Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Feb 2013
ReviewCan platelet-rich plasma (PRP) improve bone healing? A comparison between the theory and experimental outcomes.
The increased concentration of platelets within platelet-rich plasma (PRP) provides a vehicle to deliver supra-physiologic concentrations of growth factors to an injury site, possibly accelerating or otherwise improving connective tissue regeneration. This potential benefit has led to the application of PRP in several applications; however, inconsistent results have limited widespread adoption in bone healing. This review provides a core understanding of the bone healing mechanisms, and corresponds this to the factors present in PRP. ⋯ Aggressive processing techniques and very high concentrations of PRP may not improve healing outcomes. Moreover, many other variables exist in PRP preparation and use that influence its efficacy; the effect of these variables should be understood when considering PRP use. This review includes the essentials of what has been established, what is currently missing in the literature, and recommendations for future directions.
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Arch Orthop Trauma Surg · Feb 2013
Functional results and quality of life after bilateral scaphoid reconstruction: a case series.
Unilateral scaphoid non-union remains a major problem, which can lead to major functional limitations. Until now there is no evidence of outcome of the rare case of bilateral scaphoid non-unions and in how far two-stage bilateral reconstruction affects functional results and the quality of life. Between 1997 and 2010, altogether four bilateral scaphoid non-unions were treated in the centre and retrospectively analyzed. ⋯ The evaluation of the DASH score resulted in 11.6 (±12.5), the SF36 scale in 87.1 (±9.2) points. The present case series for the first time demonstrated functional mid-term results of the rare event of bilateral scaphoid reconstruction after non-union. With respect to the impact on one affected hand, functional results, DASH score and quality of life are excellent and thus justify good prognosis in patient education after injury.
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Arch Orthop Trauma Surg · Feb 2013
Comparative StudyTreatment of periprosthetic tibial plateau fractures in unicompartmental knee arthroplasty: plates versus cannulated screws.
Periprosthetic tibial plateau fractures (TPF) are rare but represent a serious complication in unicompartmental knee arthroplasty. The most common treatment for these fractures is osteosynthesis with cannulated screws or plates. The aim of this study was to evaluate two different treatment options for periprosthetic fractures. The hypothesis was that angle-stable plates show significantly higher fracture loads than fixation with cannulated screws. ⋯ Angle-stable plates showed significantly higher fracture loads than fixation with cannulated screws. Cannulated screws show a reduced stability of the tibial plateau. Therefore in periprosthetic TPF, osteosyntheses with angle-stable plates should be recommended instead of cannulated screws.
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Arch Orthop Trauma Surg · Feb 2013
Comparative StudySubjective and objective results of arthroscopic debridement of ulnar-sided TFCC (Palmer type 1B) lesions with stable distal radio-ulnar joint.
The purpose of this study was to determine functional and subjective results of patients who received arthroscopic debridement for their TFCC Palmer 1B lesions and to compare their results with those of arthroscopic suture repair. ⋯ Arthroscopic debridement of Palmer type 1B lesions in stable DRUJ yields satisfactory to excellent results. Our study showed similar results compared with the studies of arthroscopic suture repair with shorter postoperative care and fewer complications.
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Arch Orthop Trauma Surg · Feb 2013
Comparative StudyThe importance of CT for the pre-operative surgical planning in recurrent anterior shoulder instability.
MRI is the current pre-operative imaging standard in recurrent anterior shoulder instability; however, CT has increasingly gained interest due to its advantages in the detection of bony glenoid defects. This study compares the value of CT imaging and MRI for pre-operative surgical planning in recurrent anterior shoulder instability. ⋯ Despite the advantages of MRI in the detection of soft tissue damages in recurrent anterior shoulder instability CT imaging proved to be more important for pre-operative planning by prevailing in the detection of glenoid defects. Therefore, the replacement of MRI as preoperative imaging standard with CT imaging is recommended.