Aims

The aim of this study was to assess the safety and clinical outcome of patients with a femoral shaft fracture and a previous complex post-traumatic femoral malunion who were treated with a clamshell osteotomy and fixation with an intramedullary nail (IMN).

Introduction. The postoperative management of patients after total hip replacement traditionally includes restrictions of movements and the use of aids (toiletelevation, sleeping pillow, a.o.) in the first 3 months after operation. Few studies have investigated the benefit of such restrictions. The aim of the present study was to evaluate how patients with total hip replacements (THR) are doing with and without restrictions in the first 3 months after surgery, and if walking ability and patients satisfaction was influenced by the postoperative regime. Patients and Methods. 80 patients undergoing primary uncemented THR were randomized to either the conventional regime with restrictions of movement and obligatory use of aids, or a postoperative regime without restrictions. Surgery was performed through a posterolateral short incision. The femoral component was the uncemented Bimetric prosthesis, non collared with HA coating, and a 36 mm femoral head. The cup was the Trilogy cup with a highly crosslinked polyethylen liner. No postoperative drainage was used and immediate weight bearing was allowed in both groups. We monitored walking speed, TUG score (timed up and go) and VAS pain score. The patients were scored by a trained physiotherapist preoperatively, 2 times each day during admission, and 14 and 90 days after surgery. Radiographic examination was performed after 3 days and after 3 months. At the 3 months evaluation a SF-36 score was registered. Results. The two groups were similar in age, operation time blood loss, and position of the prosthesis. None of the patients had postoperative dislocation. No significant difference was seen in any of the registered parameters (p< 0,05). The two groups were not similar regarding pain score. Preoperatively there was a significant higher pain score(p<0,05) in the group without restrictions and this difference was present throughout the first postoperative days. Accordingly they spent more time walking 10m during the first postoperative days, though this difference was not statistically significant. After 3 months the results in the two groups were similar and the SF-36 score was without significant difference. Conclusion. There is no significant difference in TUG test, 10m test, SF 36 score and VAS score the first 3 months after THR in the 2 groups. We did not see an increase in postoperative complications, which implies that postoperative mobilisation without restrictions, can be allowed without the risk of increased complications, and the use of aids in activities of daily living are not necessary. This also implies the possibility of savings in the rehabilitation of patients after THR

In a prospective, randomised trial of 81 patients with fractures of the ankle of AO types A, B and C we compared two regimes of postoperative management after internal fixation. The patients were mobilised either non-weight-bearing with crutches or weight-bearing in a below-knee walking plaster. We found a temporary benefit in subjective evaluation only (65 v 50 points, Mann-Whitney test, cft, p = 0.02) for those with a below-knee walking plaster. There were no significant differences between the groups in the loaded dorsal range of movement (25° v 23°, Mann-Whitney test, cft, p = 0.16) or in the overall clinical result. Both treatments were considered to be satisfactory and their choice depends on the ability to mobilise non-weight-bearing, wound healing, the type of work and personal preference

Aims

In this randomized study, we aimed to compare quality of regenerate in monolateral versus circular frame fixation in 30 patients with infected nonunion of tibia.

Aims

This is a prospective randomised study which compares the radiological and functional outcomes of ring and rail fixators in patients with an infected gap (> 3 cm) nonunion of the tibia.