This study aimed to compare operative outcomes between the lateral approach (LA) and the central approach (CA) to insertional Achilles tendinopathy (IAT). METHODS We retrospectively reviewed patients who underwent surgical treatment for IAT using the LA or CA. Patients' demographic data, postoperative complications and satisfaction rate were reviewed. Clinical outcomes were prospectively assessed preoperatively, at three months postoperatively and at the last visit, including patients' visual analogue scale (VAS) scores for pain, American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale scores and 36-item Short Form Health Survey (SF-36) scores. RESULTS There were 39 patients in the LA group and 32 in the CA group. In each group, average VAS and AOFAS Scale scores improved significantly. SF-36 scores improved in most parameters. No significant difference in baseline score; average AOFAS Scale score at each visit; and mean VAS score preoperatively and at last visit; satisfaction rate; and overall complication rate were observed between the groups. The mean VAS score in the LA group at postoperative three months was significantly lower than that in the CA group (2.7 ± 2.5 vs. 4.4 ± 3.0; p = 0.016). There were significantly more cases of delayed wound healing in the LA group than in the CA group (2.6% vs. 15.6%; p = 0.049). CONCLUSION Both approaches had comparable outcomes for IAT in terms of functional improvement, pain relief, overall enhancement of patients' health condition and overall postoperative complication rate. The LA provided better short-term pain relief and reduced delayed wound healing compared with the CA.
Purpose.To compare the compressive strength of cannulated versus non-cannulated cancellous screws for undisplaced femoral neck fractures in synthetic bones. Methods. 18 synthetic proximal femurs simulating an AO B1 valgus impacted femoral neck fracture in osteoporotic bone were used. The fracture angles were between 55º and 63º (Pauwels grade 2). Fixation was made using 6.5-mm non-cannulated screws (n=6), 6.5-mm cannulated screws (n=6), or 7.3-mm cannulated screws (n=6). A custom-built jig was designed to guide the insertion of the screws in an identical triangular configuration. Screws were tightened by a single operator using a torquemeasuring screwdriver. The femoral head was subjected to progressive axial loading at 5 mm/min. The load to failure and displacement were recorded. Results. The 3 groups did not differ significantly except that the load to failure was higher in the construct with 6.5-mm non-cannulated screws than Cannulated versus non-cannulated cancellous screw fixation for femoral neck fractures: a synthetic bone biomechanical study
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