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1.
Oper Orthop Traumatol ; 30(5): 388, 2018 Oct.
Article in English | MEDLINE | ID: mdl-30218132

ABSTRACT

Erratum to:Oper Orthop Traumatol 2018 https://doi.org/10.1007/s00064-018-0559-3 The article was wrongly published under the article type "Review". Please note that the article is an "Original Paper".The publisher apologizes to authors and ….

2.
Oper Orthop Traumatol ; 30(5): 369-378, 2018 Oct.
Article in English | MEDLINE | ID: mdl-30076428

ABSTRACT

OBJECTIVE: The aim is to stabilize the thoracolumbar spine with a thoracoscopically implanted vertebral body replacement (VBR). To improve intraoperative depth perception and orientation, implantation is performed under three-dimensional (3D) thoracoscopic vision. INDICATIONS: Vertebral burst fractures at the thoracolumbar junction (A4 AOSpine classification), pseudarthrosis, and posttraumatic instability with increasing kyphosis. CONTRAINDICATIONS: Severe pulmonary dysfunctions, pulmonary or thoracic infections, previous thoracic surgery, and pulmonary adhesions. SURGICAL TECHNIQUE: The patient is lying in a right lateral decubitus position. Localization of the fractured vertebra. Minimally invasive transthoracic approach. Perform single lung ventilation and insert the 3D thoracoscope two intercostal spaces above the working portal. Utilization of special binocular glasses for 3D vision of the operation field and secure resection of the fractured vertebra. Measurement of the bony defect and insertion of the expandable cage. Control of correct cage position under fluoroscopy. Insertion of a chest tube and inflate the left lung. POSTOPERATIVE MANAGEMENT: Chestâ€¯× ray Remove chest tube when output is <500 ml/24 h Early mobilization on the ward 6 weeks no weight-bearing >5 kg RESULTS: Between 2012 and 2017, 12 patients received a VBR under 3D thoracoscopic vision. After a mean follow up of 26 months, no cage dislocation was noticed and all patients recovered from the initial back pain. Complications were notable in two cases (17%) with a small pneumothorax after removal of the chest tube and postoperative pneumonia in one patient (8%). All responded to conservative treatment. Revision surgery was not necessary.


Subject(s)
Fractures, Compression/surgery , Lumbar Vertebrae/surgery , Spinal Fractures/surgery , Thoracic Vertebrae/surgery , Thoracoscopy/methods , Female , Humans , Imaging, Three-Dimensional , Infant, Newborn , Joint Instability/etiology , Joint Instability/surgery , Kyphosis/etiology , Kyphosis/prevention & control , Kyphosis/surgery , Male , Pseudarthrosis/etiology , Pseudarthrosis/surgery , Treatment Outcome
3.
Acta Paediatr ; 86(2): 213-6, 1997 Feb.
Article in English | MEDLINE | ID: mdl-9055896

ABSTRACT

Thirty-six children (median chronological age 6 years 1 month) who had undergone surgical closure of a patent ductus arteriosus through a left posterolateral thoracotomy in the neonatal period (median gestational age 32 weeks) were investigated prospectively with respect to anatomical and functional changes of the chest. At follow-up examination, residual or recurrent patent ductus arteriosus was not observed. Three patients had chronic bronchial obstruction. Two patients showed pathological musculoskeletal thoracic sequelae that did not require any treatment at the time of follow-up; persistence of immediate postoperative left phrenic palsy (n = 1) and thoracic scoliosis (n = 1). Twenty of the 27 patients in whom chest X-ray was performed had minor radiological skeletal anomalies in the form of rib deformation or fusion related to the thoracotomy, lesions which have a potential to induce thoracic scoliosis. Left shoulder elevation at chest X-ray and isolated left arm dysfunction at clinical examination were not observed. Despite the low incidence of scoliosis and the absence of left arm dysfunction observed at mid-term follow-up in our series, the incidence of minor rib deformations with a potential to induce severe anomalies such as scoliosis should motivate late follow-up examination at adolescence to definitively assess the prevalence of thoracic sequelae after surgical closure of the patent ductus arteriosus in premature infants.


Subject(s)
Ductus Arteriosus, Patent/surgery , Infant, Premature, Diseases/surgery , Thoracic Diseases/etiology , Thoracotomy , Bronchial Diseases/etiology , Child , Female , Follow-Up Studies , Humans , Infant, Newborn , Male , Postoperative Complications , Prospective Studies , Radiography, Thoracic , Scoliosis/etiology
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