Orthop Traumatol Sur
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Orthop Traumatol Sur · Feb 2019
ReviewHemiarthroplasty or total hip arthroplasty in recent femoral neck fractures?
The optimal treatment of recent femoral neck fractures remains debated. The available options are internal fixation, hemiarthroplasty (HA) and total hip arthroplasty (THA). There is a consensus in favour of internal fixation in younger patients. ⋯ When performing HA, the posterior approach should be avoided given the risk of instability. For THA, in contrast, the posterior approach is a reliable option in the hands of an experienced surgeon using a dual-mobility cup. Cement fixation of the stem is recommended to minimise the risk of peri-prosthetic fracture.
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Orthop Traumatol Sur · Feb 2019
Comparative StudyA cadaveric model of anterior compartment leg syndrome: Subcutaneous minimally invasive fasciotomy versus open fasciotomy.
Because of disabling sequelae of open fasciotomy in anterior compartment syndrome (ACS) of the leg, we wanted to describe and validate a cadaveric model of ACS. We hypothesized that, first, anterior compartment syndrome (ACS) could be reproduced in cadaveric leg and, second, fasciotomy without complete skin incision could lower the intramuscular pressure (IMP) in an equivalent range to complete dermatofasciotomy. ⋯ III, control laboratory study.
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Orthop Traumatol Sur · Feb 2019
Cementless distal fixation modular stem without reconstruction of femoral calcar for unstable intertrochanteric fracture in patients aged 75 years or more.
Hemiarthroplasty (HA) using standard-length femoral stem with reconstruction of femoral calcar or using calcar replacing prosthesis for unstable intertrochanteric fractures in elderly patients is a viable option. However, both of the techniques increase the complexity of procedure, operative trauma and complication. This study evaluated the clinico-radiological results of the MP-Link cementless distal fixation modular prosthesis without reconstruction of femoral calcar for unstable intertrochanteric fracture in patients aged 75 years or more. ⋯ IV, Retrospective study.
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Orthop Traumatol Sur · Feb 2019
Use of intramedullary nailing in poor sanitary conditions: French Military Medical Service experience.
Intramedullary (IM) nailing is the gold standard for treating long bone fractures in developed countries because of its minimally-invasive application and good biomechanical properties. In precarious conditions, external fixation or open plate fixation are often performed because surgeons do not have the means to carry out IM nailing. However, these procedures can lead to infection-related complications and mechanical failures. The aim of our study was to describe the outcomes and postoperative complications of IM nailing of closed, long bone fractures in patients operated in a French front-line combat surgical unit (role 2+). Our hypothesis was that IM nailing is a reliable technique with low morbidity for the initial treatment of long bone fractures, even in precarious situations. ⋯ II, low-powered prospective study.
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Orthop Traumatol Sur · Feb 2019
Predictive factors for satisfaction after contemporary unicompartmental knee arthroplasty and high tibial osteotomy in isolated medial femorotibial osteoarthritis.
Both high tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are viable treatment options for early osteoarthritis (OA). Although a substantial proportion of the patient selection criteria for HTO and UKA are now shared, the factors related to satisfaction following each procedure remain unclear. ⋯ Retrospective cohort study, Level III.