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کاربرد نوع شرط:
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Osteoporosis,knee osteoarthritis,Total knee arthroplasty,Proximal tibial fracture
- چکیده:
- چکیده انگلیسی: Background: Proximal tibial fractures in elderly patients with osteoporosis or knee osteoarthritis (OA) are challenging
cases. In the current study, we present our experience with uncommon acute primary total knee arthroplasty (PTKA)
in this patient population.
Methods: PTKAs were performed following proximal tibial fractures in 30 consecutive patients over 60 years of age
with osteoporosis or knee OA between 2005 and 2009. Three constrained condylar knees (CCK) and no hinged knee
prosthesis were used. Patients were followed up for 4.5±1.1 years.
Results: Patients were discharged after 4.6±1.2 days. The postoperative Tegner activity scale (3.5±1.3) was improved
significantly compared to the preoperative scale (2.5±1.2) (P<0.001). The knee flexion range was significantly greater
in the operated side (106±13 degrees) compared to the uninjured knee (120±8 degrees) (P<0.001). The two sections
of knee society knee score (knee and function section) averaged 90.7±6.5 and 69.6±8.8, respectively. All patients
returned to their previous activities. Based on the visual analogue scale, the patients’ satisfaction and pain at final visit
were scored 8.1±1 and 1.5±1.2, respectively. No infection, thromboembolic events and loosening were observed.
Conclusion: PTKA following a proximal tibial fracture in elderly patients with osteoporosis or knee degeneration can be
considered as a safe alternative for open reduction and internal fixation. PTKA resulted in immediate weight-bearing,
improved functional status and patients’ satisfaction. However, functional outcomes were dependent on the general
condition of 24 the patient. Also, constrained knee prostheses were not necessary for a vast majority of the patients.- انتشار مقاله: 10-05-1395
- نویسندگان: Mohammad M. Sarzaeem,Mohammad M. Omidian,Gholamhossein Kazemian,Aalireza Manafi
- مشاهده
- جایگاه : پژوهشی
- مجله: Archives of Bone and Joint Surgery
- نوع مقاله: Journal Article
- کلمات کلیدی: Plain radiography,Ankle fracture,CT scanning,Syndesmosis
- چکیده:
- چکیده انگلیسی:
Background: Ankle fractures, especially those resulting from external rotation mechanisms are associated with injury to
the distal tibiofibular syndesmosis. Some authors have recommended performing CT scanning after open ankle surgery to evaluate the reduction of syndesmosis. In this current study, we aimed to investigate the sensitivity of plain radiography in diagnosing syndesmosis malreduction after open reduction and internal fixation (ORIF) in patients with ankle fractures.
Methods:
Thirty patients with ankle fractures participated in this prospective study. ORIFs were performed with respect to all of the technical guidelines shown in orthopedic literature for exact syndesmosis reduction, such as fibular length and proper settings. In the operating room, plain radiography was performed in anteroposterior, mortise and lateral views to assess whether syndesmosis was malreduced. If malreduction was detected, the patient was revised. As the gold standard, patients underwent postoperative bilateral CT scanning to investigate the syndesmosis reduction which was then compared to the healthy side. Finally, the sensitivity of plain radiography in the diagnosis of syndesmosis malreduction was determined by comparing this method to CT scanning.
Results:
In both of the methods we did not find any patient with syndesmosis malreduction. Hence, the sensitivity of plain radiography was determined 100%.
Conclusion:
Based on our findings, there is no need to perform CT scanning to evaluate syndesmosis reduction after ankle ORIF in patients with ankle fractures. Plain radiography is sufficient and has satisfactory sensitivity in these patients.- انتشار مقاله: 25-04-1392
- نویسندگان: Alireza Manafi Rasi,Gholamhossein Kazemian,Mohamad M Omidian,Ali Nemati
- مشاهده