RESUMEN
Various plating systems are available to fix distal radius fractures, each with a specific design. The purpose of this study was to compare radiological outcome and complications of the Variable Angle LCP Plate 2.4-mm (DePuy Synthes) with the VariAx volar locking plate (Stryker). One hundred patients (103 wrists) operated on for a distal radius fracture were retrospectively reviewed with a mean follow-up of 3.5 years. Seventy-three wrists were treated with a DePuy Synthes plate and 30 with a VariAx plate. The overall complication rate was 32%. Nineteen cases underwent revision surgery, 18 had malunion and 3 complex regional pain syndrome. Complicaton rate was 43% with DePuy Synthes plates and 27% with Variax plates, but the difference was not significant.
Asunto(s)
Artroplastia de Reemplazo/métodos , Pérdida de Sangre Quirúrgica/prevención & control , Hemorragia Posoperatoria/prevención & control , Ácido Tranexámico/administración & dosificación , Administración Intravenosa , Administración Oral , Administración Tópica , Anciano , Anciano de 80 o más Años , Antifibrinolíticos/administración & dosificación , Femenino , Humanos , Masculino , Persona de Mediana Edad , Periodo PerioperatorioRESUMEN
We report three cases of false aneurysm involving the popliteal artery or one of its branches following total knee replacement. Two of them developed after primary total knee arthroplasty (TKA) and the third one after a revision TKA. False aneurysm is a rare complication of TKA. The main symptom is generally a painful pulsatile mass which develops postoperatively but our cases occurred with three distinct clinical manifestations. Doppler ultrasonographic and angio-CT investigations were used to achieve the correct diagnosis. Two patients were treated by percutaneous embolization; the third patient required a mini-open surgery with an endovascular prosthesis. No complications were encountered.
Asunto(s)
Aneurisma Falso/etiología , Artroplastia de Reemplazo de Rodilla/efectos adversos , Anciano , Aneurisma Falso/diagnóstico por imagen , Embolización Terapéutica , Femenino , Humanos , Masculino , Arteria Poplítea , Ultrasonografía DopplerRESUMEN
OBJECTIVES: The aim of this study was to compare the results of computer-assisted total knee arthroplasty (CA-TKA) and non-computer-assisted total knee arthroplasty (C-TKA). METHODS: We reviewed 175 cases of TKA and assigned them into two groups according to the use of computer assistance. Group A consisted of 50 cases (35 women, 15 men; mean age: 61.3 years), who had C-TKA and Group B consisted of 125 cases (94 women, 31 men; mean age: 70.9 years), CA-TKA. The results of the groups were compared based on the length of the incision, the duration of the surgery, the length of hospitalization and the final alignment of the prosthesis. RESULTS: The achievement rate of optimal alignment in the coronal plane was significantly higher in the CA-TKA group (95.2%) than the C-TKA group (74%) (p<0.0001). The average surgical time was 69.32 minutes in the C-TKA group (range: 45-94 minutes) and 70.21 minutes in the CA-TKA group (range: 46-98 minutes). The average surgical incision length was 15.78 (range: 11-18.4) cm in the C-TKA group and 12.6 (range: 9.2-16.6) cm in the CA-TKA group. The average hospital stay was 7.3 (range: 5-16) days for the CA-TKA group and 8.5 (range: 5-17) days for the C-TKA group. CONCLUSION: Our results suggested that computer assistance provides a more accurate alignment in TKA. The reduced incision length and hospitalization time appear as two other advantages of this technique.
Asunto(s)
Artroplastia de Reemplazo de Rodilla , Tiempo de Internación , Osteoartritis de la Rodilla/cirugía , Complicaciones Posoperatorias/prevención & control , Cirugía Asistida por Computador , Artroplastia de Reemplazo de Rodilla/métodos , Femenino , Humanos , Periodo Intraoperatorio , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos , Recuperación de la Función , Estudios Retrospectivos , Factores de Tiempo , Resultado del TratamientoRESUMEN
A patient with a radial nerve palsy which persisted nine months after a diaphyseal fracture of the humerus was referred to our department. Radiographs and ultrasound examination showed that the radial nerve was transected and partially entrapped in the fracture callus. This double injury was confirmed and was repaired during subsequent surgical treatment. We report this rare case of combined primary and secondary nerve lesion.
Asunto(s)
Fracturas del Húmero/complicaciones , Síndromes de Compresión Nerviosa/etiología , Neuropatía Radial/etiología , Adulto , Callo Óseo/patología , Humanos , MasculinoRESUMEN
We performed a comparative study of the short-term radiological and clinical results after implantation of an unconstrained TKA with preservation of the posterior cruciate ligament with a conventional (50 cases--group A) or navigated (50 cases--group B) technique. The primary criterion was the postoperative leg coronal alignment measured on 3-month postoperative anteroposterior long-leg radiographs by the HKA angle: the expected alignment was 180 degrees +/- 3 degrees. The mean post-operative HKA angle was 180 degrees +/- 3 degrees in group A and 180 degrees +/- 1 degrees in group B (p = 0.15). Thirty-four cases in group A and all 50 cases in group B were in the desired range (p < 0.001). The navigated system used in this study allowed for a significantly better alignment accuracy than the conventional implantation technique. Acceptable routine implantation was achieved during the time of the study (first 50 cases). We can thus hypothesise that the learning curve of the navigated technique used is not any longer than the learning curve of a conventional implantation technique.