Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2016
Systemic antibiotic therapy does not significantly improve outcome in a rat model of implant-associated osteomyelitis induced by Methicillin susceptible Staphylococcus aureus.
Treatment of implant-associated osteomyelitis regularly involves the use of systemic antibiotics in addition to surgical intervention. However, it remains unclear if perioperative systemic application of bactericide substances can improve overall outcome in models of severe intramedullary infection. The present study investigated the use of systemic gentamicin in addition to a controlled local release from a highly lipophilic gentamicinpalmitate compound while the previous study showed efficacy of sole antibiotic implant-coating. ⋯ Systemic perioperative and implant-associated application of antibiotics were both comparably effective to treat implant-associated infections whereas the combined antibiotic therapy further reduced systemic signs of infection time dependent.
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Arch Orthop Trauma Surg · Apr 2016
Case ReportsIrreducible plantar dislocation of the interphalangeal joint of the great toe due to an accessory sesamoid bone: a case report.
Great toe dislocation frequently occurs at the metatarsophalangeal joint. However, an irreducible dislocation of the great toe interphalangeal (IP) joint due to an accessory sesamoid bone is relatively unusual. ⋯ The sesamoid bone at the IP joint is anatomically located dorsal to the flexor hallucis longus tendon and volar plate. The sesamoid bone fitted exactly in the distal intercondylar area. The sesamoid bone in our patient could be rotated by forcible plantar flexion of the IP joint displaced proximally and hooked into the intercondylar area from the proximal aspect. Then, the distal phalanx was pulled proximally through the volar plate. This is the first report on a plantar dislocation of the IP joint.
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Arch Orthop Trauma Surg · Apr 2016
Patient characteristics and outcomes of a hip fracture and concomitant fracture compared with hip fracture alone: results from a United Kingdom teaching hospital.
A proportion of patients sustaining hip fractures present with a concomitant fracture. We aimed to evaluate the relationship between patient characteristics and clinical outcomes, in those with a hip and concomitant fracture compared with those sustaining a hip fracture alone from a clinical service registry. ⋯ Patients with concomitant fractures have similar patient characteristics, except gender, polypharmacy and long term steroid use; and outcomes to those presenting with hip fracture alone, except a longer average inpatient stay.
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Arch Orthop Trauma Surg · Apr 2016
A new classification system of patellar instability and patellar maltracking.
To date there is no classification of patellar dislocations considering clinical and radiological pathologies. As a result many studies mingle the dislocation's underlying pathologies, so that there are no consistent therapy recommendations. It is this article's objective to introduce a patellar dislocation classification based on the current literature to allow for the application of a structured diagnosis and treatment algorithm. ⋯ Maltracking can only be fixed by means of corrective osteotomy. The classification is referenced to current literature and each type is introduced by a case example. The resulting treatment consequence is also presented.
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Arch Orthop Trauma Surg · Mar 2016
Comparative StudySupplementary arthrolysis of the proximal interphalangeal finger joint in Dupuytren's contracture: primary operation versus revision.
In operative treatment of Dupuytren's disease, in certain cases proximal interphalangeal joint (PIP) flexion contracture remains after fasciectomy which can be corrected by a supplementary arthrolysis, but few data comparing primary and revision surgery are available. ⋯ After a mean follow-up of 2 years, the outcome of recurrent PIP contracture is comparable in patients with Dupuytren's disease that were treated by partial fasciectomy and supplementary arthrolysis for the first time and as a revision.