Papers by Leonidas Badras
Aims: Evaluation of the efficacy of autotransfusion in reducing the need for homologous blood tra... more Aims: Evaluation of the efficacy of autotransfusion in reducing the need for homologous blood transfusion in total knee arthroplasty. Methods: Prospective randomized study. Patients undergoing total knee arthroplasty were divided in: Group A (72 patients) receiving autotransfusion (Suretrans) and control group B (30 patients) with suction drainage only. Preoperative Hb and demographics of the two groups were comparable. The level of Hb was followed for the first 5 days postoperatively. The amount of homologous blood transfused was also recorded. Results: The average autotransfusion volume in group A was 405±191ml. On the day of the operation and the first postoperative day the Hb in group A was found statistically significantly higher (p Conclusions: there is a statistically significant reduction in the need for blood transfusion by using an autotransfusion system reducing also the possible dangers and complications. Autotransfusion is a simple, safe and cost effective method.
American journal of orthopedics (Belle Mead, N.J.)
Trans-scaphoid transcapitate (TSTC) perilunate fracture-dislocation (PLFD) is a rare type of peri... more Trans-scaphoid transcapitate (TSTC) perilunate fracture-dislocation (PLFD) is a rare type of perilunate injury. Because of the rarity and complexity of this entity, initial diagnosis may be delayed and the extent of osseous and ligamentous lesions underestimated. Early surgical treatment by open reduction and fracture stabilization is recommended to avoid complications such as avascular necrosis, nonunion, posttraumatic arthritis, and functional impairment. In this article, we report the case of a 32-year-old man who sustained a TSTC-PLFD. We describe the radiographic and intraoperative findings, review the current surgical principles for reduction and stabilization of this injury, and assess the clinical and radiologic outcomes.
Journal of Orthopaedic Surgery and Research, 2010
Background: Intertrochanteric fractures are surgically treated by using different methods and imp... more Background: Intertrochanteric fractures are surgically treated by using different methods and implants. The optional type of surgical stabilization is still under debate. However, between devices with the same philosophy, different design characteristics may substantially influence fracture healing. This is a prospective study comparing the complication and final functional outcome of two intramedullary devices, the intramedullary hip screw (IMHS) and the ENDOVIS nail. Materials and methods: Two hundred fifteen patients were randomized on admission in two treatment groups. Epidemiology features and functional status was similar between two treatment groups. Fracture stability was assessed according to the Evan's classification. One hundred ten patients were treated with IMHS and 105 with ENDOVIS nail. Results: There were no significant statistical differences between the two groups regarding blood loss, transfusion requirements and mortality rate. In contrast, the number of total complications was significantly higher in the ENDOVIS nail group. Moreover, the overall functional and walking competence was superior in the patients treated with the IMHS nail. Conclusions: These results indicate that the choice of the proper implant plays probably an important role in the final outcome of surgical treatment of intertrochanteric fractures. IMHS nail allows for accurate surgical technique, for both static and dynamic compression and high rotational stability. IMHS nail proved more reliable in our study regarding nail insertion and overall uncomplicated outcome.
Injury, 2009
Conclusions: The retrograde intramedullary nailing system is simple to use, reduces the operative... more Conclusions: The retrograde intramedullary nailing system is simple to use, reduces the operative time and avoids completely the radiation exposure. In selected patients, it constitutes a satisfactory option in fixing femoral shaft fractures, especially those who demand quick and safe osteosynthesis.
Injury, Jan 8, 2014
Numerous high quality studies have shown the positive effects of various osteoporotic medical tre... more Numerous high quality studies have shown the positive effects of various osteoporotic medical treatment regimens on bone mass and on the reduction of risk for new spinal, hip and non-spinal fractures in osteoporotic patients. However, the effect of osteoporotic treatment on the functional and clinical outcome of patients who have sustained hip fractures and been treated surgically has not yet been addressed. Five hundred and twenty patients out of 611 who were admitted (2009-2011), operated on due to a hip fracture and completed their follow-up evaluations were included in this study. Data related to functional outcome scores, re-fracture rate, quality of life and mortality rate were prospectively recorded, analysed and correlated to osteoporotic medical treatment. There were 151 (25%) men and 369 (71%) women with a mean age of 80.7 years (range, 60 to 90 years). At a mean follow-up of 27.5 months (range, 24 to 36 months) a mortality rate of 23.6% at 2 years was recorded. Mean value...
The aim of this study is to evaluate the mid-term results of the Genesis Total Knee Prosthesis, o... more The aim of this study is to evaluate the mid-term results of the Genesis Total Knee Prosthesis, one of the first prostheses with asymmetric shape of the tibial component .The arthroplasty was performed on our patients with retention of the posterior cruciate ligament and, in most of the cases, without replacement of the patella. During the period 1992–1999, 90 patients (116 knees) were operated in our clinic: 81 of them were women and 9 were men with an average age of 68 (52–82) years. The primary indication for the operation was osteoarthritis. 84 patients (109 knees) were evaluated clinically and roentgenographically (Knee Society Knee Score) for a mean time of 98.1 (29.6 – 137.7) months after surgery. There were no infections. (Three) Four of the patients had to undergo a second operation . Two of them, eventually, had their patellae replaced (1,5 and 3 years postoperatively) due to persisting pain of the patellofemoral articulation and lateral patellar subluxation .The other two...
HIP International
Background: Various factors, other than the quality of surgery, may influence clinical outcomes o... more Background: Various factors, other than the quality of surgery, may influence clinical outcomes of hip fracture patients. We aimed to evaluate the relative impact of several factors on functional outcome, quality of life, re-fracture and mortality rates following surgery for hip fractures. Methods: We studied 498 (62.2%) women and 302 (37.8%) men with a mean age of 81.3 years (range, 60–95) with hip fractures (femoral neck and pertrochanteric). The mean follow-up was 74 months (range 58–96). Various patient-related and surgery-related parameters were recorded and correlated to both objective and subjective mobility, functional recovery and quality of life scales. Mortality and re-fracture rates were also evaluated. Results: Using multiple regression analysis, age >80 years ( p = 0.000; 95% CI, 1.077–1.143) and ASA score III and IV ( p = 0.000; 95% CI, 2.088–3.396) (both non-modifiable factors) both proved to be independent (s.s.) factors affecting mortality rates. Age <80 year...
Acta Orthopaedica Belgica, Jul 1, 2007
This is a prospective case series, in which the outcome of shoulder hemiarthroplasty in recent th... more This is a prospective case series, in which the outcome of shoulder hemiarthroplasty in recent three- and four-part fractures of the proximal humerus was evaluated in patients over 65 years of age. From February 1993 to October 2002, 51 patients with 3- or 4-part fractures of the proximal humerus were entered into the study. The criteria for inclusion were age over 65 years and 3- or 4- part displaced fracture. The mean age of the patients was 73 years (range: 65 to 84). The mean follow-up was 5.5 years (range: 2 to 12). According to the Constant-Murley scale, the results were satisfactory or very satisfactory for 74% of the patients. Thirty nine patients (78%) experienced mild or no pain, 50% achieved active anterior elevation greater than 120 degrees, while 40% had active lateral elevation of more than 120 degrees. None of the patients experienced complete recovery of strength and full range of motion. Thirty four patients were able to resume all their daily activities. There were complications in 26% of the patients. Assessment following the Constant-Murley scale demonstrated that two thirds of the patients were pain free and regained a wide range of shoulder movement, while one third resumed their pre-fracture activities to a great extent. The majority of the patients did not recover normal strength.
Journal of Orthopaedic Surgery, Dec 1, 2012
Post-traumatic premature closure of the distal fibular growth plate is a rare entity leading to s... more Post-traumatic premature closure of the distal fibular growth plate is a rare entity leading to shortening of the lateral malleolus. We report on a 14-year old boy who presented with a 4-year history of worsening, diffuse discomfort and swelling of his left ankle, as well as fibular shortening and talar malreduction. He had sustained a distal tibial fracture 4 years earlier and had been treated with closed reduction. He reported instability of the ankle and difficulty with running. There was 1-cm shortening of the left fibula, 1-cm shortening of the proximal fibula, and slight widening of the medial clear space. Both tibial and fibular growth plates were already closed and the left ankle joint space was slightly narrowed. He was treated with late fibular lengthening and autogenous iliac crest tricortical bone grafting and achieved anatomic restoration of the distal tibiofibular relationship. At one-year follow-up, the ankle-hindfoot score had improved from 69 to 100.
Journal of orthopaedic surgery (Hong Kong), 2012
Post-traumatic premature closure of the distal fibular growth plate is a rare entity leading to s... more Post-traumatic premature closure of the distal fibular growth plate is a rare entity leading to shortening of the lateral malleolus. We report on a 14-year old boy who presented with a 4-year history of worsening, diffuse discomfort and swelling of his left ankle, as well as fibular shortening and talar malreduction. He had sustained a distal tibial fracture 4 years earlier and had been treated with closed reduction. He reported instability of the ankle and difficulty with running. There was 1-cm shortening of the left fibula, 1-cm shortening of the proximal fibula, and slight widening of the medial clear space. Both tibial and fibular growth plates were already closed and the left ankle joint space was slightly narrowed. He was treated with late fibular lengthening and autogenous iliac crest tricortical bone grafting and achieved anatomic restoration of the distal tibiofibular relationship. At one-year follow-up, the ankle-hindfoot score had improved from 69 to 100.
Acta orthopaedica Belgica, 2010
The optimal treatment method for displaced proximal humeral fractures continues to be under debat... more The optimal treatment method for displaced proximal humeral fractures continues to be under debate. There are a variety of fixation techniques, none of which has been proven to be more effective. We retrospectively studied 24 patients with displaced proximal humerus fractures, treated with the Polarus intramedullary nail. All patients were followed radiographically and clinically for one year. Clinical outcome was assessed with the Constant score. All fractures went on to clinical and radiographic union. Mean time to union was 9.2 weeks (range: 9-16). Only one patient with a 3-part fracture had an asymptomatic malunion and one patient had iatrogenic radial nerve palsy, which spontaneously recovered. In total, 83.3% of the patients had an excellent or good clinical outcome. The Polarus nail appeared in this study as an effective device to treat proximal humeral fractures, with good overall functional results and a low complication rate.
Hip international : the journal of clinical and experimental research on hip pathology and therapy
We report the clinical and radiological outcome of 99 Zweymuller metal on metal total hip arthrop... more We report the clinical and radiological outcome of 99 Zweymuller metal on metal total hip arthroplasties in 84 patients followed up prospectively for a mean period of 9.5 (range, 6-15) years. There were 29 (34.5%) male and 55 (65.5%) female patients with a mean age of 62.85 years (range, 50-70 years) at the time of surgery. All patients had osteoarthritis. One acetabular component and one stem were revised due to aseptic loosening. One femoral stem was revised due to a periprosthetic fracture. HHS score improved from a preoperative mean of 62.56 points (SD 8.87) to a final postoperative follow-up mean of 93.48 (SD 7.7). Cumulative success rate for both implants at 13 years, with aseptic loosening as the end point, was 97.05%, while for both implants at 13 years, with revision for any reason as the end point, it was 91.17%. Satisfactory results were observed with the use of this prosthesis.
The Journal of bone and joint surgery. American volume, 2003
American journal of orthopedics (Belle Mead, N.J.), 2003
We report a case of successful treatment of a very rare triplane fracture of the proximal tibia i... more We report a case of successful treatment of a very rare triplane fracture of the proximal tibia in an adolescent boy. The fracture was internally fixed using cannulated Herbert screws. The final result was excellent.
Acta orthopaedica Belgica, 2007
This is a prospective case series, in which the outcome of shoulder hemiarthroplasty in recent th... more This is a prospective case series, in which the outcome of shoulder hemiarthroplasty in recent three- and four-part fractures of the proximal humerus was evaluated in patients over 65 years of age. From February 1993 to October 2002, 51 patients with 3- or 4-part fractures of the proximal humerus were entered into the study. The criteria for inclusion were age over 65 years and 3- or 4- part displaced fracture. The mean age of the patients was 73 years (range: 65 to 84). The mean follow-up was 5.5 years (range: 2 to 12). According to the Constant-Murley scale, the results were satisfactory or very satisfactory for 74% of the patients. Thirty nine patients (78%) experienced mild or no pain, 50% achieved active anterior elevation greater than 120 degrees, while 40% had active lateral elevation of more than 120 degrees. None of the patients experienced complete recovery of strength and full range of motion. Thirty four patients were able to resume all their daily activities. There were...
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Papers by Leonidas Badras