Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2016
Case ReportsA double-barrelled fibula graft restoring pelvic stability after late posterior ring instability related to a surgical treated osteitis pubis: a case report.
Osteitis pubis or symphysitis pubis is a rare occurring non-infectious inflammation of the symphysis, the adjacent pubic bones and surrounding tissue. The therapy might be conservative or surgical by a resection of the symphysis and involved parts of the pubic bone. Nevertheless, this resection might lead to an anterior instability impairing the posterior arch and the sacroiliac joints in the aftermath. ⋯ The present case highlights the possible complication of surgical treated osteitis pubis leading to anterior arch instability affecting the posterior arch and thus impairing pelvic ring stability and patient mobility. Furthermore, we describe an opportunity to treat this complication or other etiologies contributing to anterior pelvic ring stability with large bone defects using a vascularized double-barrelled fibula graft to restore pelvic stability.
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Arch Orthop Trauma Surg · Jan 2016
Provisional pin fixation: An efficient alternative to manual maintenance of reduction in nailing of intertrochanteric fractures.
During nailing of intertrochanteric fractures, there is always a risk of reduction loss despite achieving an acceptable reduction status after a percutaneous procedure. Most surgeons usually attempted to maintain the reduction with a manual endeavor. However, we experienced varying amounts of intraoperative reduction loss and had to perform readjustments several times. These struggles motivated us to attempt provisional pin fixation as an alternative method. The purpose of this study was to analyze the factors affecting intraoperative reduction loss, especially in comparison between two methods. ⋯ As a reasonable approach for maintaining reduction, provisional pin fixation can significantly decrease intraoperative reduction loss after percutaneous reduction of intertrochanteric fractures during nailing.
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Arch Orthop Trauma Surg · Jan 2016
Randomized Controlled Trial Multicenter Study Comparative StudyFifth metacarpal neck fractures treated with soft wrap/buddy taping compared to reduction and casting: results of a prospective, multicenter, randomized trial.
The majority of fifth metacarpal neck fractures (boxers fracture) are treated conservatively without surgery. The purpose of this prospective, randomized, multicenter trial was to determine if the outcomes of soft wrap and buddy taping (SW) was noninferior to reduction and cast (RC) in boxer's fracture with palmar angulation ≤70° and no rotational deformity. ⋯ This study supports the use of soft wrap and buddy taping for treatment of boxer's fracture with palmar angulation ≤70° and no rotational deformity. Although there was no statistical difference in satisfaction with the esthetic appearance, the patient must be willing to accept the loss of the "knuckle" with this treatment method.
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The incidence of infection by Mycobacterium marinum is rising, mainly due to the increasing popularity of home aquariums. The infection typically manifests as skin lesions, with septic arthritis being a rare presentation form. ⋯ Thus, establishment of appropriate treatment is often delayed. Synovectomy, capsular thinning, and joint drainage together with prolonged, combined antibiotic therapy may be needed to cure the infection.
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Arch Orthop Trauma Surg · Jan 2016
The distal radial decompression osteotomy for ulnar impingement syndrome.
The decompression of the distal radioulnar joint (DRUJ) is performed by ulnar translation of the radial shaft proximal to the sigmoid notch, i.e. detensioning of the distal part of the interosseous membrane (DIOM) while containment of the DRUJ is achieved by closed wedge osteotomy of the radius. The osteotomy shortens the radius which entails detensioning of the triangular fibrocartilage complex (TFCC). ⋯ Distal radial decompression osteotomy of the DRUJ preserves DRUJ function while relieving painful impingement. Further surgical interventions are not compromised in case of failure.