| 11. |
- Abdulghani, Saba, et al.
(författare)
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The influence of initial pressurization and cup introduction time on the depth of cement penetration in an acetabular model.
- 2007
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 78:3, s. 333-339
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Tidskriftsartikel (refereegranskat)abstract
- Background Acetabular cementation during total hip arthroplasty is considered difficult mainly due to the appearance and anatomy of the acetabulum. Improved cementation technique has been shown to improve the longevity of acetabular components. Method We designed a ceramic model to investigate the effect of varying the initial cement pressurization and cup introduction times on the depth of cement penetration. 4 groups were prepared, 2 of which involved varying initial cement pressurization and cup introduction times. Group 3 involved initial cement pressurization with no cup introduction, while group 4 involved cup introduction with no prior cement pressurization. Results and interpretation Most cement penetration occurred in the early pressurization phase, and we conclude that a relatively early and longer cement pressurization time and late cup introduction are positive factors for increased cement penetration in the acetabulum model.
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| 12. |
- Abramo, Antonio, et al.
(författare)
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Evaluation of a treatment protocol in distal radius fractures: a prospective study in 581 patients using DASH as outcome.
- 2008
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 79:3, s. 376-385
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Distal radius fractures are most often treated nonoperatively, but sometimes they are treated surgically when deemed unstable. Based on the literature, a consensus protocol for treatment has been developed in southern Sweden to aid clinicians in their decision making. We evaluated the results of this protocol prospectively using a validated outcome instrument (DASH) in a large consecutive and population based series of unselected patients. METHODS: 581 patients were treated according the protocol. Age, sex, fracture side, and type of treatment were registered. The subjective outcome was measured by DASH. 133 patients were operated. RESULTS: 75% of the patients returned the questionnaire. The median DASH score at 3 months was 18.3 and at 12 months it was 7.5. All treatment groups had low DASH scores at the final follow-up. Reduced, nonoperated fractures had a worse score (11.6) than undisplaced (4.2) or operated fractures (6.0). Age was the only other predictor, with older patients having a worse score. A correlation was found between the short-version 11-item QuickDASH questionnaire and the full 30-item DASH, both at 3 months (r = 0.98) and at 1 year (r = 0.97) (p< 0.001 for both). INTERPRETATION: Most patients have residual symptoms at 3 months after the fracture but are normalized at 1 year. Good final subjective result was achieved with the proposed protocol regardless of initial severity and treatment of the fracture, as indicated by a low median DASH score in all groups. There was correlation between QuickDASH and the full DASH, and the former could be used in future studies.
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| 13. |
- Abramo, Antonio, et al.
(författare)
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Open reduction and internal fixation compared to closed reduction and external fixation in distal radial fractures A randomized study of 50 patients
- 2009
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 80:4, s. 478-485
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose In unstable distal radial fractures that are impossible to reduce or to maintain in reduced position, the treatment of choice is operation. The type of operation and the choice of implant, however, is a matter of discussion. Our aim was to investigate whether open reduction and internal fixation would produce a better result than traditional external fixation. Methods 50 patients with an unstable or comminute distal radius fracture were randomized to either closed reduction and bridging external fixation, or open reduction and internal fixation using the TriMed system. The primary outcome parameter was grip strength, but the patients were followed for 1 year with objective clinical assessment, subjective outcome using DASH, and radiographic examination. Results At 1 year postoperatively, grip strength was 90% (SD 16) of the uninjured side in the internal fixation group and 78% (17) in the external fixation group. Pronation/supination was 150 degrees (15) in the internal fixation group and 136 degrees (20) in the external fixation group at 1 year. There were no differences in DASH scores or in radiographic parameters. 5 patients in the external fixation group were reoperated due to malunion, as compared to 1 in the internal fixation group. 7 other cases were classified as radiographic malunion: 5 in the external fixation group and 2 in the internal fixation group. Interpretation Internal fixation gave better grip strength and a better range of motion at 1 year, and tended to have less malunions than external fixation. No difference could be found regarding subjective outcome.
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| 14. |
- Abramo, Antonio, et al.
(författare)
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Osteotomy of dorsally displaced malunited fractures of the distal radius: no loss of radiographic correction during healing with a minimally invasive fixation technique and an injectable bone substitute.
- 2008
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 79:2, s. 262-268
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Malunion after a distal radius fracture can be treated with an osteotomy of the distal radius. Often autologous iliac crest bone graft is used to fill the gap, but this is associated with donor site morbidity. Instead of bone graft, we have used a slow-resorbing bone substitute in combination with a minimally invasive fixation technique. PATIENTS AND METHODS: 25 consecutive patients with a dorsal malunion after a distal radius fracture underwent an osteotomy. A TriMed buttress pin and a radial pin plate were used for fixation, and Norian SRS as bone substitute. The patients were followed for a minimum of 1 year and range of motion, grip strength, DASH scores, and the radiographic correction were measured. RESULTS: Forearm rotation improved from 137 degrees to 155 degrees , flexion/extension from 102 degrees to 120 degrees , and radioul-nar deviation from 32 degrees to 43 degrees . Grip strength increased from 62% of the contralateral hand to 82%. DASH scores decreased from 36 to 23. Radiographically, all osteotomies but 1 healed and the radiographic correction achieved was consistent over the first year. INTERPRETATION: Osteotomy of the distal radius is effective in increasing motion and grip strength after a malunited distal radial fracture. Patient satisfaction is high and subjective results measured with DASH are good. Using a bone substitute, the operation can be performed as an outpatient procedure and donor-site pain avoided. No loss of the radiographic correction achieved was noted during osteotomy healing.
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| 15. |
- Abul-Kasim, Kasim, et al.
(författare)
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The rate of screw misplacement in segmental pedicle screw fixation in adolescent idiopathic scoliosis.
- 2011
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3682 .- 1745-3674. ; 82, s. 50-55
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Tidskriftsartikel (refereegranskat)abstract
- Background and purpose There are no reports in the literature on the influence of learning on the pedicle screw insertion. We studied the effect of learning on the rate of screw misplacement in patients with adolescent idiopathic scoliosis treated with segmental pedicle screw fixation. Method We retrospectively evaluated low-dose spine computed tomography of 116 consecutive patients (aged 16 (12-24) years, 94 females) who were operated during 4 periods over 2005-2009 (group 1: patients operated autumn 2005-2006; group 2: 2007; group 3: 2008; and group 4: 2009). 5 types of misplacement were recorded: medial cortical perforation, lateral cortical perforation, anterior cortical perforation of the vertebral body, endplate perforation, and perforation of the neural foramen. Reslts 2,201 pedicle screws were evaluated, with an average of 19 screws per patient. The rate of screw misplacement for the whole study was 14%. The rate of lateral and medial cortical perforation was 7% and 5%. There was an inverse correlation between the occurrence of misplacement and the patient number, i.e. the date of operation (r = -0.35; p < 0.001). The skillfulness of screw insertion improved with reduction of the rate of screw misplacement from 20% in 2005-2006 to 11% in 2009, with a breakpoint at the end of the first study period (34 patients). Interpretation We found a substantial learning curve; cumulative experience may have contributed to continued reduction of misplacement rate.
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| 16. |
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| 17. |
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| 18. |
- Adolfsson, Lars, et al.
(författare)
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Elbow hemiarthroplasty for acute reconstruction of intraarticular distal humerus fractures : A preliminary report involving 4 patients
- 2006
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Ingår i: Acta Orthopaedica. - : Medical Journals Sweden AB. - 1745-3674 .- 1745-3682. ; 77:5, s. 785-787
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Tidskriftsartikel (refereegranskat)abstract
- We treated 4 female patients (mean age 80) with complex intraarticular acute fracture of the distal humerus with a Kudo humeral component, i.e. a hemiarthroplasty. All fractures were considered impossible to treat with open reduction and internal fixation. At mean 10 (3-14) months, 3 patients had an excellent result and 1 a good result according to the Mayo elbow performance score. We conclude that a hemiarthroplasty may be a valuable alternative in eldery patients with complex fractures of the distal humerus. Copyright© Taylor & Francis 2006.
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| 19. |
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| 20. |
- Affas, Fatin, et al.
(författare)
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Pain control after total knee arthroplasty : a randomized trial comparing local infiltration anesthesia and continuous femoral block
- 2011
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Ingår i: Acta Orthopaedica. - New York : Taylor & Francis. - 1745-3674 .- 1745-3682. ; 82:4, s. 441-447
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Pain after total knee arthroplasty (TKA) is usually severe, and epidural analgesia or femoral nerve block has been considered to be an effective pain treatment. Recently, local infiltration analgesia (LIA) has become increasingly popular but the outcome of this method regarding the analgesic effect has not been fully evaluated. We compared local infiltration analgesia and femoral block with regard to analgesia and morphine demand during the first 24 h after TKA.METHODS: 40 patients undergoing TKA under spinal anesthesia were randomized to receive femoral nerve block (group F) or peri- and intraarticular infiltration analgesia (group LIA) with a mixture containing ropivacaine, ketorolac, and epinephrine. All patients had access to intravenous patient-controlled analgesia (PCA) with morphine postoperatively. Pain intensity at rest and upon movement was assessed on a numeric rating scale (0-10) on an hourly basis over 24 h if the patients were awake.RESULTS: The average pain at rest was marginally lower with LIA (1.6) than with femoral block (2.2). Total morphine consumption per kg was similar between the 2 groups. Ancillary analysis revealed that 1 of 20 patients in the LIA group reported a pain intensity of > 7 upon movement, as compared to 7 out of 19 in the femoral block group (p = 0.04).INTERPRETATION: Both LIA and femoral block provide good analgesia after TKA. LIA may be considered to be superior to femoral block since it is cheaper and easier to perform.
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