Acta Orthopaedica Belgica
Not a member yet
578 research outputs found
Sort by
Minimally Invasive versus Open Surgery for Acute Achilles Tendon Ruptures – A Systematic Review and Meta-analysis.
No full textBackground: The minimally invasive surgery (MIS) approach has been popularised as an alternative to the standard open approach in acute Achilles tendon repair. Advocates of MIS suggest earlier functional recovery, due to reduced trauma to adjacent soft tissues. Critics, however, argue that due to inadequate surgical exposure, complications of such surgery are higher compared to an open technique. Methods: A systematic review and meta-analysis of randomised, prospective studies weas conducted to compare MIS and open surgery in acute Achilles tendon ruptures. Results: Thirteen studies were included in the meta-analysis with a total of 854 patients. Although re-rupture rates were not significantly different between the groups (P = 0.43), there were significantly more complications in the open surgery group (P = <.00001). Conclusions: MIS in acute achilles tendon ruptures result in similar re-rupture rates, sural nerve injury rates and return to sport time in comparison with open surgical method, but with significantly less post-operative complications
ANATOMICAL AND FUNCTIONAL EVALUATION OF DIAPHYSEAL FEMORAL FRACTURE IN CHILDREN =< 6 YEARS OLD
No full textAbstract v ObjectiveThe aim of this study is to evaluate both the anatomical and functional consequence that follow our treatment protocols.v MethodsA retrospective analysis of a series containing 50 children in Strasbourg University Hospital whom had traumatic diaphyseal femoral fractures and underwent conservative treatment by traction followed by casting with a mean follow-up period of 25 months.v ResultsAll fractures healed without complications i.e. gait disorders, back pain and limitation of activity. Results showed a significant correlation between the initial varus angulation and shortening which could influence the final remodeling result within the first 24 months. Using the Receiver Operating Characteristic curve, we developed the Initial Displacement Index on Traction (IDIT) which is the sum of both the initial varus in degrees and the initial shortening in millimeters.v ConclusionThe treatment by traction for childrens ≤ 6 years old gives comparable clinical and radiological results with those of immediate casting method, The hospitalization period is longer in traction method but with less exposure to general anesthesia (GA) and risks of secondary displacements.
Correlation of Pirani score and Foot bimalleolar (FBM) angle in the treatment of idiopathic congenital talipes equino varus (CTEV) by Ponseti method in infant. Authors : rahul ANSHUMAN* mahipal SINGH** anil kumar JAIN***
No full textAim: Correlation of Pirani score and Foot bimalleolar (FBM) angle in the treatment of idiopathic congenital talipes equino varus (CTEV) by Ponseti method in infant.Material and Methods:35 feet with idiopathic CTEV deformity<1 year were prospectively treated by Ponseti method. Deformity evaluated each successive week of treatment by Pirani score and FBM angle. Feet were divided according to Pirani score in groups: one(0-2.0), two(2.5-4) and three(4.5-6). Correlation between mean Pirani score and mean FBM angle was evaluated every week and at follow up, firstly by using Pearson’s and Spearman’s correlation and then, after dividing data in groups by using ANOVA and Tukey test.Results:Correlation between Pirani score and FBM angle was statistically significant(p value <0.05).Conclusion: Pirani score decreases and FBM angle increases with correction. Pirani score and FBM angle correlated in severity of deformity and correction achieved, thus FBM angle provides objective evidence of clubfoot deformity/improvement/deterioration.
Distal femoral medial closing wedge osteotomy for degenerative valgus knee: mid-term results in active patients
No full textBACKGROUNDDistal femoral medial closing wedge osteotomy (DFMCWO) may be a valuable treatment for arthritic valgus knees in young and active adults, with the possible aim of procrastinating knee replacement. METHODS32 valgus knees (mean age: 41.4±11.2) treated with DFMCWO were retrospectively reviewed. All the knees had a lateral compartment osteoarthritis graded I-II-III according to Kellgren Lawrence classification. 20 knees had osteochondral lesions, treated with microfractures (8) or bone marrow derived cells transplantation (12). Patients were clinically (IKDC, KOOS, NRS, Tegner) and radiologically evaluated. A mean follow-up of 62.12±15.65 was achieved.RESULTSKOOS score peaked at 24 months, showed a decremental trend, achieved a final results of 83,34±13,56. Similar trend was evident for IKDC. The final NRS score was 2.73±1.82; the final Tegner score was 2.65±1.89. Radiographs showed degenerative progression in 5 knees: 2 patients underwent knee replacement at the final follow-up.CONCLUSIONDFMCWO is an effective treatment to treat osteoarthritic symptomatology, delay degenerative progression and avoid knee replacement in valgus knees at mid-term follow-u
Popliteal artery dissection presented 12 hours after admission for a Salter III fracture of proximal tibia
No full textA 16-year-old boy suffered a salter III fracture of the upper tibia following a motorcycle accident. Except for well localized knee pain, the patient did not have any other symptoms. Repeated clinical examination did not find any absent peripheral pulses. Given the state of the fracture, anatomical reduction and screw fixation was planned in the operating room. 12 hours after admission, having had many normal vascular clinical examinations within this period, the patient was taken to the operating room. Further clinical assessment was performed in the operating room and remained to be normal. Only after induction and then only upon extension of the lower limb, peripheral pulses in the affected side were abruptly lost. Urgent vascular exploration of the area showed a popliteal artery dissection necessitating a by pass graft to restore blood flow. We present a review of the literature alongside a case report showing how popliteal artery pathology in a similar context can present late and be for a period of time undetectable clinically hence warranting more clinical curiosity
An atypical case of elbow fracture; Bilateral Capitellum Humeri Fracture in a Teenager
No full textFractures of the capitellum are rare injures of the elbow rarely seen in adolescents.We report a case of a 14 year-old boy who sustained a bilateral Hahn-Steinthal type fracture of his capitelum humeri. To our knowledge, such bilateral injury has not been reported before in teenagers.This paper reviews the literature regarding the epidemiology, classification and management of this rare pediatric capitellar fracture.
Prevention of re-fractures of both bones of the forearm in children
No full textFast and good fracture healing is generally encountered in pediatric traumatology with rare re- fractures .Diaphysis fractures of both bones of the forearm are an exception with 4-26% of re-fractures in the 6 months following the fracture. Diaphyseal fractures of the 2 bones in the forearm in children represent about 5% of fractures and are generally treated by casting. Change in physical activities and sport in children have increased its incidence throughout the years . There is however a high risk of re-fracture on the same location , the first post traumatic year, related to greenstick-type fracture, residual angular deformity, younger ages and shorter periods of casting.The aim of this study was to test if the wearing of a protective brace for 6 months following the fracture could decrease the rate of re-fractures
The TRAC-PS dual radius total knee arthroplasty: Disappointing medium and long terms results.
No full textThe TRAC prosthesis is a dual radius, mobile bearing, posterior stabilized prosthesis, to increase stability by optimizing contact area and control wear using a mobile polyethylene. Between February 1995 and January 2000, a single surgeon performed a continuous series of 85 TRAC-PS TKAs in 85 patients. A retrospective review on charts was performed. Patients were scored clinically using the Knee Society Score, WOMAC index, SF 36 and a VAS for pain.34 patients were examined with a mean follow-up of 13 years(mean age 83 years). 43 patients had died, three were unavailable due to bad general health and five were lost to follow up. The mean range of flexion was 105°. The mean WOMAC score was 78,4(SD 17,9). The mean Knee Society Score was 86.8(SD 8,4) clinical and 42,6(SD 28) functional. The mean SF-36 score was 59,8(SD 15,4). The VAS for pain was 6(SD 9). With revision as endpoint, survival rate of the prosthesis was 92% at 13 years. Twenty-three Serious Adverse Events(28%) in 17 patients, related to the prosthesis were registered.Long term results of this prosthesis were satisfying but a large number of serious adverse events led to abandonment of the TRAC-prosthesis
Acute Injuries Sustained by Racing Drivers: A Cross-Sectional Study
No full textAim of the present study was to investigate the prevalence and type of acute injuries sustained by 137 racing drivers. An ad hoc questionnaire was developed and was completed by 137 drivers with a mean age (SD) of 42 (15) years. Approximately half of the drivers had < 10 years of experience in auto racing (49%). Multiple logistic regression analyses were performed. There was a wide distribution of injuries of the knee (n=17, 12%), shoulder injuries (n=15, 11%), thorax/rib or ankle (n=13, 9%), hand (n=11, 8%), forearm (n=9, 7%) and neck or wrist injuries (n=7, 5%). Long-distance racing, more than 10 days per month spent on testing, short-distance racing, and full-time occupation were associated with increased incidence of injuries on multivariable analyses. The high incidence of acute injuries in race car driving indicates the need for further improvements.
Transosseous ‘over the top’ reconstruction of capsule and tendons in primary total hip arthroplasty using a posterior approach.
No full textBackground: Dislocation after total hip arthroplasty (THA) remains a devastating complication and a primary cause for revision arthroplasty. Historical data indicate that a posterior approach is associated with a higher dislocation rate. In this study, we present a highly reliable and anatomical reconstruction, based on the biomechanical findings of a previous cadaveric experiment. Description of Technique: The posterior soft tissues were repaired in 2 layers. First a reattachment of the posterior orbicular ligament is performed at the anterior capsule. Subsequently a transosseous ‘over the top’ reinsertion of both capsule and tendons is performed close to there anatomical insertion. Patients and Methods: We prospectively collected data of 408 THAs from January 2004 until December 2013, through a posterior approach and with a capsule and tendon reconstruction based on a previous cadaveric study. Results: There was a low early dislocation rate in primary THA (one of 408 THAs, 0,2%) and no complications related to the technique. Conclusions: This anatomical reconstruction of both capsule and tendons is associated with a low dislocation rate without complications at the level of the greater trochanter