RESUMO
We carried out a multicentre study to compare the postoperative femorotibial radiographic axis in two total knee replacement groups; one using manual instrumentation and the other using navigation. In the latter group, three navigation systems were used: Stryker, Orthopilot and Navitrack. The prior circumstances of patients in terms of age, weight, aetiology, epicondylar perimeter, patellar tendon length and knee deformity was similar in both groups. The duration of the operation was longer in the group with navigation (16.7 min). A normal femorotibial axis was more frequently obtained in the group with a navigator compared to the manual group (48.1% and 30%, respectively). A varus axis was most common in the manual group (42.2 and 26.9%, respectively). When we analysed the final postoperative radiographic axis, taking 180 degrees to be a normal result, we noted that cases where manual instrumentation was used deviated by 1.19 degrees more than those carried out with navigation, with this difference being statistically significant (P<0.001). No significant differences were found in the final angle of the extremity with the different navigation systems. The navigation systems used in this study improve the frontal angle of the arthroplasty.
Assuntos
Artroplastia do Joelho/instrumentação , Artroplastia do Joelho/métodos , Cirurgia Assistida por Computador/instrumentação , Idoso , Humanos , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/cirurgia , Estudos Prospectivos , Ajuste de Prótese/instrumentação , Ajuste de Prótese/métodos , Radiografia , Cirurgia Assistida por Computador/métodos , Resultado do TratamentoRESUMO
A case of femoral head necrosis in a patient who suffered an intertrochanteric fracture, treated with Ender nails 1 year before, is presented. The rarity, and possible mechanisms (reduction and type of osteosinthesis) of necrosis are discussed.
Assuntos
Necrose da Cabeça do Fêmur/etiologia , Fraturas do Quadril/complicações , Idoso , Feminino , Necrose da Cabeça do Fêmur/diagnóstico por imagem , Necrose da Cabeça do Fêmur/cirurgia , Fixação Intramedular de Fraturas , Fraturas do Quadril/diagnóstico por imagem , Fraturas do Quadril/cirurgia , Prótese de Quadril , Humanos , Radiografia , ReoperaçãoRESUMO
Among 33 patients with a Galeazzi-type fracture-dislocation of the forearm, there were two children and 26 adults with a classic Galeazzi injury, and five patients with a Galeazzi-equivalent lesion. The worst results were obtained in type-I lesions. Closed reduction was primarily successful in children. The results of surgical treatment were much better in adults. It is advisable to treat this complex injury by anatomic reduction and internal fixation of the radial shaft fracture. Immobilization in a fully supinated position is recommended to reduce the dislocation of the distal radioulnar joint. Additional temporary radioulnar fixation with Kirschner wires is also necessary in cases of severe derangement of the distal radioulnar joint.
