Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2015
Randomized Controlled Trial Comparative StudyThe effect of antegrade femoral nailing on femoral head perfusion: a comparison of piriformis fossa and trochanteric entry points.
Piriformis fossa entry antegrade femoral nailing is a common method for stabilizing diaphyseal femur fractures. However, clinically significant complications such as chronic hip pain, hip abductor weakness, heterotopic ossification and femoral head osteonecrosis have been reported. A recent cadaveric study found that piriformis entry nailing damaged either the deep branch of the medial femoral circumflex artery (MFCA) or its distal superior retinacular artery branches in 100% of specimens and therefore recommended against its use. However, no study has quantitatively assessed the effect of different femoral entry points on femoral head perfusion. ⋯ No statistically significant difference in femoral head perfusion was found between the two groups. Therefore, we cannot recommend against the use of piriformis entry femoral nails. However, we caution against multiple errant starting point attempts and recommend meticulous soft tissue protection during the procedure.
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Arch Orthop Trauma Surg · Apr 2015
Retrospective lumbar fusion outcomes measured by ODI sub-functions of 100 consecutive procedures.
Low back pain has been quite prevalent in the general population. Chronic low back pain can be defined as back pain lasting for more than 12 weeks. For chronic symptoms, fusion surgeries are the most common surgeries to alleviate the pain. Visual Analog Scale (VAS) is a measurement for subjective characteristics or attitudes that can be difficult to be directly measured. Respondents specify their level of agreement to a statement by indicating a position along a continuous line between two end points. ⋯ Successful outcomes were demonstrated for each of the categories assessed and no statistical differences were seen in the ODI % for any comparison after 5 years on 19% of data reported which may have limited forecast reliability. Our data suggest that post-operative outcome is independent of preoperative condition, procedure to be preformed, age, and BMI. Our data support the continual practice of spinal fusion for the treatment of degenerative disk disease.
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Arch Orthop Trauma Surg · Apr 2015
Thumb fingertip reconstruction with palmar V-Y flaps combined with bone and nail bed grafts following amputation.
The aim of treating thumb fingertip amputations with no indication for replantation is to reestablish functional and esthetic properties. ⋯ We believe that the combination of palmar V-Y flap and bone and nail bed grafts provides a distinct advantage over other choices. It improves function when replantation is not an option.
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Arch Orthop Trauma Surg · Apr 2015
Comparison of treatment of oblique and spiral metacarpal and phalangeal fractures with mini plate plus screw or screw only.
We aimed to compare results of treatment of oblique-spiral metacarpal and phalangeal fractures with screw only or mini plate plus screw, respectively. ⋯ Treatment with mini plate plus screw should be avoided in spiral and oblique phalangeal fractures, and fixation should be done with screw only with a short surgical incision and dissection. On the other hand, treatment with mini plate plus screw should be preferred in patients with spiral and oblique metacarpal fractures, especially in those who work in occupations requiring higher physical strength.
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Restoring optimal strength and biomechanics of a pathologic shoulder knowledge of activity patterns of healthy glenohumeral muscles is mandatory. Yet, data on normal shoulder muscle activity are not always conclusive. The study was undertaken (a) to evaluate muscle activity patterns in the healthy shoulder using surface and fine-wire electromyography (EMG), and (b) to assess method's suitability in the clinical setting especially regarding painfulness and practicability. ⋯ Basic Science, Electrodiagnostic Study.