Orthop Traumatol Sur
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Orthop Traumatol Sur · Jun 2019
Meta AnalysisShould Kirschner wires for fixation of lateral humeral condyle fractures in children be buried or left exposed? A systematic review.
Displaced lateral humeral condyle fractures in children are usually treated with open reduction and internal fixation. When treated operatively with Kirschner wires, the bent cut near side wire ends are either buried in the subcutaneous tissue or are left exposed. It is believed that burying the wires allows them to remain in longer and hence facilitate better union. Leaving them exposed seems to necessitate earlier removal, especially to reduce the risk of wire tract infection. There is not a clear consensus in published literature whether subcutaneous wire burial is better or not. ⋯ II, systematic review.
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Orthop Traumatol Sur · Jun 2019
Observational StudyEffectiveness of closed reduction and percutaneous fixation of isolated sacral fractures. Functional outcomes and sagittal alignment after 3.6 years in 20 patients.
Displaced U- or H-shaped sacral fractures (Roy-Camille Grade II or III) are treated at our institution by early transcondylar traction and manual countertraction, hyperlordosis induced by a pad positioned under the lumbo-sacral junction, and percutaneous ilio-sacral screw fixation. The objective of this study was to evaluate the outcome of this technique used in a level 1 trauma centre. Hypothesis Our early reduction technique provides anatomical reduction of U- or H-shaped sacral fractures by correcting the sagittal malalignment due to the intra-sacral kyphosis, thereby obviating the need for decompression laminectomy and improving neurological outcomes. ⋯ IV, retrospective observational study.
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Orthop Traumatol Sur · May 2019
Can the number of surgery delays and postponements due to unavailable instrumentation be reduced? Evaluating the benefits of enhanced collaboration between the sterilization and orthopedic surgery units.
The development of outpatient surgery, cost-reduction pressures and instrumentation storage limitations have led to their use "just-in-time". A recent study showed that stoppage of surgical procedures immediately before the incision (No-Go) was often due to the management of supplies and implantable medical devices. To our knowledge, since the development of outpatient surgery and the shortening of hospital stays, managing the flow of instrumentation has not been optimized. At our hospital, we used a two-prong approach consisting of a tool to manage instrumentation and working group from the sterilization and orthopedic surgery units. The aims of this study were to: 1) evaluate whether this approach led to better notification of the risk of supply shortage for instrumentation and 2) determine whether it could reduce by at least half operating room disruptions such as delays or cancellation of surgical procedures. ⋯ III, prospective comparative study.
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Orthop Traumatol Sur · May 2019
A novel transverse ultrasonography technique for minimally displaced lateral humeral condyle fractures in children.
Management of minimally displaced lateral humeral condyle fractures in pediatric patients is controversial. This is primarily because with current imaging modalities it is difficult to accurately and conveniently determine the stability of the fractures by detecting the integrity of the cartilage hinge. Nevertheless, transverse ultrasonography has not been intensively reported in previous studies. ⋯ IV, retrospective cohort study.
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Orthop Traumatol Sur · May 2019
Comparative StudyMinimally invasive internal fixation for extra-articular distal radius fracture: Comparison between volar plate and intramedullary nail.
There are numerous internal fixation techniques for distal radius fracture, using pins, plates or nails. Some authors have developed minimally invasive procedures. The aim of the present study was to compare two minimally invasive internal fixation techniques for unstable extra-articular distal radius fracture in women over 50 years of age: volar plate (minimally invasive plate osteosynthesis: MIPO), and intramedullary nail. ⋯ III, retrospective study.