbon PIP total joint can lead to malpositioning that we attribute to its incomplete accommodation of the morphology of the proximal and middle phalanx, the surgical challenges the design poses, or both acting together.
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Arch Orthop Trauma Surg · Feb 2015
Incompliance of total hip arthroplasty (THA) patients to limited weight bearing.
Limited weight bearing of the lower extremity is a commonly applied procedure in orthopedic rehabilitation following trauma surgery and joint replacement. The compliance of patients with limited weight bearing after cementless total hip arthroplasty has not yet been surveyed using sensor-loaded insoles. The objective of this study was to investigate foot loadings in patients after THA under the assumption of limited weight bearing. ⋯ Patients following cementless do not comply with limited weight bearing when they are trained by the use of a bathroom scale.