Dépouillements

Variety in diagnosis and treatment of periprosthetic joint infections in Belgium and the Netherlands / Jesse W.P. Kuiper in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 149-160 Titre : Variety in diagnosis and treatment of periprosthetic joint infections in Belgium and the Netherlands Type de document : texte imprimé Auteurs : Jesse W.P. Kuiper ; Stan Vos ; Bart J. Burger ; Sascha Colen Année de publication : 2016 Article en page(s) : p. 149-160 Langues : Anglais (eng) Mots-clés : infection  articulation  prothese  arthroplastie Résumé : Recently, guidelines regarding diagnosis and treatment of periprosthetic joint infection (PJI) have been published, but it is unknown how well these are followed in the Netherlands and Belgium. Therefore, a survey study was performed in the Netherlands and Belgium. 81 orthopedic departments responded (54% in the Netherlands, 52% in Belgium). The majority used protocols for antibiotic and surgical treatment. To discriminate between early and late infection, differences in periods used were seen between respondents, and between countries. Empirical antibiotic treatment varied greatly. Debridement, antibiotics, irrigation and retention of the prosthesis (DAIR) is the almost unanimous treatment of choice for early PJI. Guidelines are available, but seem not (yet) to be followed accurately, and do not have answers to all possible treatment options. Perhaps, national guidelines might produce more standardized care, and consequentially, easier comparison for research, more transparency for patients, and less health care costs. Permalink : ./index.php?lvl=notice_display&id=46076 [article] Variety in diagnosis and treatment of periprosthetic joint infections in Belgium and the Netherlands [texte imprimé] / Jesse W.P. Kuiper ; Stan Vos ; Bart J. Burger ; Sascha Colen . - 2016 . - p. 149-160. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 149-160 Mots-clés : infection  articulation  prothese  arthroplastie Résumé : Recently, guidelines regarding diagnosis and treatment of periprosthetic joint infection (PJI) have been published, but it is unknown how well these are followed in the Netherlands and Belgium. Therefore, a survey study was performed in the Netherlands and Belgium. 81 orthopedic departments responded (54% in the Netherlands, 52% in Belgium). The majority used protocols for antibiotic and surgical treatment. To discriminate between early and late infection, differences in periods used were seen between respondents, and between countries. Empirical antibiotic treatment varied greatly. Debridement, antibiotics, irrigation and retention of the prosthesis (DAIR) is the almost unanimous treatment of choice for early PJI. Guidelines are available, but seem not (yet) to be followed accurately, and do not have answers to all possible treatment options. Perhaps, national guidelines might produce more standardized care, and consequentially, easier comparison for research, more transparency for patients, and less health care costs. Permalink : ./index.php?lvl=notice_display&id=46076

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Acromioclavicular joint cyst in ASA 3-4 patients. Whether and how quickly it recurs after aspiration and steroid injection / S. Gumina in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 161-165 Titre : Acromioclavicular joint cyst in ASA 3-4 patients. Whether and how quickly it recurs after aspiration and steroid injection Type de document : texte imprimé Auteurs : S. Gumina ; V. Candela ; D. Passaretti Année de publication : 2016 Article en page(s) : p. 161-165 Langues : Anglais (eng) Mots-clés : articulation acromio-claviculaire  rupture  coiffe des rotateurs  douleur  épaule Résumé : We observed the clinical course, in the short-medium term, of patients with voluminous type II acromioclavicular (AC) joint cyst who underwent aspiration and steroid injection regarded as the only possible treatment to avoid possible skin complications. Four patients (7.4% of cases described in literature) (3F-1M ; mean age 83 years, range : 78-87 years) with a voluminous (> 7 cm) oval, no mobile, no fluctuant cyst overlying the AC joint, were retrospectively observed. The patients, judged by the anesthesiologist as ASA 3-4 patients, were merely submitted to cyst aspiration and steroid injection. The content of the cyst was microscopically analysed. All patients were clinically evaluated on the day of aspiration and after 14- 30 days and after 1 year. Shoulder function and pain intensity were analysed with Constant score and VAS. We were able to aspirate 80-150 ml of amorphous joint fluid. At the first follow-up, all patients had a recurrence of the cyst, a lower grade of tension of the skin overlying the cyst and also a very little decreasing of pain intensity. After a month from aspiration, the cysts of the 4 patients had the same size as that present before aspiration. The range of motion, the average value of VAS and Constant were similar to those recorded before aspiration. In no case signs of infection or draining sinus occurred. Aspiration is a useless practice. However it is still a motive for discussion if the reduced suffering of the skin overlying the cyst after the aspiration has avoided, or simply postponed, an imminent complication. Permalink : ./index.php?lvl=notice_display&id=46077 [article] Acromioclavicular joint cyst in ASA 3-4 patients. Whether and how quickly it recurs after aspiration and steroid injection [texte imprimé] / S. Gumina ; V. Candela ; D. Passaretti . - 2016 . - p. 161-165. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 161-165 Mots-clés : articulation acromio-claviculaire  rupture  coiffe des rotateurs  douleur  épaule Résumé : We observed the clinical course, in the short-medium term, of patients with voluminous type II acromioclavicular (AC) joint cyst who underwent aspiration and steroid injection regarded as the only possible treatment to avoid possible skin complications. Four patients (7.4% of cases described in literature) (3F-1M ; mean age 83 years, range : 78-87 years) with a voluminous (> 7 cm) oval, no mobile, no fluctuant cyst overlying the AC joint, were retrospectively observed. The patients, judged by the anesthesiologist as ASA 3-4 patients, were merely submitted to cyst aspiration and steroid injection. The content of the cyst was microscopically analysed. All patients were clinically evaluated on the day of aspiration and after 14- 30 days and after 1 year. Shoulder function and pain intensity were analysed with Constant score and VAS. We were able to aspirate 80-150 ml of amorphous joint fluid. At the first follow-up, all patients had a recurrence of the cyst, a lower grade of tension of the skin overlying the cyst and also a very little decreasing of pain intensity. After a month from aspiration, the cysts of the 4 patients had the same size as that present before aspiration. The range of motion, the average value of VAS and Constant were similar to those recorded before aspiration. In no case signs of infection or draining sinus occurred. Aspiration is a useless practice. However it is still a motive for discussion if the reduced suffering of the skin overlying the cyst after the aspiration has avoided, or simply postponed, an imminent complication. Permalink : ./index.php?lvl=notice_display&id=46077

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Empty can and drop arm tests for cuff rupture : Improved specificity after subacromial injection / Ludo I.F. Penning in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 166-173 Titre : Empty can and drop arm tests for cuff rupture : Improved specificity after subacromial injection Type de document : texte imprimé Auteurs : Ludo I.F. Penning ; Rob A. De Bie ; Pieter Leffers ; [et al...] Année de publication : 2016 Article en page(s) : p. 166-173 Langues : Anglais (eng) Mots-clés : coiffe de rotateurs  épaule  sensibilité  test Résumé : Empty can and drop arm tests for cuff rupture : Improved specificity after subacromial injection 2016, N° 2 (Vol. 82/2) p.166-173 Ludo I. F. PENNING, Rob A. DE BIE, Pieter LEFFERS, René E. WEIJERS, Geert H. I. M. WALENKAMP From the orthopaedic outpatient clinic at Maastricht University Medical Centre , Maastricht, the Netherlands Abstract: Shoulder disorders are common in the general population : they occur in about 25 of every 1000 patients per year. A rather large majority are caused by cuff disorders. Differentiating between impingement and cuff rupture is essential to adequate treatment. Clinical tests have been developed, but their accuracy is limited. This study was performed to improve clinical accuracy by combining single tests and adding a subacromial injection. We postulated that the empty can and drop arm tests would result in higher sensitivity and specificity after subacromial injection. Method : We prospectively assessed 49 patients with the empty can and drop arm tests and used ultrasound to compare the individual and combined results. Results : The ultrasound found six cuff ruptures. Specificity improved and sensitivity decreased after subacromial injection. Conclusions : Only specificity improved after subacromial injection. Combining the test results led to an increase in both sensitivity and specificity without injection. Permalink : ./index.php?lvl=notice_display&id=46078 [article] Empty can and drop arm tests for cuff rupture : Improved specificity after subacromial injection [texte imprimé] / Ludo I.F. Penning ; Rob A. De Bie ; Pieter Leffers ; [et al...] . - 2016 . - p. 166-173. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 166-173 Mots-clés : coiffe de rotateurs  épaule  sensibilité  test Résumé : Empty can and drop arm tests for cuff rupture : Improved specificity after subacromial injection 2016, N° 2 (Vol. 82/2) p.166-173 Ludo I. F. PENNING, Rob A. DE BIE, Pieter LEFFERS, René E. WEIJERS, Geert H. I. M. WALENKAMP From the orthopaedic outpatient clinic at Maastricht University Medical Centre , Maastricht, the Netherlands Abstract: Shoulder disorders are common in the general population : they occur in about 25 of every 1000 patients per year. A rather large majority are caused by cuff disorders. Differentiating between impingement and cuff rupture is essential to adequate treatment. Clinical tests have been developed, but their accuracy is limited. This study was performed to improve clinical accuracy by combining single tests and adding a subacromial injection. We postulated that the empty can and drop arm tests would result in higher sensitivity and specificity after subacromial injection. Method : We prospectively assessed 49 patients with the empty can and drop arm tests and used ultrasound to compare the individual and combined results. Results : The ultrasound found six cuff ruptures. Specificity improved and sensitivity decreased after subacromial injection. Conclusions : Only specificity improved after subacromial injection. Combining the test results led to an increase in both sensitivity and specificity without injection. Permalink : ./index.php?lvl=notice_display&id=46078

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Radiological and clinical outcome of arthroscopic labral repair with all-suture anchors / Laurent Willemot in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 174-178 Titre : Radiological and clinical outcome of arthroscopic labral repair with all-suture anchors Type de document : texte imprimé Auteurs : Laurent Willemot ; Redouan Elfadalli ; Kjell C. Jaspars ; [et al...] Année de publication : 2016 Article en page(s) : p. 174-178 Langues : Anglais (eng) Mots-clés : épaule  instabilité  bourrelet glénoïdien  suture Résumé : Purpose : The aim of this study was to assess radiological and clinical outcome after arthroscopic all-suture anchor labral repair. Methods : 20 patients treated for anterior and superior labral instability (mean age 29, range 14-51 years) were assessed at a minimum follow-up time of 1 year (mean 19 months ; range, 12-28 months). Postoperative MRI scans were assessed by 3 independent radiologists. The radiological appearance of bone at the anchor-site was judged by the presence of cyst formation, tunnel widening (> 2 mm) or bone edema. Clinical outcome analysis included standard follow-up and the Disabilities of the Arm, Shoulder and Hand score (DASH), Constant Shoulder score and the Western Ontario Shoulder Instability Index (WOSI). Results : All patients were available for follow-up. In total, 58 all-suture anchors were implanted. None of the patients displayed large cyst formation. Small cysts were found in two patients (2 anchors). Tunnel widening was apparent in 3 patients (3 anchors) with an average widening of 3.3 mm (range 3-4 mm). Bone edema at the anchor-site was seen in 6 patients (8 anchors). The remaining 9 patients (45 anchors) did not display reactive bone changes. Clinical outcomes showed a WOSI of 70.6, a DASH of 18.9 and a Constant score of 89.3, and no recurrence of instability. Conclusion : Satisfying radiological and clinical outcome was observed after arthroscopic instability surgery using all-suture anchors. Imaging revealed good labral healing without important bony reactions or the formation of large cysts at early follow-up. Level of evidence : IV Case series. Permalink : ./index.php?lvl=notice_display&id=46079 [article] Radiological and clinical outcome of arthroscopic labral repair with all-suture anchors [texte imprimé] / Laurent Willemot ; Redouan Elfadalli ; Kjell C. Jaspars ; [et al...] . - 2016 . - p. 174-178. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 174-178 Mots-clés : épaule  instabilité  bourrelet glénoïdien  suture Résumé : Purpose : The aim of this study was to assess radiological and clinical outcome after arthroscopic all-suture anchor labral repair. Methods : 20 patients treated for anterior and superior labral instability (mean age 29, range 14-51 years) were assessed at a minimum follow-up time of 1 year (mean 19 months ; range, 12-28 months). Postoperative MRI scans were assessed by 3 independent radiologists. The radiological appearance of bone at the anchor-site was judged by the presence of cyst formation, tunnel widening (> 2 mm) or bone edema. Clinical outcome analysis included standard follow-up and the Disabilities of the Arm, Shoulder and Hand score (DASH), Constant Shoulder score and the Western Ontario Shoulder Instability Index (WOSI). Results : All patients were available for follow-up. In total, 58 all-suture anchors were implanted. None of the patients displayed large cyst formation. Small cysts were found in two patients (2 anchors). Tunnel widening was apparent in 3 patients (3 anchors) with an average widening of 3.3 mm (range 3-4 mm). Bone edema at the anchor-site was seen in 6 patients (8 anchors). The remaining 9 patients (45 anchors) did not display reactive bone changes. Clinical outcomes showed a WOSI of 70.6, a DASH of 18.9 and a Constant score of 89.3, and no recurrence of instability. Conclusion : Satisfying radiological and clinical outcome was observed after arthroscopic instability surgery using all-suture anchors. Imaging revealed good labral healing without important bony reactions or the formation of large cysts at early follow-up. Level of evidence : IV Case series. Permalink : ./index.php?lvl=notice_display&id=46079

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Histological and biochemical evidence related to the collagen quality in torn rotator cuff tendons / Sokratis Varitimidis in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 179-188 Titre : Histological and biochemical evidence related to the collagen quality in torn rotator cuff tendons Type de document : texte imprimé Auteurs : Sokratis Varitimidis ; Zoe Dailiana ; Dimitrios Christou ; [et al...] Année de publication : 2016 Article en page(s) : p. 179-188 Langues : Anglais (eng) Mots-clés : coiffe des rotateurs  rupture Résumé : This study investigates the histological background of torn rotator cuff tendons, evaluates the stability of newly synthesized collagen by measuring the hydroxyproline content and attempts to correlate these findings with the clinical outcome after reconstruction of the rotator cuff. Sixty-one patients underwent reconstruction for a rotator cuff tear. They were evaluated preoperatively with the Constant-Murley score, MRI and ultrasound. Biopsy samples were taken from chronic rotator cuff tears and histological analysis was performed. Hydroxyprolin presence was evaluated in various tissues. Mean follow-up was 46 months. Histological analysis revealed collagen fragmentation and thinning (90.2% of patients), myxoid degeneration (88%), hyaline degeneration (50.8%), chondroid metaplasia (44.3%), calcification (24.7%), fatty infiltration (20.4%) and vascular proliferation (62.3%). Hydroxyproline was under-represented in newly synthesized collagen in 57% of patients. In the majority of the patients with a low hydroxyproline/collagen ratio the histological findings were abnormal. None of the findings was related to the clinical outcome with a statistical significance. Histological and biochemical findings reflected the poor quality of the tendon. The good clinical outcome did not depend on the histological or biochemical findings but rather on the meticulous surgical reconstruction and physical therapy. Permalink : ./index.php?lvl=notice_display&id=46081 [article] Histological and biochemical evidence related to the collagen quality in torn rotator cuff tendons [texte imprimé] / Sokratis Varitimidis ; Zoe Dailiana ; Dimitrios Christou ; [et al...] . - 2016 . - p. 179-188. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 179-188 Mots-clés : coiffe des rotateurs  rupture Résumé : This study investigates the histological background of torn rotator cuff tendons, evaluates the stability of newly synthesized collagen by measuring the hydroxyproline content and attempts to correlate these findings with the clinical outcome after reconstruction of the rotator cuff. Sixty-one patients underwent reconstruction for a rotator cuff tear. They were evaluated preoperatively with the Constant-Murley score, MRI and ultrasound. Biopsy samples were taken from chronic rotator cuff tears and histological analysis was performed. Hydroxyprolin presence was evaluated in various tissues. Mean follow-up was 46 months. Histological analysis revealed collagen fragmentation and thinning (90.2% of patients), myxoid degeneration (88%), hyaline degeneration (50.8%), chondroid metaplasia (44.3%), calcification (24.7%), fatty infiltration (20.4%) and vascular proliferation (62.3%). Hydroxyproline was under-represented in newly synthesized collagen in 57% of patients. In the majority of the patients with a low hydroxyproline/collagen ratio the histological findings were abnormal. None of the findings was related to the clinical outcome with a statistical significance. Histological and biochemical findings reflected the poor quality of the tendon. The good clinical outcome did not depend on the histological or biochemical findings but rather on the meticulous surgical reconstruction and physical therapy. Permalink : ./index.php?lvl=notice_display&id=46081

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The necessity of strength evaluation in assessment of clinical outcome after shoulder surgery : follow-up data from patients with complex proximal humerus fractures treated by locking plate fixation / Y. Wu in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 189-196 Titre : The necessity of strength evaluation in assessment of clinical outcome after shoulder surgery : follow-up data from patients with complex proximal humerus fractures treated by locking plate fixation Type de document : texte imprimé Auteurs : Y. Wu ; P. Shang ; L. Che ; [et al...] Année de publication : 2016 Article en page(s) : p. 189-196 Langues : Anglais (eng) Mots-clés : humérus  fracture  chirurgie Résumé : In order to minimize the bias of Constant score we modified the allocation of strength subscore. One hundred and two patients with 3- and 4-part proximal humerus fractures were treated using locking plate fixation and followed up for > 1 year. The clinical outcomes were assessed by DASH score abbreviated Constant score (AbbCS strength item excluded) modified Constant score (ModCS with 12-pound strength) and original Constant score (CS with 25-pound strength). The satisfaction rate was determined for each scoring instrument. Compared to CS the satisfaction rate was significantly higher in DASH score AbbCS and ModCS (all p < 0.001) but the latter 3 groups did not show significant difference. ROC analysis showed that a > 7-pound shoulder strength was present in patients with satisfied outcome assessed by DASH score. In conclusion strength evaluation is necessary for the assessment of shoulder function but the over-allocated strength should be modified in Constant score. Permalink : ./index.php?lvl=notice_display&id=46082 [article] The necessity of strength evaluation in assessment of clinical outcome after shoulder surgery : follow-up data from patients with complex proximal humerus fractures treated by locking plate fixation [texte imprimé] / Y. Wu ; P. Shang ; L. Che ; [et al...] . - 2016 . - p. 189-196. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 189-196 Mots-clés : humérus  fracture  chirurgie Résumé : In order to minimize the bias of Constant score we modified the allocation of strength subscore. One hundred and two patients with 3- and 4-part proximal humerus fractures were treated using locking plate fixation and followed up for > 1 year. The clinical outcomes were assessed by DASH score abbreviated Constant score (AbbCS strength item excluded) modified Constant score (ModCS with 12-pound strength) and original Constant score (CS with 25-pound strength). The satisfaction rate was determined for each scoring instrument. Compared to CS the satisfaction rate was significantly higher in DASH score AbbCS and ModCS (all p < 0.001) but the latter 3 groups did not show significant difference. ROC analysis showed that a > 7-pound shoulder strength was present in patients with satisfied outcome assessed by DASH score. In conclusion strength evaluation is necessary for the assessment of shoulder function but the over-allocated strength should be modified in Constant score. Permalink : ./index.php?lvl=notice_display&id=46082

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Avulsions of Triceps Brachii : associated injuries and surgical treatment ; a case series / Kaveh Gharanizadeh in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 197-202 Titre : Avulsions of Triceps Brachii : associated injuries and surgical treatment ; a case series Type de document : texte imprimé Auteurs : Kaveh Gharanizadeh ; Farid Nadj Mazhar ; Nima Molavy ; [et al...] Année de publication : 2016 Article en page(s) : p. 197-202 Langues : Anglais (eng) Mots-clés : triceps  chirurgie Résumé : This study reports the clinical presentations, intra operative findings, type of the treatments, outcome of the treatment and specially associated injuries in patients with the avulsion of the distal end of the triceps brachii (TB) tendon. We studied 6 patients with rupture or avulsion of the distal end of the TB tendon. The medical records, imaging files, clinical outcomes at the final follow up visit were reviewed. The clinical outcomes were assessed by Mayo Elbow Score at the final follow-up visit. All patients were male, 4 of them having injury in the left hand as the non-dominant hand. Mean age of them was 34.5 years. All cases had small bony fleck in the posterior of elbow in lateral radiograph. Three patients had associated injuries including intra-articular fractures and medial collateral ligament rupture. In one case V-Y plasty of the distal TB was done. In 4 patients the results of surgery were excellent, one was good and one was fair. Although TB tendon rupture is rare, it should be considered in differential diagnosis of the upper extremity trauma and its associated injuries should be addressed properly. Permalink : ./index.php?lvl=notice_display&id=46083 [article] Avulsions of Triceps Brachii : associated injuries and surgical treatment ; a case series [texte imprimé] / Kaveh Gharanizadeh ; Farid Nadj Mazhar ; Nima Molavy ; [et al...] . - 2016 . - p. 197-202. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 197-202 Mots-clés : triceps  chirurgie Résumé : This study reports the clinical presentations, intra operative findings, type of the treatments, outcome of the treatment and specially associated injuries in patients with the avulsion of the distal end of the triceps brachii (TB) tendon. We studied 6 patients with rupture or avulsion of the distal end of the TB tendon. The medical records, imaging files, clinical outcomes at the final follow up visit were reviewed. The clinical outcomes were assessed by Mayo Elbow Score at the final follow-up visit. All patients were male, 4 of them having injury in the left hand as the non-dominant hand. Mean age of them was 34.5 years. All cases had small bony fleck in the posterior of elbow in lateral radiograph. Three patients had associated injuries including intra-articular fractures and medial collateral ligament rupture. In one case V-Y plasty of the distal TB was done. In 4 patients the results of surgery were excellent, one was good and one was fair. Although TB tendon rupture is rare, it should be considered in differential diagnosis of the upper extremity trauma and its associated injuries should be addressed properly. Permalink : ./index.php?lvl=notice_display&id=46083

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The value of manipulation of displaced distal radius fractures in the emergency department / Robert W. Jordan in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 203-209 Titre : The value of manipulation of displaced distal radius fractures in the emergency department Type de document : texte imprimé Auteurs : Robert W. Jordan ; Rahil Naeem ; Saqiba Jadoon ; [et al...] Année de publication : 2016 Article en page(s) : p. 203-209 Langues : Anglais (eng) Mots-clés : radius  fracture  réduction Résumé : The aim of this study was to report the success of maintaining reduced distal radius fractures with cast immobilisation and analyse risk factors for redisplacement. A retrospective analysis of distal radius fracture manipulated between April 2011 and 2013 was conducted. Age, gender, fracture classification, ulna fracture, dorsal comminution and volar alignment were recorded. Reduction and redisplacement were measured using Sarmiento’s modification of Lidstrom’s system. 110 patients were included ; mean age 62.8 years and 83.4% female. The AO classification was used to grade initial fractures A2 (44%), A3 (25%), C1 (20%) and C2 (10%). 86.4% of cases were improved following manipulation, although 48.4% redisplaced and 27.4% required surgical intervention. The radial length (60%) was harder to maintain than dorsal alignment (44%) in cases of redisplacement. Successful alignment of the volar cortices was associated with a statistically significant reduction in redisplacement (p = 0.024). Manipulation of distal radius fractures is initially beneficial but half of cases redisplace. Permalink : ./index.php?lvl=notice_display&id=46084 [article] The value of manipulation of displaced distal radius fractures in the emergency department [texte imprimé] / Robert W. Jordan ; Rahil Naeem ; Saqiba Jadoon ; [et al...] . - 2016 . - p. 203-209. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 203-209 Mots-clés : radius  fracture  réduction Résumé : The aim of this study was to report the success of maintaining reduced distal radius fractures with cast immobilisation and analyse risk factors for redisplacement. A retrospective analysis of distal radius fracture manipulated between April 2011 and 2013 was conducted. Age, gender, fracture classification, ulna fracture, dorsal comminution and volar alignment were recorded. Reduction and redisplacement were measured using Sarmiento’s modification of Lidstrom’s system. 110 patients were included ; mean age 62.8 years and 83.4% female. The AO classification was used to grade initial fractures A2 (44%), A3 (25%), C1 (20%) and C2 (10%). 86.4% of cases were improved following manipulation, although 48.4% redisplaced and 27.4% required surgical intervention. The radial length (60%) was harder to maintain than dorsal alignment (44%) in cases of redisplacement. Successful alignment of the volar cortices was associated with a statistically significant reduction in redisplacement (p = 0.024). Manipulation of distal radius fractures is initially beneficial but half of cases redisplace. Permalink : ./index.php?lvl=notice_display&id=46084

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Scaphoid nonunion with carpal ligament injury – radiological, arthroscopical assessment and clinical results / Masahiro Tatebe in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 210-215 Titre : Scaphoid nonunion with carpal ligament injury – radiological, arthroscopical assessment and clinical results Type de document : texte imprimé Auteurs : Masahiro Tatebe ; Hitoshi Hirata ; Kenji Tanaka ; [et al...] Année de publication : 2016 Article en page(s) : p. 210-215 Langues : Anglais (eng) Mots-clés : scaphoïde  ligament  arthroscopie  traumatisme Résumé : The purpose of this study was to review the clinical results of carpal ligaments injuries with scaphoid nonunion. We hypothesized that scaphoid nonunion with carpal ligament injury is associated with clinical result. We retrospectively reviewed 60 cases of Herbert screw fixation with bone graft for scaphoid nonunions. Scapholunate (SL) and lunotriquetral (LT) ligaments lesions were confirmed by arthroscopy. Approximately half of the nonunion scaphoid cases had carpal ligaments injuries. At final follow-up evaluation, wrist function as evaluated by the Mayo wrist score was excellent in 34 patients, good in 16 patients, fair in 8 patients, and poor in 2 patients. Cases with both SL/LT ligaments injuries tended to have decreased wrist flexion-extension motion. Our results suggest that there is an indication for arthroscopy in scaphoid nonunion if surgical fixation is offered to avoid detrimental effects of an undiagnosed ligament tear. Permalink : ./index.php?lvl=notice_display&id=46085 [article] Scaphoid nonunion with carpal ligament injury – radiological, arthroscopical assessment and clinical results [texte imprimé] / Masahiro Tatebe ; Hitoshi Hirata ; Kenji Tanaka ; [et al...] . - 2016 . - p. 210-215. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 210-215 Mots-clés : scaphoïde  ligament  arthroscopie  traumatisme Résumé : The purpose of this study was to review the clinical results of carpal ligaments injuries with scaphoid nonunion. We hypothesized that scaphoid nonunion with carpal ligament injury is associated with clinical result. We retrospectively reviewed 60 cases of Herbert screw fixation with bone graft for scaphoid nonunions. Scapholunate (SL) and lunotriquetral (LT) ligaments lesions were confirmed by arthroscopy. Approximately half of the nonunion scaphoid cases had carpal ligaments injuries. At final follow-up evaluation, wrist function as evaluated by the Mayo wrist score was excellent in 34 patients, good in 16 patients, fair in 8 patients, and poor in 2 patients. Cases with both SL/LT ligaments injuries tended to have decreased wrist flexion-extension motion. Our results suggest that there is an indication for arthroscopy in scaphoid nonunion if surgical fixation is offered to avoid detrimental effects of an undiagnosed ligament tear. Permalink : ./index.php?lvl=notice_display&id=46085

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Non-Metastatic Pelvic Ewing’s Sarcoma : oncologic outcomes and evaluation of prognostic factors / Asterios Dramis in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 216-221 Titre : Non-Metastatic Pelvic Ewing’s Sarcoma : oncologic outcomes and evaluation of prognostic factors Type de document : texte imprimé Auteurs : Asterios Dramis ; Robert J. Grimer ; Konstantinos Malizos ; [et al...] Année de publication : 2016 Article en page(s) : p. 216-221 Langues : Anglais (eng) Mots-clés : sarcome d'Ewing  bassin  traitement Résumé : We are reporting our experience on patients with pelvic Ewing’s Sarcoma treated in our unit. We retrospectively reviewed a series of patients with non-metastatic pelvic Ewing’s sarcoma treated between 1977 and 2009. Patients were classified into three groups according to the local treatment received : Group 1. radiotherapy-chemo ; Group 2. surgery-chemo and Group 3. radiotherapy-surgery-chemo. Recurrence free and overall survival rates were calculated using the Kaplan-Meier method. Influence of various factors (age at diagnosis, gender, tumour site and size, chemotherapy response, surgical margins and type of treatment) on survival was assessed with a logistic regression model. A total of 85 patients were treated with a mean follow-up of 65.8 months and mean tumour volume of 435ml. The 5-year survival for all patients was 40.7% decreased to 36.2% at 10 years. A significant prognostic factor identified was chemotherapy response only. There was a trend for improved survival and local control rates for patients who had chemotherapy and surgery and the results were apparent for all tumours irrespective of size but not statistically significant. Currently, the optimal management of pelvic Ewing’s sarcoma is controversial but our study shows a trend for improved survival for patients treated with chemotherapy and surgery. Permalink : ./index.php?lvl=notice_display&id=46086 [article] Non-Metastatic Pelvic Ewing’s Sarcoma : oncologic outcomes and evaluation of prognostic factors [texte imprimé] / Asterios Dramis ; Robert J. Grimer ; Konstantinos Malizos ; [et al...] . - 2016 . - p. 216-221. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 216-221 Mots-clés : sarcome d'Ewing  bassin  traitement Résumé : We are reporting our experience on patients with pelvic Ewing’s Sarcoma treated in our unit. We retrospectively reviewed a series of patients with non-metastatic pelvic Ewing’s sarcoma treated between 1977 and 2009. Patients were classified into three groups according to the local treatment received : Group 1. radiotherapy-chemo ; Group 2. surgery-chemo and Group 3. radiotherapy-surgery-chemo. Recurrence free and overall survival rates were calculated using the Kaplan-Meier method. Influence of various factors (age at diagnosis, gender, tumour site and size, chemotherapy response, surgical margins and type of treatment) on survival was assessed with a logistic regression model. A total of 85 patients were treated with a mean follow-up of 65.8 months and mean tumour volume of 435ml. The 5-year survival for all patients was 40.7% decreased to 36.2% at 10 years. A significant prognostic factor identified was chemotherapy response only. There was a trend for improved survival and local control rates for patients who had chemotherapy and surgery and the results were apparent for all tumours irrespective of size but not statistically significant. Currently, the optimal management of pelvic Ewing’s sarcoma is controversial but our study shows a trend for improved survival for patients treated with chemotherapy and surgery. Permalink : ./index.php?lvl=notice_display&id=46086

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Combined Open Reduction and Dega Transiliac Osteotomy for Developmental Dysplasia of the Hip in walking children / Mazen M. Ibrahim in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 222-232 Titre : Combined Open Reduction and Dega Transiliac Osteotomy for Developmental Dysplasia of the Hip in walking children Type de document : texte imprimé Auteurs : Mazen M. Ibrahim ; Mohamed R.S. El-Lakkany ; Mohamed M. Wahba ; [et al...] Année de publication : 2016 Article en page(s) : p. 222-232 Langues : Anglais (eng) Mots-clés : hanche  dysplasie  chirurgie  enfant Résumé : The iliac osteotomy described by Dega in Poland, in 1969, is an acetabuloplasty that changes the acetabular configuration and its inclination. The aim of this work is to analyze a group of patients with DDH treated by combined open reduction and Dega transiliac osteotomy ,to evaluate the results and determine the advantages and disadvantages, as well as, assess the factors affecting the final outcome of such procedure. A prospective study was conducted during the period, from November 2010 to October 2014, on 39 hips, in 29 children, with neglected DDH after walking age, either diagnosed late or after failure to respond to previous non operative treatment. The mean age at the time of surgery was 27.6 months ranging from 18 to 48 months. All hips were followed up clinically and radiologically for a mean period of 33.6 months (range from 18 to 48 months). No patient was lost to follow up. At the end of follow up, satisfactory final clinical results were obtained in 34 hips (87.2%) and unsatisfactory in 5 (12.8%) according to McKay’s criteria. Radiologically, satisfactory results were obtained in 32 hips (82.1%) and unsatisfactory in seven (17.9%), according to Severin’s criteria. In conclusion, the results of our series show open reduction combined with Dega transiliac osteotomy to be a safe and efficient method for the surgical treatment of DDH in selected patients, and can easily and safely be combined with associated procedures for single stage correction of acetabular dysplasia. Permalink : ./index.php?lvl=notice_display&id=46087 [article] Combined Open Reduction and Dega Transiliac Osteotomy for Developmental Dysplasia of the Hip in walking children [texte imprimé] / Mazen M. Ibrahim ; Mohamed R.S. El-Lakkany ; Mohamed M. Wahba ; [et al...] . - 2016 . - p. 222-232. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 222-232 Mots-clés : hanche  dysplasie  chirurgie  enfant Résumé : The iliac osteotomy described by Dega in Poland, in 1969, is an acetabuloplasty that changes the acetabular configuration and its inclination. The aim of this work is to analyze a group of patients with DDH treated by combined open reduction and Dega transiliac osteotomy ,to evaluate the results and determine the advantages and disadvantages, as well as, assess the factors affecting the final outcome of such procedure. A prospective study was conducted during the period, from November 2010 to October 2014, on 39 hips, in 29 children, with neglected DDH after walking age, either diagnosed late or after failure to respond to previous non operative treatment. The mean age at the time of surgery was 27.6 months ranging from 18 to 48 months. All hips were followed up clinically and radiologically for a mean period of 33.6 months (range from 18 to 48 months). No patient was lost to follow up. At the end of follow up, satisfactory final clinical results were obtained in 34 hips (87.2%) and unsatisfactory in 5 (12.8%) according to McKay’s criteria. Radiologically, satisfactory results were obtained in 32 hips (82.1%) and unsatisfactory in seven (17.9%), according to Severin’s criteria. In conclusion, the results of our series show open reduction combined with Dega transiliac osteotomy to be a safe and efficient method for the surgical treatment of DDH in selected patients, and can easily and safely be combined with associated procedures for single stage correction of acetabular dysplasia. Permalink : ./index.php?lvl=notice_display&id=46087

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The reliability and validity of the Unified Classification System of periprosthetic femoral fractures after hip arthroplasty / Jie-Feng Huang in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 233-239 Titre : The reliability and validity of the Unified Classification System of periprosthetic femoral fractures after hip arthroplasty Type de document : texte imprimé Auteurs : Jie-Feng Huang ; Jun-Jie Chen ; Jian-Jian Shen ; [et al...] Année de publication : 2016 Article en page(s) : p. 233-239 Langues : Anglais (eng) Mots-clés : hanche  fracture  prothèse  arthroplastie Résumé : The Unified Classification System has expanded and updated the Vancouver Classification System and applied treatment principles to all periprosthetic fractures. This study assessed the reliability and validity of the Unified Classification System for femur fractures after hip arthroplasty. Thirty-eight radiographs were finally evaluated by 6 observers, 3 consultants and 3 trainees. Each observer read the radiographs on 2 separate occasions, independently, at least 2 weeks apart. Interobserver and intraobserver agreement and validity were analyzed, using weighted ? statistics. The mean ? value for interobserver agreement was found to be 0.849 (0.838-0.871) for consultants (almost perfect agreement) and 0.761 (0.707-0.836) for the trainees (substantial agreement). Intraobserver ? values ranged from 0.740 to 0.903, showing substantial to almost perfect agreement. Validity analysis of 23 type B cases revealed 79.710% agreement within B1, B2, and B3 subgroups with a mean ? value of 0.694 (0.670-0.741) (substantial agreement). Permalink : ./index.php?lvl=notice_display&id=46088 [article] The reliability and validity of the Unified Classification System of periprosthetic femoral fractures after hip arthroplasty [texte imprimé] / Jie-Feng Huang ; Jun-Jie Chen ; Jian-Jian Shen ; [et al...] . - 2016 . - p. 233-239. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 233-239 Mots-clés : hanche  fracture  prothèse  arthroplastie Résumé : The Unified Classification System has expanded and updated the Vancouver Classification System and applied treatment principles to all periprosthetic fractures. This study assessed the reliability and validity of the Unified Classification System for femur fractures after hip arthroplasty. Thirty-eight radiographs were finally evaluated by 6 observers, 3 consultants and 3 trainees. Each observer read the radiographs on 2 separate occasions, independently, at least 2 weeks apart. Interobserver and intraobserver agreement and validity were analyzed, using weighted ? statistics. The mean ? value for interobserver agreement was found to be 0.849 (0.838-0.871) for consultants (almost perfect agreement) and 0.761 (0.707-0.836) for the trainees (substantial agreement). Intraobserver ? values ranged from 0.740 to 0.903, showing substantial to almost perfect agreement. Validity analysis of 23 type B cases revealed 79.710% agreement within B1, B2, and B3 subgroups with a mean ? value of 0.694 (0.670-0.741) (substantial agreement). Permalink : ./index.php?lvl=notice_display&id=46088

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Direct anterior approach versus posterolateral approach in total hip arthroplasty : one surgeon, two approaches / Bas Fransen in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 240-248 Titre : Direct anterior approach versus posterolateral approach in total hip arthroplasty : one surgeon, two approaches Type de document : texte imprimé Auteurs : Bas Fransen ; Marco Hoozemans ; Stan Vos Année de publication : 2016 Article en page(s) : p. 240-248 Langues : Anglais (eng) Mots-clés : prothèse totale  hanche  chirurgie Résumé : Early research shows several advantages of the Direct Anterior Approach (DAA) in total hip arthroplasty (THA), although no studies evaluated the DAA on a regular operating table without using fluoroscopy. We performed a retrospective cohort study on the outcome of this variation of the DAA compared with the posterolateral approach (PLA) with one year follow- up. All procedures were uncemented THA performed in 2012 by a single surgeon. Patients in the DAA group (N = 45) had a lower Body Mass Index (p < .001) than the PLA group (N = 38). Functional outcome, pain scores and complications were comparable between the two approaches. Compared with PLA, the DAA was associated with longer operation time (p < 0.001), more blood loss (p < 0.001), shorter length of stay (p = .009), and more adequate acetabular cup inclination (p = .004). This study shows that the DAA on a regular operating table without using fluoroscopy has several advantages compared to the PLA. Permalink : ./index.php?lvl=notice_display&id=46089 [article] Direct anterior approach versus posterolateral approach in total hip arthroplasty : one surgeon, two approaches [texte imprimé] / Bas Fransen ; Marco Hoozemans ; Stan Vos . - 2016 . - p. 240-248. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 240-248 Mots-clés : prothèse totale  hanche  chirurgie Résumé : Early research shows several advantages of the Direct Anterior Approach (DAA) in total hip arthroplasty (THA), although no studies evaluated the DAA on a regular operating table without using fluoroscopy. We performed a retrospective cohort study on the outcome of this variation of the DAA compared with the posterolateral approach (PLA) with one year follow- up. All procedures were uncemented THA performed in 2012 by a single surgeon. Patients in the DAA group (N = 45) had a lower Body Mass Index (p < .001) than the PLA group (N = 38). Functional outcome, pain scores and complications were comparable between the two approaches. Compared with PLA, the DAA was associated with longer operation time (p < 0.001), more blood loss (p < 0.001), shorter length of stay (p = .009), and more adequate acetabular cup inclination (p = .004). This study shows that the DAA on a regular operating table without using fluoroscopy has several advantages compared to the PLA. Permalink : ./index.php?lvl=notice_display&id=46089

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Augmentative compression plating versus exchanging reamed nailing for nonunion of femoral shaft fracture after intramedullary nailing : A retrospective cohort study / Jiangying Ru in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 249-257 Titre : Augmentative compression plating versus exchanging reamed nailing for nonunion of femoral shaft fracture after intramedullary nailing : A retrospective cohort study Type de document : texte imprimé Auteurs : Jiangying Ru ; Haidong Xu ; Wenbo Kang ; [et al...] Année de publication : 2016 Article en page(s) : p. 249-257 Langues : Anglais (eng) Mots-clés : fracture  femur  chirurgie Résumé : Aim of the present study was to compare the outcomes between exchanging reamed nailing (ERN) and augmentative compression plating (ACP) in treatment of femoral shaft nonunion after intramedullary nailing (IMN) retrospectively. A retrospective, multicentre study was performed with 188 patients (190 cases)with femoral shaft nonunion after IMN, who received therapy with either ERN (n = 92) for 44/92 (47.8%) cases of nonisthmal nonunions and 48/92 (52.2%) cases of isthmal nonunions or ACP (n = 98) for 48/98 (49%) cases of nonisthmal nonunions and 50/98 (51%) cases of isthmal nonunions. Operation time, intraoperative blood loss, time to union, union rate, postoperative draining volume and complication rate were compared between ERN and ACP group. After a mean follow-up of 4.6 years (range 1-8.1 years), the bone union occurred in 98/98 (100%) cases in total ACP group versus 80/92 (87%) cases in total ERN group [odds ratio (OR) = 3.34, 95% confidence interval (CI) 0.8-1.6]. Twelve cases with re-nonunion in the total ERN group included 10/12 (83.3%) cases of nonisthmal nonunions and 2/12 (16.7%) cases of isthmal nonunion with cortical bone defect > 3 cm. The average time to union, the intraoperative blood loss and the complication rate in total ERN group were also both significantly more than that in total ACP group (p = 0.031, p = 0.042, p = 0.028). No significant difference was found in the average operation time between the two total groups (p = 0.213). However, for nonisthmal nonunions, the mean operation time for ERN group was 126.8 ± 19.6 min in comparison to ACP group (88.6 ± 15.2 min), significant difference was found between ERN group and ACP group (p = 0.021). ACP could obtain the higher bone union rate and shorter time to union than ERN in the treatment of femoral shaft nonunion after failed IMN. Especially for nonisthmal femoral shaft nonunions or isthmal nonunions with larger bone defect, ACP could bring more advantages to patients than ERN. A prospective observational study is needed. Permalink : ./index.php?lvl=notice_display&id=46090 [article] Augmentative compression plating versus exchanging reamed nailing for nonunion of femoral shaft fracture after intramedullary nailing : A retrospective cohort study [texte imprimé] / Jiangying Ru ; Haidong Xu ; Wenbo Kang ; [et al...] . - 2016 . - p. 249-257. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 249-257 Mots-clés : fracture  femur  chirurgie Résumé : Aim of the present study was to compare the outcomes between exchanging reamed nailing (ERN) and augmentative compression plating (ACP) in treatment of femoral shaft nonunion after intramedullary nailing (IMN) retrospectively. A retrospective, multicentre study was performed with 188 patients (190 cases)with femoral shaft nonunion after IMN, who received therapy with either ERN (n = 92) for 44/92 (47.8%) cases of nonisthmal nonunions and 48/92 (52.2%) cases of isthmal nonunions or ACP (n = 98) for 48/98 (49%) cases of nonisthmal nonunions and 50/98 (51%) cases of isthmal nonunions. Operation time, intraoperative blood loss, time to union, union rate, postoperative draining volume and complication rate were compared between ERN and ACP group. After a mean follow-up of 4.6 years (range 1-8.1 years), the bone union occurred in 98/98 (100%) cases in total ACP group versus 80/92 (87%) cases in total ERN group [odds ratio (OR) = 3.34, 95% confidence interval (CI) 0.8-1.6]. Twelve cases with re-nonunion in the total ERN group included 10/12 (83.3%) cases of nonisthmal nonunions and 2/12 (16.7%) cases of isthmal nonunion with cortical bone defect > 3 cm. The average time to union, the intraoperative blood loss and the complication rate in total ERN group were also both significantly more than that in total ACP group (p = 0.031, p = 0.042, p = 0.028). No significant difference was found in the average operation time between the two total groups (p = 0.213). However, for nonisthmal nonunions, the mean operation time for ERN group was 126.8 ± 19.6 min in comparison to ACP group (88.6 ± 15.2 min), significant difference was found between ERN group and ACP group (p = 0.021). ACP could obtain the higher bone union rate and shorter time to union than ERN in the treatment of femoral shaft nonunion after failed IMN. Especially for nonisthmal femoral shaft nonunions or isthmal nonunions with larger bone defect, ACP could bring more advantages to patients than ERN. A prospective observational study is needed. Permalink : ./index.php?lvl=notice_display&id=46090

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A posteromedial approach for open reduction and internal fixation of posteromedial tibial plateau fracture / Hong-wei Chen in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 258-264 Titre : A posteromedial approach for open reduction and internal fixation of posteromedial tibial plateau fracture Type de document : texte imprimé Auteurs : Hong-wei Chen ; Jun Pan ; Xian-hong Yi ; [et al...] Année de publication : 2016 Article en page(s) : p. 258-264 Langues : Anglais (eng) Mots-clés : plateau tibial  fracture  chirurgie Résumé : The aim of this study was to evaluate the clinical outcomes of patients with posteromedial tibial plateau fractures treated by open reduction and internal fixation (ORIF) through a posteromedial approach. Thirty-six patients with posteromedial tibial plateau fracture underwent ORIF through a posteromedial approach and were retrospectively analyzed. Preoperative X-ray pictures and CT images were obtained. And there were 11 cases of posteromedial tibial plateau fracture and 25 cases of posteromedial and posterolateral tibial plateau fracture. All the patients were treated surgically with posteromedial approach. The clinical outcomes were assessed according to the Rasmussen knee function grading system. The patients were followed-up for an average of 17.5 months (range, 12-32 months). All the fractures attained satisfactory reduction. No major complications were observed. According to the Rasmussen knee function grading system, the results were graded as excellent in 21 cases, good in 13 cases, fair in 2 cases. The rate of excellent and good results was 94.4%. The posteromedial approach in our opinion is the best option to treat the posteromedial tibial plateau fractures because it can provide direct visualization of the fracture site and avoid dissection of neurovascular bundle in the popliteal fossa area with minimal soft tissue injury. Permalink : ./index.php?lvl=notice_display&id=46091 [article] A posteromedial approach for open reduction and internal fixation of posteromedial tibial plateau fracture [texte imprimé] / Hong-wei Chen ; Jun Pan ; Xian-hong Yi ; [et al...] . - 2016 . - p. 258-264. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 258-264 Mots-clés : plateau tibial  fracture  chirurgie Résumé : The aim of this study was to evaluate the clinical outcomes of patients with posteromedial tibial plateau fractures treated by open reduction and internal fixation (ORIF) through a posteromedial approach. Thirty-six patients with posteromedial tibial plateau fracture underwent ORIF through a posteromedial approach and were retrospectively analyzed. Preoperative X-ray pictures and CT images were obtained. And there were 11 cases of posteromedial tibial plateau fracture and 25 cases of posteromedial and posterolateral tibial plateau fracture. All the patients were treated surgically with posteromedial approach. The clinical outcomes were assessed according to the Rasmussen knee function grading system. The patients were followed-up for an average of 17.5 months (range, 12-32 months). All the fractures attained satisfactory reduction. No major complications were observed. According to the Rasmussen knee function grading system, the results were graded as excellent in 21 cases, good in 13 cases, fair in 2 cases. The rate of excellent and good results was 94.4%. The posteromedial approach in our opinion is the best option to treat the posteromedial tibial plateau fractures because it can provide direct visualization of the fracture site and avoid dissection of neurovascular bundle in the popliteal fossa area with minimal soft tissue injury. Permalink : ./index.php?lvl=notice_display&id=46091

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Postoperative pain relief and functional outcome following total knee arthroplasty – a prospective comparative audit of three analgesic regimes / Aysha Rajeev in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 265-270 Titre : Postoperative pain relief and functional outcome following total knee arthroplasty – a prospective comparative audit of three analgesic regimes Type de document : texte imprimé Auteurs : Aysha Rajeev ; Nezar Tumia ; Kaushlendra Karn ; [et al...] Année de publication : 2016 Article en page(s) : p. 265-270 Langues : Anglais (eng) Mots-clés : prothèse totale de genou  chirurgie  douleur Résumé : Pain control plays a key role in joint-replacement surgery. As a surgeon the challenge is to reduce pain to an acceptable level in the post-operative period. The aim of the study was to assess the efficacy of bolus local anaesthesia, infusion in to the surgical site and nerve blocks with femoral nerve catheter and its functional outcome. A prospective audit of 114 patients undergoing total knee arthroplasty were carried out.The patients were divided in to three groups : Group 1 (n = 27) received a bolus injection of 20 ml 0.25% levobupivacaine + 10 ml 0.25%bupivacaine + adrenaline + 30 ml saline. Group 2 (n = 39) received a bolus injection as on group 1 with 240 ml 0.25% bupivacaine infusion and 5 ml/hour using a Pain Buster pump. Group 3 (n = 48) received 30 ml 0.125% levobupivacaine to femoral (3- in-1) block with 30 ml 0.25% levobupivacaine to sciatic nerve and introduction of a femoral nerve catheter. All patients were prescribed paracetamol 1 g QDS, Oxycontin 20 mg BD and Ibuprofen post operatively. Pain was assessed with a Visual Analog Scale (VAS). The incidence of PONV was measured by PONY intensity score. The mean post-op VAS score for Group 3 was 4. The demand of oxynorm and NSAID were minimal in Group 3. The mean in patient stay for Group 3 was 3.1 days. The PONV intensity score was > 50 for 9 (36%) in Group 1, 15 (40%) in Group 2 and 9 (20%) in Group 3. There was loss of 20-30 degrees of flexion movements in Group 3 in the first 4 to 6 days post-op. Our study demonstrated that Regime 3 with the use of nerve blocks and femoral nerve catheter has given the maximum pain relief and good functional outcome following total knee replacement. Permalink : ./index.php?lvl=notice_display&id=46092 [article] Postoperative pain relief and functional outcome following total knee arthroplasty – a prospective comparative audit of three analgesic regimes [texte imprimé] / Aysha Rajeev ; Nezar Tumia ; Kaushlendra Karn ; [et al...] . - 2016 . - p. 265-270. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 265-270 Mots-clés : prothèse totale de genou  chirurgie  douleur Résumé : Pain control plays a key role in joint-replacement surgery. As a surgeon the challenge is to reduce pain to an acceptable level in the post-operative period. The aim of the study was to assess the efficacy of bolus local anaesthesia, infusion in to the surgical site and nerve blocks with femoral nerve catheter and its functional outcome. A prospective audit of 114 patients undergoing total knee arthroplasty were carried out.The patients were divided in to three groups : Group 1 (n = 27) received a bolus injection of 20 ml 0.25% levobupivacaine + 10 ml 0.25%bupivacaine + adrenaline + 30 ml saline. Group 2 (n = 39) received a bolus injection as on group 1 with 240 ml 0.25% bupivacaine infusion and 5 ml/hour using a Pain Buster pump. Group 3 (n = 48) received 30 ml 0.125% levobupivacaine to femoral (3- in-1) block with 30 ml 0.25% levobupivacaine to sciatic nerve and introduction of a femoral nerve catheter. All patients were prescribed paracetamol 1 g QDS, Oxycontin 20 mg BD and Ibuprofen post operatively. Pain was assessed with a Visual Analog Scale (VAS). The incidence of PONV was measured by PONY intensity score. The mean post-op VAS score for Group 3 was 4. The demand of oxynorm and NSAID were minimal in Group 3. The mean in patient stay for Group 3 was 3.1 days. The PONV intensity score was > 50 for 9 (36%) in Group 1, 15 (40%) in Group 2 and 9 (20%) in Group 3. There was loss of 20-30 degrees of flexion movements in Group 3 in the first 4 to 6 days post-op. Our study demonstrated that Regime 3 with the use of nerve blocks and femoral nerve catheter has given the maximum pain relief and good functional outcome following total knee replacement. Permalink : ./index.php?lvl=notice_display&id=46092

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Pedobarographic measurements after repair of Achilles tendon by minimal invasive surgery / Huseyin Ozkan in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 271-274 Titre : Pedobarographic measurements after repair of Achilles tendon by minimal invasive surgery Type de document : texte imprimé Auteurs : Huseyin Ozkan ; Tolga Ege ; Kenan Koca ; [et al...] Année de publication : 2016 Article en page(s) : p. 271-274 Langues : Anglais (eng) Mots-clés : tendon d'Achille  chirurgie  pression plantaire Résumé : The aim of the current study was to assess the changes of plantar foot pressures with pedobarography in patients with Achilles tendon repair by minimally invasive surgical technique. This retrospective study consisted of 15 consecutive patients who were treated for acute Achilles’ tendon repair with minimally invasive technique in our clinic in a two year period between 2010 and 2012. All patients were male. The mean age was 28.7 years (24-42) and the mean follow-up time was 2.3 years (1.5- 3). All patients had sports related Achilles’ tendon rupture and all had undergone surgery in 24-48 hours. After surgery, extremity was immobilized with short leg cast for 6 weeks. Peak and mean heel and forefoot pressures in injured extremity were measured by pedobarograph and compared with noninvolved foot. There wasn’t any complication associated with surgery such as wound problems, re rupture or neurologic injury. Only three patients had some numbness at the incision site. When we compare the mean foot pressures between the operated foot and the normal foot, there was no statistical difference about peak and mean heel and forefoot plantar pressure between involved site and non involved site. As a result, Achilles tendon repair with minimal invasive technique and early rehabilitation may prevent changes of plantar foot pressure distribution. Permalink : ./index.php?lvl=notice_display&id=46093 [article] Pedobarographic measurements after repair of Achilles tendon by minimal invasive surgery [texte imprimé] / Huseyin Ozkan ; Tolga Ege ; Kenan Koca ; [et al...] . - 2016 . - p. 271-274. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 271-274 Mots-clés : tendon d'Achille  chirurgie  pression plantaire Résumé : The aim of the current study was to assess the changes of plantar foot pressures with pedobarography in patients with Achilles tendon repair by minimally invasive surgical technique. This retrospective study consisted of 15 consecutive patients who were treated for acute Achilles’ tendon repair with minimally invasive technique in our clinic in a two year period between 2010 and 2012. All patients were male. The mean age was 28.7 years (24-42) and the mean follow-up time was 2.3 years (1.5- 3). All patients had sports related Achilles’ tendon rupture and all had undergone surgery in 24-48 hours. After surgery, extremity was immobilized with short leg cast for 6 weeks. Peak and mean heel and forefoot pressures in injured extremity were measured by pedobarograph and compared with noninvolved foot. There wasn’t any complication associated with surgery such as wound problems, re rupture or neurologic injury. Only three patients had some numbness at the incision site. When we compare the mean foot pressures between the operated foot and the normal foot, there was no statistical difference about peak and mean heel and forefoot plantar pressure between involved site and non involved site. As a result, Achilles tendon repair with minimal invasive technique and early rehabilitation may prevent changes of plantar foot pressure distribution. Permalink : ./index.php?lvl=notice_display&id=46093

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Heel reconstruction with parallel fibular osteoseptocutaneous flap / Ruiduan Liu in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 275-279 Titre : Heel reconstruction with parallel fibular osteoseptocutaneous flap Type de document : texte imprimé Auteurs : Ruiduan Liu ; Xhaoxu Li ; Anmin Jin Année de publication : 2016 Article en page(s) : p. 275-279 Langues : Anglais (eng) Mots-clés : calcaneum  talon  chirurgie Résumé : Reconstruction of heel defects can be challenging and requires careful consideration in restoring both the functional and aesthetic deficit. This study assessed the use of parallel fibular osteoseptocutaneous flap to repair composite heel defects. Follow-up of the 4 patients included in this study ranged from 24 months to 3 years after their operation. The flap survival rate was 100% in all patients, with good coverage of the heel defects. Postoperative complication was one superficial wound infection. Union of the graft with the host bone was achieved in all patients at an average of 6 months (range : 5-10 months). The parallel fibular osteoseptocutaneous flap is thus a reliable means of reconstruction of composite bone and softtissue defect in the heel region. Permalink : ./index.php?lvl=notice_display&id=46094 [article] Heel reconstruction with parallel fibular osteoseptocutaneous flap [texte imprimé] / Ruiduan Liu ; Xhaoxu Li ; Anmin Jin . - 2016 . - p. 275-279. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 275-279 Mots-clés : calcaneum  talon  chirurgie Résumé : Reconstruction of heel defects can be challenging and requires careful consideration in restoring both the functional and aesthetic deficit. This study assessed the use of parallel fibular osteoseptocutaneous flap to repair composite heel defects. Follow-up of the 4 patients included in this study ranged from 24 months to 3 years after their operation. The flap survival rate was 100% in all patients, with good coverage of the heel defects. Postoperative complication was one superficial wound infection. Union of the graft with the host bone was achieved in all patients at an average of 6 months (range : 5-10 months). The parallel fibular osteoseptocutaneous flap is thus a reliable means of reconstruction of composite bone and softtissue defect in the heel region. Permalink : ./index.php?lvl=notice_display&id=46094

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Evaluation of the metaphyseal ulnar shortening technique according to Sennwald / Joris Beckers in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 280-286 Titre : Evaluation of the metaphyseal ulnar shortening technique according to Sennwald Type de document : texte imprimé Auteurs : Joris Beckers ; Bertram The ; Ilse Degreef ; Luc De Smet Année de publication : 2016 Article en page(s) : p. 280-286 Langues : Anglais (eng) Mots-clés : ulna  chirurgie Résumé : The outcome of a metaphyseal ulnar shortening osteotomy, reported by Sennwald as an alternative option for ulnar abutment syndrome, was evaluated with regard to the functional results, pain relief and incidence of complications. Methods : We conducted a review of 12 patients ; measured parameters were DASH score, PRWE, VAS for pain, grip force and wrist motion. Results : Only disability improved significantly with a DASH score of 42 (p = 0.03). The function and pain assessment scores did not improve in 3 patients. We found no correlation between change in functional scores and other measured variables. Six patients were reoperated for prominent screw heads or newonset distal radioulnar joint osteoarthritis. Conclusion : All osteomies healed fast and uneventfully and disability improved in most patients but 25% did not improve and 50% were re-operated. Further investigation is needed to evaluate the value of the metaphyseal osteotomy as an alternative treatment for ulnar abutment syndrome. Permalink : ./index.php?lvl=notice_display&id=46095 [article] Evaluation of the metaphyseal ulnar shortening technique according to Sennwald [texte imprimé] / Joris Beckers ; Bertram The ; Ilse Degreef ; Luc De Smet . - 2016 . - p. 280-286. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 280-286 Mots-clés : ulna  chirurgie Résumé : The outcome of a metaphyseal ulnar shortening osteotomy, reported by Sennwald as an alternative option for ulnar abutment syndrome, was evaluated with regard to the functional results, pain relief and incidence of complications. Methods : We conducted a review of 12 patients ; measured parameters were DASH score, PRWE, VAS for pain, grip force and wrist motion. Results : Only disability improved significantly with a DASH score of 42 (p = 0.03). The function and pain assessment scores did not improve in 3 patients. We found no correlation between change in functional scores and other measured variables. Six patients were reoperated for prominent screw heads or newonset distal radioulnar joint osteoarthritis. Conclusion : All osteomies healed fast and uneventfully and disability improved in most patients but 25% did not improve and 50% were re-operated. Further investigation is needed to evaluate the value of the metaphyseal osteotomy as an alternative treatment for ulnar abutment syndrome. Permalink : ./index.php?lvl=notice_display&id=46095

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Gait analysis in tumor patients after distal femoral resection and implantation of a megaprosthesis / J. Bruns in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 287-297 Titre : Gait analysis in tumor patients after distal femoral resection and implantation of a megaprosthesis Type de document : texte imprimé Auteurs : J. Bruns ; K. Raabe ; G. Deuretzbacher Année de publication : 2016 Article en page(s) : p. 287-297 Langues : Anglais (eng) Mots-clés : ostéosarcome  os  tumeur  analyse de la marche  fémur  prothèse Résumé : We analysed nine patients who had had a megaprosthesis implanted into the distal femur and knee joint for treatment of sarcomas. Data obtained from the leg operated on were compared with those from the contralateral side and healthy volunteers. Gait data, kinematics, ground reaction forces and the EMG from five muscles around the knee joint were analysed by means of a video-based analysis system recording data from reflection markers ; a Kistlerplate recorded the GRF and a ten channel surface EMG the muscle activity. Muscle around the knee showed a cocontraction between the extensor and flexor muscles in the thigh and the calf in the operated leg as well as contralaterally. Gait characteristics exhibited a reduced speed, cadence, and a shorter step. This correlated with a reduced flexion in the hip and knee joint. The GRF exhibited significant changes in the data representing the reduced gait dynamic. Permalink : ./index.php?lvl=notice_display&id=46096 [article] Gait analysis in tumor patients after distal femoral resection and implantation of a megaprosthesis [texte imprimé] / J. Bruns ; K. Raabe ; G. Deuretzbacher . - 2016 . - p. 287-297. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 287-297 Mots-clés : ostéosarcome  os  tumeur  analyse de la marche  fémur  prothèse Résumé : We analysed nine patients who had had a megaprosthesis implanted into the distal femur and knee joint for treatment of sarcomas. Data obtained from the leg operated on were compared with those from the contralateral side and healthy volunteers. Gait data, kinematics, ground reaction forces and the EMG from five muscles around the knee joint were analysed by means of a video-based analysis system recording data from reflection markers ; a Kistlerplate recorded the GRF and a ten channel surface EMG the muscle activity. Muscle around the knee showed a cocontraction between the extensor and flexor muscles in the thigh and the calf in the operated leg as well as contralaterally. Gait characteristics exhibited a reduced speed, cadence, and a shorter step. This correlated with a reduced flexion in the hip and knee joint. The GRF exhibited significant changes in the data representing the reduced gait dynamic. Permalink : ./index.php?lvl=notice_display&id=46096

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Bicondylar tibial plateau fractures involving the posteromedial fragment : morphology based fixation / Barakat El-Alfy in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 298-204 Titre : Bicondylar tibial plateau fractures involving the posteromedial fragment : morphology based fixation Type de document : texte imprimé Auteurs : Barakat El-Alfy ; Ayman M. Ali ; Abdelrahman El-Ganiney Année de publication : 2016 Article en page(s) : p. 298-204 Langues : Anglais (eng) Mots-clés : fracture  plateau tibial  chirurgie Résumé : The aim of this study is to describe the morphology of the posteromedial fragment in the setting of bicondylar tibial plateau fractures and to use it as a base for selection of the method of fixation. Twenty two patients with bicondylar tibial plateau fractures involving the posteromedial fragment were included in this study. Plain X- ray and computed tomogram (CT) were performed in all patients. Thirteen patients were treated by dual plating while nine were treated by single lateral plate. The mean posteromedial fragment height was 39 mm. The cephalad surface area percentage of the posteromedial fragment relative to the entire tibial plateau ranged from 10% to 43%. with an average of 28%. The average knee motion at the final follow up was 110°. Two cases were complicated by implant failure. Morphological study of the posteromedial fragment could help in selection of the proper method of fixation. Permalink : ./index.php?lvl=notice_display&id=46097 [article] Bicondylar tibial plateau fractures involving the posteromedial fragment : morphology based fixation [texte imprimé] / Barakat El-Alfy ; Ayman M. Ali ; Abdelrahman El-Ganiney . - 2016 . - p. 298-204. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 298-204 Mots-clés : fracture  plateau tibial  chirurgie Résumé : The aim of this study is to describe the morphology of the posteromedial fragment in the setting of bicondylar tibial plateau fractures and to use it as a base for selection of the method of fixation. Twenty two patients with bicondylar tibial plateau fractures involving the posteromedial fragment were included in this study. Plain X- ray and computed tomogram (CT) were performed in all patients. Thirteen patients were treated by dual plating while nine were treated by single lateral plate. The mean posteromedial fragment height was 39 mm. The cephalad surface area percentage of the posteromedial fragment relative to the entire tibial plateau ranged from 10% to 43%. with an average of 28%. The average knee motion at the final follow up was 110°. Two cases were complicated by implant failure. Morphological study of the posteromedial fragment could help in selection of the proper method of fixation. Permalink : ./index.php?lvl=notice_display&id=46097

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Analysis of soft-tissue complications of volar plate fixation for managing distal radius fractures and clinical effect while preserving pronator quadratus / Jian Fan in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 305-312 Titre : Analysis of soft-tissue complications of volar plate fixation for managing distal radius fractures and clinical effect while preserving pronator quadratus Type de document : texte imprimé Auteurs : Jian Fan ; Bo Jiang ; Bing Wang ; [et al...] Année de publication : 2016 Article en page(s) : p. 305-312 Langues : Anglais (eng) Mots-clés : fracture  radius  chirurgie Résumé : The aim of the study was to analysis soft-tissue complications of volar plate fixation and it’s prevention strategies along with exploring clinical effects of preserving pronator quadratus (PQ) muscle. From February 2011 to February 2013, sixty-five patients with distal radius fracture underwent open reduction and internal fixation with the volar locking palmar plates. The group with preserving PQ involved 30 patients and group with PQ repair involved 35 patients. Surgeons must took great care of not letting drill pierce dorsal cortical bone rapidly and dorsal carpal tangential fluoroscopy was also taken in addition to lateral fluoroscopy to get accurate screw length. Volar plate must be placed not go beyond the watershed region of distal radius. The wrist pain, forearm range of motion, grip strength, wrist functional recovery score, X-ray and CT imaging were followed-up after surgery. Two groups were compared for Clinical efficacy. The minimum follow-up for the whole cohort was one year. The relevant post operative data were collected after 2 weeks, 6 weeks, 3 and 12 month respectively. Fractures healing after postoperative 3 months are significant in X -ray and CT imaging. Fixation position and stability were good, but each group had one case with a screw piercing the dorsal cortical. The differences between the two groups were significant regarding the wrist pain, forearm range of motion, grip and strength at 2 and 6 weeks after operation, but not significant at 3 and 12 month after operation. The differences between the two groups were also significant regarding wrist functional scores at 6 weeks, but not significant at 3 and 12 month after operation. Drilling the dorsal cortical bone gently and accurate screws length can avoid extensor tendon injury. Dorsal carpal tangential fluoroscopy is a useful supplement for accurate screws length besides lateral fluoroscopy. Volar plate’s position not go beyond the watershed region of distal radius is the key factor in reducing the flexor tendon injury and preservation of the PQ muscle can also prevent the flexor tendon injury, yield better early wrist function and shorten rehabilitation time. Permalink : ./index.php?lvl=notice_display&id=46098 [article] Analysis of soft-tissue complications of volar plate fixation for managing distal radius fractures and clinical effect while preserving pronator quadratus [texte imprimé] / Jian Fan ; Bo Jiang ; Bing Wang ; [et al...] . - 2016 . - p. 305-312. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 305-312 Mots-clés : fracture  radius  chirurgie Résumé : The aim of the study was to analysis soft-tissue complications of volar plate fixation and it’s prevention strategies along with exploring clinical effects of preserving pronator quadratus (PQ) muscle. From February 2011 to February 2013, sixty-five patients with distal radius fracture underwent open reduction and internal fixation with the volar locking palmar plates. The group with preserving PQ involved 30 patients and group with PQ repair involved 35 patients. Surgeons must took great care of not letting drill pierce dorsal cortical bone rapidly and dorsal carpal tangential fluoroscopy was also taken in addition to lateral fluoroscopy to get accurate screw length. Volar plate must be placed not go beyond the watershed region of distal radius. The wrist pain, forearm range of motion, grip strength, wrist functional recovery score, X-ray and CT imaging were followed-up after surgery. Two groups were compared for Clinical efficacy. The minimum follow-up for the whole cohort was one year. The relevant post operative data were collected after 2 weeks, 6 weeks, 3 and 12 month respectively. Fractures healing after postoperative 3 months are significant in X -ray and CT imaging. Fixation position and stability were good, but each group had one case with a screw piercing the dorsal cortical. The differences between the two groups were significant regarding the wrist pain, forearm range of motion, grip and strength at 2 and 6 weeks after operation, but not significant at 3 and 12 month after operation. The differences between the two groups were also significant regarding wrist functional scores at 6 weeks, but not significant at 3 and 12 month after operation. Drilling the dorsal cortical bone gently and accurate screws length can avoid extensor tendon injury. Dorsal carpal tangential fluoroscopy is a useful supplement for accurate screws length besides lateral fluoroscopy. Volar plate’s position not go beyond the watershed region of distal radius is the key factor in reducing the flexor tendon injury and preservation of the PQ muscle can also prevent the flexor tendon injury, yield better early wrist function and shorten rehabilitation time. Permalink : ./index.php?lvl=notice_display&id=46098

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Morphological characteristics of olecranon fractures in adults : a Computed Tomography-based study / Yuki Fujihara in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 313-318 Titre : Morphological characteristics of olecranon fractures in adults : a Computed Tomography-based study Type de document : texte imprimé Auteurs : Yuki Fujihara ; Masahiro Tatebe ; Nasa Fujihara ; [et al...] Année de publication : 2016 Article en page(s) : p. 313-318 Langues : Anglais (eng) Mots-clés : olécrane  fracture  coude  imagerie médicale Résumé : The aim of this study was to identify the fragment’s shape by evaluating olecranon fractures. We examined the CT images of 48 olecranon fractures (28 women and 20 men). Mean age was 59.9 years. On the olecranon’s posterior surface, we measured the distance between the apex of the olecranon fragment and the radial edge of the flat spot on the short axis and the width of the flat spot on the same short axis. The tip radial ratio (i.e., the tip radial edge to the flat spot width) was derived from these parameters. The mean tip radial edge was 1.96 mm, and the flat spot width was 12.64 mm ; therefore, the tip radial ratio was 0.15 mm. Radial inclination on the articular surface was 30.55°. Our findings confirmed our hypothesis that the fracture lines run from the proximal ulnar side to the distal radial side on the olecranon’s posterior and articular surfaces. Permalink : ./index.php?lvl=notice_display&id=46099 [article] Morphological characteristics of olecranon fractures in adults : a Computed Tomography-based study [texte imprimé] / Yuki Fujihara ; Masahiro Tatebe ; Nasa Fujihara ; [et al...] . - 2016 . - p. 313-318. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 313-318 Mots-clés : olécrane  fracture  coude  imagerie médicale Résumé : The aim of this study was to identify the fragment’s shape by evaluating olecranon fractures. We examined the CT images of 48 olecranon fractures (28 women and 20 men). Mean age was 59.9 years. On the olecranon’s posterior surface, we measured the distance between the apex of the olecranon fragment and the radial edge of the flat spot on the short axis and the width of the flat spot on the same short axis. The tip radial ratio (i.e., the tip radial edge to the flat spot width) was derived from these parameters. The mean tip radial edge was 1.96 mm, and the flat spot width was 12.64 mm ; therefore, the tip radial ratio was 0.15 mm. Radial inclination on the articular surface was 30.55°. Our findings confirmed our hypothesis that the fracture lines run from the proximal ulnar side to the distal radial side on the olecranon’s posterior and articular surfaces. Permalink : ./index.php?lvl=notice_display&id=46099

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Does the implant make the difference ? – Prospective comparison of two different proximal femur nails / Sascha Hopp in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 319-331 Titre : Does the implant make the difference ? – Prospective comparison of two different proximal femur nails Type de document : texte imprimé Auteurs : Sascha Hopp ; Reiner Wirbel ; Ishaq Ojodu ; [et al...] Année de publication : 2016 Article en page(s) : p. 319-331 Langues : Anglais (eng) Mots-clés : fracture  fémur  chirurgie Résumé : The aim of this study was to compare two proximal femur nails with regard to the complication rate and midterm clinical outcome : the InterTAN nail (ITN) versus the third generation gamma nail (GN). 78 patients older than 60 years with an unstable intertrochanteric femoral fracture (AO/OTA 31 A2/A3) were randomised over a 20 month period into either ITN (n = 39) or GN (n = 39). The outcomes of interest were the perioperative implant-related complications and the functional status (Harris Hip Score) at 6 months postoperatively. In 14 of the ITN and in two of the GN procedures the surgeons rated the implant as cumbersome (p = 0.002). Functional outcome and complication rate did not differ between both groups. The mechanical failure correlated with the positioning of the lag screw independent on the used implant. The surgeon’s technique (closed reduction, positioning of lag screw) and not implant configuration, is of crucial importance in achieving successful outcome. Permalink : ./index.php?lvl=notice_display&id=46100 [article] Does the implant make the difference ? – Prospective comparison of two different proximal femur nails [texte imprimé] / Sascha Hopp ; Reiner Wirbel ; Ishaq Ojodu ; [et al...] . - 2016 . - p. 319-331. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 319-331 Mots-clés : fracture  fémur  chirurgie Résumé : The aim of this study was to compare two proximal femur nails with regard to the complication rate and midterm clinical outcome : the InterTAN nail (ITN) versus the third generation gamma nail (GN). 78 patients older than 60 years with an unstable intertrochanteric femoral fracture (AO/OTA 31 A2/A3) were randomised over a 20 month period into either ITN (n = 39) or GN (n = 39). The outcomes of interest were the perioperative implant-related complications and the functional status (Harris Hip Score) at 6 months postoperatively. In 14 of the ITN and in two of the GN procedures the surgeons rated the implant as cumbersome (p = 0.002). Functional outcome and complication rate did not differ between both groups. The mechanical failure correlated with the positioning of the lag screw independent on the used implant. The surgeon’s technique (closed reduction, positioning of lag screw) and not implant configuration, is of crucial importance in achieving successful outcome. Permalink : ./index.php?lvl=notice_display&id=46100

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Four-corner arthrodesis using two headless compression screws / Sorin Daniel Iordache in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 332-338 Titre : Four-corner arthrodesis using two headless compression screws Type de document : texte imprimé Auteurs : Sorin Daniel Iordache ; Diane Nam ; Jacques Peylan ; Terry Axelrod Année de publication : 2016 Article en page(s) : p. 332-338 Langues : Anglais (eng) Mots-clés : scaphoïde  arthrodèse Résumé : We present the outcome of four-corner wrist arthrodesis using two headless compression screws for fixation. The study group consisted of 27 patients who underwent arthrodesis from 1998 through 2007. Data on demographic parameters, diagnosis, range of motion, pain and complications were collected from the medical files. A total of 77 series of anteroposterior, oblique, and lateral x-rays were reviewed by three independent interpreters ; consensus of at least two was required for the bones to be considered fused. Fusion was achieved in 24/27 wrists. Overall, inter-observer agreement in identifying radiographic bony fusion was fair (? = 0.41). At the critical timing, 86 (SD 68) days postoperatively, when the decision regarding fusion was made, inter-observer agreement was poor (? = 0.07). Our rates of fusion are consistent with reports in the literature. Radiographs performed at 3 months after four-corner arthrodesis are not reliable for the diagnosis of fusion. Permalink : ./index.php?lvl=notice_display&id=46101 [article] Four-corner arthrodesis using two headless compression screws [texte imprimé] / Sorin Daniel Iordache ; Diane Nam ; Jacques Peylan ; Terry Axelrod . - 2016 . - p. 332-338. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 332-338 Mots-clés : scaphoïde  arthrodèse Résumé : We present the outcome of four-corner wrist arthrodesis using two headless compression screws for fixation. The study group consisted of 27 patients who underwent arthrodesis from 1998 through 2007. Data on demographic parameters, diagnosis, range of motion, pain and complications were collected from the medical files. A total of 77 series of anteroposterior, oblique, and lateral x-rays were reviewed by three independent interpreters ; consensus of at least two was required for the bones to be considered fused. Fusion was achieved in 24/27 wrists. Overall, inter-observer agreement in identifying radiographic bony fusion was fair (? = 0.41). At the critical timing, 86 (SD 68) days postoperatively, when the decision regarding fusion was made, inter-observer agreement was poor (? = 0.07). Our rates of fusion are consistent with reports in the literature. Radiographs performed at 3 months after four-corner arthrodesis are not reliable for the diagnosis of fusion. Permalink : ./index.php?lvl=notice_display&id=46101

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Arthroscopic treatment of the young degenerative shoulder joint ; is there a role for interpositioning arthroplasty ? / Anne Karelse in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 339-345 Titre : Arthroscopic treatment of the young degenerative shoulder joint ; is there a role for interpositioning arthroplasty ? Type de document : texte imprimé Auteurs : Anne Karelse ; Nouchka Spapens ; Alexander Van Tongel ; Lieven De Wilde Année de publication : 2016 Article en page(s) : p. 339-345 Langues : Anglais (eng) Mots-clés : épaule  arthroscopie  ostéoarthrite  arthroplastie Résumé : We evaluate our experience with arthroscopic interpositioning arthroplasty as a treatment of the young degenerative shoulder joint. Between 2007 and 2009 ten patients were treated with either a dermal allograft or a meniscal allograft. In seven patients the graft failed and within 13 months these were revised to a total shoulder arthroplasty. Three patients are still satisfied after 7 to 8 years follow-up. Biologic resurfacing of the glenoid may have a role in the management of glenohumeral arthritis in the young and active patient, but the optimal graft and pathology still need to be defined. Permalink : ./index.php?lvl=notice_display&id=46102 [article] Arthroscopic treatment of the young degenerative shoulder joint ; is there a role for interpositioning arthroplasty ? [texte imprimé] / Anne Karelse ; Nouchka Spapens ; Alexander Van Tongel ; Lieven De Wilde . - 2016 . - p. 339-345. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 339-345 Mots-clés : épaule  arthroscopie  ostéoarthrite  arthroplastie Résumé : We evaluate our experience with arthroscopic interpositioning arthroplasty as a treatment of the young degenerative shoulder joint. Between 2007 and 2009 ten patients were treated with either a dermal allograft or a meniscal allograft. In seven patients the graft failed and within 13 months these were revised to a total shoulder arthroplasty. Three patients are still satisfied after 7 to 8 years follow-up. Biologic resurfacing of the glenoid may have a role in the management of glenohumeral arthritis in the young and active patient, but the optimal graft and pathology still need to be defined. Permalink : ./index.php?lvl=notice_display&id=46102

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Dynamic hip screw fixation of intertrochanteric fractures without using traction table / Satish Kumar in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 346-350 Titre : Dynamic hip screw fixation of intertrochanteric fractures without using traction table Type de document : texte imprimé Auteurs : Satish Kumar ; Naresh Chadha Année de publication : 2016 Article en page(s) : p. 346-350 Langues : Anglais (eng) Mots-clés : fracture  hanche  chirurgie Résumé : To evaluate a new technique of Dynamic hip screw (DHS) fixation without using traction table. From july 2006 to july 2012, 328 patients undergoing DHS fixation using manual traction technique were evaluated in terms of Tip apex distance (TAD), quality of fracture reduction, operation time, preoperative preparation time. In 97% cases good to moderate reduction could be achieved. The mean TAD was 19.2 millimeters, mean operation time 37 minutes and screw cutout rate was only 0.91%. This technique is easy, reproducible, cheap do not sacrifice reduction alignment, screw position and is extremely beneficial in polytrauma patients where multiple surgeries are to be done. Permalink : ./index.php?lvl=notice_display&id=46103 [article] Dynamic hip screw fixation of intertrochanteric fractures without using traction table [texte imprimé] / Satish Kumar ; Naresh Chadha . - 2016 . - p. 346-350. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 346-350 Mots-clés : fracture  hanche  chirurgie Résumé : To evaluate a new technique of Dynamic hip screw (DHS) fixation without using traction table. From july 2006 to july 2012, 328 patients undergoing DHS fixation using manual traction technique were evaluated in terms of Tip apex distance (TAD), quality of fracture reduction, operation time, preoperative preparation time. In 97% cases good to moderate reduction could be achieved. The mean TAD was 19.2 millimeters, mean operation time 37 minutes and screw cutout rate was only 0.91%. This technique is easy, reproducible, cheap do not sacrifice reduction alignment, screw position and is extremely beneficial in polytrauma patients where multiple surgeries are to be done. Permalink : ./index.php?lvl=notice_display&id=46103

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Median nerve biodegradable wrapping : Clinical outcome of 10 patients / Zinon T. Kokkalis in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 351-357 Titre : Median nerve biodegradable wrapping : Clinical outcome of 10 patients Type de document : texte imprimé Auteurs : Zinon T. Kokkalis ; Andreas F. Mavrogenis ; Christos Vottis ; [et al...] Année de publication : 2016 Article en page(s) : p. 351-357 Langues : Anglais (eng) Mots-clés : nerf median  canal carpien  chirurgie Résumé : Nerve wrap protectors are bioabsorbable synthetic materials made of collagen or extracellular matrix that provide a non-constricting encasement for injured peripheral nerves. They are designed to be used as an interface between the nerve and the surrounding tissue. After hydrated, they transform into a soft, pliable, nonfriable, easy to handle porous conduit. The wall of the nerve wrap has a longitudinal slit that allows to be placed around the injured nerve. ?his article presents the surgical technique for median nerve neurolysis and nerve coverage using a collagen or an extracellular matrix nerve wrap protector in 10 patients with recurrent or persistent carpal tunnel syndrome. All patients had a mean of three previous open carpal tunnel operations, which were not successful. The mean follow-up was 3 years. Under axillary nerve block anaesthesia with the use of pneumatic tourniquet, a standard open carpal tunnel approach was done incorporating the previous incision. Scar tissue was excised in a healthy bed and the median nerve was thoroughly released with external neurolysis. An appropriate length of nerve wrap protector was cut longitudinally according to the length of nerve release. The nerve wrap was loosely sutured with separate polypropylene sutures No. 7-0. A volar splint was applied for a mean of 2 weeks followed by progressive passive and active range of motion rehabilitation exercises of the wrist and fingers. At the last follow-up, all patients showed improvement of clinical symptoms, static two-point discrimination test and median nerve conduction studies, and absence of Tinel sign. Differences in outcome and complications with respect to the nerve wrap materials used were not observed. Permalink : ./index.php?lvl=notice_display&id=46104 [article] Median nerve biodegradable wrapping : Clinical outcome of 10 patients [texte imprimé] / Zinon T. Kokkalis ; Andreas F. Mavrogenis ; Christos Vottis ; [et al...] . - 2016 . - p. 351-357. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 351-357 Mots-clés : nerf median  canal carpien  chirurgie Résumé : Nerve wrap protectors are bioabsorbable synthetic materials made of collagen or extracellular matrix that provide a non-constricting encasement for injured peripheral nerves. They are designed to be used as an interface between the nerve and the surrounding tissue. After hydrated, they transform into a soft, pliable, nonfriable, easy to handle porous conduit. The wall of the nerve wrap has a longitudinal slit that allows to be placed around the injured nerve. ?his article presents the surgical technique for median nerve neurolysis and nerve coverage using a collagen or an extracellular matrix nerve wrap protector in 10 patients with recurrent or persistent carpal tunnel syndrome. All patients had a mean of three previous open carpal tunnel operations, which were not successful. The mean follow-up was 3 years. Under axillary nerve block anaesthesia with the use of pneumatic tourniquet, a standard open carpal tunnel approach was done incorporating the previous incision. Scar tissue was excised in a healthy bed and the median nerve was thoroughly released with external neurolysis. An appropriate length of nerve wrap protector was cut longitudinally according to the length of nerve release. The nerve wrap was loosely sutured with separate polypropylene sutures No. 7-0. A volar splint was applied for a mean of 2 weeks followed by progressive passive and active range of motion rehabilitation exercises of the wrist and fingers. At the last follow-up, all patients showed improvement of clinical symptoms, static two-point discrimination test and median nerve conduction studies, and absence of Tinel sign. Differences in outcome and complications with respect to the nerve wrap materials used were not observed. Permalink : ./index.php?lvl=notice_display&id=46104

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Supplementary tibial fixation in anterior cruciate ligament reconstruction – Direct cortical fixation using spiked washer screw vs. post-tie using washer screw / Jung Ho Noh in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 358-364 Titre : Supplementary tibial fixation in anterior cruciate ligament reconstruction – Direct cortical fixation using spiked washer screw vs. post-tie using washer screw Type de document : texte imprimé Auteurs : Jung Ho Noh ; Hee Soo Kyung ; Kyoung Ho Yoon ; Young Hak Roh Année de publication : 2016 Article en page(s) : p. 358-364 Langues : Anglais (eng) Mots-clés : cheville  chirurgie  ligament Résumé : We compare clinical outcomes of two different supplementary tibial fixation in anterior cruciate ligament (ACL) reconstruction using free tendon Achilles allograft. Eighty subjects underwent ACL reconstruction using Endobutton CL for femoral fixation and Bio-interference screw for tibial fixation. Supplementary tibial fixation was performed as direct cortical fixation using spiked washer screw (group I) or as post-tie using washer screw (group II). Lachman test, pivot shift test, IKDC classification, Lysholm score, and side-to-side difference (SSD) were evaluated. Thirty six in group I and thirty five in group II could follow up for at least 2 years. At the last followup, 7 in group I and 1 in group II showed 2+ or 3+ in Lachman test (p = 0.027). Mean SSD was 2.4mm in group I and 1.4mm in group II (p = 0.048). Post-tie using washer screw was more effective than direct cortical fixation using spiked washer screw to restore stability. Level of evidence : Therapeutic Level I ; Randomized controlled clinical trial. Permalink : ./index.php?lvl=notice_display&id=46105 [article] Supplementary tibial fixation in anterior cruciate ligament reconstruction – Direct cortical fixation using spiked washer screw vs. post-tie using washer screw [texte imprimé] / Jung Ho Noh ; Hee Soo Kyung ; Kyoung Ho Yoon ; Young Hak Roh . - 2016 . - p. 358-364. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 358-364 Mots-clés : cheville  chirurgie  ligament Résumé : We compare clinical outcomes of two different supplementary tibial fixation in anterior cruciate ligament (ACL) reconstruction using free tendon Achilles allograft. Eighty subjects underwent ACL reconstruction using Endobutton CL for femoral fixation and Bio-interference screw for tibial fixation. Supplementary tibial fixation was performed as direct cortical fixation using spiked washer screw (group I) or as post-tie using washer screw (group II). Lachman test, pivot shift test, IKDC classification, Lysholm score, and side-to-side difference (SSD) were evaluated. Thirty six in group I and thirty five in group II could follow up for at least 2 years. At the last followup, 7 in group I and 1 in group II showed 2+ or 3+ in Lachman test (p = 0.027). Mean SSD was 2.4mm in group I and 1.4mm in group II (p = 0.048). Post-tie using washer screw was more effective than direct cortical fixation using spiked washer screw to restore stability. Level of evidence : Therapeutic Level I ; Randomized controlled clinical trial. Permalink : ./index.php?lvl=notice_display&id=46105

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Outcomes of combined tibial tuberosity transfer and medial patellofemoral ligament reconstruction for recurrent patellar instability / Gopalakrishna Pemmaraju in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 365-371 Titre : Outcomes of combined tibial tuberosity transfer and medial patellofemoral ligament reconstruction for recurrent patellar instability Type de document : texte imprimé Auteurs : Gopalakrishna Pemmaraju ; James Bassett ; Raad Abbas ; [et al...] Année de publication : 2016 Article en page(s) : p. 365-371 Langues : Anglais (eng) Mots-clés : Patella  instabilité  ligament  chirugie  genou Résumé : Patellofemoral instability is multifactorial and is associated with pathomechanics secondary to anatomical variance. Surgical management of this problem must be tailored to each patient and a thorough clinical and radiological assessment of the anatomical alignment should be carried out pre-operatively. The aim of this study is to assess the role of medial patellofemoral ligament reconstruction combined with tibial tuberosity transfer in patients with increased tibial tuberosity to trochlear groove (TT-TG) distance. Twenty-four patients (27 knees) over 2-years were operated on by a single surgeon, with standardised post-operative rehabilitation and follow up. Mean follow up was 31-months. Two patients had problems with recurrent instability, 1 had a traumatic re-dislocation at 2 years and a total of 4 required further operation for complications. Mean post-operative Kujala scores were 87.4 (SD 9.8). Combined medial patellofemoral ligament reconstruction and tibial tuberosity transfer is an appropriate treatment for patients with increased TT-TG distance. Permalink : ./index.php?lvl=notice_display&id=46246 [article] Outcomes of combined tibial tuberosity transfer and medial patellofemoral ligament reconstruction for recurrent patellar instability [texte imprimé] / Gopalakrishna Pemmaraju ; James Bassett ; Raad Abbas ; [et al...] . - 2016 . - p. 365-371. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 365-371 Mots-clés : Patella  instabilité  ligament  chirugie  genou Résumé : Patellofemoral instability is multifactorial and is associated with pathomechanics secondary to anatomical variance. Surgical management of this problem must be tailored to each patient and a thorough clinical and radiological assessment of the anatomical alignment should be carried out pre-operatively. The aim of this study is to assess the role of medial patellofemoral ligament reconstruction combined with tibial tuberosity transfer in patients with increased tibial tuberosity to trochlear groove (TT-TG) distance. Twenty-four patients (27 knees) over 2-years were operated on by a single surgeon, with standardised post-operative rehabilitation and follow up. Mean follow up was 31-months. Two patients had problems with recurrent instability, 1 had a traumatic re-dislocation at 2 years and a total of 4 required further operation for complications. Mean post-operative Kujala scores were 87.4 (SD 9.8). Combined medial patellofemoral ligament reconstruction and tibial tuberosity transfer is an appropriate treatment for patients with increased TT-TG distance. Permalink : ./index.php?lvl=notice_display&id=46246

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Prospective mid-term results of a consecutive series of a short stem / Nicola Stadler in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 372-375 Titre : Prospective mid-term results of a consecutive series of a short stem Type de document : texte imprimé Auteurs : Nicola Stadler ; Johann Lehner ; Klemens Trieb Année de publication : 2016 Article en page(s) : p. 372-375 Langues : Anglais (eng) Mots-clés : chirurgie  hanche  arthroplastie  prothèse Résumé : A large number of short stem prostheses for hip arthroplasty have been introduced in the past years. Although there is a large increase of publications about short stems, there is still little data available about survival and revision rates. We report prospectively on the outcome of 84 consecutive NANOS® short stem prostheses in 81 patients. We have included 37 female patients and 44 male patients with an average age of 61.6 ± 9.2 years. The main diagnoses were osteoarthritis in 67 patients, dysplastic osteoarthritis in 8 patients and avascular necrosis of the femoral head in 6 patients. Along with demographic data and co-morbidities, the Harris Hip Score was recorded preoperatively and at follow-up. The Harris Hip Score increased from 36.6 ± 14.5 preoperatively to 94.5 ± 8.8 at the final follow-up. During the main follow- up time (27.7 months ± 5.7) none of the 84 stems were revised, intraoperatively three fissure fractures occurred. Permalink : ./index.php?lvl=notice_display&id=46247 [article] Prospective mid-term results of a consecutive series of a short stem [texte imprimé] / Nicola Stadler ; Johann Lehner ; Klemens Trieb . - 2016 . - p. 372-375. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 372-375 Mots-clés : chirurgie  hanche  arthroplastie  prothèse Résumé : A large number of short stem prostheses for hip arthroplasty have been introduced in the past years. Although there is a large increase of publications about short stems, there is still little data available about survival and revision rates. We report prospectively on the outcome of 84 consecutive NANOS® short stem prostheses in 81 patients. We have included 37 female patients and 44 male patients with an average age of 61.6 ± 9.2 years. The main diagnoses were osteoarthritis in 67 patients, dysplastic osteoarthritis in 8 patients and avascular necrosis of the femoral head in 6 patients. Along with demographic data and co-morbidities, the Harris Hip Score was recorded preoperatively and at follow-up. The Harris Hip Score increased from 36.6 ± 14.5 preoperatively to 94.5 ± 8.8 at the final follow-up. During the main follow- up time (27.7 months ± 5.7) none of the 84 stems were revised, intraoperatively three fissure fractures occurred. Permalink : ./index.php?lvl=notice_display&id=46247

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Atypical femur fractures – Patient characteristics and results of intramedullary nailing for a series of 21 patients / Sivaraman Subramanian in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 376-381 Titre : Atypical femur fractures – Patient characteristics and results of intramedullary nailing for a series of 21 patients Type de document : texte imprimé Auteurs : Sivaraman Subramanian ; Martyn J. Parker Année de publication : 2016 Article en page(s) : p. 376-381 Langues : Anglais (eng) Mots-clés : chirurgie  hanche  fracture Résumé : Atypical femoral fractures have been associated with long term use of bisphosphonates. Our study plan was to report the outcome of treatment for a series of patients with an atypical femoral fracture and to compare the characteristics of those patients with a proximal femoral fracture. 21 atypical fractures were identified over a seven year period and these were compared with those of 2.547 hip fracture patients treated over the same time period at a single centre. The mean age of patients with an atypical fracture was on average nine years less than that for the hip fracture patients (72 as against 81 years, p = 0.002). Four (19.0%) of the patients with atypical fracture had no injury associated with the fracture and nine (42.9%) patients had pain prior to presentation at hospital for a mean of 31 days. Patients with atypical fractures were more likely to be smokers (9/21(42.9%) versus 319/2547 (12.5%), p = 0.0001) and more likely to be on long term oral steroid therapy (8/21 (38.1%) versus 131/2547 (5.1%), p < 0.0001) in comparison to other hip fracture patients. All the atypical fractures were treated by intramedullary nailing and healed uneventfully apart from one fracture that developed non-union requiring revision nailing. Residual pain at one year from injury was more prevalent for patients with atypical fractures. Permalink : ./index.php?lvl=notice_display&id=46248 [article] Atypical femur fractures – Patient characteristics and results of intramedullary nailing for a series of 21 patients [texte imprimé] / Sivaraman Subramanian ; Martyn J. Parker . - 2016 . - p. 376-381. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 376-381 Mots-clés : chirurgie  hanche  fracture Résumé : Atypical femoral fractures have been associated with long term use of bisphosphonates. Our study plan was to report the outcome of treatment for a series of patients with an atypical femoral fracture and to compare the characteristics of those patients with a proximal femoral fracture. 21 atypical fractures were identified over a seven year period and these were compared with those of 2.547 hip fracture patients treated over the same time period at a single centre. The mean age of patients with an atypical fracture was on average nine years less than that for the hip fracture patients (72 as against 81 years, p = 0.002). Four (19.0%) of the patients with atypical fracture had no injury associated with the fracture and nine (42.9%) patients had pain prior to presentation at hospital for a mean of 31 days. Patients with atypical fractures were more likely to be smokers (9/21(42.9%) versus 319/2547 (12.5%), p = 0.0001) and more likely to be on long term oral steroid therapy (8/21 (38.1%) versus 131/2547 (5.1%), p < 0.0001) in comparison to other hip fracture patients. All the atypical fractures were treated by intramedullary nailing and healed uneventfully apart from one fracture that developed non-union requiring revision nailing. Residual pain at one year from injury was more prevalent for patients with atypical fractures. Permalink : ./index.php?lvl=notice_display&id=46248

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Long term results after bipolar radial head arthroplasty / Emanuel Van Hoecke in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 382-388 Titre : Long term results after bipolar radial head arthroplasty Type de document : texte imprimé Auteurs : Emanuel Van Hoecke ; Arne Van De Wijver ; Francis Van Glabbeek ; Jan Gielen Année de publication : 2016 Article en page(s) : p. 382-388 Langues : Anglais (eng) Mots-clés : Fracture  coude  radius  chirugie  prothèse Résumé : Radial head fractures are common injuries, occurring mostly in active young people 85%. Treatment of the more complex radial head fractures (Mason type III and IV), appear to be challenging and remain a subject of controversy. Replacement of the radial head with a metal prosthesis imitates the stabilizing role of the radial head and has been considered as the treatment of choice. However, long-term results are scarce. We report our mid to long-term (mean 9.4 year) clinical and radiographic results after insertion of a Judet Bipolar Radial Head prosthesis. 34 patients were treated with the Judet Bipolar Head prosthesis between 2000 and 2008. In this study, 21 patients were re-examined after a mean period of 113 months (range, 174-84), ie, 9.4 years (range, 14.5- 7). Follow-up examinations included both the Mayo Elbow Performance Index (MEPI) and Dis- abilities of the arm, shoulder and hand (DASH) score. Range of motion was measured with a hand goniometer. X-rays were evaluated for peri-articular ossifications, radiolucent lines and signs of proximal erosion, capitellar erosion. Mean Mayo Elbow Performance Index was 88.6 (Range 100-50). According to the MEPI score we had 14 excellent, 1 good, 5 fair results and one poor result. One patient reported severe pain, 3 patients reported moderate pain, one patient reported mild pain and 16 patients reported no pain at all. Difference between pronation-suppination range was noted between primary or secondary indication of the radial head, no other significant differences were found. Mean DASH score was 23.1° (Range 0-63) without difference between primary and secondary indication. Mean flexion was 121.8° (Range : 110-140), mean extension deficit was 24.8° (Range 15-40), mean pronation was 62.4° (Range : 50-80) and suppination 58.8° (Range : 45-80). Ten patients showed signs of ulnohumeral joint degenerative arthritis. One patient developed symptomatic ulna plus. One patient showed radiolucent lines surrounding the prosthesis with proximal bone erosion. There were no reports of dislocations of the prosthesis. One case of radiological signs of overlenghtening was noted. Mainly good clinical results are achieved with the Judet bipolar radial head implant. Functional results after long term follow-up are, however less optimistic then the excellent results achieved after short- to midterm follow-up. No clear link between radiological signs and functional results can be found. Permalink : ./index.php?lvl=notice_display&id=46249 [article] Long term results after bipolar radial head arthroplasty [texte imprimé] / Emanuel Van Hoecke ; Arne Van De Wijver ; Francis Van Glabbeek ; Jan Gielen . - 2016 . - p. 382-388. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 382-388 Mots-clés : Fracture  coude  radius  chirugie  prothèse Résumé : Radial head fractures are common injuries, occurring mostly in active young people 85%. Treatment of the more complex radial head fractures (Mason type III and IV), appear to be challenging and remain a subject of controversy. Replacement of the radial head with a metal prosthesis imitates the stabilizing role of the radial head and has been considered as the treatment of choice. However, long-term results are scarce. We report our mid to long-term (mean 9.4 year) clinical and radiographic results after insertion of a Judet Bipolar Radial Head prosthesis. 34 patients were treated with the Judet Bipolar Head prosthesis between 2000 and 2008. In this study, 21 patients were re-examined after a mean period of 113 months (range, 174-84), ie, 9.4 years (range, 14.5- 7). Follow-up examinations included both the Mayo Elbow Performance Index (MEPI) and Dis- abilities of the arm, shoulder and hand (DASH) score. Range of motion was measured with a hand goniometer. X-rays were evaluated for peri-articular ossifications, radiolucent lines and signs of proximal erosion, capitellar erosion. Mean Mayo Elbow Performance Index was 88.6 (Range 100-50). According to the MEPI score we had 14 excellent, 1 good, 5 fair results and one poor result. One patient reported severe pain, 3 patients reported moderate pain, one patient reported mild pain and 16 patients reported no pain at all. Difference between pronation-suppination range was noted between primary or secondary indication of the radial head, no other significant differences were found. Mean DASH score was 23.1° (Range 0-63) without difference between primary and secondary indication. Mean flexion was 121.8° (Range : 110-140), mean extension deficit was 24.8° (Range 15-40), mean pronation was 62.4° (Range : 50-80) and suppination 58.8° (Range : 45-80). Ten patients showed signs of ulnohumeral joint degenerative arthritis. One patient developed symptomatic ulna plus. One patient showed radiolucent lines surrounding the prosthesis with proximal bone erosion. There were no reports of dislocations of the prosthesis. One case of radiological signs of overlenghtening was noted. Mainly good clinical results are achieved with the Judet bipolar radial head implant. Functional results after long term follow-up are, however less optimistic then the excellent results achieved after short- to midterm follow-up. No clear link between radiological signs and functional results can be found. Permalink : ./index.php?lvl=notice_display&id=46249

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The Accessory muscles of the Axilla / Filip Verhaegen in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 389-396 Titre : The Accessory muscles of the Axilla Type de document : texte imprimé Auteurs : Filip Verhaegen ; Philippe Debeer ; Maximiliaan Moyaert Année de publication : 2016 Article en page(s) : p. 389-396 Langues : Anglais (eng) Mots-clés : chirurgie  aisselle  variation anatomique  muscle accesoire Résumé : The axilla is a region of clinical and surgical importance with plenty of anatomical variations. One of these is the presence of accessory muscles. The literature was reviewed in order to identify the different supernumerary muscles that are described in the axilla. Variant muscle slips arising from the pectoral muscle or latissimus dorsi muscle have been described. There still remains controversy regarding the phylogenetic origin of these different muscles. We described the most frequently reported muscles, their origin, and course. Further research is required regarding the innervation and influence on glenohumeral and scapulothoracic kinematics. Permalink : ./index.php?lvl=notice_display&id=46250 [article] The Accessory muscles of the Axilla [texte imprimé] / Filip Verhaegen ; Philippe Debeer ; Maximiliaan Moyaert . - 2016 . - p. 389-396. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 389-396 Mots-clés : chirurgie  aisselle  variation anatomique  muscle accesoire Résumé : The axilla is a region of clinical and surgical importance with plenty of anatomical variations. One of these is the presence of accessory muscles. The literature was reviewed in order to identify the different supernumerary muscles that are described in the axilla. Variant muscle slips arising from the pectoral muscle or latissimus dorsi muscle have been described. There still remains controversy regarding the phylogenetic origin of these different muscles. We described the most frequently reported muscles, their origin, and course. Further research is required regarding the innervation and influence on glenohumeral and scapulothoracic kinematics. Permalink : ./index.php?lvl=notice_display&id=46250

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Effectiveness and safety of collagenase Clostridium histolyticum in Dupuytren’s disease : an observational study in Belgium / Frederik Verstreken in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 397-404 Titre : Effectiveness and safety of collagenase Clostridium histolyticum in Dupuytren’s disease : an observational study in Belgium Type de document : texte imprimé Auteurs : Frederik Verstreken ; Ilse Degreef ; Arne Decramer ; [et al...] Année de publication : 2016 Article en page(s) : p. 397-404 Langues : Anglais (eng) Mots-clés : maladie de Dupuytren  collagène Résumé : Dupuytren’s disease is a connective tissue disorder leading to contractures. It can be treated surgically or through injections of collagenase Clostridium histolyticum (CCH). Patients with Dupuytren’s contracture (> 20°) and a palpable cord were included in this observational study, aiming to characterise the Belgian patient population and to assess the effectiveness and safety of CCH. Overall, 108 patients (114 joints) received at least one injection of CCH, and 104 patients completed the study. The percentages of joints achieving a degree of contracture of 5° or less, or a relative contracture reduction of at least 50% after the extension procedure were 64.9% and 90.1%, respectively. The mean number of injections per cord was 1.0. The Unité Rhumatologique des Affections de la Main score decreased from 29.4 ± 11.0 to 12.9 ± 6.3 (mean ± SD ; p < 0.0001). CCH was demonstrated to be effective, safe and able to increase quality of life. Permalink : ./index.php?lvl=notice_display&id=46251 [article] Effectiveness and safety of collagenase Clostridium histolyticum in Dupuytren’s disease : an observational study in Belgium [texte imprimé] / Frederik Verstreken ; Ilse Degreef ; Arne Decramer ; [et al...] . - 2016 . - p. 397-404. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 397-404 Mots-clés : maladie de Dupuytren  collagène Résumé : Dupuytren’s disease is a connective tissue disorder leading to contractures. It can be treated surgically or through injections of collagenase Clostridium histolyticum (CCH). Patients with Dupuytren’s contracture (> 20°) and a palpable cord were included in this observational study, aiming to characterise the Belgian patient population and to assess the effectiveness and safety of CCH. Overall, 108 patients (114 joints) received at least one injection of CCH, and 104 patients completed the study. The percentages of joints achieving a degree of contracture of 5° or less, or a relative contracture reduction of at least 50% after the extension procedure were 64.9% and 90.1%, respectively. The mean number of injections per cord was 1.0. The Unité Rhumatologique des Affections de la Main score decreased from 29.4 ± 11.0 to 12.9 ± 6.3 (mean ± SD ; p < 0.0001). CCH was demonstrated to be effective, safe and able to increase quality of life. Permalink : ./index.php?lvl=notice_display&id=46251

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How often absence of palmaris longus and functional deficiency of flexor digitorum superficialis occurs ? / Nikola Vucinic in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 405-411 Titre : How often absence of palmaris longus and functional deficiency of flexor digitorum superficialis occurs ? Type de document : texte imprimé Auteurs : Nikola Vucinic ; Mirela Eric ; Mirjana Savic Année de publication : 2016 Article en page(s) : p. 405-411 Langues : Anglais (eng) Mots-clés : main  muscle palmaire  flexion Résumé : This study was designed to find a possible correlation between the presence of the palmaris longus and function of the fifth flexor digitorum superficialis. We examined 300 participants to assess the absence of palmaris longus and flexor digitorum superficialis function by several clinical tests. Overall absence of palmaris longus, was seen in 157 participants (52.3%). Overall deficiency of flexor digitorum superficialis was noted in 100 participants (33.3%). In 15 participants (5%) we noted bilateral absence of palmaris longus and flexor digitorum superficialis deficiency. Five participants (1.7%) had unilateral absence of palmaris longus and flexor digitorum superficialis deficiency on the same, left or right hand. Bilaterally presence of these muscles we noted in 95 participants (31.7%). We believe that there is no connection between absent palmaris longus and absent function of flexor digitorum superficialis. We found a much higher prevalence of muscles absence individually and jointly than in other studies. Permalink : ./index.php?lvl=notice_display&id=46252 [article] How often absence of palmaris longus and functional deficiency of flexor digitorum superficialis occurs ? [texte imprimé] / Nikola Vucinic ; Mirela Eric ; Mirjana Savic . - 2016 . - p. 405-411. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 405-411 Mots-clés : main  muscle palmaire  flexion Résumé : This study was designed to find a possible correlation between the presence of the palmaris longus and function of the fifth flexor digitorum superficialis. We examined 300 participants to assess the absence of palmaris longus and flexor digitorum superficialis function by several clinical tests. Overall absence of palmaris longus, was seen in 157 participants (52.3%). Overall deficiency of flexor digitorum superficialis was noted in 100 participants (33.3%). In 15 participants (5%) we noted bilateral absence of palmaris longus and flexor digitorum superficialis deficiency. Five participants (1.7%) had unilateral absence of palmaris longus and flexor digitorum superficialis deficiency on the same, left or right hand. Bilaterally presence of these muscles we noted in 95 participants (31.7%). We believe that there is no connection between absent palmaris longus and absent function of flexor digitorum superficialis. We found a much higher prevalence of muscles absence individually and jointly than in other studies. Permalink : ./index.php?lvl=notice_display&id=46252

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Unilateral lumbar interbody fusion (ULIF) / Benoit Zachee in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 412-420 Titre : Unilateral lumbar interbody fusion (ULIF) Type de document : texte imprimé Auteurs : Benoit Zachee ; Luc Vanden Berghe Année de publication : 2016 Article en page(s) : p. 412-420 Langues : Anglais (eng) Mots-clés : colonne lombaire  disque intervertébral  chirugie Résumé : Results and clinical outcome of a prospective multicenter clinical study involving 100 patients undergoing a lumbar interbody fusion procedure using an unilateral approach to the spine to introduce a new surgical technique as a viable and less invasive alternative to standard posterior (PLIF) or transforaminal (TLIF) lumbar interbody fusion techniques : For certain indications clinical data show that unilateral lumbar interbody fusion (ULIF) offers the surgeon a considerable time advantage compared to standard lumbar interbody fusion techniques. Permalink : ./index.php?lvl=notice_display&id=46253 [article] Unilateral lumbar interbody fusion (ULIF) [texte imprimé] / Benoit Zachee ; Luc Vanden Berghe . - 2016 . - p. 412-420. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 412-420 Mots-clés : colonne lombaire  disque intervertébral  chirugie Résumé : Results and clinical outcome of a prospective multicenter clinical study involving 100 patients undergoing a lumbar interbody fusion procedure using an unilateral approach to the spine to introduce a new surgical technique as a viable and less invasive alternative to standard posterior (PLIF) or transforaminal (TLIF) lumbar interbody fusion techniques : For certain indications clinical data show that unilateral lumbar interbody fusion (ULIF) offers the surgeon a considerable time advantage compared to standard lumbar interbody fusion techniques. Permalink : ./index.php?lvl=notice_display&id=46253

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Combination of transpedicular enucleation and Plate-Rod System for single-stage correction of progressive hemivertebral scoliosis / Kuang Zhengda in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 420-424 Titre : Combination of transpedicular enucleation and Plate-Rod System for single-stage correction of progressive hemivertebral scoliosis Type de document : texte imprimé Auteurs : Kuang Zhengda ; Wang Guanjun ; Ye Qibin ; [et al...] Année de publication : 2016 Article en page(s) : p. 420-424 Langues : Anglais (eng) Mots-clés : scoliose  chirugie Résumé : The purpose of this study is to report the effectiveness of transpedicular enucleation and Plate-Rod System for Scoliosis (PRSS) fixation for the treatment of hemivertebral (HV) scoliosis. 16 patients with progressive HV scoliosis underwent the combined procedure. The technique involves excision of cancellous bone to eliminate the blood supply of the cartilaginous endplate and destroy the superior and inferior vertebral end plates, followed by PRSS fixation to correct the main curve and compensatory curve. The mean age at operation was 8.125 ± 1.82 years. The scoliosis curve was corrected from average 55.06 ± 25.68° preoperatively to 21.25 ± 15.51° postoperatively. At the latest follow-up, the Cobb angle was 24.38 ± 16.44°, and there was no significant difference compared with immediate postoperative angle (P > 0.05). No surgical complication of neurological deficits occurred in any patients. Combined use of transpedicular enucleation and PRSS fixation is a safe and effective single-stage method for the management of HV scoliosis in growing children. Permalink : ./index.php?lvl=notice_display&id=46254 [article] Combination of transpedicular enucleation and Plate-Rod System for single-stage correction of progressive hemivertebral scoliosis [texte imprimé] / Kuang Zhengda ; Wang Guanjun ; Ye Qibin ; [et al...] . - 2016 . - p. 420-424. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 420-424 Mots-clés : scoliose  chirugie Résumé : The purpose of this study is to report the effectiveness of transpedicular enucleation and Plate-Rod System for Scoliosis (PRSS) fixation for the treatment of hemivertebral (HV) scoliosis. 16 patients with progressive HV scoliosis underwent the combined procedure. The technique involves excision of cancellous bone to eliminate the blood supply of the cartilaginous endplate and destroy the superior and inferior vertebral end plates, followed by PRSS fixation to correct the main curve and compensatory curve. The mean age at operation was 8.125 ± 1.82 years. The scoliosis curve was corrected from average 55.06 ± 25.68° preoperatively to 21.25 ± 15.51° postoperatively. At the latest follow-up, the Cobb angle was 24.38 ± 16.44°, and there was no significant difference compared with immediate postoperative angle (P > 0.05). No surgical complication of neurological deficits occurred in any patients. Combined use of transpedicular enucleation and PRSS fixation is a safe and effective single-stage method for the management of HV scoliosis in growing children. Permalink : ./index.php?lvl=notice_display&id=46254

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