Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Mar 2013
Relationship between distal screws and femoral arteries in closed hip nailing on computed tomography angiography.
Iatrogenic vascular injury as a result of closed hip nailing is not common, but is a regularly reported complication after hip fracture surgeries. ⋯ These data indicate that insertion of distal screws into intramedullary nails increases the risk of injury to vascular structures. Surgeons must take care in drilling or inserting screws to ensure the prevention of vascular injury.
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Arch Orthop Trauma Surg · Mar 2013
Comparative StudyThe effect of additional video documentation to photo documentation in wrist arthroscopies on intra- and interobserver reliability.
The reproducibility of diagnoses based on photo documents in wrist arthroscopies is limited and is expected to improve through the addition of video documents. ⋯ As long as videos do not meet further quality criteria, they are not able to improve reliability in general. Nevertheless, videos should be used for documentation of the TFCC.
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Arch Orthop Trauma Surg · Mar 2013
Comparative StudyX-treme CT analysis of cancellous bone at the rotator cuff insertion in human individuals with osteoporosis: superficial versus deep quality.
Rotator cuff (RC) repair-especially in the elderly population-is problematic since the patients suffer to a high extent from bone mineral density loss at the reattachment site. Therefore, the study was primarily driven by the question whether it is possible to reach more or qualitatively better cancellous bone and thus a more stable postoperative result if anchors with greater length are used for RC repair and/or the conventional anchors are screwed deeper into the bone. In anatomical terms, the question is raised whether cancellous bone is of better quality close to or far off the RC enthesis. ⋯ Our data show that cancellous bone presents with decreasing bone quality when analyzing increasingly deeper portions of the bone cylinders of the GT and LT starting at the articular surface. This information seems to be crucial for shoulder surgeons, especially when treating elderly patients. Our results clearly prove that screwing in anchors to a deeper extent will not improve stability, since the deeper bone stock is of worse quality.
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Arch Orthop Trauma Surg · Mar 2013
Comparative StudyMedial placement of the acetabular component in an alumina-on-alumina total hip arthroplasty: a comparative study with propensity score matching.
In an alumina-on-alumina total hip arthroplasty (THA), recommended with a small inclination angle <45°, the acetabular component (cup) may be positioned more medially to be covered almost completely by host bone. The purpose of this study was to identify the correlating factors and to evaluate the outcomes of medial placement of the cup in patients with alumina-on-alumina THAs. ⋯ Thin acetabular medial wall and a small inclination angle of the cup were the correlating factors of medial placement of the cup in patients who underwent an alumina-on-alumina THA. Medial placement did not lead to differences in the clinical or radiological outcomes.
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Arch Orthop Trauma Surg · Mar 2013
Theatre within 36 h for patients with fracture of the proximal femur: can we deliver?
Proximal femur fractures carry significant levels of morbidity and mortality. Surgical delay is one factor that adversely affects outcome in these patients. In 2010, hospital-income from patients with proximal femur fractures was linked to the surgery being undertaken within 36 h of admission. Can we deliver this target? ⋯ Not all patients with a fracture of the proximal femur can have surgery within 36 h of their injury. However, we have identified and describe four specific areas that could increase the number of patients who meet this target.