Journal of orthopaedic surgery (Hong Kong)
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J Orthop Surg (Hong Kong) · Jan 2017
Multicenter StudyProposal of new classification of femoral trochanteric fracture by three-dimensional computed tomography and relationship to usual plain X-ray classification.
Classification of femoral trochanteric fractures is usually based on plain X-ray findings using the Evans, Jensen, or AO/OTA classification. However, complications such as nonunion and cut out of the lag screw or blade are seen even in stable fracture. This may be due to the difficulty of exact diagnosis of fracture pattern in plain X-ray. Computed tomography (CT) may provide more information about the fracture pattern, but such data are scarce. In the present study, it was performed to propose a classification system for femoral trochanteric fractures using three-dimensional CT (3D-CT) and investigate the relationship between this classification and conventional plain X-ray classification. ⋯ It is difficult to evaluate fracture patterns involving the greater trochanter, especially large oblique fragments including the lesser trochanter, using plain X-rays. The 3D-CT shows the fracture line very clearly, making it easy to classify the fracture pattern.
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J Orthop Surg (Hong Kong) · Jan 2017
Subtalar arthroscopy and fluoroscopy in percutaneous fixation of intra-articular calcaneal fractures.
Percutaneous fixation of intra-articular calcaneal fractures is traditionally assisted only by intraoperative fluoroscopy. Previous studies have demonstrated that the additional use of subtalar arthroscopy in anatomical reduction of the posterior calcaneal facet of the subtalar joint for less complex calcaneal fractures yielded positive results up to 2-year follow-up. This study aims to investigate long-term outcomes of these patients using similar evaluation parameters. We hypothesized that this novel technique with dual-imaging can provide sustainable, long-term benefits with good functional outcomes and significant restoration of the Bohler's angle. ⋯ Subtalar arthroscopy with intraoperative fluoroscopy in anatomical reduction of the posterior calcaneal facet of the subtalar joint is most useful in Sanders type II, AO-OTA 83-C2 fractures with excellent functional outcomes and good preservation of the corrected Bohler's angle on long-term follow-up.
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J Orthop Surg (Hong Kong) · Jan 2017
The relationship between radiological alignment of united distal radius fractures and functional and patient-perceived outcomes in elderly patients.
The purpose of this study was to investigate the relationship between radiological alignment and functional outcomes including strength, range of motion (ROM), and disabilities of the arm, shoulder, and hand (DASH) and patient-rated wrist evaluation (PRWE) scores in elderly patients with united distal radius fractures. ⋯ This study suggests that minor deformities of the distal radius following distal radius fractures treated with either operative or nonoperative treatment are unlikely to be clinically relevant and have no impact on patient perceived outcomes for elderly patients.
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J Orthop Surg (Hong Kong) · Jan 2017
A new technique for arthroscopic reduction and fixation of displaced tibial intercondylar eminence fractures, using suture anchor and EndoButton system.
The study aims to describe a less invasive technique for displaced tibial intercondylar eminence fractures, using only one bone tunnel with suture anchor and EndoButton system. ⋯ The study demonstrated that the procedure is safe and effective, which can be another option for tibial intercondylar eminence fractures.
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J Orthop Surg (Hong Kong) · Jan 2017
Comparative evaluation of posterior cruciate ligament in total knee arthroplasty.
It has been realized that for osteoarthritis (OA) knee with varus deformity, posterior cruciate ligament (PCL) release resulted in the increase of the flexion gap without significant effect on the extension gap. While the effect of release on gap angle is still obscure. On the other hand, gap distance and varus angle measured under different distraction forces suggest different patterns. ⋯ Our study indicated that the sacrifice of PCL will decrease the varus deformity at both extension and flexion, but with the exception under low distraction force at flexion. A proper distraction tension is of great importance in gap balancing during TKA. Sufficient attention of varus differences should be paid to the gap balance technique when choosing from different techniques, PCL-retained TKA or PCL-sacrificed TKA, as well as and an appropriate distract tension during measurement.