Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Oct 2014
Findings related to rotational malalignment in tibial fractures treated with reamed intramedullary nailing.
Rotational malalignment following closed intramedullary nailing of tibial fractures does not attract attention but is a complication which may lead to serious results. This study aimed to present findings related to rotational malalignment from rotational alignment measurements made clinically and with computerised tomography (CT) in patients who had undergone locked intramedullary nailing for tibial fracture. ⋯ A significant number of patients treated with intramedullary nailing for a tibial fracture may result in rotational malalignment. To determine rotational malalignment, a thorough clinical evaluation must be made and different kinds of clinical measurements taken and, when suspicions remain, determination should be made by CT.
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Arch Orthop Trauma Surg · Oct 2014
Comparative StudyCallus formation is related to the expression ratios of estrogen receptors-alpha and -beta in ovariectomy-induced osteoporotic fracture healing.
This study characterizes ovariectomized (OVX)-induced osteoporotic fracture healing with focus on estrogen receptors (ERs). Callus formation plays a critical role in fracture healing, and ERs are well-known mechanosensors in osteogenic pathways. It was hypothesized that callus formation was related to and partially determined by the difference in expression patterns of ERs in both normal and OVX-induced osteoporotic fractures. ⋯ We conclude that the delayed healing rate and impaired callus quality in OVX-induced osteoporotic fracture is related to the delayed expression of ERs. A high ER-α:ER-β ratio favors callus formation.
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Arch Orthop Trauma Surg · Oct 2014
Failure modes for total ankle arthroplasty: a statistical analysis of the Norwegian Arthroplasty Register.
It is imperative to understand the most common failure modes of total ankle arthroplasty (TAA) to appropriately allocate the resources, healthcare costs, enhancing surgical treatment methods, and improve design and longevity of the implant. The objective of this study was to investigate the primary mode or modes of failure (Loose talar component, loose tibial component, dislocation, instability, misalignment, deep infection, Fracture (near implant), Pain, defect polyethylene (PE), other, and missing information) of TAA implants, so these failure mode/modes can be targeted for future improvement. ⋯ Since there is no statistical evidence showing which failure mode contributes most to revision surgeries, it is concluded that more information/data is needed to further investigate failure modes in ankle arthroplasties. Since the numbers of such surgeries are increasing, sufficient data should become available in time.
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Arch Orthop Trauma Surg · Oct 2014
Pathoanatomy and incidence of the posterolateral fractures in bicondylar tibial plateau fractures: a clinical computed tomography-based measurement and the associated biomechanical model simulation.
The aim of our study is to evaluate the incidence and pathoanatomy of posterolateral fragments and analyze the associated fracture mechanism in bicondylar tibial plateau fractures. ⋯ The incidence of posterolateral fractures is 44.32 % in bicondylar tibial plateau fractures. The morphology of posterolateral area can be referenced for the surgeon in the future clinical work. The information is also helpful for the design of locking plate and fracture modeling in biomechanical test. In addition, that posterolateral split and posterolateral depression might be caused by different injury mechanisms. Different angles of knee flexion under the axial impact loading are possibly the interpretations for these two fracture patterns.
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Arch Orthop Trauma Surg · Oct 2014
Arthroscopic Broström repair with Gould augmentation via an accessory anterolateral port for lateral instability of the ankle.
Although several arthroscopic surgical techniques for the treatment of lateral instability of the ankle have been introduced recently, some concern remains over their procedural complexity, complications, and unclear clinical outcomes. We have simplified the arthroscopic technique of Broström repair with Gould augmentation. ⋯ The inferior extensor retinaculum is directly visualized through the accessory anterolateral port and is attached to the fibula with another suture anchor under arthroscopic view via the anterolateral port. The use of two small ports offers a procedure that is simple to perform and less morbid for patients.