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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 179 - 179
1 Feb 2004
Kalos S Giannakopoulos A Brantzikos T Tzioupis C Scouteris G
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Aims: The aim of this prospective study is to compare the results regarding non-union and AVN of two different methods of treatment after displaced femoral neck fractures in young and middle age population.

Methods: Between 1980–1998 we treated 91 patients with displaced femoral neck fractures. In 56 patients (Group A) we performed open reduction, dynamic screw fixation and gluteus minimus muscle pedicle bone graft from greater trochanter inserted through a tunnel prepared parallel to screw. 38 patients had fracture Type Garden III and 18 Garden IV. In 35 patients (Group B) after closed reduction the fracture was fixed with three parallel canullated screws. 24 had fracture Type Garden III and 11 Type IV. All patients were operated within 24 hours. After reduction, Garden Index of 1600±100/1800±100 was acceptable. Follow up varied between 3 to 12 years. Fischer’s Exact test was used to evaluate the results.

Results: 3 patients (5,4%) of Group A and 2 patients (5,7%) of Group B developed non-union. AVN was evident in 9 patients (17%) of Group A and in 6 patients (16,2%) of Group B.

Conclusions: Displaced intracapsular hip fractures are a challenge. Preservation of the femoral head should be the goal of treatment. The rate of non-union in the 2 groups (p:0, 942) as well that of AVN (p:0, 893) did not seem to differ statistically significally. The use of muscle pedicle bone graft did not seem to alter the incidence of complications. We believe that open reduction should be performed in fractures that cannot be reduced closed in younger patients.


Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 186 - 186
1 Feb 2004
Scouteris G Giannakopoulos Á Tzioupis C Dagiakidis Ì Rizonaki A Kontozoglou Í Seretis F
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Purpose: The aim of this study is the evaluation of the results of the treatment of knee osteoarthritis in varus knee with high tibial osteotomy.

Method: Between 1985 – 1991, 54 patients (62 cases) were treated with high tibial osteotomy, which was fixed with A. Renieri technique. The patients were divided in three groups:

- patients who were further treated with TKR

- patients who died without any further surgical treatment

- patients who are still alive and were treated only with high tibial osteotomy

Our study showed that 15 patients (19 cases) needed TKR within mean time 7 years from the osteotomy, 14 patients(15 cases) died without any further surgical treatment in mean time 9 years from the osteotomy and 25 patients (28 cases) who are still alive were treated only with high tibial osteotomy and twelve years later the results are good in 66% and poor in 34%.

Results: As shown from our study high tibial osteotomy with correction of the knee axis and changes of the weight bearing helped in the treatment of pain and delayed the development of knee osteoarthritis in 39 patients (43 cases), who are still alive or died without any further operation after the osteotomy. 15 patients (19 cases) needed TKR after 7 years mean time.

Conclusions: Despite the satisfactory results of TKR, osteoarthritis of knee can be treated with high tibial osteotomy mainly in younger patients, so that TKR if needed, can be performed later. The operation is relatively easy with less complication rate and does not impend the possible TKR later.