Acta Orthopaedica Belgica
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Is there any difference between the biomechanical strengths of the current fixation techniques for comminuted distal patellar fractures?
No full textoai:actaob.journals.sfu.ca:article/1392In this biomechanical study, the strength of five different fixation techniques -anterior tension band wiring with K-wires, separate vertical wiring, headless compression screws with anterior tension band wiring, cannulated screws with tension band wiring and memory shape patellar fixator- for distal patellar fractures were compared. Forty calf knees were used for the biomechanical testing. Each specimen was pre-loaded with 10 N at 1 N/s. The distraction forces were applied consistently with the velocity of 5 mm/s. The ultimate load (N) and displacement (mm) values were recorded. The headless compression screw with anterior tension band wiring (656.9±167.9 N) and the cannulated screws with anterior tension band wiring (642.6±166.0 N) obtained significantly higher ultimate loading values compared to the other fixation methods (p<0.05). Fixation via cannulated screws with anterior tension band wiring techniques are more stabile than the patellar shape memory fixator and anterior K wire fixation.
Union rates and midterm results after Extended Trochanteric Osteotomy in Revision Hip Arthroplasty. Useful and safe technique
No full text Aim of this study was to evaluate the outcome following Extended Trochanteric Osteotomy in series of single surgeon, with emphasis on complications and union of osteotomy.MethodsRetrospective Case Series of all patients who had revision Total Hip Replacement surgery performed by senior author between 2003 and 2012, with follow up between 1 and 10 years.Results108 cases of revision hip arthroplasty with use of Extended Trochanteric Osteotomy were evaluated. In 101 cases solid bony union was achieved. In 7 cases the bony union was not seen, asymptomatic fibrous union was achieved. In 12 cases greater trochanter fracture was noted postoperatively with proximal migration 5 to 15mm. 1 patient required surgery to re-attach greater trochanter.ConclusionsExtended Trochanteric Osteotomy is safe and very useful technique that can be utilized in revision hip surgery.
Evaluation of the Posterior Tibial Slope in Noncontact ACL Injuries Using Magnetic Resonance Imagıng
No full text Objectives: This study investigated whether an increased posterior tibial slope (PTS) was a risk factor for noncontact anterior cruciate ligament (ACL) injuries.Methods: We retrospectively evaluated the Magnetic Resonance (MR) images of 60 patients with noncontact complete ruptures of the ACL and 60 age-matched, healthy individuals with normal knee MR images. We measured the medial and lateral PTS on the sagittal T1W images separately in both the patients with complete ACL ruptures and the control group, as described by Hudek et al. Medial and lateral PTS were investigated between two groups .Results: The patients with complete ACL ruptures had a statistically significantly (p<0.01) larger PTS on the lateral tibial condyle than the control group (4.5° and 3.8°, respectively). However, there was no statistically significant differences between the two groups’ medial PTS. Also, the lateral PTS was greater in the complete ACL group than the control group in both females and males (p<0.01).Conclusions: A statistically significant difference between the posterior tibial slopes of the groups with and without ACL ruptures was observed, which is consistent with the literature. Therefore, increased lateral PTS may be an anatomic risk factor for ACL injuries
Atypical Femoral Fractures: Three cases and a review of literature.
No full textIn recent years, bisphosphonates and RANK-ligand inhibitors have become the mainstay of treatment for multiple types of osteoporosis, as well as several other metabolic bone diseases. Although rare, atypical femoral fracture is a recent but clearly defined complication of antiresorptive therapy with bisphosphonates, and likely also with denosumab. In this article, we present 3 different cases of atypical femoral fracture: an incomplete fracture linked to a bisphosphonate, an incomplete fracture linked to denosumab, and a complete atypical femoral fracture. Specific diagnostic steps and therapy are described. We also offer a complete overview of available literature concerning diagnosis, epidemiology, pathogenesis, treatment and future outlooks concerning this entity. Although antiresorptive therapy offers a very significant benefit in the prevention of osteoporotic fractures, clinicians should be aware of the possible complications, especially with long-term therapy
Long-term outcome in dislocated lateral humeral condyle fractures following internal screw fixation in children
No full textBackground. Aim of this study was to present the long-term outcome comparing primary and secondary dislocated lateral humeral condyle fractures treated by open reduction and internal screw fixation.Methods. 31 children (5.8±2.4 years) operated for a displaced LCF were examined by a standardized clinical and compared using the Mayo score (MaS), the Morger score (MoS) and a Patients Satisfaction Score (PSS). Results. The scores did not differ significantly between the primary and secondary displacement groups. Deficits in range of motion and joint axis deviation were minor (< 10°) and no elbow instabilities were observed.Conclusions. Surgical treatment of a secondary displaced LCF by open reduction and internal screw fixation leads to a favorable long-term outcome, which is comparable between primary and secondary dislocated LCFs
360° fixation with modern instrumentations of segment separation cervical spine injury in a 23 –month-old
No full textIn this case report clinical and technical lessons including seven years follow up learned from a flexion-distraction, highly unstable cervical spine injury causing a complete separation of C6-7 cervical segment with qaudriparesis in a 23 –month-old boy, are presented. To our knowledge this is the only documented case in medical literature where adult size implants (cage, plate and lateral mass screw-rod system) were utilized for cervical combined anterior and posterior internal fixation in a child under the age of two years without implant-size related problem. Seven years after the injury the child attends elementary school, can operate a wheelchair manually, and can eat and write. Computed tomography control showed no failure of the hardware and fusion was later observed in the intervertebral space of the stabilized cervical segment, however adjacent segment syndrome occurred without deterioration of the patient’s status. The decision on the mode of realignment and fixation to be made in such a case is difficult because there is no standard procedure for infants
Prevalence of bilateral discoid lateral meniscus: a systematic review
No full textThis systematic review assessed the prevalence of bilateral discoid lateral meniscus (BDLM) as well as its subtypes, among patients with symptomatic discoid lateral menisci (DLM), reported in the current literature. Medline, Cochrane, EMBASE, and Google Scholar were searched for studies published prior to May 1, 2015 that reported prevalences of BDLM diagnosed with MRI, arthroscopy and physical examination. Both prospective or retrospective studies were included. The characteristics evaluated included demographics, examination method, prevalence of BDLM and DLM, and subtypes of BDLM and DLM. Based on these seven studies, BDLM among patients who were treated for DLM in only East Asian countries (i.e., China, Japan, and Korea) ranged from 8.8 to 97%, similar to the prevalence of BDLM reported elsewhere, which ranged from 6.8 to 90%. Only three studies (two Korean and one Japanese) reported BDLM subtypes, and the reported prevalence of homotypes among BDLM patients ranged from 82.9 to 91.7%.
Hip Preservation Surgery for Adolescents and Young Adults with Post-Perthes Sequelae
No full textElimination of narrow arc of pathologic loading due to impingement is the main advantage of the proposed surgical technique. Other advantages include increased abductor lever arm and restoration of hip joint range of motion with normalization of the loading conditions, and hence future development of degenerative arthritis and the anticipated need for a future joint replacement surgery could be prevented or delayed. Femoral head vascularity is well maintained with the proven safety of the presented surgical approach
Outcomes of open reduction and internal fixation in displaced intra-articular scapular fractures: A case series
No full textIntroduction: Scapular fractures are rare injuries and usually occur due to high energy trauma. Displaced Intra articular fractures usually require operative treatment and yields better outcomes as compared to conservative management.Objectives: To assess the functional and radiological outcomes of displaced intra-articular scapular fractures managed with open reduction and internal fixation.Methods: 12 patients over a period of 3 years (2012-2014) were included in the study. Post-operative functional outcomes were assessed using mean quick DASH (Disability of arm, hand and shoulder) score while radiological outcomes were analyzed as percentage of implant cut-through, mal-union, non-union or infection. Results: The mean follow up was 14 months. Mean age was 40 years. The mean quick DASH score was 7.19 +/- 4.86. All of the patients had successful clinical and radiological healing and pain-free movements.Conclusions: Open reduction and internal fixation in displaced intra-articular scapular-fractures yields exceptional and promising outcomes
Functional outcome following internal fixation of intraarticular fractures of the distal femur.
No full text The purpose of this study was to evaluate functional outcome, fracture healing, and the complications of distal femoral intra-articular fractures using locking compression plates. This prospective study was carried out at Orthopaedics department of School of Medical Sciences and Research, Sharda University from December 2010 to December 2014. . A total of 170 patients with intraarticular fractures of the distal femur were recruited from Emergency and outpatient department and treated with distal femoral locking compression plates. Clinical and functional outcomes were assessed using the Knee Society score. All patients were followed for twelve months. All fractures united in average 3.2 months (range 7-19 weeks). The results were excellent in 66.47% (113/170) patients, good in 22.35% (38/170), fair in 7.05% (12/170) and poor in 5.83% (7/170) patients at final follow-up. Non-union was not seen in this study. 5.83% (7/170) patients had limb length discrepancy of <2 cm and no treatment were needed.