Archives of orthopaedic and trauma surgery
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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.
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Arch Orthop Trauma Surg · Mar 2013
One-stage posterior debridement, transforaminal lumbar interbody fusion and instrumentation in treatment of lumbar spinal tuberculosis: a retrospective case series.
The purpose of this study is to compare the clinical outcomes of surgical management by one-stage posterior debridement, transforaminal lumbar interbody fusion (TLIF) and instrumentation and combined posterior and anterior approaches for lumbar spinal tuberculosis, and determine the clinical effectiveness of the posterior only surgical treatment for lumbar spinal TB at the same time. ⋯ Surgical management by one-stage posterior debridement, TLIF and instrumentation for lumbar tuberculosis is feasible and effective. This approach obtained better clinical outcomes than combined posterior and anterior surgeries.
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Arch Orthop Trauma Surg · Mar 2013
Benefits of using customized instrumentation in total knee arthroplasty: results from an activity-based costing model.
The growing demand for total knee arthroplasty (TKA) associated with the efforts to contain healthcare expenditure by advanced economies necessitates the use of economically effective technologies in TKA. The present analysis based on activity-based costing (ABC) model was carried out to estimate the economic value of patient-matched instrumentation (PMI) compared to standard surgical instrumentation in TKA. ⋯ The analysis suggests that use of PMI in TKA is economically effective when compared to standard instrumentation.
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Arch Orthop Trauma Surg · Mar 2013
Eighteen-year follow-up after rotationplasty for a grade IIIC open fracture of the distal femur.
We report the 18-year follow-up of a patient who underwent rotationplasty for severe bone loss and infection after an grade IIIC open fracture of the distal femur. The patient is now 49 years old and fully satisfied with his life. During the follow-up period, he has never had significant physical or psychological problems directly concerning the rotationplasty. ⋯ Gait patterns including climbing slopes and stairs were close to normal. Examination in sports physiology showed lower maximum power of hip and knee muscles compared to the healthy side, but better muscular endurance. These findings emphasize that rotationplasty can be a good alternative to arthrodesis or amputation in trauma patients providing high satisfaction and activity levels in the long-term follow-up.
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Arch Orthop Trauma Surg · Mar 2013
Computer-assisted total knee arthroplasty: impact of the surgeon's experience on the component placement.
Accuracy of implant positioning in total knee arthroplasty (TKA) has a major impact on postoperative outcomes. We investigate the accuracy of positioning of multiples values simultaneously in TKA navigated, even among novice users. ⋯ The satisfactory HKA alignment was not the result of reversed errors between the tibia and the femur, since it correlated the successful simultaneous results of alpha and beta angles.