Abstract:
OBJECTIVE:Illustration of a nowadays only rarely performed operative procedure for the treatment of osteonecrosis of the femoral head to prevent or at least delay advanced arthrosis and the need for a total hip replacement. The pedicled vascularized iliac bone graft is raised without the need for special microsurgical techniques and has less vascular complications often seen in free vascularized grafts. INDICATIONS:Early stages of osteonecrosis of the femoral head stages II and III according to the Association Research Circulation Osseous (ARCO) up to the detection of fracture lines (crescent sign) but without mechanical insufficiency. CONTRAINDICATIONS:Osteonecrosis of the femoral head with collapse of the femoral head (ARCO stage ≥IIIB) and mechanical insufficiency. Patients who are noncompliant or a not able to take the weight off the operated leg. Patients who had radiotherapy or an operation on ipsilateral inguinal lymph nodes and patients who have vascular anomalies or severe arteriosclerosis. SURGICAL TECHNIQUE:Debridement of the femoral head osteonecrosis and implantation of a pedicled vascularized iliac bone graft. POSTOPERATIVE MANAGEMENT:Free movement of the hip joint 4 weeks after surgery. Outward rotation of the hip joint allowed after 3 months and restriction of weight load on the operated leg for at least 3-6 months postoperatively depending on the bony consolidation. RESULTS:Vascularized bone grafts for the treatment of femoral head necrosis show better clinical and radiological results than avascular bone grafts. Nevertheless, after 5 years follow-up approximately 25% of the operated hips formerly in stage II show further progression of radiological necrosis. In stage III all hips eventually show progress of femoral head collapse and the need of a total hip replacement. Concerning the outcome of a free vascularized bone graft (fibula flap) compared to the pedicled vascularized graft from the iliac crest for treatment, the anatomically demanding area and a higher complication rate should be considered even though the cancellous bone of the iliac crest is biologically ideal. Nowadays a free vascularized fibular graft is the most frequently used bone graft for treatment of femoral head necrosis.
journal_name
Oper Orthop Traumatoljournal_title
Operative Orthopadie und Traumatologieauthors
Asmus A,Vogel K,Vogel A,Eichenauer F,Kim S,Eisenschenk Adoi
10.1007/s00064-020-00650-2subject
Has Abstractpub_date
2020-04-01 00:00:00pages
127-138issue
2eissn
0934-6694issn
1439-0981pii
10.1007/s00064-020-00650-2journal_volume
32pub_type
杂志文章,评审abstract:OBJECTIVE:Safe and definitive stabilization of fully displaced, unstable fractures of the humerus which cannot be fixed conservatively; plaster cast: subcapital humerus fractures, fractures of the shaft, and supracondylar fractures. INDICATIONS:These depend on two major factors: first, on the morphology (strongly disp...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
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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
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abstract:OBJECTIVE:Full arthroscopic treatment of severe anterior shoulder instability due to glenoid bone loss, Hill-Sachs lesion and irreparable ligament damage. INDICATIONS:Recurrent anterior dislocations or subluxations, previously failed Bankart repairs; patients with anterior glenoid bone loss, Hill-Sachs defect; patient...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
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更新日期:2014-06-01 00:00:00
abstract:OBJECTIVE:Reconstruction of the extensor mechanism of the knee joint by stable suture of the quadriceps tendon. Early functional treatment. INDICATIONS:Acute or partial disruption of the quadriceps tendon close to the proximal patella pole with loss of extensor function of the knee joint. CONTRAINDICATIONS:Open ruptu...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-008-1229-7
更新日期:2008-03-01 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
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更新日期:2015-04-01 00:00:00
abstract:OBJECTIVE:To shift the weight-bearing axis of the lower limb medially by opening a lateral-based metaphyseal osteotomy at the distal femur. INDICATIONS:Femoral-based valgus malalignment and symptomatic lateral unicompartimental osteoarthritis, lateral hyperpression syndrome, cartilage therapy of the lateral compartmen...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-017-0503-y
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:Stable fixation of periprosthetic or periimplant fractures with an angular stable plate and early weight bearing as tolerated. INDICATIONS:Periprosthetic femur fractures around the hip, Vancouver type B1 or C. Periprosthetic femur and tibia fractures around the knee. Periprosthetic fractures of the humerus. ...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
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更新日期:2013-08-01 00:00:00
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journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
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journal_title:Operative Orthopadie und Traumatologie
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journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
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更新日期:2005-09-01 00:00:00
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pub_type: 杂志文章
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更新日期:2019-01-01 00:00:00
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journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章,评审
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更新日期:2017-10-01 00:00:00
abstract:OBJECTIVES:Correction of recurrent dislocation of the patella in children using a semitendinosus tenodesis and a double breasting of the medial retinaculum. INDICATIONS:Recurrent lateral patellar sub- or dislocation in skeletally immature patient. Patella alta with recurrent subluxation of the patella. Patella disloca...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
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更新日期:1999-09-01 00:00:00
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journal_title:Operative Orthopadie und Traumatologie
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更新日期:2011-04-01 00:00:00
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journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
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更新日期:2015-02-01 00:00:00
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journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
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更新日期:2011-10-01 00:00:00
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更新日期:2013-06-01 00:00:00
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journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
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更新日期:2012-04-01 00:00:00
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journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
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更新日期:2013-10-01 00:00:00
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pub_type: 杂志文章
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更新日期:2017-10-01 00:00:00
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journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
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更新日期:2011-10-01 00:00:00
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journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
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更新日期:2013-10-01 00:00:00
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journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章,评审
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更新日期:2018-06-01 00:00:00
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journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
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更新日期:2017-02-01 00:00:00
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journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-013-0236-5
更新日期:2014-12-01 00:00:00
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journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
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更新日期:2010-11-01 00:00:00
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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: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:Lengthening of the lower limb with or without correction of angular deformity using an intramedullary nail with new correction strategies to restore or maintain a normal mechanical axis and orientation of the joints compared to traditional strategies using external fixation. Postsurgical lengthening will occu...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 杂志文章
doi:10.1007/s00064-009-1709-4
更新日期:2009-06-01 00:00:00
abstract:OBJECTIVE:One-stage procedure for gaining adequate bone stock and rotator cuff repair. INDICATIONS:Tears of the rotator cuff in combination with bony cysts or reduced bone quality at the footprint. CONTRAINDICATIONS:Allergies to contents of the bone void filler, fatty infiltration of infraspinatus and subscapularis o...
journal_title:Operative Orthopadie und Traumatologie
pub_type: 临床试验,杂志文章
doi:10.1007/s00064-012-0180-9
更新日期:2012-11-01 00:00:00