Archives of Orthopaedic and Trauma Surgery | Page 2

S Quadlbauer, Ch Pezzei, J Jurkowitsch, R Rosenauer, B Kolmayr, T Keuchel, D Simon, T Beer, T Hausner, M Leixnering
Although the literature generally agrees that displaced distal radius fractures require surgery, no single consensus exists concerning the length of immobilization and type of post-operative physiotherapeutic rehabilitation program. Palmar locking plate fixation represents a very stable fixation of the distal radius, and was assessed biomechanically in various studies. Surprisingly, most authors report additional immobilization after plate fixation. One reason might be due to the pain caused during active wrist mobilization in the early post-operative stages or secondly to protect the osteosynthesis in the early healing stages preventing secondary loss of reduction...
March 19, 2020: Archives of Orthopaedic and Trauma Surgery
Christian K Spies, Martin Langer, Lars P Müller, Johannes Oppermann, Frank Unglaub
Distal radioulnar joint (DRUJ) instability is often an underestimated or missed lesion which may entail fatal consequences. The triangular fibrocartilage complex is a biomechanically very important stabilizer of the DRUJ and guarantees unrestricted range of motion of the forearm. To detect DRUJ instability a systematic examination is of uppermost importance. The contralateral healthy arm will be used for comparison during clinical examination. X-rays are required to exclude osseous lesions or deformities. Computed tomography of both wrists in neutral forearm rotation, supination, and pronation may be necessary to verify DRUJ instability in ambiguous situations...
March 19, 2020: Archives of Orthopaedic and Trauma Surgery
M Leixnering, R Rosenauer, Ch Pezzei, J Jurkowitsch, T Beer, T Keuchel, D Simon, T Hausner, S Quadlbauer
Distal Radius fractures (DRF) are one of the most common injuries in the upper extremity and incidence is expected to rise due to a growing elderly population. The complex decision to treat patients operatively or conservatively depends on a large variety of parameters which have to be considered. No unanimous consensus has been reached yet, which operative approach and fixation technique would produce the best postoperative functional results with lowest complication rates. This article addresses the available evidence for indications, approaches, reduction, and fixation techniques in treating DRF...
March 19, 2020: Archives of Orthopaedic and Trauma Surgery
Johannes Schraknepper, Dimitris Dimitriou, Naeder Helmy, Julian Hasler, Stephan Radzanowski, Andreas Flury
BACKGROUND: Implant malpositioning, low surgical caseload, and improper patient selection have been identified as essential factors, which could negatively affect the longevity of unicompartmental knee arthroplasty (UKA). The aim of the current study was to evaluate the impact of the surgeon's caseload on patient selection, component positioning, as well as component survivorship and functional outcomes following a PSI-UKA. METHODS: A total of 125 patient-specific instrumented (PSI) UKA were included...
March 19, 2020: Archives of Orthopaedic and Trauma Surgery
Tobias Kastenberger, Peter Kaiser, Gernot Schmidle, Peter Schwendinger, Markus Gabl, Rohit Arora
Wrist arthroscopy is mainly used to assist fracture reduction and fixation and to diagnose and treat concomitant injuries mainly to the scapholunate (SL), lunotriquetral (LT) ligament and the triangular fibrocartilage complex (TFCC). Arthroscopy is beneficial in improving anatomical reduction of fracture steps and gaps in intra-articular distal radius fractures (DRFs). Yet, the literature that the functional outcome correlates with the use of arthroscopy, is limited. Non-surgical treatment and immobilization is recommended for Geissler grade I-III Sl-ligament injuries, while open reduction, ligament suture and/or K-wire pinning is mandatory for complete ligament tears according to Geissler grade IV...
March 19, 2020: Archives of Orthopaedic and Trauma Surgery
R Rosenauer, Ch Pezzei, S Quadlbauer, T Keuchel, J Jurkowitsch, T Hausner, M Leixnering
In the recent years, treatment of distal radius fractures (DRF) has advanced considerably. Surgical fixation with palmar angular stable plate has gained popularity, due to a reported lower complication rate when compared to dorsal fixation. The type of trauma or injury, surgical procedure and impaired bone quality are all contributors to complications in DRF. The main aim of this review is to summarize the most common complications and possible therapeutic solutions. In addition, strategies for minimizing these complications will be discussed...
March 19, 2020: Archives of Orthopaedic and Trauma Surgery
Tina Keuchel-Strobl, S Quadlbauer, J Jurkowitsch, R Rosenauer, T Hausner, M Leixnering, Ch Pezzei
Indications for surgical treatment of distal radius fractures (DRF) remain controversial in the literature, especially in elderly patients. Complication rates after operatively treated DRF are low and well documented. These include malunion, degenerative osteoarthritis in the radiocarpal joint and subsequently pain and impaired hand function. If conservative treatment fails then salvage procedures are necessary. This review summarizes the therapeutic options available to treat degenerative osteoarthritis after malunited distal radius fractures, regardless of the initial operative or conservative treatment...
March 19, 2020: Archives of Orthopaedic and Trauma Surgery
Stefan Quadlbauer, Martin Leixnering
No abstract text is available yet for this article.
March 19, 2020: Archives of Orthopaedic and Trauma Surgery
Matthias Braito, Stephan Wolf, Dietmar Dammerer, Johannes Giesinger, Jürgen Wansch, Rainer Biedermann
INTRODUCTION: Global discussions regarding the treatment of Legg-Calvé-Perthes disease (LCPD) are still controversial. The aim of this study was to characterize the worldwide regional differences in nonoperative and operative treatment for LCPD. MATERIALS AND METHODS: Based on a comprehensive literature search, 123 studies describing the results of nonoperative and operative treatment for LCPD were included. Overall, disease and outcome parameters of 6,968 hips were recorded and compared among the continents-Europe, North America, Asia, Africa, South America, and Australia...
March 14, 2020: Archives of Orthopaedic and Trauma Surgery
Ajith Malige, Shawn Yeazell, Matthew Beck, Franzes Anne Liongson, Henry Boateng, Chinenye Nwachuku
INTRODUCTION: Periprosthetic femur fractures are complex injuries that can be difficult to treat and recover from. With a growing number of total hip arthroplasties (THA) and revision arthroplasties being performed in an aging population, the incidence of these injuries is on the rise. Multiple studies exist detailing outcomes associated with periprosthetic femur fractures after THA, but no study has directly compared the post-operative course between fracture types as classified by the Vancouver classification system...
March 14, 2020: Archives of Orthopaedic and Trauma Surgery
Rasmus Elsoe, Peter Larsen
INTRODUCTION: Disregarding proximal femoral fractures, the current literature includes only limited information regarding mortality following lower extremity fractures. Information regarding risk of mortality related to specific fracture patterns is essential when planning treatment modalities. The primary aim of this study was to report the long-term cumulative survival rate in patients with a tibial plateau fracture compared to an age- and gender-matched reference population. MATERIALS AND METHODS: Patients who sustained a tibial plateau fracture in Denmark between 1996 and 2000 were included in the study...
March 14, 2020: Archives of Orthopaedic and Trauma Surgery
Stephan H Wirth, Arnd F Viehöfer, Timo Tondelli, Rebecca Hartmann, Martin C Berli, Thomas Böni, Felix W A Waibel
BACKGROUND: Failed conservative treatment and complications are indications for foot reconstruction in Charcot arthropathy. External fixation using the Ilizarov principles offers a one-stage procedure for deformity correction and resection of osteomyelitic bone. The aim of this study was to determine whether external fixation with an Ilizarov ring fixator leads reliably to walking ability. MATERIALS AND METHODS: 29 patients treated with an Ilizarov ring fixator for Charcot arthropathy were retrospectively analyzed...
March 13, 2020: Archives of Orthopaedic and Trauma Surgery
Manuel Zafra, Pilar Uceda, Francisco Muñoz-Luna, Rafael C Muñoz-López, Pilar Font
BACKGROUND: The purpose of this prospective study was to compare the clinical and structural findings following the arthroscopic repair of partial-thickness (exceeding 50%) articular-sided rotator cuff tears using either a single-row or a double-row suture bridge fixation. MATERIALS AND METHODS: Fifty patients were included in this study. The patients were randomly placed into two groups: 25 underwent the single-row (Group I) and 25 a double-row suture bridge fixation (Group II)...
March 13, 2020: Archives of Orthopaedic and Trauma Surgery
Filippo Migliorini, Andromahi Trivellas, Arne Driessen, Valentin Quack, Yasser El Mansy, Hanno Schenker, Markus Tingart, Jörg Eschweiler
INTRODUCTION: Displaced femoral neck fractures (FNF) are complicated by high mortality rates and continue to represent an important cause of disability, having a negative impact on patient mobility and physical independence. The purpose of this study was to update and analyse current outcomes and evidence concerning hip hemiarthroplasty (HHA) versus total hip arthroplasty (THA) for displaced femoral neck fractures in the elderly. Thus, a meta-analysis of randomized clinical trials was conducted...
March 13, 2020: Archives of Orthopaedic and Trauma Surgery
Hwan-Hee Lee, Weon-Yoo Kim, Yong-Woo Kim, Kyong-Jun Kim, Se-Won Lee
INTRODUCTION: Unicondylar femoral fractures are uncommon injuries, known to occur primarily in young people, with high energy trauma. However, according to our experiences, unicondylar femoral fractures in geriatric patients generally involved the medial femoral condyle, unlike previously reported. In addition, the fractures of medial femoral condyle (FMFC) showed a characteristic fracture pattern. To date, there has been no published article focusing on the FMFC in geriatric patients...
March 11, 2020: Archives of Orthopaedic and Trauma Surgery
P Savov, S Budde, S Tsamassiotis, H Windhagen, M Klintschar, M Ettinger
INTRODUCTION: Computed tomography-based three-dimensional models may allow the accurate determination of the center of rotation, lateral and anterior femoral offsets, and the required implant size in total hip arthroplasty. In this cadaver study, the accuracy of anatomical reconstruction was evaluated using a three-dimensional planning tool. MATERIALS AND METHODS: A total of eight hip arthroplasties were performed on four bilateral specimens. Based on a computed tomography scan, the position and size of the prosthesis were templated with respect to the anatomical conditions...
March 10, 2020: Archives of Orthopaedic and Trauma Surgery
Fay Ruth Katharina Sanders, Mirjam Van't Hul, Rosanne Maria Güzelleke Kistemaker, Tim Schepers
INTRODUCTION: Post-operative wound complications remain among the most common complications of orthopedic (trauma) surgery. Recently, studies have suggested environmental factors such as season to be of influence on wound complications. Patients operated in summer are reported to have more wound complications, compared to other seasons. The aim of this study was to identify if "seasonality" was a significant predictor for wound complications in this cohort of trauma-related foot/ankle procedures...
March 9, 2020: Archives of Orthopaedic and Trauma Surgery
Antonio Klasan, Sven Edward Putnis, Samuel Grasso, Thomas Neri, Myles Raphael Coolican
INTRODUCTION: The most commonly used tool for implant positioning are conventional instruments (CI) followed by computer-assisted surgery (CAS). A number of studies have investigated the cutting error of the tibial component when CAS is used, but most of them were focused on the cutting angles. The accuracy of CAS to determine the depth of the cut has not received much attention, even though implications are similar or worse, than with an angle mismatch. MATERIALS AND METHODS: This was an ethics board approved, prospective study of 23 consecutive varus TKAs by a single surgeon...
March 7, 2020: Archives of Orthopaedic and Trauma Surgery
Antoine Morvan, Nicolas Bouguennec, Nicolas Graveleau
PURPOSE: The purpose of this study was to systematically assess the possibility for a patient younger than 15 to return to a competitive level of sport following an ACL injury. METHODS: Four databases were analyzed (PubMed, MedLine, Cinahl, Cochrane Library and LISTA). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were used to guide the screening of the literature. Studies about functional and surgical treatments were included with a minimum of 5 years of mean follow-up...
March 6, 2020: Archives of Orthopaedic and Trauma Surgery
Yong-Cheol Yoon, Chang-Wug Oh, Jong-Keon Oh
Although indirect reduction with intramedullary (IM) nailing is the gold standard for long bone fractures, IM nailing in meta-diaphyseal fractures often results in malalignment. Placement of Poller (blocking) screws is an attractive and useful technique in these situations; however, the selection of accurate placement points and the placement process itself are often complicated. This paper proposes an intuitive, simple, and clear technique for selecting the location of Poller screw placement that can be used in either the anteroposterior or lateral view regardless of the fracture type and discusses techniques for Poller screw placement that enable displacement correction...
March 6, 2020: Archives of Orthopaedic and Trauma Surgery
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