Abstract:
AIM:Treatment of periprosthetic fractures by implantation of a specially constructed, retrograde hollow nail which fits over the tip of the prosthesis and becomes locked on it. INDICATIONS:Periprosthetic femoral fractures with firmly anchored prosthesis shaft after total hip arthroplasty of types B1 and C according to the Vancouver classification. CONTRAINDICATIONS:Loosened prosthesis (type B2/B3) and trochanteric fractures (type A). Broken or damaged prosthesis, florid inflammation and soft tissue injuries in the operation field, contracted knee joint, advanced deformation in the knee joint and distal femur, enclosed prosthesis and general contraindications. SURGICAL TECHNIQUE:In a supine position the periprosthetic fracture is exposed via a lateral access. For cemented prostheses the cement is removed around the tip of the prosthesis (at least 2-3 cm) and medullary cavity. Arthrotomy with flexion of the knee joint and marking of the nail entry point. Drill the medullary cavity, retrograde introduction of the nail, visually fit the nail over the tip of the prosthesis and lock the nail with the prosthesis. If necessary use additional spongiosaplasty or also placement of additional cerclages depending on fracture type and size of the defect zone. Lock the nail distally. Use intraoperative radiological imaging to control correct positioning and length of the nail. Close the wound layer by layer with placement of suction drainage devices and dressing. POSTOPERATIVE MANAGEMENT:Partial loading for 6 weeks with a subsequent pain-adapted loading gradient until full loading is possible. If selective partial loading is not possible, a decision must be made in individual cases as to whether the intraoperative findings allow immediate full loading. RESULTS:From 2004 to 2011 a total of 25 periprosthetic femoral fractures in 25 patients were treated in 2 locations using specially constructed slotted hollow nails. Within the framework of a retrospective study 20 of these patients (16 female and 4 male; average age 77.2 [72-84] years) were clinically and radiologically re-examined on average 19.3 (7-31) months postoperatively. No postoperative bleeding, wound healing disorders and infections. In all patients there was a loading stable consolidation of the fracture in the correct femoral axis, length and rotation with no evidence for radiological signs of loosening of the prosthesis or dislocation of the nails. In one case there was loosening of the prosthesis which had obviously occurred during the operative procedure. After consolidation of the fracture it was necessary to exchange the prosthesis for a long shafted prosthesis. A comparable situation to the preoperative degree of mobility was found in 12 out of the 20 patients, a moderate deterioration in 5 patients, a substantial residual impairment in 2 patients and an improvement of the situation in 1 patient.
journal_name
Oper Orthop Traumatoljournal_title
Operative Orthopadie und Traumatologieauthors
Szalay G,Meyer C,Mika J,Schnettler R,Thormann Udoi
10.1007/s00064-013-0236-5subject
Has Abstractpub_date
2014-12-01 00:00:00pages
611-24issue
6eissn
0934-6694issn
1439-0981journal_volume
26pub_type
杂志文章abstract:OBJECTIVE:Decompression of the median nerve by complete release of the flexor retinaculum and the distal antebrachial fascia. In the case of revision surgery providing of a scar-free covering of the median nerve, if necessary. INDICATIONS:Carpal tunnel release is indicated for symptomatic patients with painful paraest...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-020-00662-y
更新日期:2020-06-01 00:00:00
abstract:OBJECTIVE:Accessibility of any anatomical structure of the hand via surgical approach. INDICATIONS:Any surgical treatment of the hand. CONTRAINDICATIONS:Any contraindication to surgical treatment of the hand. SURGICAL TECHNIQUE:Skin incision at the hand with access to any anatomical structure. POSTOPERATIVE MANAGEM...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-019-0622-8
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVE:Reduction and stabilization of unstable spinal injuries with reconstruction of the anterior column resulting in a permanent restitution of the physiologic spinal alignment, stability and load-bearing capacity. INDICATIONS:Unstable injuries and lesions of the spine from T4 to L5 resulting in a reduced load-be...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-005-1132-4
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVE:Reconstruction of segmental bone defects of the proximal femur following wide tumor resection or revision arthroplasty. INDICATIONS:Aggressive benign or primary malignant bone tumors of the proximal femur; destructive metastases; massive segmental bone defects of the proximal femur; periprosthetic fractures....
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-011-0061-7
更新日期:2012-07-01 00:00:00
abstract:OBJECTIVE:Callus distraction of the femur or tibia with an intramedullary distractor, which lengthens mechanically through alternating rotations of at least 3 degrees. INDICATIONS:Femoral or tibial shortening between 20 and 80 mm. Angular and rotational deformities can be corrected at the osteotomy site. CONTRAINDICA...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-005-1123-5
更新日期:2005-02-01 00:00:00
abstract:OBJECTIVE:Simultaneous arthrodesis of ankle and subtalar joints and, at the same sitting, correction of axial malalignment of hindfoot, treatment of bony defects and of sequelae of circulatory disturbances after multiple previous interventions. Internal stabilization with a short distal femur nail. Restitution of a pai...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-005-1137-7
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVE:Femoral medial closing wedge osteotomy for the correction of valgus malalignment to unload the cartilage in the lateral compartment and/or correction of symptomatic torsional malalignment. INDICATIONS:Lateral unicompartmental osteoarthritis of the knee with genu valgum in young patients. Symptomatic torsiona...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-013-0258-z
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:Multilevel posterior decompression of subaxial cervical spinal canal stenosis through a less-invasive unilateral approach. INDICATIONS:Degenerative cervical myelopathy due to multilevel subaxial spinal canal stenosis. CONTRAINDICATIONS:Cervical kyphosis or instability, bilateral radiculopathy due to foramin...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章,评审
doi:10.1007/s00064-017-0527-3
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:Reconstruction of the medial patellofemoral ligament with autologous tendon augmentation and soft tissue fixation at the patellar insertion with resorbable suture material. INDICATIONS:Patellofemoral instability due to insufficiency of the medial passive stabilizers and dysplastic trochlea. CONTRAINDICATION...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-015-0428-2
更新日期:2015-12-01 00:00:00
abstract:OBJECTIVE:The procedure is selected based on the stage of infection with careful removal of the focal infection in the area of the nail fold. INDICATIONS:All infections of the periungual area. CONTRAINDICATIONS:Herpes infections [1, 12]. All purulent infections of the periungual area should be eliminated. SURGICAL T...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-011-0025-y
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:Precise adaptable fixation of a supracondylar humerus osteotomy with a radial/lateral external fixator to correct posttraumatic cubitus varus. INDICATIONS:Acquired, posttraumatic cubitus varus as a result of a malhealed and unsatisfactorily treated supracondylar humerus fracture. Idiopathic, congenital cubit...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-015-0403-y
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:Bony fusion of the trapeziometacarpal joint. INDICATIONS:High demands concerning stability and strength of the thumb in primary or secondary osteoarthritis (e.g., posttraumatic osteoarthritis following injuries to the carpometacarpal joint of the thumb); instability in the absence of osteoarthritis due to ma...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章,评审
doi:10.1007/s00064-017-0515-7
更新日期:2017-10-01 00:00:00
abstract:OBJECTIVE:To stabilize the distal radioulnar joint (DRUJ) by performing dorsal capsular imbrication in patients presenting with dorsal instability. The goal was to reduce pain and prevent the occurrence of posttraumatic arthrosis. INDICATIONS:Posttraumatic dorsal instability of the DRUJ with missing block while perfor...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-012-0223-2
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:Treatment of posterior shoulder instability with increased retroversion of the glenoid using open-wedge osteotomy of the glenoid neck stabilized with an autologous bone block. INDICATIONS:Symptomatic, atraumatic posterior shoulder instability with increased retroversion (>20°) of the glenoid and previously f...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-016-0457-5
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVE:Stabilization of the ulnohumeral joint against rotation and shear forces, preserving flexion and extension movements, in order to safeguard the healing of the collateral ligaments. INDICATIONS:Persistent instability of the elbow joint in 90 degrees flexion following elbow dislocation, particularly in the ant...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-006-1161-7
更新日期:2006-03-01 00:00:00
abstract:OBJECTIVE:Indirect decompression of the spinal canal and the neuroforamina by means of interspinous process distraction and limitation of extension movements. Reduction of forces acting on the posterior joint structures of a functional spinal unit (posterior anulus, facet joints, intervertebral discs). INDICATIONS:Pri...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-010-9042-5
更新日期:2010-11-01 00:00:00
abstract:OBJECTIVE:Immediate two-step coverage of dorsal finger and thumb-tip soft-tissue defects with a dorsal flag flap, which can bridge over two fingers if necessary. INDICATIONS:Soft-tissue defects on the dorsal aspect of fingers between the metacarpophalangeal and the distal interphalangeal joint as well as on the tip of...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-008-1304-0
更新日期:2008-09-01 00:00:00
abstract:OBJECTIVE:Serious lower extremity injuries sometimes warrant emergency amputation. The goal of amputation in polytrauma patients is to increase chances of survival, while the goal of amputation in a single limb injury is to prevent further complications, e.g., infection, septic shock. INDICATIONS:Rescue from life-thre...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-011-0043-9
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:Anatomical reconstruction and recovery to complete range of function of the upper ankle joint. Therefore, the most stable but least invasive osteosynthesis is required to enable the patient early functional mobilization. INDICATION:Supination and pronation fracture with luxation mechanism of the upper ankle ...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-015-0412-x
更新日期:2015-08-01 00:00:00
abstract:OBJECTIVE:In simple pelvic osteotomy in childhood the aim is for better lateral roofing, a safe centering of the femoral head and tuning between the volumes of the acetabulum and the femoral head. By the combination of anterior modified Pemberton osteotomy with dorsal osteotomy according to Salter these objectives can ...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-013-0239-2
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVE:To make a transtibial stump as long as possible, free from local and phantom pain with a maximum of terminal load bearing. In order to preserve the knee joint, an ultra-short tibial stump of 5-6 cm may be indicated. INDICATIONS:A hindfoot amputation level is not possible to achieve. CONTRAINDICATIONS:In amp...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-011-0040-z
更新日期:2011-10-01 00:00:00
abstract:OBJECTIVE:Reconstruction of the anterior talofibular (ATFL) and calcaneofibular (CFL) ligament in patients with chronic lateral ankle instability. INDICATIONS:Symptomatic chronic lateral ankle instability. CONTRAINDICATIONS:Bony malalignment, advanced arthritic changes of the ankle joint, diabetic foot syndrome. SUR...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-011-0126-7
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:Debridement and irrigation of the knee joint and the donor site to reduce the amount of bacteria and to remove bacterial enzymes and inflammatory cytokines in cases with infection after replacement of the anterior cruciate ligament (ACL). INDICATIONS:Proven infection, suspected infection. CONTRAINDICATIONS:...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-013-0262-3
更新日期:2014-02-01 00:00:00
abstract:OBJECTIVE:Salvage of the respective extremity. Standardized approach to adequate soft-tissue coverage (isolated severe soft-tissue trauma) and preconditioning for fracture healing (in complex trauma) as a basis for functional restoration. Limitation of secondary soft-tissue loss. Prevention of infection. INDICATIONS:I...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章,评审
doi:10.1007/s00064-010-8045-6
更新日期:2010-05-01 00:00:00
abstract:OBJECTIVE:Arthroscopic capsular release for refractory shoulder stiffness to recreate active and passive shoulder joint mobility. INDICATIONS:Adhesive capsulitis of the shoulder (primary and secondary frozen shoulder) after receiving at least 3 months of conservative treatment. CONTRAINDICATIONS:Boney-related stiffen...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-013-0284-x
更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:An anatomically preformed approach to the posterior tibial plateau is described. In avulsion fractures of the posterior cruciate ligament (PCL), the aim is to restore stability of the knee joint with functional treatment, while in posterior shearing tibial plateau fractures the aim is to restore anatomical do...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-013-0255-2
更新日期:2015-02-01 00:00:00
abstract:OBJECTIVE:Restoration of anatomy of the joint surface of the tibial plateau in posttraumatic deformity. INDICATIONS:Malunions of the tibial plateau with significant intra-articular depression and/or steps. CONTRAINDICATIONS:Local or systemic infection, critical soft tissues in the area of planned incisions; advanced ...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-020-00671-x
更新日期:2020-08-01 00:00:00
abstract:OBJECTIVE:Soft-tissue defect coverage with well vascularized tissue (musculocutaneous or fasciocutaneous) in the arthroplasty setting. Where arthroplasty has been removed due to infection, as a muscle flap to close infected cavities. INDICATIONS:Soft tissue defects, wound-edge necrosis in arthroplasty, and persistent ...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-012-0213-4
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVES:Restoration of extension in the metacarpophalangeal joints of the fingers as well as in the interphalangeal joint of the thumb by transfer of the superficial flexor tendons of the long and ring fingers (flexor digitorum superficialis III and IV). INDICATIONS:The indications for surgery are substantial loss ...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-012-0204-5
更新日期:2013-08-01 00:00:00
abstract:OBJECTIVE:Tibial tubercle osteotomy facilitates access to the knee joint without excessive tension of the extensor apparatus with the lateral parapatellar approach and the medial parapatellar approach in case of contracture or revision arthroplasty. INDICATIONS:Inadequate exposure of the knee joint with the lateral pa...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-011-0079-x
更新日期:2012-04-01 00:00:00