Abstract:
INTRODUCTION:Cerclage wiring for reduction of complex femoral shaft fractures can create iatrogenic vascular injury. OBJECTIVE:To describe the anatomical relation of blood vessels to the femur and develop a technical guide for safe passage of cerclage wire. MATERIALS AND METHODS:CT lower-limb angiographs (CTA) of 80 patients were reviewed and analysed to identify the superficial femoral artery (SFA) and the deep femoral artery (DFA) as well as the relation of those arteries to the femoral cortex. The total length of the femur was measured and divided into eight equal segments (seven levels). At each level, the medial half of the femur was divided into eight sectors labelled A through H and the position of the SFA and DFA was recorded. The shortest distance between the femoral cortex and the SFA and DFA at each level was measured. The data was analysed using STATA version 10.0. RESULTS:The average total femoral length from the tip of greater trochanter to lateral joint line was 402.98 ± 26.16 cm. The average distances from the SFA to the femur (d1) for levels 1 through 7 were 37.20 ± 5.0, 32.09 ± 4.74, 27.13 ± 4.19, 27.71 ± 5.46, 23.71 ± 4.40, 13.63 ± 3.59 and 10.08 ± 3.09 mm, respectively. The average distances between the DFA and the femur (d2) for levels 1 through 3 were 26.70 ± 4.13, 14.76 ± 3.27 and 9.58 ± 3.79 mm, respectively. The position of the SFA is located in sectors B through E at levels 1-3 and in sectors E through H at levels 4-7 and the position of the DFA located in sectors B through F at levels 1-3. CONCLUSION:Cerclage wiring should be started from the posterior intermuscular septum at the linea aspera. The safe area is the proximal half (midshaft) of the femur where the SFA and DFA lie at a safe distance from the femur. Between the midshaft and the distal 1/4, insertion of the passer must be done meticulously with the tip kept close to posteromedial cortex. Below the distal 1/4, the tip of the passer should be kept close to the posterior cortex to avoid injury to the SFA and the sciatic nerve.
journal_name
Arch Orthop Trauma Surgjournal_title
Archives of orthopaedic and trauma surgeryauthors
Apivatthakakul T,Siripipattanamongkol P,Oh CW,Sananpanich K,Phornphutkul Cdoi
10.1007/s00402-017-2804-xsubject
Has Abstractpub_date
2018-01-01 00:00:00pages
43-50issue
1eissn
0936-8051issn
1434-3916pii
10.1007/s00402-017-2804-xjournal_volume
138pub_type
杂志文章abstract::Posttraumatic malunion or secondary dislocation can cause wrist joint incongruency. Uncorrected malalignment increases the risk of secondary degenerative changes and chronic pain. Therefore, early correction using the available fixed-angle devices, cancellous bone grafting only becomes necessary in larger bony defects...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
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abstract:INTRODUCTION:The concept of femoroacetabular impingement (FAI) and the indication for surgical intervention have been established in the last decade. Despite promising short-term results and emerging arthroscopic techniques, it remains unclear whether patients benefit from surgical correction in the mid- to long-term a...
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doi:10.1007/s00402-009-0929-2
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abstract:BACKGROUND:Dynamic hip screw (DHS) osteosynthesis represents one of the most frequently performed fixation methods in orthopedic practice. The purpose of this study was to determine the potential risk of vascular damage by DHS side-plate screws (PS) and plunging instruments for individual femoral vessels and screw posi...
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journal_title:Archives of orthopaedic and trauma surgery
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journal_title:Archives of orthopaedic and trauma surgery
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00434095
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abstract::From 1985 to 1995, 417 patients with dislocated medial femoral neck fractures (Garden III-IV) were treated with hemiarthroplasty using a Biolox ceramic head. The average patient age at the time of operation was 81.5 years. A total of 140 survivors was available for follow-up examination with a mean prosthesis longevit...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-016-2594-6
更新日期:2017-02-01 00:00:00
abstract::Fracture stabilization and reduction using temporary plates during intramedullary tibial nailing was introduced as a novel concept in fracture surgery by Benirschke et al. (Orthop Trans 18:1055-1056, 1995). The concept of temporary reduction using one-third tubular plates proved useful in aiding metaphyseal and periar...
journal_title:Archives of orthopaedic and trauma surgery
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doi:10.1007/s00402-009-1008-4
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journal_title:Archives of orthopaedic and trauma surgery
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doi:10.1007/s00402-013-1774-x
更新日期:2013-08-01 00:00:00
abstract::Osteoid osteoma is a benign bone tumor that rarely localizes in the hand or the carpal bones. We report two cases of osteoid osteoma localized in two different carpal bones. Unremitting wrist pain was a major clinical symptom. Surgical treatment including excision of the nidus was dramatically curative. In young patie...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020000152
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-007-0299-6
更新日期:2007-09-01 00:00:00
abstract:PURPOSE:To cross-culturally adapt and validate the International Knee Documentation Committee Subjective Knee Form to Simplified Chinese (SC-IKDC-SKF). METHODS:The original version was translated and cross-culturally adapted into Simplified Chinese according to standard guidelines. A total of 103 patients enrolled in ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-018-2973-2
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journal_title:Archives of orthopaedic and trauma surgery
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doi:10.1007/s00402-010-1079-2
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abstract::The treatment of open distal tibia fractures remains challenging, particularly when the fracture is infected and involves segmental bone loss. We report the case of a 38-year-old man who sustained an open distal tibiofibular fracture with segmental bone loss and a closed proximal tibial fracture. The fractures were in...
journal_title:Archives of orthopaedic and trauma surgery
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doi:10.1007/s00402-009-0981-y
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-007-0439-z
更新日期:2008-03-01 00:00:00
abstract::In this retrospective study we analyse the results of primary anterior cruciate ligament (ACL) sutures, primary ACL plasties and secondary ACL plasties 5 years after operation. All operations were performed with an additional PDS augmentation. Follow-ups of 100 of 130 patients could be done (80 male and 20 female). Th...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00452087
更新日期:1995-01-01 00:00:00
abstract::The locked or unlocked intramedullary nail is considered today in most institutions the first choice for stabilisation of the majority of closed diaphyseal fractures of the femur and tibia. In 1st and 2nd degree open fractures of the tibia, the unreamed locked nail may perhaps become the preferred implant. In spite of...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00636169
更新日期:1990-01-01 00:00:00
abstract::Eight patients with delayed rupture of the extensor pollicis longus tendon are presented. Six had suffered from a fracture of the wrist without dislocation. This is in our opinion a predisposing factor in the etiology of delayed tendon rupture. Our treatment of choice is transfer of the extensor indicis proprius tendo...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00441626
更新日期:1994-01-01 00:00:00
abstract:PURPOSE:Radial neuropathy represents a devastating complication in a posterior approach to the distal humerus. This study aimed to propose "safe zones" regarding the radial nerve (RN) location at the posterior aspect of the humerus to minimize the risk of iatrogenic injury. METHODS:In 100 embalmed specimens, the dista...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-015-2300-0
更新日期:2015-11-01 00:00:00
abstract:PURPOSE:Initial graft tension in anterior cruciate ligament (ACL) reconstruction affects stability and tension loss at follow-up. This study investigated the influence of hybrid tibial fixation in 3-tunnel double-bundle ACL reconstruction on initial graft tension and tension change and stability under anterior and comb...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-017-2698-7
更新日期:2017-07-01 00:00:00
abstract:INTRODUCTION:Our report shows a rare case of suprascapular nerve palsy due to a SLAP-related ganglion cyst resulting in isolated weakness of the infraspinatus muscle. CASE REPORT:We report on a 31-year old volleyball player with severe shoulder pain. A ganglion cyst was excised in an open procedure and was completely ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-005-0067-4
更新日期:2006-11-01 00:00:00
abstract:INTRODUCTION:Knee cartilage lesions are very frequent in arthroscopic surgery. This multi-center-study was aimed to evaluate the distribution and possible associated factors of these pathologies in more than 1000 patients. MATERIALS AND METHODS:The German cartilage registry (KnorpelRegister DGOU) started in 2013. In t...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,多中心研究
doi:10.1007/s00402-016-2432-x
更新日期:2016-06-01 00:00:00
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journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2013-08-01 00:00:00