53Summary Introduction. Dysplasia of hip joint leads to osteoarthritis. Suffer relatively young population in ages between 20 and 40. Due to severe changes of anatomy total hip replacement (THR) in dysplastic hip patients is a challenge for orthopaedic surgeons. Radical anatomical and biomechanical reconstruction may lead to high complication rate. The planning of the rotation center of hip joint is a key of success in the treatment of dysplastic osteoarthritis patients. Aim of the Study. The aim of the study was to evaluate the early results for dysplastic osteoarthritis patients (DOA), who underwent THR in Riga State Hospital of Traumatology and Orthopaedics in 2008-2009. Materials and methods. 63 THR were performed in 59 patients (50 women, 9 men). In all cases cementless acetabular components of endoprosthesis were used. Functional evaluation was made due to method of grading functional value of hip -Merle d'Aubigne and Postel. Hip dysplasia was divided in 4 groups due to classification after Crowe. Special digital orthopaedic programmes (AGFA, IMPAX) were used for preoperative planning and radiographic postoperative analysis. Results. Regarding to method of grading functional value of hip -Merle d'Aubigne and Postel we found out a significant improvement in range of movements, mobility and pain relief. Due to Crowe classification there were 19 patients with Crowe type I dysplasia, 29 with Crowe type II and 15 with Crowe type III. 43 acetabular cups were placed in the primary socket and 20 in the secondary socket. Radiographic analysis showed significant changes in location of rotation center of hip and offset after THR in dysplastic hip patients. Conclusions. Significant functional improvement was achieved after THR in DOA patients and the radiographic analysis showed significant decrease of horizontal location of RC and increase of offset after THR in DOA patients.
48Summary Introduction. The ilioinguinal approach is well established for the treatment of pelvic fractures. As an alternative, the anterior retroperitoneal lower laparatomy (modified Stoppa) approach can be used to expose pelvic and acetabular fractures. We describe our experience with this approach in polytrauma patients with pelvic ring and acetabular fractures . Aim of the Study.The aim of study was to evaluate possibilities and impossibilities of internal fixation of pelvic ring and acetabular fractures using the anterior retroperitoneal lower laparatomy approach. Materials and methods. This retrospective study describes a series of 20 consecutive patients where a modified Stoppa approach was used for pelvic or acetabular fracture fixation. Results. 10 patients with acetabular fractures, six patients with a pelvic ring injury not involving the acetabular joint and 4 patients with a combined fracture were operated through a modified Stoppa approach. Anatomic or satisfactory reduction was achieved in 92% of the acetabular fractures. Pelvic ring fractures had an anatomic (displacement <1 cm) postoperative result in 100% . Conclusions. using this approach may have good the postoperative radiological un surgical results. This is a method of choice for patients with combined trauma with internal organ damage and patients with both side pelvic bone fracture.
This article presents the results of a prospective cohort study that included 63 patients with intra-articular (AO Type C) distal radial fractures who were treated using an arthroscopically assisted approach with either volar locking plates or external fixator and K-wires. Postoperative analysis was carried out using X-ray assessment, clinical data, Patient-Rated Wrist Evaluation score, Gartland and Werley score, Modern Activity Subjective Survey of 2007 score, range of motion, grip, pinch and tripod pinch assessment at 1, 3, 6 and 12 months postoperatively. Despite the statistically significant differences found in a number of parameters during the period of observation, there were no clinically relevant differences determined between the two methods. There was a greater number of complications in the external fixator and K-wire treated patients. Level of evidence: II
Introduction: The increasing number of primary total hip replacements means that there is an increased need for hip arthroplasty revisions. The periprosthetic fractures which cause bone defects can occur during removal of the femoral component and healing of these fractures can be delayed. In femoral bone defects during revisions, there are no metal augments for filling these defects. Case Report: Fifty-nine-year-old female presented with infected loosening of the left hip non-cemented endoprosthesis 5 years after surgery. The patient underwent removal of endoprosthesis. In 2 months, re-implantation of non-cemented endoprosthesis was performed and biphasic calcium phosphate (BCP) ceramic granules with hydroxyapatite/?-tricalcium phosphate (HAp/?-TCP) were implanted in the femoral bone defects. Eleven months following the arthroplasty patient had periprosthetic fracture of the distal third of the left femur. The osteosynthesis was performed and BCP ceramic granules with HAp/?-TCP were used to fill the bone defect. Long-term follow-up showed very good functional outcome and bone defect healing. Conclusion: The BCP ceramic granules with HAp/?-TCP material adjusted to the bone defect anatomy, showed effective femoral bone defect and periprosthetic fracture healing in a patient with hip arthroplasty revision and periprosthetic fracture. Keywords: Bone defect, femoral, revision.
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