Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2017
Comparative StudyManagement of comminuted fractures of the distal humerus: clinical outcome after primary external fixation versus immediate fixation with locking plates.
The surgical treatment of comminuted fractures of the distal humerus remains a challenging problem. The aim of the present study was to compare the clinical outcomes of primary external fixation with second-staged open reduction and internal fixation (ORIF) and initial definitive internal fixation in surgically treated patients with comminuted distal humerus fractures. ⋯ Therapeutic level III.
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Arch Orthop Trauma Surg · Dec 2017
Reverse total shoulder arthroplasty for type I fracture sequelae after internal fixation of proximal humerus fractures.
Complications after internal fixation of proximal humerus fracture are common and may require surgical revision. Reverse total shoulder arthroplasty (RTSA) is frequently performed in such cases. The aim of the present study was to evaluate the functional results and complications after RTSA for the treatment of type I fracture sequelae after internal fixation of proximal humerus fractures. ⋯ Satisfying results can be obtained with RTSA as a salvage procedure for type I fracture sequelae after previous internal fixation of proximal humerus fractures.
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Arch Orthop Trauma Surg · Dec 2017
Evaluation of donor site morbidity after medial triceps brachii free flap for lower limb reconstruction.
The medial head of the triceps brachii muscle (MTB)-free flap is an attractive solution to cover small-to-medium defects of the lower limb. This muscular head has no well-identified function, suggesting minimal impact of its removal on elbow mobility. The aim of this study was to evaluate the safety and reliability of the harvest procedure and the functional and cosmetic morbidity of this donor site. ⋯ Objective evaluation of patients who underwent an MTB-free flap for limb reconstruction shows no impact of the harvesting procedure on elbow extension. Patient satisfaction with the donor site was high. From this retrospective study, it appears that this surgery is safe, aesthetically acceptable, and has minimal impact on donor site elbow function.
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We intend to describe and analyze the spectrum of upper extremity injuries that arises from both accidental and intentional machete injuries with a focus on associated complications and comorbidities. This review is the first from a United States institution, and the only from a designated level 1 trauma center. ⋯ IV; Prognostic Study.
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Arch Orthop Trauma Surg · Dec 2017
Meta AnalysisAccuracy of a patient-specific template for pedicle screw placement compared with a conventional method: a meta-analysis.
Accurate placement of pedicle screws in spine surgery is a challenge for surgeons. Patient-specific template techniques have the potential for improving the accuracy of screw placement. The target of this analysis was to investigate differences in terms of accuracy of pedicle screw insertion between patient-specific template assistance and the conventional free-hand method for reconstruction of spinal stability. ⋯ The template-assisted technique is superior to the conventional method for the reduction of pedicle violation. The template-assisted technique is a promising technique that should be considered as another available navigation tool for surgeons to improve the accuracy of pedicle screw placement. As an available technique for emerging applications in spine surgeries, this technique will face challenges but ultimately prove successfully.