Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2011
Review Comparative StudyTo retain or remove the syndesmotic screw: a review of literature.
Syndesmotic positioning screws are frequently placed in unstable ankle fractures. Many facets of adequate placement techniques have been the subject of various studies. Whether or not the syndesmosis screw should be removed prior to weight-bearing is still debated. In this study, the recent literature is reviewed concerning the need for removal of the syndesmotic screw. ⋯ There is paucity in randomized controlled trials on the absolute need for removal of the syndesmotic screw. However, current literature suggests that it might be reserved for intact screws that cause hardware irritation or reduced range of motion after 4-6 months.
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Arch Orthop Trauma Surg · Jul 2011
Comparative StudyRepeated percutaneous vertebroplasty for refracture of cemented vertebrae.
Percutaneous vertebroplasty is an efficient procedure to treat painful osteoporotic vertebral compression fractures. However, refracture of cemented vertebrae occurs rarely after percutaneous vertebroplasty. This study was undertaken to investigate the incidence, characteristics, predisposing factors, and mistakes in technique associated with refracture of the same vertebra after percutaneous vertebroplasty. ⋯ Our study suggests that larger height restoration and solid lump filling cement are risk factors of refracture of cemented vertebral bodies. Symmetric cement distribution and fluid aspiration would be the potential ways to avoid refracture of cemented vertebral bodies.
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Arch Orthop Trauma Surg · Jul 2011
Comparative StudyOutcome after operative treatment of Vancouver type B1 and C periprosthetic femoral fractures: open reduction and internal fixation versus revision arthroplasty.
The rate of periprosthetic femoral fractures after hip arthroplasty is rising and the estimated current lifetime incidence is 0.4-2.1%. While most authors recommend revision arthroplasty in patients with loose femoral shaft components, treatment options for patients with stable stem are not fully elucidated. ⋯ The use of angular stable implants, additional cable wires or bone enhancing means is recommended.
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Arch Orthop Trauma Surg · Jul 2011
Treatment of lower extremity long bone nonunion with expandable intramedullary nailing and autologous bone grafting.
Nonunion of long bones in lower limbs is a common complication of orthopedic trauma that can be extremely debilitating. This retrospective study describes our experience using expandable intramedullary nails and autologous bone grafting in treating lower limb long bone nonunion with bone defects. ⋯ The use of expandable intramedullary nails and autologous bone grafts was an effective method for repair of nonunion of lower limb fractures combining with bone defects with minimal complications.
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Arch Orthop Trauma Surg · Jul 2011
Tendon transfers for drop foot correction: long-term results including quality of life assessment, and dynamometric and pedobarographic measurements.
Drop foot deformity is a common problem with severe restrictions in quality of life and impairment of daily activities. A technique of posterior tibial tendon transfer through the interosseus membrane and fixation to the anterior tibial and the long peroneal tendon "Bridle procedure" (stirrup-plasty) offers a physiological alternative to surgical correction. ⋯ Fusion of the transposed posterior tibial, anterior tibial and the peroneus longus tendon prevents drop foot deformity sufficiently. The stirrup mechanism, in combination with tenodesis of the toe extensors, provides a balanced foot and avoids equinovarus and cavus deformity without immobilizing the ankle joint. Improvements in quality of life parameters justify the risk of the operative procedure for the patient.