Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Aug 2016
Comparative StudyThe value of CT compared to radiographs in the classification and treatment plan of trochanteric fractures.
The clinical relevance of classification for trochanteric fractures is limited and little agreement exists on what type of implant should be used. It is unknown whether more advanced radio-diagnostics, such as CT, result in better agreement on the treatment. We assessed the effect of CT on agreement of classification and subsequent treatment for trochanteric fractures. ⋯ This study confirmed that trochanteric fractures can be reliably classified on both radiographs and CT, according to the main groups of the AO classification. The implementation of CT for trochanteric fractures does not lead to higher agreement on fracture classification or choice of treatment. Therefore, the clinical relevance of CT for classification of trochanteric fractures seems low. For specific subgroups such as A3 fractures, CT may be of value for adequate fracture classification and subsequent treatment strategies.
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Arch Orthop Trauma Surg · Aug 2016
Observational StudyFailed treatment of long bone nonunions with low intensity pulsed ultrasound.
The use of low intensity pulsed ultrasound (LIPUS) in the treatment of nonunions is still controversial. The present study is concerned with whether this procedure has a clinical use and which cofactors influence its therapeutic results. ⋯ Despite patients being chosen strictly according to EXOGEN(®) indications, only a small number of patients with nonunions who underwent LIPUS therapy experienced successful treatment (32.8 %). Overall, its use resulted in a clear delay in the time of treatment, so that according to our results, the use of LIPUS should be seen critically in long bone nonunions and use should be made on a case-by-case basis.
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Arch Orthop Trauma Surg · Aug 2016
Two-staged application of PRP in arthroscopic rotator cuff repair: a matched-pair analysis.
Failure rates after arthroscopic rotator cuff repair remain high. Platelet-rich plasma has gained interest as a potential biological augmentation to enhance bone-tendon healing. The purpose of this study is to evaluate the clinical and structural outcomes of repeated PRP application on rotator cuff repair. ⋯ Level III, Retrospective comparative study.
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Arch Orthop Trauma Surg · Aug 2016
The Penrod score: a prognostic instrument to balance an increasing geriatric fracture caseload with diminishing health care resources?
Geriatric hip fracture patients are a highly heterogeneous collective, what distinctly aggravates the best possible treatment. Consequently, it is becoming more important to identify selection criteria that can distinguish those patients who can benefit the most from treatment in a geriatric fracture center. In our pilot study, we assessed the 2007 published Penrod score for its utility as a useful selection tool by prospectively comparing our own patient's outcome with the Penrod study. ⋯ Our preliminary results support the prognostic value of the Penrod score in the treatment of geriatric hip fracture patients. With the help of the Penrod score, it may be possible to identify patients, who are expected to significantly profit from an intensified treatment in a geriatric fracture center (clusters 2B, 3A, and 3B). By utilizing this score, improved outcomes and simultaneously a more effective utilization of valuable health care resources could be achieved.
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Arch Orthop Trauma Surg · Aug 2016
Bone morphogenetic protein 7 and autologous bone graft in revision surgery for non-union after lumbar interbody fusion.
Potential adverse and unknown long-term effects as well as additional costs limit the use of BMPs (Bone morphogenetic proteins) in primary fusion procedures. However, the proven osteoinductive properties render BMPs attractive for the attempt to reach fusion of symptomatic non-unions. The aim of this study is to evaluate the fusion rate and potential disadvantages of eptotermin alfa (rhBMP-7) used with autologous bone graft in revision procedures for lumbar pseudoarthrosis. ⋯ 4; retrospective follow-up study.