Abstract:
BACKGROUND:Tibial nonunion remains a considerable burden for patients and the surgeons who treat them. In recent years, alternatives to autogenous grafts for the treatment of tibial nonunions have been sought. The purpose of this study was to evaluate the efficacy of autogenous iliac crest bone graft (ICBG) in the treatment of tibial shaft nonunions. MATERIAL AND METHODS:Sixty-nine patients were identified who underwent ICBG for repair of atrophic or oligotrophic tibial nonunion and had complete data with at least one year of follow-up (mean 27.9 months). Surgical treatments consisted of revision/supplemental fixation ± ICBG. Surgical approaches for graft placement were either posterolateral (PL), anterolateral (AL), or direct medial (DM). Healing status, time to union, postoperative pain, and functional outcomes were assessed. RESULTS:Bony union was achieved by 97.1% (67/69) of patients at a mean time of 7.8 ± 3.2 months postoperatively. There was no significant difference in mean time to union between the three surgical approach groups: (PL (44.9%) = 7.3 months, AL (20.3%) = 9.2 months, DM (34.8%) = 7.6 months; p = 0.22). Intraoperative cultures obtained at the time of nonunion surgery were positive in 27.5% of patients (19/69). Positive cultures were associated with need for secondary surgery as 8/19 patients (42.1%) with positive cultures required re-operation. Two out of four patients that developed iliac donor site hematomas/infections requiring washout had positive intraoperative cultures as well. There was no difference in final SMFA among the three surgical approach groups. CONCLUSIONS:Autogenous ICBG remains the gold standard in the management of persistent tibial nonunions regardless of surgical approach. There is a small risk for complication at the iliac crest donor site. Given the high union rate, autogenous iliac crest bone grafting for tibial nonunion remains the gold standard for this difficult condition. LEVEL OF EVIDENCE:Level III.
journal_name
Arch Orthop Trauma Surgjournal_title
Archives of orthopaedic and trauma surgeryauthors
Konda SR,Littlefield CP,Carlock KD,Ganta A,Leucht P,Egol KAdoi
10.1007/s00402-020-03735-6subject
Has Abstractpub_date
2021-01-08 00:00:00eissn
0936-8051issn
1434-3916pii
10.1007/s00402-020-03735-6pub_type
杂志文章abstract:BACKGROUND:Trochanteric osteotomies (TO) facilitate exposure and "true hip reconstruction" in complex primary and revision total hip arthroplasty (THA). However, non-union represents a clinically relevant complication. The purpose of the present study was to identify risk factors for trochanteric non-union. METHODS:Al...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-011-1457-4
更新日期:2012-05-01 00:00:00
abstract:PURPOSE:To investigate the effects of a trial femoral component on the intraoperative joint gap and intraoperative joint gap kinematics throughout the range of knee motion in minimally invasive surgery-total knee arthroplasty (MIS-TKA) with the gap technique. MATERIALS AND METHODS:A total of 103 patients [15 men (15 k...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-014-1955-2
更新日期:2014-06-01 00:00:00
abstract:BACKGROUND:The aim of the study was to compare the efficacies of steroid injections guided by scintigraphy, ultrasonography, and palpation in plantar fasciitis. METHODS:A total of 35 heels of 27 patients were randomly assigned to three steroid injection groups: palpation-guided (pg), ultrasound-guided (ug), and scinti...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,随机对照试验
doi:10.1007/s00402-008-0760-1
更新日期:2009-05-01 00:00:00
abstract::In patients with persistent localized pain at the level of a sesamoid bone of the thumb not obviously related to trauma, sesamoidectomy gives excellent results. Often no X-ray or histological abnormalities are found, leaving the origin of pain problems still unsolved. ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00431360
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Open fractures are orthopaedic emergencies that carry a high risk for infection, non-union and soft tissue complications. Evidence-based treatment is impeded by the lack of high-quality evidence-based studies. The aim of this investigation was to elucidate the current practice of open fracture management in ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-016-2566-x
更新日期:2016-12-01 00:00:00
abstract::Thirteen patients with aneurysmal bone cyst of the spine (excluding sacral lesions) were retrospectively reviewed. Treatment for aneurysmal bone cysts remains controversial, but surgical resection, irradiation, and embolization are common treatment modalities for those involving the spine. Of 102 patients with aneurys...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020050381
更新日期:1999-01-01 00:00:00
abstract::Proprioceptive mechanisms appear to play a role in stabilizing the glenohumeral joint and may serve as a means for interplay between the static stabilizers and the dynamic muscle restraints. The aim of this study was to investigate proprioception of the joint in healthy and surgically repaired shoulders. Shoulder prop...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s004020000245
更新日期:2001-07-01 00:00:00
abstract::We describe a case of fracture of the axial neural arch that occurred after a dome-like cervical laminoplasty and caused dural compression. Cervical laminoplasty with dome-like laminoplasty of the axis was performed on a patient with cervical myelopathy due to ossification of the posterior longitudinal ligament extend...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
doi:10.1007/s004020050324
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Scant evidence exists to support antibiotic use for low velocity ballistic fractures (LVBF). We therefore sought to define current practice patterns. We hypothesized that most surgeons prescribe antibiotics for LVBF, prescribing is not driven by institutional protocols, and that decisions are based on protoc...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-016-2450-8
更新日期:2016-06-01 00:00:00
abstract:BACKGROUND:Large acetabular defects and pelvic discontinuity represent complex problems in revision total hip arthroplasty. This study aimed to investigate whether reconstruction with the Ganz reinforcement ring would provide durable function in large acetabular defects. PATIENTS AND METHODS:46 hips (45 patients, 19 m...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-017-2731-x
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:High tibial osteotomy has been successfully performed on patients with varus gonarthrosis for many years now. The prospective study presented here serves to verify the long-term outcome of this procedure. METHODS:A supratuberous high tibial osteotomy was carried out on 100 patients with varus gonarthrosis. ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-002-0446-z
更新日期:2003-02-01 00:00:00
abstract:BACKGROUND:Intra-articular fractures of the distal radius (DRF) are associated with a twofold increase in the risk of scapholunate ligament injury (SLI). The aim of this study was to compare functional outcome, pain, and disability between patients with operatively treated DRF and either an acute, repaired scapholunate...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-013-1797-3
更新日期:2013-09-01 00:00:00
abstract::We report on a patient who sustained a fracture of the tibial shaft during the removal of the newest type of an intramedullary nail (Expert Tibia Nail, Synthes. In this case report, we discuss the causes of this complication and possible ways to prevent this. ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-008-0805-5
更新日期:2009-07-01 00:00:00
abstract:INTRODUCTION:Rotational acetabular osteotomy (RAO) has been used successfully in patients with developmental dysplasia of the hip (DDH). However, some patients are forced to undergo total hip arthroplasty (THA) because of the progression of osteoarthritis. We evaluated the effect of previous RAO on the outcome of THA p...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-015-2154-5
更新日期:2015-03-01 00:00:00
abstract:INTRODUCTION:Most of all osteochondral talar lesions are located in the middle and posterior area of the talar surface. Malleolar osteotomy is often used to access the defect but may be associated with malunion or secondary osteoarthritis. We present an alternative approach to the talus with temporary removal and repla...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-005-0058-5
更新日期:2006-05-01 00:00:00
abstract::We conducted a systematic review of the literature on the use of both resorbable and non-resorbable cement as an adjunct to internal fixation of intertrochanteric hip fractures. Two reviewers independently assessed the methodological quality and extracted relevant data from each included study. In cases in which the o...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
doi:10.1007/s00402-012-1677-2
更新日期:2013-04-01 00:00:00
abstract:INTRODUCTION:The purpose of this study was to identify the tear pattern that could be anatomically repaired by preserving the remaining tendon on footprint and evaluate clinical outcomes of patients who underwent remaining tendon preserving cuff repair. MATERIALS AND METHODS:Of 523 patients with full-thickness rotator...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-018-2956-3
更新日期:2018-08-01 00:00:00
abstract:INTRODUCTION:We used a new internal fixative implant, the AO clavicle hook-plate, for treatment of unstable fractures of the distal clavicle. This study describes the operative procedure and the clinical results obtained, as well as discussion of the advantages and problems encountered. PATIENTS AND METHODS:Fifteen co...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-006-0284-5
更新日期:2007-04-01 00:00:00
abstract:INTRODUCTION:The correct choice of a fracture-specific surgical approach with an articular accessibility in complex tibial plateau fractures to facilitate durable fracture fixation of the anatomic articular reconstruction is under debate, as the most important risk factor for malreduction in complex tibial plateau frac...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-019-03200-z
更新日期:2019-10-01 00:00:00
abstract:PURPOSE:The physical examination of the shoulder is usually not reliable for the true diagnosis of superior glenoid labrum anterior to posterior (SLAP) lesions. Magnetic resonance imaging (MRI) has been routinely used for the diagnosis. This prospective study investigates the radiological diagnosis of the SLAP lesions ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-016-2605-7
更新日期:2017-02-01 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
更新日期:2018-10-01 00:00:00
abstract::Spondylitis/spondylodiscitis is still an uncommon diagnosis often with a delay in diagnosis and treatment due to the uncharacteristic symptoms. The aim of this study is to increase the awareness and outline a pattern of investigation and treatment. We present six children with an average age of 23 months (19-33 months...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-007-0316-9
更新日期:2007-08-01 00:00:00
abstract::In revision total knee arthroplasty, osteotomy of the tibial tubercle provided satisfactory exposure to extract the broken tibial metal tray with rigidly fixed stem easily and safely. Three patients (three knees) underwent this osteotomy and were followed for a minimum of 2 years (range 2 years and 2 months to 2 years...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00433999
更新日期:1997-01-01 00:00:00
abstract::Magnetic resonance imaging (MRI) and plain X-ray and CT studies were performed in patients with a history of lumbar back pain due to spinal disc disease. Spin-echo pulse sequences (SE), phase-contrast techniques (partial saturation sequences with delayed readout, PS), and fat-suppressing inversion recovery sequences (...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00439383
更新日期:1990-01-01 00:00:00
abstract::Fractures of the distal radius are extremely common injuries, which are steadily becoming a public health issue. One of the most common complications following distal radius fractures is still malunion of the distal radius. This review of the literature surrounding distal radius malunion covers the biomechanics of dis...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章,评审
doi:10.1007/s00402-012-1466-y
更新日期:2012-05-01 00:00:00
abstract::To determine the fate of an impacted allograft after a minimum follow-up of 1 year, we examined 9 of 40 patients who underwent revision arthroplasty with the impaction grafting technique. The allograft used in this study was morselized cancellous freeze-dried allograft. We examined these 9 patients with technetium-99 ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/pl00013773
更新日期:2000-01-01 00:00:00
abstract::The prophylactic effect of nonsteroid anti-inflammatory drugs on the recurrence of high-grade periarticular heterotopic ossification after resection was studied in ten patients operated on for loosening of one or both components of a cemented total hip prosthesis. These drugs, given at a standard dosage for 1-3 weeks ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00439378
更新日期:1990-01-01 00:00:00
abstract:INTRODUCTION:Various surgical treatment options have been described in athletes with degenerative osteitis pubis who fail to respond to conservative treatment modalities. Although adductor longus tendinopathy often represents an additional pain generator in chronic groin pain associated with osteitis pubis, this has no...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-013-1777-7
更新日期:2013-07-01 00:00:00
abstract:INTRODUCTION:Rotator cuff tears commonly necessitate surgical repair; however, the optimal technique for repair continues to be investigated. Recently, double-row repairs have been considered an alternative to single-row repair, allowing a greater coverage area for healing and a possibly stronger repair. AIM:We perfor...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/s00402-016-2558-x
更新日期:2016-11-01 00:00:00
abstract::We report on a patient with a 3-week-old acetabular fracture and pelvic ring disruption, in whom supra-acetabular osteotomy was performed for reduction and internal fixation of the fracture. Fourteen months after surgery, the results are satisfactory and the patient is walking without aids. ...
journal_title:Archives of orthopaedic and trauma surgery
pub_type: 杂志文章
doi:10.1007/BF00441840
更新日期:1994-01-01 00:00:00