Transperitoneal screw fixation of the sacroiliac joint.
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Biomedical subjects
Publications and source records attributed to C Van der Werken.
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We report a case of a recurrent traumatic dislocation of the hip joint in a young man at the age of 13 and 17. The patient had retroversion of the femoral neck, instead of a physiological anteversion. We found no consensus about the management of a recurrent traumatic dislocation of the hip joint in the literature. The various therapeutic options are discussed. We advised posterior capsulorraphy with femoral rotation osteotomy. The patient refused surgery.
Currently available intramedullary devices for the treatment of unstable pertrochanteric femoral fractures are technically demanding and show a considerable failure rate due to their massiveness and the persistent rotational instability of the head-neck fragment. The Arbeitsgemeinschaft für Osteosynthesefragen (AO/ASIF) therefore designed a new intramedullary device, the proximal femoral nail (PFN), which during a handling study was tested in 4 European clinics. Within one year 191 proximal femoral fractures were treated with the PFN. After a follow up period of at least 4 months technical failures (poor reduction, malrotation or wrong choice of screws) were seen in just 4.6% of the cases. One patient showed a cut-out of the implant but there were no mechanical failures (bending, breaking of the implant) or ipsilateral fractures of the femoral shaft at the tip of the implant. It is therefore concluded that the results of this new implant compare favourably to the currently available implants for the treatment of the unstable pertrochanteric femoral fracture.
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Anatomic reduction and internal fixation of the lateral malleolus are the key to management of ankle fractures. The usual application of one-third tubular plates to the lateral surface of the distal fibula has certain disadvantages. In selected cases we prefer a dorsal approach to the lateral malleolus. Indications, technique and experience are discussed.
To evaluate the role of CT in acetabular fractures, CT findings were compared in 45 patients with the information yielded by conventional radiography. In 16 cases the additional information obtained by CT was of importance; indications for CT in initial assessment of acetabular fractures are discussed.
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