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Orthopaedics & Traumatology, Surgery & Research: OTSR

Jonathan Thomas, Olivier Rosello, Ioana Oborocianu, Federico Solla, Jean-Luc Clement, Virginie Rampal
BACKGROUND: Studies have established that Blount's method is reliable for treating extension supracondylar fractures (SCFs) in paediatric patients. Reduction in the emergency room (ER) under procedural sedation followed by orthopaedic treatment is increasingly used for many fracture types. The primary objective of this study was to determine whether SCF reduction in the ER was feasible, by determining the failure rate. The secondary objective was to identify causes of failure with the goal of improving patient selection to reduction in the ER...
September 12, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Maxime Lleu, Yann Philippe Charles, Benjamin Blondel, Laurent Barresi, Benjamin Nicot, Vincent Challier, Joël Godard, Pascal Kouyoumdjian, Nicolas Lonjon, Paulo Marinho, Eurico Freitas, Sébastien Schuller, Stéphane Fuentes, Jérémy Allia, Julien Berthiller, Cédric Barrey
INTRODUCTION: Three types of C1 fracture have been described, according to location: type 1 (anterior or posterior arc), type 2 (Jefferson: anterior and posterior arc), and type 3 (lateral mass). Stability depends on transverse ligament integrity. The main aim of the present study was to analyze complications and consolidation rates according to fracture type, age and treatment. MATERIAL AND METHODS: The French Society of Spinal Surgery (SFCR) performed a multicenter prospective study on C1-C2 trauma...
September 4, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Yann Sabah, Jean-Luc Clément, Federico Solla, Olivier Rosello, Virginie Rampal
BACKGROUND: Cobalt-chrome (CoCr) and the titanium alloy TA6V (Ti) are the materials most widely used for spinal instrumentations in patients with adolescent idiopathic scoliosis (AIS). The objective of this work was to compare the effectiveness of CoCr and Ti rods in terms of coronal and sagittal correction by pedicle-screw constructs in patients with AIS. HYPOTHESIS: Correction is similar with CoCr and Ti rods in patients with AIS. MATERIAL AND METHOD: A retrospective single-surgeon study was conducted in patients with AIS managed using pedicle-screw posterior spinal fusion with high implant density and reduction by postero-medial translation...
September 4, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Lakhal Walid, Chanthany Kitisack, Bund Laurent, Schneider Ludovic, Gicquel Philippe
BACKGROUND: Outpatient surgery is now widely performed in adults but remains rarely used for paediatric orthopaedic procedures. As with adult surgery, both the arthroscopic equipment and anaesthesia techniques have improved over the last few years. Arthroscopy is particularly well advanced at the knee but can also be used at other joints (hip, ankle, elbow, shoulder). The primary objective of this study was to evaluate the feasibility of outpatient paediatric arthroscopy. HYPOTHESIS: Arthroscopic surgery can be performed in children on an outpatient basis provided an appropriate care programme is applied...
September 4, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Baver Acar, Ozkan Kose, Yusuf Alper Kati, Omer Faruk Egerci, Adil Turan, Halil Yalcın Yuksel
PURPOSE: Scaphoid waist fractures may be fixed through volar or dorsal screw fixation. However, there is no consensus on which surgical fixation method should be performed. The purpose of this study was to compare volar versus dorsal screw fixation of scaphoid waist fractures under physiological loading conditions utilizing finite element analysis. METHODS: A transverse scaphoid waist fracture (Herbert type B2) model was fixed with a headless cannulated compression screw using either a volar or dorsal approach...
September 1, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Xavier Cassard, Valérie Garnault, Boris Corin, Denis Claverie, Jérôme Murgier
BACKGROUND: Total knee arthroplasty (TKA) on an outpatient basis is controversial due to concerns about patient safety. In France, only 1.1% of TKAs performed in 2017 were outpatient procedures. Nevertheless, recent advances in the multi-modal and multidisciplinary management of TKA patients combined with optimisation of the various components of perioperative care are increasing the use of outpatient TKA. However, studies on outcomes remain scarce. The primary objective of this work was to compare readmission rates within 30 days after TKA between patients managed as outpatients and as inpatients...
September 1, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Ferrero Emmanuelle, Lonjon Guillaume, Bouyer Benjamin, Sabourin Marc, Ould-Slimane Mourad, Guigui Pierre
INTRODUCTION: In degenerative lumbar spinal stenosis (DLSS) variability of symptoms according to the severity of stenosis is not well understood. Therefore, another factor that impacts functional outcomes of DLSS patients has been evoked: patient's comorbidities. The aim of this study was to investigate influence of comorbidities on clinical symptoms and functional outcomes in DLSS patients. METHODS: In this prospective study, patients treated for DLSS were included during 12 consecutive months...
September 1, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Christopher A Becker, Christian Kammerlander, Adrian Cavalcanti Kußmaul, Fabian Dotzauer, Matthias Woiczinski, Bianka Rubenbauer, Fabian Sommer, Christoph Linhart, Simon Weidert, Christian Zeckey, Axel Greiner
INTRODUCTION: Operative treatments of T-type acetabular fractures are challenging surgical procedures. Open reduction and internal fixation is the standard method for the operative management of these fractures, however this is associated with high blood loss, long hospital stay and longer rehabilitation. Anterior subcutaneous pelvic fixation (internal fixation=INFIX) and retrograde pubic screw fixation have shown promising results in minimally invasive treatment of pelvic ring fractures...
September 1, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Manabu Ide, Katsutaka Yamada, Kanichirou Kaneko, Tatsuhiro Sekiya, Kenzo Kanai, Takayuki Higashi, Tomoyuki Saito
INTRODUCTION: Previous studies reported that teriparatide (recombinant human parathyroid hormone) accelerated spinal fusion following posterior lumbar inter-body fusion surgery, and combination therapy using teriparatide and denosumab increased bone marrow density more than teriparatide alone.The purpose of this study is to evaluate the influence of combination therapy with teriparaide and denosumab on spinal fusion after posterior lumbar interbody fusion. MATERIALS AND METHODS: Sixteen osteoporotic patients with lumbar canal stenosis were randomly divided into two treatment groups, a teriparatide group (n=8; 20 μg of teriparatide daily alone, administered from a month before surgery to 12 months after surgery) and a combination group (n=8; 20 μg of teriparatide administered daily from a month before surgery to 12 months after surgery with 60 mg denosumab every 6 months, administered at 2 and 8 months following surgery)...
September 1, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Johanne J Garçon, Bertille Charruau, Emilie Marteau, Jacky Laulan, Guillaume Bacle
INTRODUCTION: Surgery is indicated in De Quervain's tenosynovitis only after failure of medical treatment, often due to individual anatomical variants. We use Le Viet's technique, to avoid tendon instability. The aim of the present study was to evaluate long-term results, with the hypothesis that this surgical technique is reliable, providing lasting results. PATIENTS AND METHODS: All patients operated on between 1993 and 2015 were included, and results were assessed by telephone questionnaire at a minimum 1-year's follow-up...
August 22, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Henri Migaud, Harold Common, Julien Girard, Denis Huten, Sophie Putman
Bone defects during acetabular revision of total hip arthroplasty raise a problem of primary fixation and of durable reconstruction. Bone graft with direct cemented fixation or in a reinforcement cage was long considered to be the gold standard; however, failures were reported after 10 years' follow-up, especially in segmental defect of the roof or pelvic discontinuity. In such cases, metallic materials were proposed, to ensure primary fixation by a roughness effect with added screws, and especially to avoid failure due to bone resorption in the medium term...
August 20, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Pierre Desmoineaux
After rotator cuff repair, few patients require revision surgery, and failure to heal does not always translate into clinical failure, although healing is associated with better outcomes. Failure of rotator cuff repair is perceived differently by the patient, by the surgeon, and in terms of social and occupational abilities. The work-up of failed cuff repair differs little from the standard work-up of cuff tears. Information must be obtained about the circumstances of the first repair procedure, a possible diagnostic inadequacy and/or technical error, and early or delayed trauma such as an aggressive rehabilitation programme...
August 18, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Mathieu Thaunat, Jean Marie Fayard, Bertrand Sonnery-Cottet
In anterior cruciate ligament (ACL) reconstruction, success depends on several factors: patient selection; surgical technique, taking account of associated meniscal and ligamentous lesions; and postoperative rehabilitation. Improved hamstring-tendon graft preparation and fixation techniques now provide results in terms of laxity and retear comparable to patellar tendon graft, which has long been the gold-standard for patients with strong functional demand, despite its higher risk of extension stiffness and anterior pain...
August 18, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Jean-Christophe Bel
The use of locking plates relies on novel mechanical and biological concepts: the bone healing is endochondral because of the elasticity of the constructs. Preoperative planning is required to determine the fracture reduction strategy and select the implants. The type of plate and the type of screws and their position determine the mechanical properties of the construct. Failure of locking plate fixation is a new phenomenon that differs from conventional plate fixation. These are brought on by inadequate planning, which is made worse when minimally invasive surgery is performed...
August 18, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
S Steinmetz, B Puliero, D Brinkert, N Meyer, P Adam, F Bonnomet, M Ehlinger
No abstract text is available yet for this article.
August 16, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Matthieu Malatray, Turki Al Qahtani, Olivier Monneuse, Vincent Pibarot, Julien Wegrzyn
Tricortical cortico-cancellous bone allografts from the anterior iliac crest are routinely used in revision arthroplasty and to treat non-union. Trans-iliac herniation (TIH) has been reported as an exceptional complication after extensive graft harvesting. The various reconstruction techniques include isolated parietal reconstruction and combined parietal and bone reconstruction using allografts or a spacer to reconstruct the bone defect. No previous study has evaluated a combined reconstruction technique involving both bone reconstruction with a titanium plate and abdominal wall reconstruction with a parietal reinforcement prosthesis...
August 13, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Esat Uygur, Oguz Poyanli, İbrahim Mutlu, Talip Çelik, Fuat Akpinar
BACKGROUND: This study compared the biomechanical properties of three different fixation methods of tension band wirings, used in the treatment of medial malleolus fractures. The first method used an innovative "handmade bent pin" for cerclage fixation. The second method used a U-shaped K-wire to attach the cerclage to the medial tibial cortex. These two novel fixation techniques were compared with the traditional tension band wiring technique which is fixated to the bone by a screw...
August 11, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Benjamin Degeorge, Louis Dagneaux, Julien Andrin, Cyril Lazerges, Bertrand Coulet, Michel Chammas
BACKGROUND: No surgical management is better than another regarding functional recovery for trapeziometacarpal joint osteoarthritis. Metacarpophalangeal (MCP) hyperextension, directly due to the shortening of thumb height, appears to be a factor of poor prognosis. HYPOTHESIS: MCP hyperextension can be corrected by implantation of a trapeziometacarpal prosthesis (TMP), as opposed to trapeziectomy and ligamentoplasty (TL), and pinch strength is greater with TMP in this indication...
August 11, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Gaoyang Chen, Bo Liu, He Liu, Hanyang Zhang, Kerong Yang, Qingyu Wang, Jianxun Ding, Fei Chang
BACKGROUND: Antibiotics impregnated calcium phosphate cement (CPC) has emerged as a local treatment of osteomyelitis. However, there is no study investigating the optimal concentrations of vancomycin (VCM) included in CPC to obtain prolonged drug release (≥8 weeks) and also with enough compressive strength (>the normal cancellous bone, 11MPa) for osteomyelitis therapy. Therefore, we bring forward two questions: 1) Was antibiotic activity of the eluates correlated to the load of antibiotics within the cement? 2) Were the mechanical properties of CPC affected by VCM-loading? HYPOTHESIZED: There was an optimal concentrations of vancomycin (VCM) loaded in CPC which could provide sufficient effective antibacterial time (≥8 weeks) and enough compressive strength (>11MPa)...
August 11, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Dhong Won Lee, Sung Gyu Moon, Na Ra Kim, Min Seok Chang, Jin Goo Kim
BACKGROUND: An event of painful popping is a highly predictive clinical sign of medial meniscal posterior root tears (MMPRTs) in middle-aged to older patients. There are lacks of studies about the prevalence of a painful popping event and the condition of the medial compartment at the time of popping event in MMPRTs. HYPOTHESIS: We hypothesized that most of MMPRTs with a single painful popping event would show pre-existed pathologic medial meniscal extrusion (MME) and articular cartilage degeneration, and larger contact area of medial femoral condyle to medial tibial plateau could affect the MME...
August 11, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
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