Introduction: There is a lack of in vivo studies comparing the functional outcome and knee stability after anterior cruciate ligament reconstruction (ACLR) using fixed loop (EndoButton (EB) CL) and adjustable loop (TightRope (TR) RT) devices for femoral fixation of soft tissue grafts. Materials and methods: Functional outcomes were assessed in terms of the International Knee Documentation Committee (IKDC) and Lysholm scores, knee stability by anteroposterior laxity and side-to-side difference (SSD) using KT-1000 arthrometer. The evaluation was performed preoperatively and postoperatively at 6 months and 2 years. Results: Both groups were matched in terms of demographic, preoperative, intraoperative and post-operative covariates. EB (n ¼ 52) appeared to have better IKDC and Lysholm scores at 6 months post-operative when compared to TR (n ¼ 50). However, at a final follow-up of 2 years, the results were similar. The anterior tibial translation and SSD were statistically insignificant between the two groups at 6 months and 2 years. Conclusion: ACLR using EB or TR for femoral fixation gives substantially equivalent functional results and knee stability at mid-term follow-up.
Twenty cases of neglected (more than 1 month old) displaced femoral neck fractures in young adults were treated with a valgus intertrochanteric osteotomy. A fracture union rate of 85% (17 cases) was achieved. Two of the healed cases developed avascular necrosis. After 30 months 15 patients (75%) had achieved good to excellent results. We believe that intertrochanteric osteotomy provides good alternative management for neglected femoral neck fractures.Resumé Vingt cas de fractures du col fémoral déplacées et négligées chez l'adulte jeune ont été traités avec une ostéotomie de valgisation intertrochanterienne. Dix sept fractures ont consolidés. Deux des cas consolidés ont dé-veloppé une nécrose avasculaire. Quinze patients avaient un bon ou excellent résultat avec une moyenne de suivi de trente mois. L'ostéotomie intertrochanterienne est une bonne alternative pour le traitement des fractures du col fémoral négligées.
Background. Intertrochanteric fractures of the proximal femur are one of the most common fractures encountered, and dynamic hip screw with a side plate is the standard treatment. We compared a minimally invasive surgical technique with the conventional surgical technique used in the fixation of intertrochanteric fractures with the dynamic hip screw (DHS) device. Methods. Thirty patients with such fractures were treated with the conventional open technique and 30 with a new minimally invasive technique. Patients in both groups were followed up for 1 year. Results. There was less blood loss, minimal soft tissue destruction, shorter hospital stay, and early mobilization with the minimally invasive technique. Conclusion. The present study finds minimally invasive technique superior to conventional (open) DHS.
We believe that intertrochanteric osteotomy provides a good outcome for neglected femoral neck fractures. Performing the procedure on a routine table, with Watson Jones approach and fixing with double angle blade plate is a good option.
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