Operative Orthopädie und Traumatologie
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Oper Orthop Traumatol · Oct 2014
Multicenter Study Clinical Trial[Femoral nailing using a helical nail shape (LFN(®))].
Antegrade femoral nailing through a greater trochanteric entry portal avoids damage to the proximal external rotators and to the ramus profundus of the medial femoral circumflex artery, furthermore eases insertion in adipose subjects. However a helical nail shape is necessary for this pathway because bending in two perpendicular planes has to be passed by the nail. ⋯ In a prospective mulicentric study, 227 helical femoral nails were used for antegrade femoral nailing. Follow-up after 12 month was available in 74 %. Surgeons' rating for ease of identifying entry site was excellent or good in 89 %. Functional and radiological results after 12 months do not prove significant benefits over conventional antegrade femoral nails.
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Oper Orthop Traumatol · Aug 2014
Multicenter Study Clinical Trial[Newly developed modular reverse fracture endoprosthesis in non-reconstructable humeral head fracture in old people].
Primary endoprosthetic joint replacement in non-reconstructable proximal humeral fracture in the elderly. Alternative to fracture hemi-endoprosthesis with resorption of tuberosities and secondary rotator cuff insuffiency which leads to unsatisfying functional results. ⋯ One dislocated acromion fracture.
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Oper Orthop Traumatol · Dec 2011
Multicenter Study Clinical Trial[Stabilization of inter- and subtrochanteric femoral fractures with the PFNΑ®].
Intramedullary nail system fixation of inter- and subtrochanteric femoral fractures allows early weight-bearing, especially in osteoporotic bone. Restoration of anatomical shape and early return to function of the injured leg. ⋯ Between April 2004 and June 2005, the AO multicenter study at 11 European trauma centers included 313 patients (mean age 80.6 years, 77% women, 23% men) with 315 unstable trochanteric fractures treated with a Peroximal Femoral Nail Antirotation® (PFNΑ®) device for consecutive follow-up [24]. In 82%, the fractures were 31-A2, while in 18% the fractures were 31-A3. Average operation time for A2 fractures was 56 min and 66 min for A3 fractures. Average duration of hospital stay in the trauma center was 12 days. Surgical reduction and fracture fixation that permitted full weight-bearing immediately after operation was achieved in 72% of cases. Of 165 complications, 46 were surgery-related with unplanned revision surgery in 28 cases (including 7 femur fractures and 4 acetabular penetrations). Follow-up for more than 1 year was possible in 56% of patients. After 1 year, 89% of the fractures were consolidated. The highest complication rate was found in fractures type 31-A2.3 and in patients older than 90 years. The recorded number of implant-related complications (14.6%) is comparable to the results of other intramedullary and extramedullary implants.