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shown that in > 80% of cases CT scans provided additional information about the fracture configuration which resulted in a change of the initially planned surgical approach in 64%. 16 Tornetta and Gorup, 16 on the basis of CT investigations of
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– indication for operative management of the PM fragment, for example 25% of the articular surface, is now replaced by a morphology-adapted approach. Here the biomechanical aspect of the unstable syndesmosis is the key ( 25 , 26 ). A direct posterolateral
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by Duncan and Masri, 22 which was later further expanded into the Unified Classification System. 25 An algorithmic treatment approach for femoral periprosthetic fractures according to the Vancouver classification system is currently widely
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due to inadequate surgical exposure. 3 , 4 Anatomical considerations The two classically recognized approaches for shoulder arthroplasty are the deltopectoral approach and the transdeltoid approach. In both cases, the glenoid is exposed
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the art and the authors experience on this specific topic. Planning the surgical approach Once the resection has been planned and confirmed at the multidisciplinary consultation meeting, the surgeon can begin the second stage of surgical
Orthopedic Department, Spine Unit, Hotel Dieu de France Hospital, Beirut, Lebanon
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Orthopedic Department, Spine Unit, Hotel Dieu de France Hospital, Beirut, Lebanon
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the period of growth, posterior arthrodesis is the preferred may be the method of choice, while at the adult age, the two-stage anteroposterior fusion is ideal with more rigid curves ( 51 ). Two-stage approach is the method of choice when deformation
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modern vehicles. 5 Since fractures of the femoral head are usually high-energy, intra-articular injuries, they pose unique challenges for the treating surgeon. Treatment of this injury ranges from simple closed reduction to a surgical approach, which
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and Gellman 3 described the safe working zone into which instruments could be placed by a transforaminal approach and it was subsequently recognised that this provided an ideal portal for endoscopic access. 4 Following an initial series of
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the fracture morphology, degree of joint depression and appropriate surgical approach. 4 , 5 Luo et al 4 recently described a CT-based three-column model to evaluate tibial plateau fractures and clinical decision-making ( Fig. 1 ). According
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approach using external fixation is recommended in complex patterns and high-energy trauma, especially in cases of axial instability. Knee-spanning external fixators can be used to approximate the fracture fragments by the process of ligamentotaxis. 1 , 6