Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Jul 2009
Treatment of isolated posterior coronal fracture of the lateral tibial plateau through posterolateral approach for direct exposure and buttress plate fixation.
To present a case series of patients with isolated posterior coronal fractures of lateral tibial plateau treated by direct exposure and buttress plate fixation through posterolateral approach. ⋯ Direct posterolateral approach by dividing lateral border of soleus muscle, provides excellent fracture reduction under visualization and internal buttress plate fixation for posterior coronal fracture of the lateral tibial plateau. Good functional results and recovery can be expected.
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Arch Orthop Trauma Surg · Jul 2009
A novel model to study metaphyseal bone healing under defined biomechanical conditions.
Experimental studies on metaphyseal fractures are rare and do not control the biomechanical conditions in the healing zone. This study aimed to develop an improved experimental model, which characterizes and controls the biomechanical condition in the fracture gap of a metaphyseal fracture. ⋯ This metaphyseal bone-healing model provides defined and adjustable biomechanical conditions. The histological images demonstrated intramembranous and endochondral bone healing in the osteotomy gap without callus formation. The model therefore seems appropriate to study metaphyseal bone healing under differing mechanical conditions.
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Arch Orthop Trauma Surg · Jul 2009
Successful use of posterior instrumented spinal fusion alone for scoliosis in 19 patients with neurofibromatosis type-1 followed up for at least 25 months.
Posterior instrumented fusion alone has been considered inadequate to correct scoliosis in most patients with neurofibromatosis type-1 (NF-1) because of their weak bone structure. This study was undertaken to evaluate whether the extension of fusion one level beyond the conventional fusion level would enable posterior instrumented fusion alone to be as effective as anterior-posterior fusion in treating patients with NF-1 and scoliosis who are more than 10 years old and whose scoliosis is <90 degrees . ⋯ These results demonstrate that a satisfactory stabilization of scoliosis can be achieved by posterior fusion with instrumentation alone in patients with NF-1 who are more than 10 years old, and whose scoliosis is <90 degrees .
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Arch Orthop Trauma Surg · Jun 2009
Review Comparative StudyShaft fractures of the clavicle: current concepts.
Fractures of the clavicle are common and have been typically addressed to nonoperative treatment. Favorable results, which predominantly were achieved in the young and adolescents, were supposed to be usual in midshaft clavicular fractures. However, in the presence of comminution or complete displacement, especially when occurring in females or elderly patients, there is a marked risk of nonunion, malunion, and poor outcome. ⋯ Plate fixation and intramedullary stabilization seem to be equally favored. Though, indications for operative management remain controversial. Further prospective randomized comparative clinical trials are necessary for a well-founded risk-benefit analysis.
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Arch Orthop Trauma Surg · Jun 2009
Comparative StudyHigh revision rate after treatment of femoral neck fractures with an optionally (un)cemented stem.
The advantages of uncemented and cemented components in hip arthroplasty have been subject of debate. We have studied on a hemiprosthesis, which can be optionally implanted with or without cement. Since the stem geometry and surface in cemented arthroplasty differs from the uncemented one and cannot be fused into one general design, we hypothesised that this hemiprosthesis used without cement has a considerable high revision rate, based on aseptic loosening. ⋯ Because of the rather high revision rate, the authors advice not to use this hemiprosthesis without cement.