ISSN:1041-9918    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Fractures of the distal end of the femur continue to present a challenge to orthopedic surgeons. Successful management requires a thorough knowledge of the regional anatomy, a comprehensive clinical and radiographic evaluation, an understanding of the "personality" of the fracture, and selection of the appropriate device. Nonsurgical and surgical treatment options exist, but the majority of supracondylar and intercondylar femur fractures are managed surgically. Several surgical options are available for fixation of distal femur fractures, including the fixed-angle blade plate, dynamic condylar screw and sideplate, condylar buttress plate, intramedullary nail, and external fixator. Considering that patient characteristics differ considerably, and fracture patterns, energy imparted, and soft tissue integrity vary, protocols for treatment for each patient must be individualized.

ISSN:1041-9918    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Despite the evolution of surgical technique and implants, fractures of the tibial plateau remain a challenging clinical problem. The spectrum of injury with varying degrees of articular depression, displacement, and soft tissue injury is so great that no single treatment has proven uniformly successful. Optimal treatment requires a complete understanding of the "personality" of the injury and familiarity with a variety of techniques, both surgical and nonsurgical. Improved understanding and recognition of injury patterns and recent developments in minimally invasive techniques, external fixation, plate design, and cement osteosynthesis will allow the surgeon to achieve good results in the majority of cases.

ISSN:1041-9918    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Fractures of the patella are a common injury. When they result in a disruption of the articular surface as well as the extensor mechanism of the knee, surgical intervention is indicated. Although the modified tension technique is a well-accepted method, recent developments have been proposed to decrease the complication rate and improve the clinical outcome. The etiology and surgical management of injuries of the patella ligament and quadriceps tendon are also reviewed.

ISSN:1041-9918    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Supracondylar periprosthetic femur fractures following total knee arthroplasty present a difficult and frequently unfamiliar problem. Reconstruction of the knee with the aim if return to prefracture functional level is a difficult task. These fractures are likely to be seen more frequently with the increasing numbers of primary and revision knee arthroplasties being performed. Treatment with immobilization, bracing, or additional surgery can cause stiffness, malunion, or nonunion. The location and character of the periprosthetic fracture, with the eventual alignment, angulation, translation, shortening, and rotation, can all alter the clinical outcome and durability of the prosthesis. Fracture malunion can result in malalignment and compromise an excellent initial outcome. This review focuses on current treatment algorithms for the management of these fractures. Because of the uncommon nature of this fracture, an absolute treatment algorithm does not exist. Typically, displaced fractures are treated with rigid internal fixation with a plate and screw device or an intramedullary nail inserted in retrograde fashion. Undisplaced fractures with a well-functioning prosthesis may be treated closed with a cast-brace. In the presence of a loose prosthesis or with extensive osteolysis and impending failure, revision surgery using stemmed components is the treatment of choice.

ISSN:1041-9918    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Pediatric knee injuries are increasing. The evaluation and treatment of traumatic knee effusion is different in children than adults. Patellofemoral osteochondral fractures are the most common cause of sports-related hemarthroses in children. Magnetic resonance imaging is generally not useful in evaluating acute pediatric knee trauma. Children and adolescents sustain unique serious injuries to the patellofemoral mechanism that may be obscure (sleeve fracture). The treatment of anterior tibial eminence fractures is becoming more aggressive but remains controversial. Hemiepiphyseal stapling is gaining popularity for the correction of knee deformities, even in young children. Percutaneous epiphysiodesis has replaced the Phemister technique of limb length equalization. Resorbable implants are being tested.

ISSN:1041-9918    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1041-9918    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

The principle of the Ilizarov method is the exertion of a continuous traction on bones and soft tissue that is increased in small measures, thus stimulating growth of all tissue types involved. The fixators used are distinguished by their gentleness concerning periosteal circulation and the soft tissues. This renders them especially eligible in tissue-endangering situations like complicated joint-involving fractures of the tibial plateau, where they can be used alone or in combination with minimally invasive, percutaneously applied screw osteosyntheses. The growth of bones and soft tissue during distraction treatment constitutes the principle of treatment for bone and tissue defects, marked joint contractures, and axial deviations. This technique allows the gradual controlled correction of genua valga and vara with their accompanying ligamental imbalances.

ISSN:1041-9918    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1041-9918    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1041-9918    

出版商:OVID    

年代:1999

数据来源: OVID