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Orthopaedic Proceedings
Vol. 86-B, Issue SUPP_II | Pages 159 - 159
1 Feb 2004
Papageorgiou K Andreadis E Tilaveridis P Vradelis K
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These fractures are usually caused from high energy road accidents and sports injuries and are accompanied by meniscal and collateral ruptures. Aim the study is to present the surgical treatment of these fractures in relation to quality and technique of the reduction and the evaluation of results with base clinical and radiological criteria. From 1996 until 2001. 30 patients with mean of age 48.5 years mainly men, we have treated with tibial plateau fractures, that main cause had the road accident. According to the classification of AO, were predominate of type A and associated injuries had 12 patients. The diagnosis became with simple radiographs, tomographies and in 5 with computed tomography. All patients were operated on average 5 days after the injury and were used in 16 with lag screw {8 with subcutaneous technique } and in 14 with buttress plate and screws In the 1/3 of patients were used bone grafts and in 12 were observed rupture of lateral meniscus. They were re-examined 27/30 patients 1–7 years after the injury and the result it was satisfactory in 24/27. A radiologic control revealed arthritic changes in 17 patients and painful only 5 of them. while all patients had been operated with subcutaneous technique of lag screws had excellent result.. 23 came back in their work while serious instability of the Knee was not observed. As shown in the bibliography in this fractures the quality of reduction and atraumatic technique in combination with stable fixation and early range of motion they constitute strategical goals of treatment that it ensures a good result. The arthritic changes are asymptomatic when do not exist serious{ cruciate -meniscal damage -} instability of the Knee.


Orthopaedic Proceedings
Vol. 85-B, Issue SUPP_III | Pages 225 - 225
1 Mar 2003
Gerakas S Vassiliadis E Bouras A Gaindatzis I Vradelis K
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Purpose: The aim of our study is to compare the outcome of Bipolar Artroplasty (BA) and Total Hip Arthroplasty (THA) in active middle-aged patients with displaced intracapsular femoral neck fractures. Material and Methods: From October 1993 until October 1997, 43 patients (6 male, 37 female) were treated with the above two methods (25 underwent BA and 18 THA), when satisfactory reduction of the fracture was not achievable or survival of femoral head was uncertain. The patients were from 55 to 76 years of age (mean 64, 8 years).

Thirty-eight patients (22 with BA and 16 with THA) were reviewed after a mean of 5, 8 years (ranging from 3 to 8 years).

Results: Comparing the clinical results we found no statistical significant difference between the two methods. Mean Harris Hip Score in BA was 89 (range 71–100) and in THA was 88 (range 74–100). The motion of the inner component of BA was 24% of total in weightbearing conditions and 17, 7% in non-weightbearing condition, as it was measured radiographically.

Conclusion: Despite our small number of patients, the results of BA are comparable to those of THA. Considering that BA it’s a more simple method, reduces the operation time, eliminates blood transfusions and is less expensive, it seems that BA is a rational method of treatment for this group of patients. THA should be reserved for patients with displaced femoral neck fractures with pre-existing hip disease (rheumatoid arthritis, osteoartritis, Paget disease).