Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2015
Randomized Controlled Trial Comparative StudyA comparison of acute and chronic anterior cruciate ligament reconstruction using LARS artificial ligaments: a randomized prospective study with a 5-year follow-up.
This prospective randomized study compared acute and chronic anterior cruciate ligament (ACL) reconstruction using ligament advanced reinforcement system (LARS) artificial ligament in young active adults with a 5-year follow-up. ⋯ These results suggest that earlier ACL reconstruction using a LARS artificial ligament may provide an advantage in the treatment and rehabilitation of ACL rupture.
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Arch Orthop Trauma Surg · Jan 2015
Comparative StudyDistal femoral fractures in the elderly: biomechanical analysis of a polyaxial angle-stable locking plate versus a retrograde intramedullary nail in a human cadaveric bone model.
Compromised bone quality and the need for early mobilization still lead to high rates of implant failure in geriatric patients with distal femoral fractures. With the newest generation of polyaxial locking plates and the proven retrograde femoral nails today two minimally invasive surgical procedures have been established. Indications for both procedures overlap. This study attempts to define the strength and failure mode of both surgical procedures. ⋯ Based on our results, no statements regarding the superiority of either of the devices can be made. Even though the load to failure values for both osteosyntheses were much higher than the loads experienced during normal walking; however, because only axial loading was applied, it remains unclear whether both osteosyntheses meet the estimated requirements for postoperative full weight-bearing for an average heavy patient with a distal femoral fracture.
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Arch Orthop Trauma Surg · Jan 2015
Determinants of patient satisfaction after surgery or corticosteroid injection for trapeziometacarpal osteoarthritis: results of a prospective cohort study.
The evaluation of patient satisfaction is becoming increasingly important in assessing treatment outcomes. The objective of this study was to analyze the determinants of treatment satisfaction in patients with trapeziometacarpal osteoarthritis (TMC OA) after surgery or corticosteroid injection. ⋯ Surgery for TMC OA leads to high patient satisfaction, whereas only half of the patients treated with corticosteroid injection were satisfied with the treatment result. An advanced stage of TMC OA and higher pain lead to reduced treatment satisfaction in the latter group, indicating that corticosteroid injection is only effective for patients in a lower stage of disease. As fulfillment of expectations was an important determinant of satisfaction in the surgical group, we emphasize the need to provide comprehensive information prior to surgery, so that the patient's expectations of treatment outcome are realistic.
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Arch Orthop Trauma Surg · Jan 2015
Crisscross-type screw fixation for transcondylar fractures of distal humerus in elderly patients.
This study presents the outcomes of low transcondylar fractures of the distal humerus treated by closed reduction and internal fixation with two screws in a crisscross orientation. ⋯ In geriatric patients with transcondylar fractures of the distal humerus, a crisscross fixation with two cannulated screws provides satisfactory results that allow a nearly full range of elbow motion with minimal surgical morbidity.
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Fragility fractures are a growing worldwide health care problem. Hip fractures have been clearly associated with poor outcomes. Fragility fractures of other bones are common reasons for hospital admission and short-term disability, but specific long-term outcome studies of non-hip fragility fractures are rare. The aim of our trial was to evaluate the 1-year outcomes of non-hip fragility fracture patients. ⋯ The outcomes of older non-hip fracture patients are comparable to the poor outcomes of older hip fracture patients, and appear to be primarily related to comorbidities, pre-fracture function and nutritional status. The low rate of patients on osteoporosis medications likely reflects the insufficient recognition of the importance of osteoporosis assessment and treatment in non-hip fracture patients. Increased clinical and academic attention to non-hip fracture patients is needed.