Dépouillements

Outcomes Following Extremity Wound Coverage With An Acellular Skin Substitute (Integra) : A Multi-Center Study / Julie E. ADAMS in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.293-300 Titre : Outcomes Following Extremity Wound Coverage With An Acellular Skin Substitute (Integra) : A Multi-Center Study Type de document : texte imprimé Auteurs : Julie E. ADAMS, Auteur Année de publication : 2014 Article en page(s) : p.293-300 Langues : Anglais (eng) Résumé : The purpose of this manuscript is to document results and complications of use of a regenerative dermal matrix skin substitute for coverage of extremity wounds. A retrospective review at 3 institutions identified 28 patients and 34 wounds who had undergone use of this material (Integra). Complications included failure in two patients (4 wounds). However, overall “take” of the regenerative matrix was 86.1%. In most cases, a split thickness skin graft was applied on average at 25 days following the initial procedure. Failures were associated with infection and irradiation of the surgical field. In this series, use of the dermal regenerative matrix was associated with a high rate of success for wound coverage, obviating the need for flap coverage or prolonged dressing changes in most cases. Further series are likely to refine the known indications and contraindications to use of this method. Permalink : ./index.php?lvl=notice_display&id=34642 [article] Outcomes Following Extremity Wound Coverage With An Acellular Skin Substitute (Integra) : A Multi-Center Study [texte imprimé] / Julie E. ADAMS, Auteur . - 2014 . - p.293-300. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.293-300 Résumé : The purpose of this manuscript is to document results and complications of use of a regenerative dermal matrix skin substitute for coverage of extremity wounds. A retrospective review at 3 institutions identified 28 patients and 34 wounds who had undergone use of this material (Integra). Complications included failure in two patients (4 wounds). However, overall “take” of the regenerative matrix was 86.1%. In most cases, a split thickness skin graft was applied on average at 25 days following the initial procedure. Failures were associated with infection and irradiation of the surgical field. In this series, use of the dermal regenerative matrix was associated with a high rate of success for wound coverage, obviating the need for flap coverage or prolonged dressing changes in most cases. Further series are likely to refine the known indications and contraindications to use of this method. Permalink : ./index.php?lvl=notice_display&id=34642

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Evaluation Of Prominence Of Straight Plates And Precontoured Clavicle Plates Using Automated Plate-To-Bone Alignment / Alexander Van Tongel in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.301-308 Titre : Evaluation Of Prominence Of Straight Plates And Precontoured Clavicle Plates Using Automated Plate-To-Bone Alignment Type de document : texte imprimé Auteurs : Alexander Van Tongel, Auteur Année de publication : 2014 Article en page(s) : p.301-308 Langues : Anglais (eng) Mots-clés : clavicle fracture  hardware irritation  precontoured plates  3D reconstruction  automated fitting Résumé : Hardware prominence after plate fixation for clavicle fractureis a common complication. The aim of the study was to perform a 3D analysis of the prominence of different types of superior clavicle plates. An automated fitting of 3 straight and 10 precontoured plates was performed on 52 3D-CT-scan reconstructed cadaver clavicles. The mean and maximum bone-plate distance and maximum prominence was significant higher with the straight plates compared to the precontoured plates. The mean and maximum boneplate distance was significant higher with the precontoured DePuy-Synthes plates compared to the precontoured Acumed plates but when evaluating the maximum prominence there was no significant difference between the most commonly used 8-holes plates. To conclude, precontoured plates of the clavicula diminish significantly hardware prominence. There exists a difference in hardware prominence between different brands of precontoured plates but this difference is limited and in most cases not significant. Permalink : ./index.php?lvl=notice_display&id=34643 [article] Evaluation Of Prominence Of Straight Plates And Precontoured Clavicle Plates Using Automated Plate-To-Bone Alignment [texte imprimé] / Alexander Van Tongel, Auteur . - 2014 . - p.301-308. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.301-308 Mots-clés : clavicle fracture  hardware irritation  precontoured plates  3D reconstruction  automated fitting Résumé : Hardware prominence after plate fixation for clavicle fractureis a common complication. The aim of the study was to perform a 3D analysis of the prominence of different types of superior clavicle plates. An automated fitting of 3 straight and 10 precontoured plates was performed on 52 3D-CT-scan reconstructed cadaver clavicles. The mean and maximum bone-plate distance and maximum prominence was significant higher with the straight plates compared to the precontoured plates. The mean and maximum boneplate distance was significant higher with the precontoured DePuy-Synthes plates compared to the precontoured Acumed plates but when evaluating the maximum prominence there was no significant difference between the most commonly used 8-holes plates. To conclude, precontoured plates of the clavicula diminish significantly hardware prominence. There exists a difference in hardware prominence between different brands of precontoured plates but this difference is limited and in most cases not significant. Permalink : ./index.php?lvl=notice_display&id=34643

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Reduction And Internal Fixation For Acute Midshaft Clavicular Fractures By Mini-Incision Using Cannulated Screws / Mahmoud A. MAHRAN in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.309-313 Titre : Reduction And Internal Fixation For Acute Midshaft Clavicular Fractures By Mini-Incision Using Cannulated Screws Type de document : texte imprimé Auteurs : Mahmoud A. MAHRAN, Auteur Année de publication : 2014 Article en page(s) : p.309-313 Langues : Anglais (eng) Mots-clés : midshaft fracture clavicle  internal fixation  cannulated screws  mini-incision Résumé : Open reduction and internal fixation of fracture clavicle has typically been done by variable types of plates. Plates carry the disadvantages of longer incisions, prominence of the plates and wound complications. The purpose of this study is to present an alternative surgical technique for acute midshaft clavicular fracture using cannulated 6.5 screws with minimal incision over the fracture site. Twenty seven adult patients with acute midshaft clavicular fractures were surgically treated with mini open technique using 6.5mm cannulated screws. The modified shoulder rating scale by Chuang was used for outcome evaluation. Union occurred in a mean of 8.3 weeks range 6-12 weeks. Restoration of clavicular length was achieved in all cases. Twenty-four patients experienced no pain on all activity at latest follow-up. All patients expressed their willingness to have the surgery again should they have the same problem. One patient stated that she would not have the surgery again. Conclusion : reduction and internal fixation with a cannulated screw is an alternative economic technique for the treatment of acute midshaft clavicular fractures that is useful in selected cases where surgery is indicated. Permalink : ./index.php?lvl=notice_display&id=34644 [article] Reduction And Internal Fixation For Acute Midshaft Clavicular Fractures By Mini-Incision Using Cannulated Screws [texte imprimé] / Mahmoud A. MAHRAN, Auteur . - 2014 . - p.309-313. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.309-313 Mots-clés : midshaft fracture clavicle  internal fixation  cannulated screws  mini-incision Résumé : Open reduction and internal fixation of fracture clavicle has typically been done by variable types of plates. Plates carry the disadvantages of longer incisions, prominence of the plates and wound complications. The purpose of this study is to present an alternative surgical technique for acute midshaft clavicular fracture using cannulated 6.5 screws with minimal incision over the fracture site. Twenty seven adult patients with acute midshaft clavicular fractures were surgically treated with mini open technique using 6.5mm cannulated screws. The modified shoulder rating scale by Chuang was used for outcome evaluation. Union occurred in a mean of 8.3 weeks range 6-12 weeks. Restoration of clavicular length was achieved in all cases. Twenty-four patients experienced no pain on all activity at latest follow-up. All patients expressed their willingness to have the surgery again should they have the same problem. One patient stated that she would not have the surgery again. Conclusion : reduction and internal fixation with a cannulated screw is an alternative economic technique for the treatment of acute midshaft clavicular fractures that is useful in selected cases where surgery is indicated. Permalink : ./index.php?lvl=notice_display&id=34644

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Reversed Revised : What To Do When It Goes Wrong ? / Bart MIDDERNACHT in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.314-321 Titre : Reversed Revised : What To Do When It Goes Wrong ? Type de document : texte imprimé Auteurs : Bart MIDDERNACHT, Auteur Année de publication : 2014 Article en page(s) : p.314-321 Langues : Anglais (eng) Mots-clés : reversed  total shoulder prothesis  revision  complications  infection  dislocation  malpositioning Résumé : Reversed total shoulder arthroplasty (RTSA) has well known indications and good to excellent results are described in the literature. When the arthroplasty fails however, revision remains a technical challenge with many questions unanswered. To analyse retrospectively and consecutively the indications and results of primary RTSA-revision. All patients that underwent revision RTSA between 2004 and 2009 were included. Indications for surgery, surgical details and clinical evaluation with the preand postoperative Constant-score (CS) were analyzed. 37 Revisions (37 patients) of RTSA were analysed with an average follow up of 41.2 months (24-84). Indications were infection (23), glenoid loosening (9), instability (2) malpositioning (2) and suprascapular nerve irritation (1). 25 patients obtained a one-stage conversion to a new reversed prosthesis ; 4 patients obtained a two-stage revision ; 8 patients got a megahead prosthesis. No difference in reinfection rate is seen between one- and two stage techniques. An overall lower CS is seen for the mega-head prosthesis. Conclusions : The main indication for revision was infection. Revision of RTSA to a new reversed prosthesis is to prefer even when several procedures are necessary in one patient. When this is impossible, a mega-head prosthesis is to consider and gives reasonable results. Permalink : ./index.php?lvl=notice_display&id=34645 [article] Reversed Revised : What To Do When It Goes Wrong ? [texte imprimé] / Bart MIDDERNACHT, Auteur . - 2014 . - p.314-321. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.314-321 Mots-clés : reversed  total shoulder prothesis  revision  complications  infection  dislocation  malpositioning Résumé : Reversed total shoulder arthroplasty (RTSA) has well known indications and good to excellent results are described in the literature. When the arthroplasty fails however, revision remains a technical challenge with many questions unanswered. To analyse retrospectively and consecutively the indications and results of primary RTSA-revision. All patients that underwent revision RTSA between 2004 and 2009 were included. Indications for surgery, surgical details and clinical evaluation with the preand postoperative Constant-score (CS) were analyzed. 37 Revisions (37 patients) of RTSA were analysed with an average follow up of 41.2 months (24-84). Indications were infection (23), glenoid loosening (9), instability (2) malpositioning (2) and suprascapular nerve irritation (1). 25 patients obtained a one-stage conversion to a new reversed prosthesis ; 4 patients obtained a two-stage revision ; 8 patients got a megahead prosthesis. No difference in reinfection rate is seen between one- and two stage techniques. An overall lower CS is seen for the mega-head prosthesis. Conclusions : The main indication for revision was infection. Revision of RTSA to a new reversed prosthesis is to prefer even when several procedures are necessary in one patient. When this is impossible, a mega-head prosthesis is to consider and gives reasonable results. Permalink : ./index.php?lvl=notice_display&id=34645

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Evaluating The Success Of Preoperative Imaging For Diagnosing Rotator Cuff Tears In A Regional Centre / Tagbo ILOZUE in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.322-330 Titre : Evaluating The Success Of Preoperative Imaging For Diagnosing Rotator Cuff Tears In A Regional Centre Type de document : texte imprimé Auteurs : Tagbo ILOZUE, Auteur Année de publication : 2014 Article en page(s) : p.322-330 Langues : Anglais (eng) Mots-clés : ultrasonography  magnetic resonance imaging  rotator cuff tear  meta-analysis  accuracy Résumé : To review the diagnostic performance of ultrasonography (US) and magnetic resonance imaging (MRI) for the detection of rotator-cuff tears, we performed a retrospective audit of patients who underwent shoulder arthroscopy at Hinchingbrooke hospital. The diagnostic accuracies of US for full and partial-thickness tears were 82% and 28% respectively. Those of MRI were 82% and 81% respectively. These were lower than expected from the literature. This discrepancy is likely to be the consequence of over-diagnosis in imaging and under-diagnosis at arthroscopy. Permalink : ./index.php?lvl=notice_display&id=34646 [article] Evaluating The Success Of Preoperative Imaging For Diagnosing Rotator Cuff Tears In A Regional Centre [texte imprimé] / Tagbo ILOZUE, Auteur . - 2014 . - p.322-330. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.322-330 Mots-clés : ultrasonography  magnetic resonance imaging  rotator cuff tear  meta-analysis  accuracy Résumé : To review the diagnostic performance of ultrasonography (US) and magnetic resonance imaging (MRI) for the detection of rotator-cuff tears, we performed a retrospective audit of patients who underwent shoulder arthroscopy at Hinchingbrooke hospital. The diagnostic accuracies of US for full and partial-thickness tears were 82% and 28% respectively. Those of MRI were 82% and 81% respectively. These were lower than expected from the literature. This discrepancy is likely to be the consequence of over-diagnosis in imaging and under-diagnosis at arthroscopy. Permalink : ./index.php?lvl=notice_display&id=34646

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Carpal Tunnel Syndrome Etiology Update : Where Do We Stand ? / Matthias VANHEES in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.331-335 Titre : Carpal Tunnel Syndrome Etiology Update : Where Do We Stand ? Type de document : texte imprimé Auteurs : Matthias VANHEES, Auteur Année de publication : 2014 Article en page(s) : p.331-335 Langues : Anglais (eng) Permalink : ./index.php?lvl=notice_display&id=34647 [article] Carpal Tunnel Syndrome Etiology Update : Where Do We Stand ? [texte imprimé] / Matthias VANHEES, Auteur . - 2014 . - p.331-335. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.331-335 Permalink : ./index.php?lvl=notice_display&id=34647

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Cup Positioning In Total Hip Arthroplasty / Th. Scheerlinck in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.336-347 Titre : Cup Positioning In Total Hip Arthroplasty Type de document : texte imprimé Auteurs : Th. Scheerlinck, Auteur Année de publication : 2014 Article en page(s) : p.336-347 Langues : Anglais (eng) Mots-clés : hip arthroplasty  cup orientation  acetabular component  biomechanics Résumé : The “optimal” positioning of the cup in total hip arthroplasty can improve hip function and reduce wear, impingement and dislocation. The cup position is described as the spatial relation between the hip rotation centre and the pelvis and, as the cup orientation around the rotation centre. The first parameter affects hip balance and, if not managed properly, might result in poor function and leg length discrepancy. The second parameter is often “silent”, unless impingement or dislocation occurs. However, inappropriate cup orientation can accelerate wear and cause early failure. As such, it is mandatory to get both right, taking into account multiple parameters : the stem position, the approach, the bearing surface, the cup coverage and the pelvic orientation during loading. In most cases a “standard” cup position is adequate. However, specific anatomic features might require an individualized approach. This paper aims at reviewing the parameters that impact on the optimal cup position. This should allow for more judicious choices in those particular cases. Permalink : ./index.php?lvl=notice_display&id=34648 [article] Cup Positioning In Total Hip Arthroplasty [texte imprimé] / Th. Scheerlinck, Auteur . - 2014 . - p.336-347. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.336-347 Mots-clés : hip arthroplasty  cup orientation  acetabular component  biomechanics Résumé : The “optimal” positioning of the cup in total hip arthroplasty can improve hip function and reduce wear, impingement and dislocation. The cup position is described as the spatial relation between the hip rotation centre and the pelvis and, as the cup orientation around the rotation centre. The first parameter affects hip balance and, if not managed properly, might result in poor function and leg length discrepancy. The second parameter is often “silent”, unless impingement or dislocation occurs. However, inappropriate cup orientation can accelerate wear and cause early failure. As such, it is mandatory to get both right, taking into account multiple parameters : the stem position, the approach, the bearing surface, the cup coverage and the pelvic orientation during loading. In most cases a “standard” cup position is adequate. However, specific anatomic features might require an individualized approach. This paper aims at reviewing the parameters that impact on the optimal cup position. This should allow for more judicious choices in those particular cases. Permalink : ./index.php?lvl=notice_display&id=34648

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Total Hip Arthroplasty In Belgium : The Contribution Of A Social Health Insurer To The Debate / Xavier DE BETHUNE in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.348-356 Titre : Total Hip Arthroplasty In Belgium : The Contribution Of A Social Health Insurer To The Debate Type de document : texte imprimé Auteurs : Xavier DE BETHUNE, Auteur Année de publication : 2014 Article en page(s) : p.348-356 Langues : Anglais (eng) Mots-clés : total hip arthroplasty  benchmarking  revision rate  costs  variability of care Résumé : This study describes current clinical practice and outcomes of Total Hip Arthroplasty in Belgian hospitals. Orthopaedic registries concentrate on implant related analyses and sometimes on patient reported outcomes. Our aim was to describe the extent and to generate hypotheses about the determinants of the variability of health care practices and of prosthesis survival in Belgium. Only unilateral elective primary Total Hip Arthroplasties were included. Length of stay, costs, transfusion rates and other care activities were analysed over 2008 and 2009 together. Prosthesis survival was studied using Kaplan-Meier and Cox regression hazard ratio computations over the period 2000-2009. 36798 elective Total Hip Arthroplasties have been included in a study of all members of the Belgian Christian Sickness Fund. The non-standardised ten year Total Hip Arthroplasty survival rate is 93% (Kaplan-Meier). Quality has progressed notably compared with 10 years earlier. Important variations still persist though between hospitals, for all studied indicators. Permalink : ./index.php?lvl=notice_display&id=34649 [article] Total Hip Arthroplasty In Belgium : The Contribution Of A Social Health Insurer To The Debate [texte imprimé] / Xavier DE BETHUNE, Auteur . - 2014 . - p.348-356. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.348-356 Mots-clés : total hip arthroplasty  benchmarking  revision rate  costs  variability of care Résumé : This study describes current clinical practice and outcomes of Total Hip Arthroplasty in Belgian hospitals. Orthopaedic registries concentrate on implant related analyses and sometimes on patient reported outcomes. Our aim was to describe the extent and to generate hypotheses about the determinants of the variability of health care practices and of prosthesis survival in Belgium. Only unilateral elective primary Total Hip Arthroplasties were included. Length of stay, costs, transfusion rates and other care activities were analysed over 2008 and 2009 together. Prosthesis survival was studied using Kaplan-Meier and Cox regression hazard ratio computations over the period 2000-2009. 36798 elective Total Hip Arthroplasties have been included in a study of all members of the Belgian Christian Sickness Fund. The non-standardised ten year Total Hip Arthroplasty survival rate is 93% (Kaplan-Meier). Quality has progressed notably compared with 10 years earlier. Important variations still persist though between hospitals, for all studied indicators. Permalink : ./index.php?lvl=notice_display&id=34649

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Re-Revision Of Failed Revision Total Hip Arthroplasty Acetabular Components / Seung-Jae LIM in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.357-364 Titre : Re-Revision Of Failed Revision Total Hip Arthroplasty Acetabular Components Type de document : texte imprimé Auteurs : Seung-Jae LIM, Auteur Année de publication : 2014 Article en page(s) : p.357-364 Langues : Anglais (eng) Mots-clés : re-revision total hip arthroplasty  failed revision total hip arthroplasty  acetabular cups  cementless cup  antiprotrusio cage Résumé : While revision of total hip arthroplasty (THA) is being performed with increasing frequency, outcomes of repeated revisions have been rarely reported in the literature. The purpose of this study was to report mid-term outcomes of re-revision of failed revision THA acetabular components. We performed at least two revisions of the failed acetabular component in 57 patients (57 hips) between August 1996 and April 2008. Of these, 15 patients with infection were excluded and one died before 4-year evaluation. The final study cohort consisted of 41 patients (41 hips) with a mean age of 55.5 years (range, 37 to 82). Preoperative acetabular bone defects was classified as Paprosky Type IIA in 4 hips, Type IIB in 6, Type IIC in 9, Type IIIA in 16, and Type IIIB in 6. The mean duration of follow-up was 7.2 years (range, 4 to 15). Mean Harris hip score improved 45 points preoperatively to 83 points postoperatively. Six hips (14.6%) required additional revision procedure : 3 for aseptic loosening, 2 for deep infection, and 1 for recurrent instability. Complications included 2 dislocations and 1 peroneal nerve palsy. Kaplan-Meier survivorship with an end point of reoperation for any reason was 88.5% (95% CI, 78.0% to 100%) at 7.2 years. For aseptic loosening of the acetabular component, the survival was 91.8% (95% CI, 80.8% to 100%) at 7.2 years. Rerevision with contemporary uncemented cup or antiprotrusio cage for failed revision THA acetabular components showed encouraging mid-term outcomes for this technically challenging condition. Permalink : ./index.php?lvl=notice_display&id=34650 [article] Re-Revision Of Failed Revision Total Hip Arthroplasty Acetabular Components [texte imprimé] / Seung-Jae LIM, Auteur . - 2014 . - p.357-364. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.357-364 Mots-clés : re-revision total hip arthroplasty  failed revision total hip arthroplasty  acetabular cups  cementless cup  antiprotrusio cage Résumé : While revision of total hip arthroplasty (THA) is being performed with increasing frequency, outcomes of repeated revisions have been rarely reported in the literature. The purpose of this study was to report mid-term outcomes of re-revision of failed revision THA acetabular components. We performed at least two revisions of the failed acetabular component in 57 patients (57 hips) between August 1996 and April 2008. Of these, 15 patients with infection were excluded and one died before 4-year evaluation. The final study cohort consisted of 41 patients (41 hips) with a mean age of 55.5 years (range, 37 to 82). Preoperative acetabular bone defects was classified as Paprosky Type IIA in 4 hips, Type IIB in 6, Type IIC in 9, Type IIIA in 16, and Type IIIB in 6. The mean duration of follow-up was 7.2 years (range, 4 to 15). Mean Harris hip score improved 45 points preoperatively to 83 points postoperatively. Six hips (14.6%) required additional revision procedure : 3 for aseptic loosening, 2 for deep infection, and 1 for recurrent instability. Complications included 2 dislocations and 1 peroneal nerve palsy. Kaplan-Meier survivorship with an end point of reoperation for any reason was 88.5% (95% CI, 78.0% to 100%) at 7.2 years. For aseptic loosening of the acetabular component, the survival was 91.8% (95% CI, 80.8% to 100%) at 7.2 years. Rerevision with contemporary uncemented cup or antiprotrusio cage for failed revision THA acetabular components showed encouraging mid-term outcomes for this technically challenging condition. Permalink : ./index.php?lvl=notice_display&id=34650

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Shape Memory Embracing Fixator For Vancouver Type B And Type C Periprosthetic Femoral Fractures / Yan XIONG in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.365-371 Titre : Shape Memory Embracing Fixator For Vancouver Type B And Type C Periprosthetic Femoral Fractures Type de document : texte imprimé Auteurs : Yan XIONG, Auteur ; Quanyin DU, Auteur Année de publication : 2014 Article en page(s) : p.365-371 Langues : Anglais (eng) Mots-clés : shape memory  periprosthetic femoral fractures  total hip arthroplasty Résumé : The purpose of this study was to analyze clinical and radiographical results of a group of patients with periprosthetic femoral fractures treated with the shape memory embracing fixator. We retrospectively reviewed twelve patients in whom a total of twelve periprosthetic femoral fractures were treated with the shape memory embracing fixator between August 2004 and February 2013. The patients were 3 men and 9 women (mean age, 69.9 years ; range 42-92 years). The average duration of follow-up was 39.3 months (range 4-103 months). In one case, bone grafting was used. Postoperative evaluation was based on radiographs and Harris hip scores. All fractures healed at on average 4.4 months (range : 3 to 6 months) after surgery. None of the patients developed nonunion or malunion during the follow up. And there was no implant failure and no infection during follow up. The average Harris hip score at the final follow-up examination was 84.8 points. Results show that the shape memory embracing fixator is a safe and effective means for Vancouver type B and type C periprosthetic femoral fractures following hip arthroplasty. Permalink : ./index.php?lvl=notice_display&id=34651 [article] Shape Memory Embracing Fixator For Vancouver Type B And Type C Periprosthetic Femoral Fractures [texte imprimé] / Yan XIONG, Auteur ; Quanyin DU, Auteur . - 2014 . - p.365-371. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.365-371 Mots-clés : shape memory  periprosthetic femoral fractures  total hip arthroplasty Résumé : The purpose of this study was to analyze clinical and radiographical results of a group of patients with periprosthetic femoral fractures treated with the shape memory embracing fixator. We retrospectively reviewed twelve patients in whom a total of twelve periprosthetic femoral fractures were treated with the shape memory embracing fixator between August 2004 and February 2013. The patients were 3 men and 9 women (mean age, 69.9 years ; range 42-92 years). The average duration of follow-up was 39.3 months (range 4-103 months). In one case, bone grafting was used. Postoperative evaluation was based on radiographs and Harris hip scores. All fractures healed at on average 4.4 months (range : 3 to 6 months) after surgery. None of the patients developed nonunion or malunion during the follow up. And there was no implant failure and no infection during follow up. The average Harris hip score at the final follow-up examination was 84.8 points. Results show that the shape memory embracing fixator is a safe and effective means for Vancouver type B and type C periprosthetic femoral fractures following hip arthroplasty. Permalink : ./index.php?lvl=notice_display&id=34651

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Primary Total Hip Arthroplasty With Hydroxyapatite Coated Titanium Femoral Stems. Does Design Philosophy Influence Long Term Outcome ? : Results Of A Prospective Randomised Controlled Trial With Follow-Up Of 10-15 Years / N.A. SANDIFORD in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.372-379 Titre : Primary Total Hip Arthroplasty With Hydroxyapatite Coated Titanium Femoral Stems. Does Design Philosophy Influence Long Term Outcome ? : Results Of A Prospective Randomised Controlled Trial With Follow-Up Of 10-15 Years Type de document : texte imprimé Auteurs : N.A. SANDIFORD, Auteur ; J.A. SKINNER, Auteur Année de publication : 2014 Article en page(s) : p.372-379 Langues : Anglais (eng) Mots-clés : prospective  randomised  fully coated  long term  hydroxyapatite Résumé : We present results of a prospective randomised controlled trial examining two cohorts of patients treated with proximally (Group A) and fully coated (Group B) femoral components with long term follow up. Patients were reviewed preoperatively and 6, 12, 26 and 52 weeks post operatively then annually. The Merle d’Aubigne Postel (MDP) hip score was used to assess clinical outcome. A Visual Analog Score (VAS) was also recorded. Statistical calculation was performed using the student’s t- test and Kaplan Meier survival analysis. One hundred and four patients were included in group A and 103 patients in group B. Mean age was 60.4 years and 60.8 years respectively. Mean follow- up was 12.9 years. Mean pre-operative MDP scores were 8.8 and 9.5 in Groups A and B respectively. Mean pre-operative VAS score 7.8 and 7.4 respectively. At final follow up mean MDP and VAS were 16.9, 16.6 and 2.1, 2.4 respectively. Three femoral revisions occurred in Group A. Seven revisions occurred in Group B. Survival of the femoral component with revision for any reason as the end point was 96% in Group A and 94.8% in Group B. Both components produced symptomatic relief and similar revision rates. Thigh pain occurred only in Group A. Permalink : ./index.php?lvl=notice_display&id=34652 [article] Primary Total Hip Arthroplasty With Hydroxyapatite Coated Titanium Femoral Stems. Does Design Philosophy Influence Long Term Outcome ? : Results Of A Prospective Randomised Controlled Trial With Follow-Up Of 10-15 Years [texte imprimé] / N.A. SANDIFORD, Auteur ; J.A. SKINNER, Auteur . - 2014 . - p.372-379. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.372-379 Mots-clés : prospective  randomised  fully coated  long term  hydroxyapatite Résumé : We present results of a prospective randomised controlled trial examining two cohorts of patients treated with proximally (Group A) and fully coated (Group B) femoral components with long term follow up. Patients were reviewed preoperatively and 6, 12, 26 and 52 weeks post operatively then annually. The Merle d’Aubigne Postel (MDP) hip score was used to assess clinical outcome. A Visual Analog Score (VAS) was also recorded. Statistical calculation was performed using the student’s t- test and Kaplan Meier survival analysis. One hundred and four patients were included in group A and 103 patients in group B. Mean age was 60.4 years and 60.8 years respectively. Mean follow- up was 12.9 years. Mean pre-operative MDP scores were 8.8 and 9.5 in Groups A and B respectively. Mean pre-operative VAS score 7.8 and 7.4 respectively. At final follow up mean MDP and VAS were 16.9, 16.6 and 2.1, 2.4 respectively. Three femoral revisions occurred in Group A. Seven revisions occurred in Group B. Survival of the femoral component with revision for any reason as the end point was 96% in Group A and 94.8% in Group B. Both components produced symptomatic relief and similar revision rates. Thigh pain occurred only in Group A. Permalink : ./index.php?lvl=notice_display&id=34652

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Treatment Of Distal Femur Fractures With Locking Plates : Comparison Of Periprosthetic Fractures Above Total Knee Arthroplasty And Non-Periprosthetic Fractures / Sang Jun SONG in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.380-390 Titre : Treatment Of Distal Femur Fractures With Locking Plates : Comparison Of Periprosthetic Fractures Above Total Knee Arthroplasty And Non-Periprosthetic Fractures Type de document : texte imprimé Auteurs : Sang Jun SONG, Auteur Année de publication : 2014 Article en page(s) : p.380-390 Langues : Anglais (eng) Mots-clés : distal femur fractures  locking plate  total knee arthroplasty  periprosthetic  non-periprosthetic Résumé : The purpose of the present study was to compare the results and plate fit of periprosthetic and non-periprosthetic distal femur fractures fixed with locking plates. Twenty-one periprosthetic fractures above a TKA and 27 non-periprosthetic fractures were retrospectively reviewed. The primary healing rate, bone union time, clinical and radiographic results, complications, and additional surgeries were compared between the two groups. The quality of the plate fit on the bone was also compared. There were no differences in the primary healing rate, bone union time, clinical and radiographic results between the two groups. The incidence of overall complication and additional surgeries did not differ (3/21 vs. 5/27, 1/21 vs. 4/27). Plate fit trouble was observed more frequently in periprosthetic fractures (10/21 vs. 1/27, p = 0.004). Fixation of distal femur fractures with locking plates provided satisfactory results with a low risk of complications and additional surgeries in both periprosthetic and non-periprosthetic fractures. Permalink : ./index.php?lvl=notice_display&id=34653 [article] Treatment Of Distal Femur Fractures With Locking Plates : Comparison Of Periprosthetic Fractures Above Total Knee Arthroplasty And Non-Periprosthetic Fractures [texte imprimé] / Sang Jun SONG, Auteur . - 2014 . - p.380-390. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.380-390 Mots-clés : distal femur fractures  locking plate  total knee arthroplasty  periprosthetic  non-periprosthetic Résumé : The purpose of the present study was to compare the results and plate fit of periprosthetic and non-periprosthetic distal femur fractures fixed with locking plates. Twenty-one periprosthetic fractures above a TKA and 27 non-periprosthetic fractures were retrospectively reviewed. The primary healing rate, bone union time, clinical and radiographic results, complications, and additional surgeries were compared between the two groups. The quality of the plate fit on the bone was also compared. There were no differences in the primary healing rate, bone union time, clinical and radiographic results between the two groups. The incidence of overall complication and additional surgeries did not differ (3/21 vs. 5/27, 1/21 vs. 4/27). Plate fit trouble was observed more frequently in periprosthetic fractures (10/21 vs. 1/27, p = 0.004). Fixation of distal femur fractures with locking plates provided satisfactory results with a low risk of complications and additional surgeries in both periprosthetic and non-periprosthetic fractures. Permalink : ./index.php?lvl=notice_display&id=34653

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Can Anterior Cruciate Ligament Reconstruction Be Performed Routinely In Day Clinic ? / Julie DE BEULE in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.391-396 Titre : Can Anterior Cruciate Ligament Reconstruction Be Performed Routinely In Day Clinic ? Type de document : texte imprimé Auteurs : Julie DE BEULE, Auteur Année de publication : 2014 Article en page(s) : p.391-396 Langues : Anglais (eng) Mots-clés : outpatient  ACL reconstruction  complication  readmission Résumé : Anterior cruciate ligament reconstruction is performed as an outpatient procedure in selected cases. Whether it can be safely performed on a routine basis in day clinic remains unclear. Our hypothesis was that routinely performing outpatient anterior cruciate ligament reconstruction would be equally safe as compared to inpatient procedures. A cohort of 355 patients who underwent outpatient primary reconstruction was analysed at an average follow-up of 3.8 years. Four patients (1.1%) could not be discharged or were readmitted within 24 hours. The 1-month readmission rate was 1.4%. The overall complication rate was 12.1% (43 cases) of which 4.2% (15 patients) occurred within the first 30 days. Performing anterior cruciate ligament reconstructions routinely in day clinic is associated with almost negligible readmission rates and has similar complication rates as for standard in-hospital anterior cruciate ligament reconstructions. Outpatient anterior cruciate ligament reconstructions can therefore be safely performed without specific preoperative patient selection protocols. Permalink : ./index.php?lvl=notice_display&id=34654 [article] Can Anterior Cruciate Ligament Reconstruction Be Performed Routinely In Day Clinic ? [texte imprimé] / Julie DE BEULE, Auteur . - 2014 . - p.391-396. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.391-396 Mots-clés : outpatient  ACL reconstruction  complication  readmission Résumé : Anterior cruciate ligament reconstruction is performed as an outpatient procedure in selected cases. Whether it can be safely performed on a routine basis in day clinic remains unclear. Our hypothesis was that routinely performing outpatient anterior cruciate ligament reconstruction would be equally safe as compared to inpatient procedures. A cohort of 355 patients who underwent outpatient primary reconstruction was analysed at an average follow-up of 3.8 years. Four patients (1.1%) could not be discharged or were readmitted within 24 hours. The 1-month readmission rate was 1.4%. The overall complication rate was 12.1% (43 cases) of which 4.2% (15 patients) occurred within the first 30 days. Performing anterior cruciate ligament reconstructions routinely in day clinic is associated with almost negligible readmission rates and has similar complication rates as for standard in-hospital anterior cruciate ligament reconstructions. Outpatient anterior cruciate ligament reconstructions can therefore be safely performed without specific preoperative patient selection protocols. Permalink : ./index.php?lvl=notice_display&id=34654

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Hip Resurfacing Arthroplasty : A New Method To Assess And Quantify Learning Phase / Tajeshwar S. AULAKH in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.397-402 Titre : Hip Resurfacing Arthroplasty : A New Method To Assess And Quantify Learning Phase Type de document : texte imprimé Auteurs : Tajeshwar S. AULAKH, Auteur Année de publication : 2014 Article en page(s) : p.397-402 Langues : Anglais (eng) Mots-clés : hip  resurfacing  learning  quantify Résumé : Hip resurfacing had initially gained acceptance and popularity as it helps preserve femoral bone stock. In this study we tried to answer the following questions ; 1. Whether there is a learning curve for hip resurfacing ? 2. Is it present in surgeons from non-developer centres ? 3. Is it present in surgeons from developer centres as well ? The Oswestry outcome centre was setup to serve an independent international registry for collecting, analysing and reporting outcomes following hip resurfacing. Over a 10 year period, 4535 patients (5000 hips) were recruited from different countries and within the UK from different centres in this study by 139 surgeons from 37 different countries. Our study has shown that function can be used to assess the level of surgical competence. The results from this multilevel analysis have helped to answer the questions posed in the introduction. Hip resurfacing is a surgical procedure with a learning phase and this learning effect is more pronounced in non-developer surgeons as compared to developer surgeons. Hip scores can be used to assess proficiency and competence of surgeons undertaking hip resurfacing arthroplasty. Permalink : ./index.php?lvl=notice_display&id=34655 [article] Hip Resurfacing Arthroplasty : A New Method To Assess And Quantify Learning Phase [texte imprimé] / Tajeshwar S. AULAKH, Auteur . - 2014 . - p.397-402. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.397-402 Mots-clés : hip  resurfacing  learning  quantify Résumé : Hip resurfacing had initially gained acceptance and popularity as it helps preserve femoral bone stock. In this study we tried to answer the following questions ; 1. Whether there is a learning curve for hip resurfacing ? 2. Is it present in surgeons from non-developer centres ? 3. Is it present in surgeons from developer centres as well ? The Oswestry outcome centre was setup to serve an independent international registry for collecting, analysing and reporting outcomes following hip resurfacing. Over a 10 year period, 4535 patients (5000 hips) were recruited from different countries and within the UK from different centres in this study by 139 surgeons from 37 different countries. Our study has shown that function can be used to assess the level of surgical competence. The results from this multilevel analysis have helped to answer the questions posed in the introduction. Hip resurfacing is a surgical procedure with a learning phase and this learning effect is more pronounced in non-developer surgeons as compared to developer surgeons. Hip scores can be used to assess proficiency and competence of surgeons undertaking hip resurfacing arthroplasty. Permalink : ./index.php?lvl=notice_display&id=34655

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Meniscal Transplantation : Still Experimental Surgery ? A Review / Kris MOENS in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.403-413 Titre : Meniscal Transplantation : Still Experimental Surgery ? A Review Type de document : texte imprimé Auteurs : Kris MOENS, Auteur Année de publication : 2014 Article en page(s) : p.403-413 Langues : Anglais (eng) Mots-clés : meniscus  transplantation  graft  surgical technique  indication  outcome Résumé : Introduction : the objective of this review is to give a state of affairs of meniscal transplantation, with the accent on preservation and surgical techniques. Materials and methods : All articles were selected by performing a search on the literature by using relevant keywords. The most relevant articles were selected with close attention to the publication date. Results : When a meniscal tear is diagnosed, suture can be an option in the vascular zone, whereas the more frequently affected avascular zone heals poorly. A meniscectomy however is not without consequences, wherefore meniscal transplantation can be seen as a therapeutic option for pain reduction and improvement of function when the meniscus is lost. The meniscal scaffold, allograft and autograft can be currently withheld as possible grafts, where the meniscal scaffolds hold great promise as an alternative to the allograft. Various fixation techniques are therefore developed, where viable, deep frozen as well as cryopreservated allografts seem to give the most promising short term results. The transplantation can be performed using an open as well as an arthroscopic technique, using soft tissue fixation, bone plugs or blocks. De primacy of one technique can’t be proven. In general meniscal transplantation can be considered as an acceptable procedure. Discussion : Since the outcomes of different studies are difficult to compare, an attempt should be made to limit new studies to the comparison of one aspect. We can conclude that larger, more comparative randomised controlled long-term studies are necessary to resolve which techniques can give the best long-term results. Permalink : ./index.php?lvl=notice_display&id=34656 [article] Meniscal Transplantation : Still Experimental Surgery ? A Review [texte imprimé] / Kris MOENS, Auteur . - 2014 . - p.403-413. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.403-413 Mots-clés : meniscus  transplantation  graft  surgical technique  indication  outcome Résumé : Introduction : the objective of this review is to give a state of affairs of meniscal transplantation, with the accent on preservation and surgical techniques. Materials and methods : All articles were selected by performing a search on the literature by using relevant keywords. The most relevant articles were selected with close attention to the publication date. Results : When a meniscal tear is diagnosed, suture can be an option in the vascular zone, whereas the more frequently affected avascular zone heals poorly. A meniscectomy however is not without consequences, wherefore meniscal transplantation can be seen as a therapeutic option for pain reduction and improvement of function when the meniscus is lost. The meniscal scaffold, allograft and autograft can be currently withheld as possible grafts, where the meniscal scaffolds hold great promise as an alternative to the allograft. Various fixation techniques are therefore developed, where viable, deep frozen as well as cryopreservated allografts seem to give the most promising short term results. The transplantation can be performed using an open as well as an arthroscopic technique, using soft tissue fixation, bone plugs or blocks. De primacy of one technique can’t be proven. In general meniscal transplantation can be considered as an acceptable procedure. Discussion : Since the outcomes of different studies are difficult to compare, an attempt should be made to limit new studies to the comparison of one aspect. We can conclude that larger, more comparative randomised controlled long-term studies are necessary to resolve which techniques can give the best long-term results. Permalink : ./index.php?lvl=notice_display&id=34656

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Medial Malleolar Screw Hemiepiphysiodesis For Ankle Valgus In Children With Spina Bifida / Ilhan A. BAYHAN in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.414-418 Titre : Medial Malleolar Screw Hemiepiphysiodesis For Ankle Valgus In Children With Spina Bifida Type de document : texte imprimé Auteurs : Ilhan A. BAYHAN, Auteur Année de publication : 2014 Article en page(s) : p.414-418 Langues : Anglais (eng) Mots-clés : spina bifida  myelomeningocele  ankle valgus  hemiepiphysiodesis Résumé : Medial malleolar screw hemiepiphysiodesis has been shown to be an effective procedure for the treatment of ankle valgus in children with spina bifida. The purpose of this study was to highlight the guided growth technique and discuss its efficacy. We retrospectively reviewed 10 spina bifida patients with 18 ankle valgus deformities treated with medial malleolar screw hemiepiphysiodesis. Medical reports were obtained to document age at surgery, gender, concurrent operative procedures and postoperative early and late complications. Anteroposterior and lateral weight bearing radiographs of both ankles were evaluated using the tibiotalar angle, pre and postoperatively. The average age at operation was 10,05 years. Average follow up was 15,33 months (11-21 months). During follow-up, the average preoperative distal tibiotalar angle of 16.27 degrees improved to an average of 2,88 degrees with statistical significance (p < 0,05). No major complications were detected. In conclusion, hemiepiphysiodesis is a safe and sufficient method to correct ankle valgus deformity in children with spina bifida, with a low incidence of complications and satisfactory results. Permalink : ./index.php?lvl=notice_display&id=34657 [article] Medial Malleolar Screw Hemiepiphysiodesis For Ankle Valgus In Children With Spina Bifida [texte imprimé] / Ilhan A. BAYHAN, Auteur . - 2014 . - p.414-418. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.414-418 Mots-clés : spina bifida  myelomeningocele  ankle valgus  hemiepiphysiodesis Résumé : Medial malleolar screw hemiepiphysiodesis has been shown to be an effective procedure for the treatment of ankle valgus in children with spina bifida. The purpose of this study was to highlight the guided growth technique and discuss its efficacy. We retrospectively reviewed 10 spina bifida patients with 18 ankle valgus deformities treated with medial malleolar screw hemiepiphysiodesis. Medical reports were obtained to document age at surgery, gender, concurrent operative procedures and postoperative early and late complications. Anteroposterior and lateral weight bearing radiographs of both ankles were evaluated using the tibiotalar angle, pre and postoperatively. The average age at operation was 10,05 years. Average follow up was 15,33 months (11-21 months). During follow-up, the average preoperative distal tibiotalar angle of 16.27 degrees improved to an average of 2,88 degrees with statistical significance (p < 0,05). No major complications were detected. In conclusion, hemiepiphysiodesis is a safe and sufficient method to correct ankle valgus deformity in children with spina bifida, with a low incidence of complications and satisfactory results. Permalink : ./index.php?lvl=notice_display&id=34657

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The Role Of Taylor Spatial Frame For The Treatment Of Acquired And Congenital Tibial Deformities In Children / Haridimos TSIBIDAKIS in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.419-425 Titre : The Role Of Taylor Spatial Frame For The Treatment Of Acquired And Congenital Tibial Deformities In Children Type de document : texte imprimé Auteurs : Haridimos TSIBIDAKIS, Auteur Année de publication : 2014 Article en page(s) : p.419-425 Langues : Anglais (eng) Mots-clés : Taylor spatial frame  external fixator  tibia deformities  children Résumé : This study evaluates the use of the Taylor Spatial Frame (TSF) for the correction of acquired and congenital tibial deformities in children. The purpose is to underline problems, obstacles and complications that can be observed during treatment to reveal the learning curve and potential risk factors and to propose solutions to avoid difficulties during its use 86 tibia deformities were corrected in 66 children during a period of 7 years and were classified according to anatomical and dominant type of deformity. Follow up was 54.2 months. Gradual correction was performed according to the individualized time schedule. We faced 42 difficulties : 29 problems, 10 obstacles and 3 complications, distributed across all years. Significant correlation was found between patient’s age and number of difficulties. The incidence of the difficulties was equally spread over the different etiologies, but it was statistically significant across the years. Proximal tibia and complex multi-plane deformities seem to be related to an increased incidence of postoperative difficulties. TSF can yield accurate results, is easy to handle and provides an excellent concomitant 3-direction correction. Permalink : ./index.php?lvl=notice_display&id=34658 [article] The Role Of Taylor Spatial Frame For The Treatment Of Acquired And Congenital Tibial Deformities In Children [texte imprimé] / Haridimos TSIBIDAKIS, Auteur . - 2014 . - p.419-425. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.419-425 Mots-clés : Taylor spatial frame  external fixator  tibia deformities  children Résumé : This study evaluates the use of the Taylor Spatial Frame (TSF) for the correction of acquired and congenital tibial deformities in children. The purpose is to underline problems, obstacles and complications that can be observed during treatment to reveal the learning curve and potential risk factors and to propose solutions to avoid difficulties during its use 86 tibia deformities were corrected in 66 children during a period of 7 years and were classified according to anatomical and dominant type of deformity. Follow up was 54.2 months. Gradual correction was performed according to the individualized time schedule. We faced 42 difficulties : 29 problems, 10 obstacles and 3 complications, distributed across all years. Significant correlation was found between patient’s age and number of difficulties. The incidence of the difficulties was equally spread over the different etiologies, but it was statistically significant across the years. Proximal tibia and complex multi-plane deformities seem to be related to an increased incidence of postoperative difficulties. TSF can yield accurate results, is easy to handle and provides an excellent concomitant 3-direction correction. Permalink : ./index.php?lvl=notice_display&id=34658

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The Treatment Of Infected Tibial Nonunion By Bone Transport Using The Ilizarov External Fixator And A Systematic Review Of Infected Tibial Nonunion Treated By Ilizarov Methods / Peng YIN in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.426-435 Titre : The Treatment Of Infected Tibial Nonunion By Bone Transport Using The Ilizarov External Fixator And A Systematic Review Of Infected Tibial Nonunion Treated By Ilizarov Methods Type de document : texte imprimé Auteurs : Peng YIN, Auteur Année de publication : 2014 Article en page(s) : p.426-435 Langues : Anglais (eng) Mots-clés : bone transport  infected nonunion  bone defects  Ilizarov methods  systematic review Résumé : This study was designed to evaluate the effectiveness of the treatment of infected tibial nonunion by bone transport using the Ilizarov external fixator. We retrospectively reviewed 66 patients with infected tibial nonunion treated by bone transport using the Ilizarov external fixator. Our study included 62 males and 4 females with a mean of age 37.06 years. The average length of the bone defects after radical debridement was 6.27 cm (range 3-13 cm). The mean follow-up after removal of the apparatus was 25.91 months (18-46 months). 6 patients were lost to follow-up. All the patients achieved bone union and no recurrence of infection was observed. The mean external fixation index was 1.38 months/cm (range 1.15-1.58 months/cm). According to Association for the Study and Application of the Method of Ilizarov (ASAMI) classification, bone results were excellent in 44, good in 15, fair in 5 and poor in 2 ; functional results were excellent in 24, good in 26, fair in 10 and no poor. Conclusions : Our study and the current evidence suggested that Ilizarov methods in the treatment of infected tibial nonunion acquired satisfied effects in bone results and functional results. Radical debridement is the key step to control bone infection. Permalink : ./index.php?lvl=notice_display&id=34659 [article] The Treatment Of Infected Tibial Nonunion By Bone Transport Using The Ilizarov External Fixator And A Systematic Review Of Infected Tibial Nonunion Treated By Ilizarov Methods [texte imprimé] / Peng YIN, Auteur . - 2014 . - p.426-435. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.426-435 Mots-clés : bone transport  infected nonunion  bone defects  Ilizarov methods  systematic review Résumé : This study was designed to evaluate the effectiveness of the treatment of infected tibial nonunion by bone transport using the Ilizarov external fixator. We retrospectively reviewed 66 patients with infected tibial nonunion treated by bone transport using the Ilizarov external fixator. Our study included 62 males and 4 females with a mean of age 37.06 years. The average length of the bone defects after radical debridement was 6.27 cm (range 3-13 cm). The mean follow-up after removal of the apparatus was 25.91 months (18-46 months). 6 patients were lost to follow-up. All the patients achieved bone union and no recurrence of infection was observed. The mean external fixation index was 1.38 months/cm (range 1.15-1.58 months/cm). According to Association for the Study and Application of the Method of Ilizarov (ASAMI) classification, bone results were excellent in 44, good in 15, fair in 5 and poor in 2 ; functional results were excellent in 24, good in 26, fair in 10 and no poor. Conclusions : Our study and the current evidence suggested that Ilizarov methods in the treatment of infected tibial nonunion acquired satisfied effects in bone results and functional results. Radical debridement is the key step to control bone infection. Permalink : ./index.php?lvl=notice_display&id=34659

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The Management Of Myxofibrosarcoma – A Ten-Year Experience In A Single Specialist Centre / Jessica DANIELS in Acta Orthopaedica Belgica, Vol 80/3 (Septembre 2014)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.436-441 Titre : The Management Of Myxofibrosarcoma – A Ten-Year Experience In A Single Specialist Centre Type de document : texte imprimé Auteurs : Jessica DANIELS, Auteur Année de publication : 2014 Article en page(s) : p.436-441 Langues : Anglais (eng) Mots-clés : myxofibrosarcoma  soft tissue sarcoma  limb salvage surgery  radiotherapy Résumé : The aim of this study was to assess the management of myxofibrosarcoma in a single specialist centre, and examine factors contributing to local recurrence, metastasis and patient survival. Retrospective analysis of the referral, diagnosis, and management were obtained. Outcome measures including local recurrence, metastasis and death were recorded. 30 patients (mean age of 65.8 years) were treated for myxofibrosarcoma with limb salvage surgery between January 2003 and July 2012. 25 patients were treated for primary disease. Mean follow-up was 49 months (range 10-122). Larger tumours were most likely to metastasise (p = 0.041). Tumour size, resection margin and grade did not predict local recurrence or death. Local recurrence developed in eight patients (26.7%) with six subsequently requiring amputation, and four patients (16.7%) developed metastasis. Our results regarding local control and patient survival compare with that of the literature regarding limb salvage for primary disease, but amputation may be required for recurrent disease. Permalink : ./index.php?lvl=notice_display&id=34660 [article] The Management Of Myxofibrosarcoma – A Ten-Year Experience In A Single Specialist Centre [texte imprimé] / Jessica DANIELS, Auteur . - 2014 . - p.436-441. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol 80/3 (Septembre 2014) . - p.436-441 Mots-clés : myxofibrosarcoma  soft tissue sarcoma  limb salvage surgery  radiotherapy Résumé : The aim of this study was to assess the management of myxofibrosarcoma in a single specialist centre, and examine factors contributing to local recurrence, metastasis and patient survival. Retrospective analysis of the referral, diagnosis, and management were obtained. Outcome measures including local recurrence, metastasis and death were recorded. 30 patients (mean age of 65.8 years) were treated for myxofibrosarcoma with limb salvage surgery between January 2003 and July 2012. 25 patients were treated for primary disease. Mean follow-up was 49 months (range 10-122). Larger tumours were most likely to metastasise (p = 0.041). Tumour size, resection margin and grade did not predict local recurrence or death. Local recurrence developed in eight patients (26.7%) with six subsequently requiring amputation, and four patients (16.7%) developed metastasis. Our results regarding local control and patient survival compare with that of the literature regarding limb salvage for primary disease, but amputation may be required for recurrent disease. Permalink : ./index.php?lvl=notice_display&id=34660

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