RESUMEN
The management of a femoral nonunion after intramedullary nailing is challenging. Exchange nailing or plate augmentation has been used to treat hypertrophic nonunions previously. The Poller screw augmentation technique is a simple procedure that can be performed in the outpatient surgery. In this study, we highlight the method of hypertrophic nonunion management according to the specific indication including our Poller screw augmentation technique.
Asunto(s)
Fracturas del Fémur , Fijación Intramedular de Fracturas , Fracturas no Consolidadas , Complicaciones Posoperatorias , Tornillos Óseos , Fracturas del Fémur/diagnóstico , Fracturas del Fémur/cirugía , Fémur/diagnóstico por imagen , Fijación Intramedular de Fracturas/efectos adversos , Fijación Intramedular de Fracturas/instrumentación , Fijación Intramedular de Fracturas/métodos , Fracturas no Consolidadas/diagnóstico , Fracturas no Consolidadas/etiología , Fracturas no Consolidadas/cirugía , Humanos , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/cirugía , Resultado del TratamientoRESUMEN
The authors present 2 cases of late mobile-bearing dislocation after unicompartmental knee arthroplasty with long-term follow-up. Patients had anterior bearing dislocation more than 10 years after primary unicompartmental knee arthroplasty. Retrieved mobile bearings showed severe erosion on the posterior lip, suggesting frequent deep knee flexion as the cause of wear. Bearing dislocation is known to occur in the early postoperative phase. However, for Asians with a lifestyle that requires high knee flexion, dislocation might occur in the late postoperative phase. Such late bearing dislocation has a mechanism different from those reported in previous studies. Loss of bump in the posterior lip was found to be the cause. After late bearing dislocation, conversion to total knee arthroplasty is unnecessary because a simple bearing exchange will suffice. [Orthopedics. 2019; 42(1):e124-e127.].
Asunto(s)
Artroplastia de Reemplazo de Rodilla , Prótesis de la Rodilla/efectos adversos , Falla de Prótesis , Anciano , Femenino , Humanos , Persona de Mediana Edad , Osteoartritis de la Rodilla/cirugía , Reoperación , Factores de TiempoRESUMEN
BACKGROUND: There are several different opinions regarding the improvements seen on the transverse plane after soft tissue surgery alone in independently ambulant patients with cerebral palsy. We performed a meta-analysis using data from previous studies to identify the effects of soft tissue surgery alone on pelvic and hip rotation in children with spastic diplegia. METHODS: We conducted a pilot study to evaluate the improvement in pelvic and hip rotation after muscle-tendon lengthening surgery in children with spastic diplegia. We also searched EMBASE and PubMed and selected 2 previous studies using the same test conditions with kinematic data on the pelvis and hip joints. A meta-analysis of the results of these 3 studies, including this pilot study, was then performed. RESULTS: The meta-analysis results showed an external rotation decrease (p = 0.005) in the mean difference of pelvic rotation of -3.61 (95% confidence interval [CI], -6.13 to -1.09) and a mean difference in hip rotation of 6.60 (95% CI, 3.34 to 9.86), indicating a significant increase in the hip external rotation after surgery (p < 0.001). CONCLUSIONS: In independently community-ambulant pediatric patients with spastic diplegia, pelvic retraction and hip internal rotation could be improved after soft tissue surgery.