Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2017
ReviewLower limb reconstruction in tumor patients using modular silver-coated megaprostheses with regard to perimegaprosthetic joint infection: a case series, including 100 patients and review of the literature.
Bone resection regarding adequate surgical margins is the treatment of choice for malignant bone tumors. In the case of metastasis-related complications, so-called skeletal-related events, it is highly important to achieve pain relief and a stable joint situation to re-mobilize the patients immediately following surgery. To bridge the often large osseous defect zones after tumor resection, both cemented and uncemented modular endoprosthetic systems are widely used. Patients undergoing tumor-related endoprosthetic orthopedic surgery are facing high risk for developing a periprosthetic joint infection (PJI). The immunocompromised condition due to anti-neoplastic treatment and long operation time with large exposure of tissue contributes to a high risk of infection. ⋯ In conclusion, our own results show that perimegaprosthetic joint infection among silver-coated implants, in patients undergoing tumor-related surgery of the lower limb, is lower compared to non-silver-coated implants. Due to heterogeneity of patients and potential treatment options, the treatment regime should be tailored for the patients' individual situation.
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Arch Orthop Trauma Surg · Feb 2017
Predictors of medium-term clinical outcomes after total shoulder arthroplasty.
The study aims to measure the relationship of potential clinical and radiographic predictors and medium-term clinical outcomes after total shoulder arthroplasty in primary osteoarthritis. ⋯ A higher Walch classification is a negative predictor for the postoperative clinical function. The proven significant negative effect on outcomes in total shoulder arthroplasty emphasizes the importance of the preoperative evaluation of humeral head subluxation and glenoid erosion, which are associated with less favorable postoperative results. The measured internal patient variables gave no negative predictions on the medium-term clinical outcomes in the study population.
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Arch Orthop Trauma Surg · Feb 2017
Case ReportsFree lateral tarsal artery perforator flap with functioning extensor digitorum brevis muscle for thenar reconstruction: a case report.
In this case report, we describe reconstructive surgery in one patient using a free lateral tarsal artery perforator flap with a functioning extensor digitorum brevis muscle. A 47-year-old woman sustained a crush-avulsion injury to her dominant right hand while working in a factory. A large thenar skin and muscle defect (5.5 cm × 4.0 cm) occurred as a consequence of surgical debridement. ⋯ The patient recovered without postoperative complications. The patient showed satisfactory functional gain without significant donor site morbidity at the 4-year follow-up visit. Thus, we have demonstrated that a functional reconstruction of a thenar skin defect complicated by muscle loss is possible by transferring a free lateral tarsal artery perforator flap with the underlying extensor digitorum brevis muscle.
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Arch Orthop Trauma Surg · Feb 2017
Treatment options and outcome after bony avulsion of the flexor digitorum profundus tendon: a review of 29 cases.
The objective of this retrospective review was to evaluate the functional and esthetic outcomes in patients with non- or minimally (<2 mm), and severely (>2 mm) displaced bony avulsions of the flexor digitorum profundus (FDP) tendon. ⋯ Therapeutic, level IV.