PurposeIt is challenging procedure to revise acetabular component in acetabulum with severe bone defect or deformity. The jumbo cup is good option for revisional arthroplasty in large bone defect. The purpose of this study is to compare the prognosis of revisional total hip arthroplasty using jumbo cup with peripheral rim fixation and no rim fixation.Materials and MethodsWe included the patients who had performed acetabular revisional total hip arthroplasty from January 2002 to March 2015 in our institute. Total of 51 hips (51 patients) were included. The mean follow up period was 51 months (range, 12 to 154 months) and mean age was 60.7 years (range, 30 to 81 years). We divided into two groups (peripheral rim fixation group and no rim fixation group) by anteroposterior and lateral plain radiograph. We compared survival rate, hip center change and clinical outcomes between two groups.ResultsThere were 37 patients in peripheral rim fixation group and 14 patients in no rim fixation group. There was one patient who had aseptic loosening necessary to re-revision in rim fixation group and 3 patients in no rim fixation group. And one patient had superficial infection in rim fixation group and one patient had periprosthetic fracture in no rim fixation group. Survival rate was higher in the peripheral rim fixation group (97.3%) than no rim fixation group (78.6%, P=0.028)ConclusionBased on our findings, peripheral rim fixation might be recommended to improve short-term outcome after revision total hip arthroplasty using jumbo cup.
Background: Cubitus varus and cubitus valgus deformities are common complications of distal humeral fractures in children. We evaluated the usefulness of supracondylar dome osteotomy as a treatment option for adults with cubitus varus or valgus deformity developed during childhood. Methods: Ten patients who had received supracondylar dome osteotomy and stabilization with plates to treat cubitus varus or valgus deformity between July 2006 and August 2013 were included in this study. Their mean age at the time of surgery was 36.50 ± 10.22 years. The mean follow-up duration was 54.80 ± 32.50 months. We evaluated humerus-elbow-wrist angles (HEWA), improvements in the lateral prominence index (LPI) or medial prominence index (MPI), Mayo elbow performance scores (MEPS), and overall results in accordance with the Banerjee criteria. Results: For the six patients with cubitus varus, the mean postoperative HEWA, mean correction angle, and mean improvement in LPI were 9.72° ± 3.95°, 27.67° ± 10.75°, and 6.92% ± 3.40%, respectively. For the four patients with cubitus valgus, the mean postoperative HEWA, mean correction angle, and mean improvement in MPI were 14.73° ± 2.97°, 11.55° ± 3.26°, and 11.33% ± 6.39%, respectively. There was no significant difference between postoperative and preoperative mean MEPS. The subjective ulnar nerve symptoms were alleviated in all patients. The overall results were excellent in six and good in four patients. Conclusions: This study suggests that supracondylar dome osteotomy with secure fixation using double plates may be useful in correcting cubitus varus or cubitus valgus deformity, yielding good functional outcomes in adults. (Clin Shoulder Elbow 2016;19(4):229-236)
Purpose: The purpose of the study was to analyze the radiologic and clinical outcomes of volar locking plate leveraging technique comparing to conventional technique and to prove the effect of volar locking plate leveraging technique on restoring volar tilt of distal radius fractures. Methods: From January 2011 to December 2015, 196 patients (50 males and 146 females) who underwent operative treatment of distal radius fracture met the inclusion criteria and retrospectively analyzed. We defined group 1 (n=93, 23 males and 70 females) as patients who were operated by conventional method, and group 2 (n=103, 27 male and 76 females) as patients who were operated by volar locking plate leveraging technique. Postoperative radiographic parameters including radial inclination, radial length, and volar tilt were measured as radiologic outcomes and range of motion, pain visual analogue scale, grip strength, shortened disabilities of arm, shoulder and hand questionnaire were measured as clinical outcomes. Results: Postoperative radial inclination, radial length, and volar tilt in group 1 was 24.22°, 12.02 mm, and 9.31°, in group 2 was 25.64°, 12.40 mm, and 11.48°. There was statistically significant difference in postoperative volar tilt (p=0.008). There were no statistic differences in other radiologic parameters and clinical outcomes. Conclusion: Volar locking plate leveraging technique is reliable and predictable technique for restoration of anatomical parameters of distal radius fracture, especially volar tilt.
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