Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology
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Earlier literature on fixation of distal third humeral fractures describes the use of elaborate modification of existing implants, custom-made implants and dual plating. These modifications have the disadvantages of limitations of hardware availability and cost as well as longer surgical exposure to accommodate the plates. The aim of this study was to assess the effectiveness of osteosynthesis of extra-articular diaphyseal fractures of the distal third of the humerus using a single 4.5-mm locking compression plate (LCP) with two-screw purchase in the distal fragment. ⋯ Level IV.
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Supracondylar humeral fractures are one of the most common skeletal injuries in children. In cases of displacement and instability, the standard procedure is early closed reduction and percutaneous Kirschner wire fixation. However, between 10 and 20 % of patients present late. According to the literature, patients with neglected fractures are those patients who presented for treatment after 14 days of injury. The delay is either due to lack of medical facilities or social and financial constraints. The neglected cases are often closed injuries with no vascular compromise. However, the elbow may still be tense and swollen with abrasions or crusts. In neglected cases, especially after early appearance of callus, there is no place for closed reduction and percutaneous pinning. Traditionally, distal humeral fractures have been managed with surgical approaches that disrupt the extensor mechanism with less satisfactory functional outcome due to triceps weakness and elbow stiffness. The aim of this study is to evaluate the outcome of delayed open reduction using the triceps-sparing approach and Kirschner wire fixation for treatment of neglected, displaced supracondylar and distal humeral fractures in children. ⋯ IV.
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The concept of a dual-mobility hip socket involves the standard femoral head component encased in a larger polyethylene liner, which in turn articulates inside a metal shell implanted in the native acetabulum. The aim of this study was to assess outcomes from using a Serf Novae(®) Dual Mobility Acetabular cup (Orthodynamics Ltd, Gloucestershire, UK) to address the problem of instability in primary and revision total hip arthroplasty (THA). ⋯ IV.
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Tranexamic acid (TXA) has been successfully used to reduce bleeding in joint replacement. Recently local TXA has been advocated to reduce blood loss in total knee or hip replacement; however, this raised concerns about potential adverse effects of TXA upon the artificial joint replacement. ⋯ V.
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Review Comparative Study
Non-operative treatment versus percutaneous fixation for minimally displaced scaphoid waist fractures in high demand young manual workers.
Managing minimally displaced scaphoid fractures in young individuals doing physically demanding work remains an issue of debate due to duration of immobilisation and time required off work. Therefore, early diagnosis and appropriate treatment are important to avoid short- and long-term consequences. The literature lacks the exact definition of minimally displaced scaphoid waist fractures. The objective of this review article was to discuss nonoperative and minimally invasive treatment (percutaneous screw fixation) for minimally displaced scaphoid waist fractures and to systematically review the literature, focussing on young workers with physically demanding employment. ⋯ Level 3.