Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jan 2012
Enhanced wound healing associated with Sharpey's fiber-like tissue formation around FGF-2-apatite composite layers on percutaneous titanium screws in rabbits.
Pin-tract infections are the most common complications of external fixation. To solve the problem, we developed a fibroblast growth factor-2 (FGF-2)-apatite composite layer for coating titanium screws. The purpose of this study was to elucidate the mechanism of the improvement in infection resistance associated with FGF-2-apatite composite layers. ⋯ It is suggested that the enhanced wound healing associated with the formation of Sharpey's fiber-like tissue triggered by FGF-2 released from the FGF-2-apatite composite layer leads to the reduction in the pin-tract inflammation rate.
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Arch Orthop Trauma Surg · Dec 2011
Cross-linked ultra-high-molecular weight polyethylene liner and ceramic femoral head in total hip arthroplasty: a prospective study at 5 years follow-up.
Recent data indicate that enhanced wear resistance can be obtained with new cross-linked ultra-high-molecular weight polyethylene (CL-UHMWPE) liners, in comparison with previous-generation liners. The current prospective, cohort study was undertaken to analyse whether the use of a new CL-UHMWPE (Rexpol) results in a lower wear rate than ultra-high-molecular weight polyethylene (UHMWPE) in a group of similar patients undergoing total hip arthroplasty (THA). This study provides the first clinical data with this particular CL-UHMWPE. ⋯ The use of CL-UHMWPE significantly reduced the risk of polyethylene wear in patients undergoing THA with biconical threaded cups and ceramic femoral heads. Further follow-up is needed to determine how this will influence long-term outcomes.
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Arch Orthop Trauma Surg · Dec 2011
Meta AnalysisAbove- or below-elbow casts for distal third forearm fractures in children? A meta-analysis of the literature.
Fractures of the distal third forearm are common fractures in childhood. Most of these fractures can be treated non-operatively by means of closed reduction and immobilization. The purpose of this meta-analysis is to investigate whether above- or below-elbow cast should be considered the first-choice for conservative treatment. ⋯ Due to heterogeneity, the trials are not fully compared. Based on the presented meta-analysis, we conclude that BEC is not inferior to AEC so that this is a valid treatment option for distal third forearm fractures.
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Arch Orthop Trauma Surg · Dec 2011
Rate of avascular necrosis following proximal humerus fractures treated with a lateral locking plate and endosteal implant.
Treatment of displaced proximal humerus fractures remains challenging. The introduction of locking plates has renewed interest in treating these fractures with joint-preserving techniques rather than hemiarthroplasty, but high complication rates are still reported. Avascular necrosis is not solely dependent on the initial fracture pattern, but can also result from intraoperative and postoperative vascular insults. ⋯ Use of the anterolateral approach and endosteal augment of a lateral locking plate can minimize avascular necrosis following proximal humerus fracture.
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Fractures of the ankle are fairly common injuries. Open ankle fractures are much less common and associated with severe injuries to surrounding tissues. We have performed a systematic review of the literature concerning the clinical results and complication rates in the treatment of open ankle fractures. ⋯ There is a lack of high quality literature concerning the (operative) treatment of patients with open ankle fractures. Remarkable is that most authors reported satisfactory results after performance of their treatment protocol. Based on the available literature, we formulated guidelines regarding: timing of operative treatment, wound irrigation, the role of internal fixation, wound coverage and closure, the use of antibiotics and additional therapies.