Journal of orthopaedic research : official publication of the Orthopaedic Research Society
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Outcomes following the open reduction and internal fixation (ORIF) of displaced acetabular fractures in the elderly have been inconsistent. Several factors associated with significant poor clinical outcomes have been reported; however, the factor that contributes independently to the outcomes remains unknown. This study aims to identify independent prognostic factors for the outcomes of surgically treated displaced acetabular fractures in the elderly. ⋯ Multivariate analysis identified three independent predictors of clinical outcomes: reduction grades (t = -10.45, p = 0.000), CPWF (t = -2.74, p = 0.008), and FHI (t = -3.51, p = 0.000). Both CPWF and FHI are important risk factors for clinical outcome. The postoperative quality of reduction independently predicted patient prognosis, and anatomical reduction is predictive of a good prognosis.
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Double fusion (i.e., fusion of the subtalar and talonavicular joint) represents a modification of triple arthrodesis preserving integrity of the calcaneocuboidal joint. Our aims were (1) to evaluate dynamic plantar pressure distribution in patients undergoing double arthrodesis, (2) to obtain a comparison of kinematic changes to healthy feet, (3) to evaluate the influence of radiographic alignment, and (4) to assess functional outcome. Sixteen feet (14 patients) treated by double fusion due to fixed planovalgus deformity were included. ⋯ The pre- and post-operative AOFAS score increased from 37 points (SD, 16.3) to 70 points (SD, 16.7). These results revealed that double arthrodesis represents a reliable method for correction of planovalgus deformity. Compared with healthy feet, force transmission of the midfoot is increased whereas push-off force decreases.