Operative Orthopädie und Traumatologie
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Oper Orthop Traumatol · Oct 2020
Review[Palmar radioscapholunate arthrodesis with distal scaphoidectomy].
Radioscapholunate (RSL) arthrodesis with distal scaphoidectomy using an angular stable plate and palmar access in post-traumatic or degenerative osteoarthritis limited to the radiocarpal joint. ⋯ Palmar RSL arthrodesis and distal scaphoidectomy using angular stable plate fixation shows a high union rate and pain relief while maintaining good residual mobility of the wrist.
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Oper Orthop Traumatol · Apr 2019
ReviewMinimally invasive internal fixation of calcaneal fractures or subtalar joint arthrodesis using the Calcanail®.
A minimally invasive technique to prevent soft tissue problems using a calcaneal nail (Calcanail®, FH Orthopedics, Heimsbrunn, France) for calcaneal fractures or in subtalar joint arthrodesis is described. ⋯ Preliminary results of 69 cases from three surgical centers have already been published. From 2013-2017, the technique was used in 48 of our own patients (42 calcaneal fracture reduction and fixation; 6 for subtalar joint arthrodesis). Mean postoperative hospital stay was 7 days for fracture reduction without any need of additional operations. During follow-up, 6 implant removals and 2 secondary subtalar fusions were noticed. All 6 cases of subtalar joint arthrodesis were planned in posttraumatic subtalar osteoarthritis.
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Oper Orthop Traumatol · Oct 2017
Review[Wrist arthrodesis with a fixed-angle, "low-profile" fusion plate without carpometacarpal joint fixation].
Total wrist arthrodesis to improve functional use of the hand by reducing pain and increasing grip strength. ⋯ Total wrist arthrodesis was performed using a fixed-angle fusion plate without CMC III joint fixation in 28 patients (21 men, 7 women). A follow-up of 14/28 patients was performed at a mean of 21 (3-39) months postoperatively. Grip strength improved from 14 (0-38) kg preoperatively to 22 (12-40) kg postoperatively. The average postoperative DASH score was 40 (6-72) points. Pain measured with the VAS scale (0-10) improved from an average of 7 (3-10) points preoperatively to 2 (0-6) points postoperatively. Overall, 13/14 patients were satisfied with the treatment; 26/28 patients achieved primary bony consolidation. Postoperative complications found in 9 of 28 patients: 2 nonunion, pain in the CMC II (n = 3) or III (n = 1) joints, 2 screw breakage, 1 postoperative bleeding and 1 infection. Both cases of nonunion healed after plate removal, re-osteosynthesis with a straight wrist arthrodesis plate, bridging the CMC III joint, and a bone graft from the iliac crest. All patients with CMC II joint pain were pain-free after removal of the protruding screw. One patient had chronic pain in the CMC III joint despite plate removal. In the 2 cases with screw breakage, no issues caused. In one patient, after primary bony consolidation, removal of the plate was performed for extensor tenolysis and not as a result of the broken screw. In the second patient, removal of the plate after primary bony consolidation was unnecessary as the patient was pain-free in the area of the broken screw, yet a protruding screw in the CMC II joint cavity was removed.
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Oper Orthop Traumatol · Oct 2017
Review[Midcarpal partial arthrodesis with locking plate osteosynthesis].
Preservation of residual mobility and pain reduction in the wrist in advanced carpal collapse (scapholunate advanced collapse, SLAC or scaphoid nonunion advanced collapse, SNAC). ⋯ Complete consolidation of the bone in the X‑ray control in all 11 patients 12 weeks postoperatively. No implant-based complications. In one case a postoperative carpal tunnel syndrome had to be surgically treated. The postoperative extent of mobility showed overall satisfactory results with extension-flexion of 53° ± 18° (47% of the healthy side) and radial-ulnar abduction 30 ± 5° (58% of the healthy side). The postoperative values on the visual analog pain scale (VAS) were 0.7 ± 1.2 at rest and 4.3 ± 2.8 under load bearing. The gripping power was 19 ± 14 kg (56% of the non-operated side) and the disabilities of the arm, shoulder, hand (DASH) value was 33 ± 24.
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Oper Orthop Traumatol · Apr 2017
Review[Minimally invasive treatment of intra-articular calcaneal fractures with the 2‑point distractor].
Open treatment of calcaneus fractures often has an increased risk of wound healing. Minimally invasive treatment with small incisions reduces complications. ⋯ Of 212 calcaneal fractures, 182 were treated with this technique. Wound healing complication rate was 2.7%; 4.7% of patients required secondary arthrodesis of the subtalar joint.