Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · May 2003
Comparative StudyWhy patients choose regional anesthesia for orthopedic and trauma surgery.
While both surgeons' and anesthesiologists' preference of regional over general anesthesia is increasing, the patients' preference remains limited. Little is known about why patients choose regional anesthesia. The aim of our study was to answer this question with regard to orthopedic and trauma surgery. ⋯ Patients choose different types of regional anesthesia for different reasons. While spinal anesthesia and femoral and sciatic block were chosen for curiosity reasons, brachial plexus block was chosen to avoid the side effects of general anesthesia. The patients' choice of regional anesthesia for orthopedic and trauma surgery is significantly influenced by the type of surgery, age, and health.
-
Arch Orthop Trauma Surg · May 2003
Comparative StudyAnatomical reconstruction of chronic lateral ligament injury of the ankle using pedicle tendon of the extensor digitorum longus.
Since 1989, we have performed ligament reconstruction using the extensor digitorum longus tendon as a pedicle graft for patients with chronic lateral instability of the ankle. ⋯ At final follow-up, pain was present in one joint in the group without chondral injury at the time of reconstruction ( n=6). However, pain was still present at the final follow-up in five of the group with chondral injury ( n=7). Chondral injury incurred during ligament reconstruction may have caused the residual ankle pain even after 7 years of postoperative follow-up. There was a statistically significant relationship between chondral injury and ankle pain at final follow-up.
-
Arch Orthop Trauma Surg · May 2003
Histological findings of tendon-bone healing following anterior cruciate ligament reconstruction with hamstring grafts.
The purpose of the study was the histological examination of tendon-bone healing of hamstring grafts after anterior cruciate ligament (ACL) reconstruction. ⋯ We conclude that the use of hamstring grafts for ACL reconstruction can lead to different histological pattern of tendon-bone healing. Micromotion of the hamstring graft inside the drilled canal can be play a role in tendon-bone healing.
-
The epidemiology of posterior cruciate ligament (PCL) injuries has not been well clarified. Isolated and combined PCL injuries are a frequently missed diagnosis. A better understanding of typical injury mechanisms may help in more accurate diagnosis of these injuries. ⋯ In many PCL lesions, initiation of an adequate treatment regimen is delayed despite typical injury mechanisms and symptoms. In the future, a better understanding of the epidemiology of PCL injuries should enable us to diagnose the injury more reliably through a detailed history and a thorough physical and radiographic examination in the acute setting.
-
Arch Orthop Trauma Surg · Apr 2003
Do orthopaedic journals provide high-quality evidence for clinical practice?
In the hierarchy of research designs, randomized controlled trials and meta-analyses are considered to be evidence of the highest grade, and scientific journals are the main source of scientific information. ⋯ Although the number of randomized controlled trials and meta-analyses is tending to increase, the conclusion of this study is that the high-quality evidence provided by the major orthopaedic journals is quite low, and more randomized controlled trials and meta-analyses are needed for evidence-based orthopaedic practice.