Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2012
Influence of trabecular microstructure and cortical index on the complexity of proximal humeral fractures.
Poor bone quality increases the susceptibility to fractures of the proximal humerus. It is unclear whether local trabecular and cortical measures influence the severity of fracture patterns. The goal of this study was to assess parameters of trabecular and cortical bone properties and to compare these parameters with the severity of fractures and biomechanical testing. ⋯ In our study population local trabecular bone structure and cortical index could not predict the severity of proximal humeral fractures in the elderly. Complex fractures do not necessarily imply lower bone quality compared to simple fractures.
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Arch Orthop Trauma Surg · Apr 2012
Review Meta Analysis Comparative StudySystematic review of cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures in older patients.
The purpose of this review was to assess the effectiveness and safety of cemented versus uncemented hemiarthroplasty for displaced femoral neck fractures in older patients. We searched the Cochrane Library, MEDLINE and EMBASE for published randomized clinical trials comparing cemented with uncemented hemiarthroplasty for femoral neck fractures. ⋯ The overall incidence of residual pain at 1 year after operation was 23.6% in the cemented prosthesis and 34.4% in the uncemented, with significant difference (relative risk 0.69, 95% CI 0.53-0.90; P = 0.007; fixed-effect models). The available evidence suggested that compared with uncemented hemiarthroplasty, cemented hemiarthroplasty in treating the elderly with displaced femoral neck fractures was not associated with a higher risk of mortality, reoperation and complications but can reduce the risk of residual pain and provide better functional results.
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Arch Orthop Trauma Surg · Apr 2012
Randomized Controlled Trial Comparative StudyA comparative study on screw loosening in osteoporotic lumbar spine fusion between expandable and conventional pedicle screws.
The aim of this study is to compare the rate of screw loosening and clinical outcomes of expandable pedicle screws (EPS) with those of conventional pedicle screws (CPS) in patients treated for spinal stenosis (SS) combined with osteoporosis. ⋯ EPS can decrease the risk of screw loosening and achieve better fixation strength and clinical results in osteoporotic lumbar spine fusion.
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Arch Orthop Trauma Surg · Apr 2012
ReviewCementless total hip arthroplasty in rheumatoid arthritis: a systematic review of the literature.
Compromised rheumatic bone is a potential risk factor for mechanical complications in cementless total hip arthroplasty (THA) in cases of rheumatoid arthritis (RA). Increased rates of intra-operative fractures, component migration and (early) aseptic loosening are to be expected. Despite this, cementless THA is performed in cases of RA. ⋯ Despite substantial rates of mechanical stem complications, no evidence was found to establish that cementless components perform less well than cemented components. The results justify the use of cementless THA in RA patients.
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Arch Orthop Trauma Surg · Apr 2012
Clinical TrialFall incidence and risk factors in patients after total knee arthroplasty.
To prospectively investigate the relationship between physical function and falls among elderly patients who underwent total knee arthroplasty (TKA) and to determine the incidence of falls as well as their risk factors. ⋯ Elderly people who underwent TKA are considered more likely to fall compared with healthy elderly people. For patients with limited knee flexion and ankle plantar flexion, improvement of ROM by exercise therapy and patient education regarding the prevention of falls and fractures are considered necessary.