Journal of orthopaedic surgery (Hong Kong)
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J Orthop Surg (Hong Kong) · May 2019
Severe varus knees result in a high rate of undercorrection of lower limb alignment after opening wedge high tibial osteotomy.
The purpose of this study was to clarify the indication for opening wedge high tibial osteotomy (OWHTO) in terms of lower limb alignment to achieve satisfactory clinical results. ⋯ Based on these results, we recommend that a preoperative FTA of <185° should be included as a criterion for OWHTO alone.
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J Orthop Surg (Hong Kong) · May 2019
A modified tarsal sinus approach for intra-articular calcaneal fractures.
Plate fixation using traditional lateral L-shape approach for intra-articular calcaneal fractures is complicated by 30% of wound complications, and the lateral small incision techniques with a tarsal sinus approach cannot sufficiently address all the fragments. A modified tarsal sinus approach with combined advantages of traditional lateral L-shape and tarsal sinus approaches for the treatment of intra-articular calcaneal fractures was developed. ⋯ The modified tarsal sinus approach in the treatment of Sander's type II and III calcaneal fractures allowed adequate reduction and rigid fixation with low incidence of wound complications. Compared to sinus tarsi approach, this technique required shorter learning curve and was more easily mastered by young orthopedic surgeons. Thus, it was worthy of application clinically.
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J Orthop Surg (Hong Kong) · May 2019
An increase in the risk of excessive femoral anteversion for relatively younger age and types of femoral morphology in total hip arthroplasty with direct anterior approach.
Direct anterior approach (DAA) is known to diminish a dislocation risk and widely used for total hip arthroplasty (THA). On the other hand, anterior dislocation due to increasing stem anteversion and cup anteversion is an important complication. ⋯ The risk of excessive femoral anteversion increases for relatively younger age and for types of femoral morphology according to the Dorr classification, moreover with an increase of CA in DAA-THA with cementless tapered-wedge stem.
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J Orthop Surg (Hong Kong) · May 2019
Comparative StudyClinical outcomes of dual 3.5-mm locking compression plate fixation for humeral shaft fractures: Comparison with single 4.5-mm locking compression plate fixation.
Recently, several in vitro biomechanical studies that used dual small locking plate fixation for humeral shaft fractures have investigated. However, in vivo studies about dual plate fixation for humeral shaft fractures are limited. The purpose of our study was to report the outcomes of dual small plating for humeral shaft fractures in comparison with those of single large fragment plating. ⋯ For diaphyseal humeral fractures, dual 3.5-mm LCP fixation to the humerus is a possible treatment choice. This method showed satisfactory union rate, ROM, and complication rate, without increasing surgical time, in comparison with the conventional single 4.5-mm LCP fixation. Level of evidence: III.
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J Orthop Surg (Hong Kong) · May 2019
Screw trajectory affects screw cut-out risk after fixation for nondisplaced femoral neck fracture in elderly patients.
Incidence of femoral neck fracture has risen with the aging of the population and has critical implications with regard to patient death, functional dependence, and social costs. Screw fixation using triangular configurations and calcar placement are still the preferred treatment for nondisplaced femoral neck fracture, to reduce the risk of loss of reduction and nonunion. However, this method is still controversial in terms of the effects of screw trajectory, including parallel or nonparallel configurations, on fixation of femoral neck fractures. This study aimed to compare the incidence of complications between patients who have undergone fixation with a parallel or a nonparallel screw trajectory. ⋯ Our results suggested that fixation with nonparallel screws for nondisplaced femoral neck fracture in elderly and osteoporotic patients might interfere with shortening of the femoral neck along with fracture healing, leaving patients at risk of postoperative screw cut-out from the femoral head.