Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2012
Functional and clinical outcome of total shoulder arthroplasty with oversized glenoid.
The Epoca-Reconstruction-(Reco)®-Glenoid has been developed to treat patients with cuff-tear-arthropathy. The glenoid component of this system has a hemispheric shape that canopies the humeral head. This design is believed to provide a stable fulcrum and restore normal deltoid function. The purpose of this study was to analyse strengths and disadvantages of the Epoca-Reco®-Glenoid in cuff-tear-arthropathy patients. Changes in functional outcome using Constant-Murley-Scoring(CMS), CMS sub-scoring parameters and radiological outcome were analysed. For this purpose, a classification for radiologic lucency was proposed. Diverging results, influencing factors and alternative treatment options have been discussed to analyse weaknesses and enhance future development of this arthroplastic model. ⋯ The semi-constraint reconstruction glenoid prosthesis model in cuff-tear-arthropathy patients significantly improves shoulder function, however, it yields controversial results, with satisfactory results in male and poor results in female patients. Revision rate of the female cohort and loosening of the glenoid component in this short-term follow-up is of concern. Further investigations taking BMD, osteopenic conditions and influence of surface area in smaller individuals into consideration are recommended, to determine whether this is the underlying cause of the inferior results in females.
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Arch Orthop Trauma Surg · Jul 2012
Augmentative locking compression plate fixation for the management of long bone nonunion after intramedullary nailing.
Intramedullary nailing is widely used in the treatment of long bone fractures. But some patients suffer from nonunion after receiving intramedullary nailing. This paper investigates the methods and effects of locking compression plate (LCP) in the treatment of long bone nonunion after intramedullary nailing. ⋯ LCP can be used for the treatment of long bone nonunion after intramedullary nailing for its convenience, minimal invasion and curative effect.
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Arch Orthop Trauma Surg · Jul 2012
Small differences between anatomical and mechanical sagittal femur axes: a radiological and navigated study of 50 patients.
The purposes of the study were to define the orientation of the anatomical and mechanical axes of the femur on the lateral plane on long leg X-rays including the femoral head, and to compare these results to the intra-operative measurement of the mechanical axis by a nonimage-based navigation system. ⋯ The differences observed are small and have probably little clinical relevance. The distal cortical axis may be the best compromise. The navigation system allows measuring accurately the orientation of the distal femoral resection in the sagittal plane.
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Arch Orthop Trauma Surg · Jun 2012
Review Case ReportsA novel method of image-based navigation in fracture surgery.
The treatment of three- and four-part fractures of the humeral head is still controversially discussed. Some advocate primary arthroplasty while the results of primary fixation seem to be superior if no necrosis of the humeral head develops. Today navigation is used in orthopaedic surgery mainly for interventions on the spine, the pelvis and arthroplasty. ⋯ In conclusion, the described technique allows an accurate fixation of the humeral head fracture as the guidance system (Surgix) ensures the "first try first hit" screw positioning. The new system was integrated in the workflow and supports the surgeon as an aiming device. The role of navigation system in enhancing minimally invasive surgery of the shoulder should be further explored.
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Arch Orthop Trauma Surg · Jun 2012
Neurological recovery after posterior decompression surgery for anterior dural compression in paralytic spinal metastasis.
Paralysis in spinal metastasis is often caused by anterior dural compression, and anterior approach has been frequently chosen for decompression despite its dreadful complications. On the other hand, the effectiveness of posterior indirect decompression has not specifically established. The objective of the present study was to investigate the anatomical patterns of dural compression, and to clarify the effectiveness of posterior surgery for anterior lesions. ⋯ Most spinal metastases cause paralysis by anterior compression; however, the result of posterior indirect decompression was similar to that of posterior direct decompression, although kyphosis negatively affected the result. Anterior decompression might not always be necessary for soft tumor compression as long as the adjuvant therapy is effective for the local control.