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Archives of Orthopaedic and Trauma Surgery

Annika Arsalan-Werner, Natallia Brui, Isabella Mehling, Michael Schlageter, Michael Sauerbier
INTRODUCTION: Fingertip injuries are frequent and several surgical strategies exist to reconstruct the amputated part and restore function and appearance. Yet, long-term results are rarely published. The purpose of this study was to examine the long-term clinical outcome of neurovascular island flaps for traumatic fingertip amputation of Allen type III/IV injuries. MATERIALS AND METHODS: We retrospectively analysed a cohort of patients with traumatic fingertip amputation that underwent reconstruction with a neurovascular island flap from January 2003 to December 2014...
May 21, 2019: Archives of Orthopaedic and Trauma Surgery
Daniel Wagner, Lukas Kamer, Takeshi Sawaguchi, Hansrudi Noser, Masafumi Uesugi, Andreas Baranowski, Dominik Gruszka, Pol M Rommens
INTRODUCTION: The use of trans-sacral implants to treat fractures of the sacrum is limited by the variable pelvic anatomy. We were interested in how many trans-sacral implants can be placed per pelvis? If a trans-sacral implant cannot be placed in S1, where is the cortex perforated, and is the use of sacroiliac screws safe in these pelves? MATERIALS AND METHODS: 3D pelvic models were created from CT scans of 156 individuals without fractures (92 European and 64 Japanese, 79 male and 77 female, mean age 66...
May 21, 2019: Archives of Orthopaedic and Trauma Surgery
Julius Kho, Erica Kholinne, Sungjoon Lim, Hanpyo Hong, Jae-Man Kwak, Yucheng Sun, Kyoung-Hwan Koh, In-Ho Jeon
INTRODUCTION: The need for precise quantification of the glenoid defect should be emphasized in the choice of surgery for bony Bankart lesion especially in its critical values of 16% to 25. The study aims to verify the validity of bare spot method for arthroscopic quantification of glenoid bone defect using several varieties of posterior portal location. MATERIALS AND METHODS: Two intact cadaveric glenoids were prepared for the study. The greatest anteroposterior diameter of the perfect circle concept of the glenoid is identified and center of the circle is marked as glenoid bare spot with metal marker...
May 20, 2019: Archives of Orthopaedic and Trauma Surgery
Clemens Gwinner, Michael Fuchs, Ufuk Sentuerk, Carsten F Perka, Thula C Walter, Imke Schatka, Julian M M Rogasch
BACKGROUND: Precise measurement of the tibial slope (TS) is crucial for realignment surgery, ligament reconstruction, and arthroplasty. However, there is little consensus on the ideal assessment. It was hypothesized that the tibial slope changes according to the acquisition technique and both tibial length as well as femoral rotation serve as potential confounders. METHODS: 104 patients (37 women, 67 men; range 12-66 years) were retrospectively selected, of which all patients underwent a 1...
May 18, 2019: Archives of Orthopaedic and Trauma Surgery
Matthias Krause, Sebastian Krüger, Gunnar Müller, Klaus Püschel, Karl-Heinz Frosch
INTRODUCTION: The correct choice of a fracture-specific surgical approach with an articular accessibility in complex tibial plateau fractures to facilitate durable fracture fixation of the anatomic articular reconstruction is under debate, as the most important risk factor for malreduction in complex tibial plateau fractures is an impaired visualization of the articular surface. MATERIALS AND METHODS: Six established surgical approaches were simulated on 12 cadaver knees...
May 17, 2019: Archives of Orthopaedic and Trauma Surgery
Jesús Payo-Ollero, Ahinoa Casajús-Ortega, Rafael Llombart-Blanco, Carlos Villas, Matías Alfonso
INTRODUCTION: A multitude of procedures has been described in the literature for the treatment of lesser toe deformities and there is currently no general consensus on the optimal method of fixation. The aim of this study is to assess the clinical and radiological outcomes of an intramedullary nitinol implant for the correction of lesser toe deformities, and to determine if the distal interphalangeal (DIP) joint and metatarsophalangeal (MTP) joint are modified during patient follow-up after correction of the PIP joint...
May 17, 2019: Archives of Orthopaedic and Trauma Surgery
Yong-Cheol Yoon, Chang-Wug Oh, Jong-Keon Oh
INTRODUCTION: In 2012, the Korean central government selected trauma centers to provide effective treatment and reduce preventable mortality in severe trauma patients. General surgeons, thoracic surgeons, orthopedists, and neurosurgeons play pivotal roles in trauma centers, as most trauma patients require orthopedic procedures. This study aimed to underscore the importance of trauma orthopedic specialists (TOSs) by comparing treatment outcomes between a TOS and general orthopedists. PATIENTS AND METHODS: Orthopedic trauma patients with injury severity scores > 15 points, admitted to level 1 trauma centers between March 2015 and December 2016, were divided into the TOS group (treated by 1 orthopedic trauma specialist who treats trauma patients with no limitation in the joint of specialization) and the general orthopedist group (GOG; treated by several general orthopedists who manage both trauma and disease but are each specialized in a certain joint)...
May 17, 2019: Archives of Orthopaedic and Trauma Surgery
Rana Ono, Shingo Komura, Akihiro Hirakawa, Hitoshi Hirose, Masanori Tsugita, Takahiro Masuda, Yoshiki Ito, Haruhiko Akiyama
Osteitis of the fingers is a serious infection that needs early diagnosis and appropriate surgical debridement and antibiotic treatment of the infected bone. If the effects of treatments are insufficient, long-term antibiotic treatment and repeated operations could be required. In worst cases, some patients may have to undergo amputation. Recently, the usefulness of the Masquelet technique in extensive traumatic bone defects has been reported. We herein describe two cases of immunocompromised patients with purulent osteitis involving joint destruction of the finger treated by two-stage arthrodesis using the Masquelet technique...
May 15, 2019: Archives of Orthopaedic and Trauma Surgery
H O Mayr, W C Prall, F Haasters, S F Baumbach, R Hube, Amelie Stoehr
PURPOSE: Purpose of the current study was to compare early effectiveness of pain relieve of 3 in 1 regional pain catheter to local infiltration anesthesia (LIA) in primary total knee arthroplasty (TKA). Secondary endpoint was quadriceps muscle strength after both procedures. MATERIAL AND METHODS: A single-center, prospective, randomized controlled trial was performed. Patients eligible to TKA were either randomized into group 3 in 1 regional pain catheter (C), or group local infiltration anesthesia (L)...
May 14, 2019: Archives of Orthopaedic and Trauma Surgery
Daniel Pfeufer, Anne Zeller, Stefan Mehaffey, Wolfgang Böcker, Christian Kammerlander, Carl Neuerburg
BACKGROUND AND PURPOSE: Reduced mobility is a severe threat to the clinical outcomes and survival of elderly hip fracture patients. These patients generally struggle to comply with partial weight bearing, yet postoperative weight-bearing restrictions are still recommended by nearly 25% of surgeons. Therefore, we hypothesized that weight-bearing restrictions in elderly hip fracture patients merely leads to reduced mobility, while transposing full weight to the fractured extremity remains unaffected disregarding the prescribed aftercare...
May 3, 2019: Archives of Orthopaedic and Trauma Surgery
Stefan Klima, Jon Cornwall, David Kieser, Niels Hammer
INTRODUCTION: Limited data exist on specialty surgical cadaver courses for graduates, their skill gain, and whether the course contents are transferable to other surgical disciplines. AIM: We present the details on the establishment of a specialist trauma and orthopedics approach course, and explore educational and career outcomes from this program. METHODS: A 3-day surgical approach course was developed, including a dissection program utilizing Thiel embalmed cadavers...
April 30, 2019: Archives of Orthopaedic and Trauma Surgery
Ching-Hou Ma, Yen-Chun Chiu, Chin-Hsien Wu, Kun-Ling Tsai, Tsung-Kai Wen, I-Ming Jou, Yuan-Kun Tu
INTRODUCTION: In this study, we aimed to ascertain the feasibility and reliability of the plate-on-plate technique for peri-implant fractures of the distal femoral locking plate when the distal femoral fracture is still unhealed. MATERIALS AND METHODS: From January 2007 to December 2016, we enrolled 11 patients who received treatment at our institution. All patients underwent at least 1 year of follow-up. Their medical records, imaging studies, visual analogue scores, walking ability, complications, and functional outcomes at 1 year postoperative based on the Short Form (36) Health Survey (SF-36) scores were retrospectively evaluated...
April 29, 2019: Archives of Orthopaedic and Trauma Surgery
Diederik O Verbeek, Jelle P van der List, David L Helfet
INTRODUCTION: Computed tomography (CT) is more accurate than plain pelvic radiography (PXR) for evaluating acetabular fracture reduction. As yet unknown is whether CT-based assessment is more predictive for clinical outcome. We determined the independent association between reduction quality according to both methods and native hip survivorship following acetabular fracture fixation. MATERIALS AND METHODS: Retrospectively, 220 acetabular fracture patients were reviewed...
April 27, 2019: Archives of Orthopaedic and Trauma Surgery
Carina Büren, Michael Hambüchen, Joachim Windolf, Tim Lögters, Ceylan Daniela Windolf
INTRODUCTION: Several scores were introduced to diagnose and to classify osteomyelitis in practice. Mouse models are often used to study the pathophysiology of bone infection and to test therapeutic strategies. Aim of the present study was to design a score to diagnose and quantify implant-associated infection in a murine experimental model. MATERIALS AND METHODS: Four independent parameters were developed: existence of callus, consolidation of the fracture, structural changes of the medullary cavity and number of bacteria...
April 24, 2019: Archives of Orthopaedic and Trauma Surgery
Shai S Shemesh, Juan Pretell-Mazzini, Patrici A J Quartin, Tal Frenkel Rutenberg, Sheila A Conway
BACKGROUND: The traditional treatment for chondrosarcoma is wide local excision (WLE), as these tumors are resistant to chemotherapy and radiation treatment. While achieving negative margins has traditionally been the goal of chondrosarcoma resection, multiple studies have demonstrated good short-term results after intralesional procedures for low-grade chondrosarcomas (LGCS) with curettage and adjuvant treatments (phenol application, cauterization or cryotherapy) followed by either cementation or bone grafting...
April 24, 2019: Archives of Orthopaedic and Trauma Surgery
Dani Rotman, Haggai Schermann, Assaf Kadar
Nerve injuries, mostly to the median nerve, are common following distal radius fractures. Ulnar nerve injuries are rarely encountered, with only few case reports of motor or motor and sensory loss described in the literature. In this paper, we report two consecutive cases of young patients with a distal radius fracture and a pure sensory ulnar neuropathy. Both patients had a radially displaced fracture and presented with sensory loss and paresthesia in the distribution of the dorsal cutaneous branch of the ulnar nerve (DCBUN), which resolved after fracture reduction...
April 22, 2019: Archives of Orthopaedic and Trauma Surgery
Jae-Jung Jeong, Chae-Gwan Kong, Sang-Eun Park, Jong-Hun Ji, Won-Ha Whang, Bong-Seok Choi
PURPOSE: Fracture stem of the reverse total shoulder arthroplasty (RTSA) was designed for better tuberosity bone healing for the proximal bone defect of complex proximal humeral fractures (PHF). Our purpose was to compare the clinical and radiological outcomes of patients using fracture stem vs non-fracture (conventional) stem of RTSA in complex PHF of elderly patients. METHODS: Between 2008 March and 2017 June, 48 patients who had undergone an RTSA with non-fracture or fracture stem for complex PHF with a minimum 18 months of follow-up were evaluated...
April 20, 2019: Archives of Orthopaedic and Trauma Surgery
Marc Schnetzke, Frank Feuchtenhofer, Holger Keil, Benedict Swartman, Sven Vetter, Paul-Alfred Grützner, Jochen Franke
INTRODUCTION: The aim of this study was to evaluate a radiographic measurement method for assessment of overlengthening of the MoPyC radial head prosthesis. MATERIALS AND METHODS: Seven cadaver specimens were studied in ten stages: native specimen (1), radial head resection (2), and implantation of the MoPyC radial head prostheses (Bioprofile, Tornier, Montbonnot-Saint-Martin, France) in four increasing length (correct length, overlengthening of 1.5 mm, 3 mm, and 5 mm) with an intact medial collateral ligament (MCL 3-6) and following transection of the MCL (7-10)...
April 13, 2019: Archives of Orthopaedic and Trauma Surgery
H Banierink, I H F Reininga, E Heineman, K W Wendt, K Ten Duis, F F A IJpma
BACKGROUND: Pelvic ring injuries are serious injuries, often associated with substantial morbidity and mortality rates. The long-term consequences of these injuries might affect the patients' personal life. Our aim was to assess the long-term effects of pelvic ring injuries on physical functioning and quality of life (QoL) using validated patient-reported outcome measures (PROMs) and comparing these results to normative data from the general population. PATIENTS AND METHODS: A retrospective cohort study was conducted on adults treated for pelvic ring injuries between 2007 and 2016...
April 11, 2019: Archives of Orthopaedic and Trauma Surgery
Renata E Gologan, M Koeck, A J Suda, U Obertacke
To clarify the role of concomitant carpal lesions in dislocated distal radius fractures (DRF), 104 consecutive patients with DRF underwent a preoperative morphological examination using CT and MRI. The study was performed between 2004 and 2006 with the aim of recording all types of concomitant carpal lesions as well as their consequences after 1 year. Carpal lesions of different types were found in all treated cases of dislocated DRF. A clinical follow-up 1 year (13.9 ± 6.5 months) after surgical treatment showed no correlation between the carpal lesions and the treatment outcome (previously described by Gologan et al...
April 10, 2019: Archives of Orthopaedic and Trauma Surgery
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