Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2015
Clinical TrialInterference screw for fixation of FDL transfer in the treatment of adult acquired flat foot deformity stage II.
Flexor digitorum longus transfer and medial displacement calcaneal osteotomy have shown favourable results in the treatment of adult acquired flat foot deformity stage 2. Little is known about the resorbable interference screw for tendon fixation and postoperative patient satisfaction though. Moreover possible changes of radiographic parameters at final follow-up, possible implant-associated complications and differences concerning clinical results at final follow-up to other studies using bone tunnel techniques for fixation of the FDL tendon were investigated. ⋯ We conclude that interference screw fixation for FDL transfer is a safe and promising operative technique, allowing a smaller skin incision without disrupting the normal interconnections at the knot of Henry, while achieving very high patient satisfaction and improving postoperative function as well as relieving pain. This method is technically easy to perform, has a low complication risk and we, therefore, recommend this fixation technique in patients with adult acquired flatfoot deformity stage 2.
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Arch Orthop Trauma Surg · Oct 2015
Preoperative virtual reduction reduces femoral malrotation in the treatment of bilateral femoral shaft fractures.
In bilateral femoral shaft fractures, significant malrotation (>15°) occurs in about 40 % of cases after intramedullary nailing. Most of the methods that provide rotational control during surgery are based on a comparison to the intact femur and, thus, not applicable for bilateral fractures. In this study, we evaluated if preoperative virtual reduction can help improving rotational alignment in patients with bilateral femoral shaft fractures. ⋯ Preoperative virtual reduction allows determining the pretraumatic femoral antetorsion and provided useful information for the definitive treatment of bilateral femoral shaft fractures. We believe that this procedure is worth being implemented in the clinical workflow to avoid malrotation after intramedullary nailing.
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Arch Orthop Trauma Surg · Oct 2015
Proximalize osteotomy of tibial tuberosity (POTT) as a treatment for stiffness secondary to patella baja in total knee arthroplasty (TKA).
Stiffness after a total knee arthroplasty (TKA) is one of the most common post-operative complications. The purpose of this study is the evaluation of the effectiveness of TT proximalization osteotomy of improving a lack of flexion and secondary pain in patella baja (infera) post-TKA. ⋯ TT proximalization osteotomy provides satisfactory results in improving a lack of flexion and pain in patella baja post-TKR.
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Arch Orthop Trauma Surg · Oct 2015
Tibial acceleration profiles during the menstrual cycle in female athletes.
Fluctuating levels of endogenous estrogen are thought to have an adverse effect on lower limb biomechanics, given the observed higher rate of ACL injury at certain phases of the menstrual cycle. The purpose of this study was to investigate the effects of fluctuating endogenous estrogen levels during the menstrual cycle on acceleration transients at the proximal tibia in young physically active females. ⋯ The results of this project strongly suggest that serum estrogen fluctuations have an effect on tibial acceleration profiles in young female athletes during different phases of the menstrual cycle.
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Arch Orthop Trauma Surg · Oct 2015
Geometric analysis of an expandable reamer for treatment of avascular necrosis of the femoral head.
"Advanced core decompression" (ACD) is a treatment option for osteonecrosis of the femoral head (ONFH) that aims at complete removal of the necrotic tissue using a percutaneous expandable reamer and refilling of the head with an osteoconductive bone-graft substitute. The objective of this study was to evaluate if the success of ACD depends on the amount of necrotic tissue remaining after the procedure and how efficiently the necrotic tissue can be removed with the current reamer. Three-dimensional models of proximal femora including ONFH were generated from the preoperative MRIs of 50 patients who underwent ACD. ⋯ Simulation of the removal procedure showed that complete removal is not possible. These results led to the conclusion that the success of ACD depends on the amount of necrotic tissue remaining in the femoral head after the procedure. Modifications to the instrument are necessary to increase the amount of necrotic tissue that can be removed.