Complications occurred in 16.2% of MPFL reconstruction surgeries for patellar instability in young patients, with almost half resulting from technical problems. Patients should be counseled preoperatively on the risk of potential complications.
This study confirms the negative effect of Harrington rods on sagittal alignment. We further found that the degree of correction in the coronal and sagittal planes was higher after Cotrel-Dubousset instrumentation than all-pedicle screw fixation. All-pedicle screw constructs offered the lower risk of mid- to long-term complications and revision surgery.
The purpose of this study was to systematically review the available evidence on lumbar paraspinal compartment syndrome with specific reference to patient demographics, aetiology, types, diagnosis, clinical features, and treatment. This was an Institutional Review Boardexempt study performed at a Level 1 trauma center. A PubMed search was conducted with the title query: lumbar paraspinal compartment syndrome. Eleven articles met our search criteria. Three of the patients with acute paraspinal compartmental syndrome treated with fasciotomy had a full recovery and were able to resume skiing after four months.
Nonunion and delayed union of patella fractures are rare conditions that are fraught with challenges. There exists limited evidence in the literature to guide the clinician in the management of these complications. Therefore, the purpose of this study was to perform a systematic review of the available evidence on the management of nonunion and delayed union of patella fractures. A total of five publications which met our criteria were identified and formed the basis of this study. The decision making in the treatment of this condition is based on the functional demands of the patient, the factors that led to the development of the nonunion, the potential impact of the biomechanical effects of a total patellectomy, and the presence of an intact extensor mechanism of the knee for a later reconstructive procedure. Patients with low functional demands may be managed with nonoperative methods; however, those who perform heavy physical work or participate in sports usually require open reduction and internal fixation. Tension band wiring is the treatment of choice for patients suitable for a reconstructive procedure. Partial or total patellectomy is also an option for small distal fragments or an inability to satisfactorily perform internal fixation.
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