Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2020
Direct anterior decompression of L4 and L5 nerve root in sacral fractures using the pararectus approach: a technical note.
To describe a new surgical technique for neurolysis and decompression of L4 and L5 nerve root entrapment after vertical sacral fractures via the pararectus approach for acetabular fractures, and to present four case examples. ⋯ The pararectus approach allows for sufficient visualisation and direct decompression and neurolysis of the L4 and L5 nerve root entrapped in vertical sacral fractures. Although neurologic recovery was not achieved in all patients in this small case series, the approach may be a suitable alternative to posterior approaches and other anterior approaches such as the lateral window of the ilioinguinal approach.
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Arch Orthop Trauma Surg · Mar 2020
The entry point of intramedullary tibia cutting guide should vary according to the individual tibia morphology in TKA.
In total knee arthroplasty (TKA) using the intramedullary tibial cutting guide (IMTCG), the positioning of the IMTCG is important for accurate tibial bone resection. The aim of this study was to evaluate the ideal entry point of IMTCG and affecting radiologic factors. ⋯ The ideal entry point of IMTCG should vary according to the individual tibial morphology.
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Arch Orthop Trauma Surg · Mar 2020
Comparative StudySecond-look arthroscopic findings and clinical outcomes of meniscal repair with concomitant anterior cruciate ligament reconstruction: comparison of suture and meniscus fixation device.
The purpose of this study was to evaluate the healing rate of repaired meniscus and functional outcomes of patients who received all-inside meniscal repair using sutures or devices with concomitant arthroscopic anterior cruciate ligament (ACL) reconstruction. ⋯ Among the patients who received meniscal repair with concomitant ACL reconstruction, suture group showed better healing status of repaired meniscus based on the second-look arthroscopy than device group. However, no significant between-group difference of clinical success rate and functional outcomes was observed.
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Arch Orthop Trauma Surg · Mar 2020
Corrective osteotomies of femur and tibia: which factors influence bone healing?
Corrective osteotomies of the lower limb are standard procedures in orthopedic surgery. Still, there is only limited research on factors affecting bone healing after osteotomies. We hypothesize that especially the location of the osteotomy, smoking status and BMI affect bone healing. ⋯ Smoking status and the localization of the osteotomy on femur and tibia (diaphysis vs. metaphysis) are significantly correlated with bone healing duration. In line with current literature emphasizing the detrimental effect of smoking on bone healing, our findings should encourage surgeons to think twice about the indication to perform osteotomies on smokers. Furthermore, if applicable, osteotomies should be performed in the metaphyseal areas of femur and tibia.
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Arch Orthop Trauma Surg · Mar 2020
Analysis of computed tomography-based infra-acetabular morphometry to assess the feasibility of infra-acetabular screws.
The number of pelvic fractures based on osteoporosis has been increasing. The infra-acetabular screw (IAS), which connected both osseous columns, is a safe method of screw placement going through the infra-acetabular corridor (IAC). However, the specifics of the anatomy of IAC have been far from completely understood, especially in the Asian population. The purpose of our study was to reveal the details of the IAC using computed tomography (CT) data. ⋯ Surgeons should pay attention to the fact that over 20% of IACs are not feasible for infra-acetabular screw placement even with the perfect reduction of fragments when treating acetabular fractures.