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Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_III | Pages 350 - 350
1 Jul 2011
Boutsiadis A Ditsios K Savvides P Stavridis S Givisis P Christodoulou A
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Although, reverse shoulder arthroplasty has initially been introduced for rotator cuff arthropathy, its application has been expanded on fracture sequelae, chronic dislocations and even comminuted fractures of the humeral head in elderly patients. The purpose of this study is to present our experience and the mid-term clinical results of this type prosthesis.

Between 2006 and 2008 16 reverse shoulder arthroplasties have been carried out in our department. Fourteen patients were female and 2 male with an average age of 72.4 years (55–81). Eleven patients had true rotator cuff arthropathy, 3 malunion of 4-part fractures, one chronic anterior shoulder dislocation and finally one patient had bilateral chronic posterior shoulder dislocation. In 2 cases we used the Delta prosthesis and in a further 14 cases the Aquealis Arthroplasty.

Routine postoperative follow up was at 3,6,12 and 24 months and included plain radiographic control and clinical evaluation with the Constant Shoulder Score. All patients report significant pain relief and an average improvement of the Constant Score from 40.5 to 72.3. Two patients had anterior dislocation of the prosthesis 4 days postoperatively and we proceeded to the application of a 9 mm metal spacer and bigger polyethylene size. In one patient neuroapraxia of the axillary nerve was observed; this resolved 3 months postoperatively. Continuous clinical improvement was observed in some patients up until 18 months postoperatively.

Our clinical results are very satisfactory and reveal that reverse shoulder arhroplasty is a very good option for a broad spectrum of pathologic shoulder conditions.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 171 - 171
1 Mar 2006
Petsatodes G Hatzisymeon A Givisis P Papadopoulos P Antonarakos P Pournaras J
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Aim: In this study we present the results of the management of muskoloskeletal injuries accompanied by rupture of a main arterial vessel, focusing on the priorities in salvaging the affected limp.

Material – methods: In a period of 5 years (Sep.1999– Sep 2004), 24 patients having sustained multiple injuries were admitted with signs of poor vascularization distally to the lesion. 19 were male and 5 female, their ages ranging from 16 to 49 years (av. 28 years). The musculoskeletal injuries were: open III C humeral fracture in 2 patients, open III C femoral fractures 4, open III C tibial shaft fractures 10, knee joint dislocations 8 patients. All patients had a preoperative angiography in order to assess the severity of the vascular lesion. Immediate stabilization of the fracture with an external fixation system was performed, followed by restoration of the vascular injury by means of a by-pass, end-to-end suture or interposition of a “stent”.

Results: Postoperative follow-up ranged from 6 to 54 months (mean 34 mon.). Amputation was performed in 4 patients due to failure of the revascularization procedure 2 weeks postoperatively. External fixation was maintained as a final method of treatment in 7 cases, while in 13 cases we exchanged it to intramedullary nailing. In the 8 cases of knee dislocation, ligament reconstruction was imperative. Eventually 20 limps were salvage with a satisfactory functional outcome.

Conclusion: In polytrauma patients with both musculoskeletal and vascular injuries the immediate application of an external fixator represents a precausative for a successful vascular operation. Exchanging the external fixation system to interlocking intramedullary nailing accelerates the healing process.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_I | Pages 173 - 173
1 Mar 2006
Petsatodes G Hatzisymeon N Givisis P Christodoulou A Antonaracos P Pournaras J
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Purpose: We evaluate the results of treatment of A.O. type C distal femoral fractures with 3 methods of internal fixation (condylar plate, 95° condylar blade plate, D.C.S.).

Material-Methods: From 1988–2003, 108 patients (59 male, 49 female), aging 19 to 84 years (aver. 46 years), with 116 fractures A.O. /C were treated. 108 were closed and 8 open, Gustillo type II. We used condylar plate in 38 patients (group A), 95° condylar blade plate in 24 (group B) and D.C.S. in 54 (group C).

Results: Postoperative follow-up ranged from 1 to 15 years. An early mobilization programme was initiated. The results were evaluated using the Schatzker-Lambert criteria. Pseudarthrosis was found in 4 cases in group A, 6 in B and 3 in C. Varous deformity was present in 10 cases in group A, 6 in B and 2 in C. Severe knee stiffness was present in 2 patients of group A, 2 of B and none of group C.

Conclusion: The Dynamic Condylar Screw – D.C.S. seems to have an advantage compared to the other 2 methods of internal fixation regarding the treatment of A.O. /C distal femoral fractures offering stability, anatomical reduction, and early mobilization with a good functional outcome.