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Advances in Orthopedics (1)
Strategies in Trauma and Limb Reconstruction (1)
Bartolozzi, P. (2)
Bondi, M. (2)
Micheloni, G. M. (2)
Dall’Oca, C. (1)
Lavini, F. (1)
Magnan, B. (1)
Maluta, T. (1)
Samaila, E. (1)
Vecchini, E. (1)
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author:("michelotti, G. M.")
Tibial plateau fractures: compared outcomes between ARIF and ORIF
Strategies in Trauma and Limb Reconstruction
The purpose of this study is to compare arthroscopic assisted reduction internal fixation (ARIF) treatment with open reduction internal fixation (ORIF) treatment in patients with tibial plateau fractures. We studied 100 patients with tibial plateau fractures (54 men and 46 women) examined by X-rays and CT scans, divided into 2 groups. Group A with associated meniscus tear was treated by ARIF technique, while in group B ORIF technique was used. The follow-up period ranged from 12 to 116 months. The patients were evaluated both clinically and radiologically according to the Rasmussen and HSS (The Hospital for Special Surgery knee-rating) scores. In group A, the average Rasmussen clinical score is 27.62 ± 2.60 (range, 19–30), while in group B is 26.81 ± 2.65 (range, 21–30). HSS score in group A was 76.36 ± 14.19 (range, 38–91) as the average clinical result, while in group B was 73.12 ± 14.55 (range, 45–91). According to Rasmussen radiological results, the average score for group A was 16.56 ± 2.66 (range, 8–18), while in group B was 15.88 ± 2.71 (range, 10–18). Sixty-nine of 100 patients in our study had associated intra-articular lesions. We had 5 early complications and 36 late complications. The study suggests that there are no differences between ARIF and ORIF treatment in Schatzker type I fractures. ARIF technique may increase the clinical outcome in Schatzker type II–III–IV fractures. In Schatzker type V and VI fractures, ARIF and ORIF techniques have both poor medium- and long-term results but ARIF treatment, when indicated, is the best choice for the lower rate of infections.
Tibial plateau fractures; ARIF; Arthroscopically assisted reduction; Post-traumatic arthrosis; External fixation
Three-Dimensional Matrix-Induced Autologous Chondrocytes Implantation for Osteochondral Lesions of the Talus: Midterm Results
Advances in Orthopedics
Introduction. We evaluate the midterm results of thirty patients who underwent autologous chondrocytes implantation for talus osteochondral lesions treatment. Materials and Methods. From 2002 to 2009, 30 ankles with a mean lesion size of 2,36 cm2 were treated. We evaluated patients using American Orthopaedic Foot and Ankle Surgery and Coughlin score, Van Dijk scale, recovering time, and Musculoskeletal Outcomes Data Evaluation and Management System. Results. The mean AOFAS score varied from 36.9 to 83.9 at follow-up. Average of Van Dijk scale was 141.1. Coughlin score was excellent/good in 24 patients. MOCART score varied from 6.3 to 3.8. Discussion. This matrix is easy to handle conformable to the lesion and apply by arthroscopy. No correlation between MRI imaging and clinical results is found. Conclusions. Our results, compared with those reported in literature with other surgical procedures, show no superiority evidence for our technique compared to the others regarding the size of the lesions.
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