Archives of orthopaedic and trauma surgery
-
Arch Orthop Trauma Surg · Oct 2017
Predictors of outcomes after arthroscopic transosseous equivalent rotator cuff repair in 155 cases: a propensity score weighted analysis of knotted and knotless self-reinforcing repair techniques at a minimum of 2 years.
To evaluate the outcomes of two commonly used transosseous-equivalent (TOE) arthroscopic rotator cuff repair (RCR) techniques for full-thickness supraspinatus tendon tears (FTST) using a robust multi-predictor model. ⋯ Level III, Retrospective Comparative Study.
-
Arch Orthop Trauma Surg · Oct 2017
Arthroscopic fixation of pediatric tibial eminence fractures using suture anchors: a mid-term follow-up.
The aim of this study was to follow a group of skeletally immature patients who received arthroscopy-assisted fixation of the displaced tibial eminence fractures with suture anchors and evaluate the clinical results. ⋯ Arthroscopy-assisted reduction and fixation of the displaced tibial eminence fractures using suture anchors is a simple and reliable technique and is suitable for skeletally immature patients.
-
Arch Orthop Trauma Surg · Oct 2017
High-resolution MRI (3T-MRI) in diagnosis of wrist pain: is diagnostic arthroscopy still necessary?
3T MRI has become increasingly available for better imaging of interosseous ligaments, TFCC, and avascular necrosis compared with 1.5T MRI. This study assesses the sensitivity and specificity of 3T MRI compared with arthroscopy as the gold standard. ⋯ 3T MRI proved to be of good value in diagnosing cartilage lesions, especially in the distal carpal row, whereas wrist arthroscopy provided therapeutic options. When evaluating the surgical therapeutical options, 3T MRI is a good diagnostic tool for pre-operatively evaluating the cartilage of the distal carpal row.
-
Arch Orthop Trauma Surg · Oct 2017
Radiological outcome of postoperative sagittal balance on standing radiographs in comparison to intraoperative radiographs in prone position when performing lumbar spinal fusion.
Aim of this study is to show the outcome of postoperatively measured lumbar lordosis in upright position in comparison to the intraoperatively estimated lumbar lordosis in prone position, as the lumbar lordosis is one of the most important factors for the clinical outcome after spinal fusion. ⋯ Measuring lordosis angles intraoperatively resulted in almost the same values as measurements in standing plane radiographs postoperatively, despite prone position. These findings could especially be shown for the level L4-S1. The intraobserver reliability was almost perfect for both, intra- and postoperative measurements. In conclusion, the intraoperative measurement of a lumbar lordosis angle can perfectly predict the postoperative result.
-
Arch Orthop Trauma Surg · Oct 2017
The female geriatric proximal humeral fracture: protagonist for straight antegrade nailing?
Straight antegrade humeral nailing (SAHN) has become a standard technique for the surgical fixation of proximal humeral fractures, which predominantly affect elderly females. The nail's proximal anchoring point has been demonstrated to be critical to ensure reliable fixation in osteoporotic bone and to prevent iatrogenic damage to the superior rotator cuff bony insertion. Anatomical variations of the proximal humerus, however, may preclude satisfactory anchoring of the nail's proximal end and may bare the risk of rotator cuff violation, even though the nail is inserted as recommended. The aim of this study was to evaluate the anatomical suitability of proximal humeri of geriatric females aged 75 years and older for SAHN. Specifically, we sought to assess the proportion of humeri not anatomically amenable to SAHN for proximal humeral fracture. ⋯ More than a third of proximal humeri of geriatric females are "critical types" as to SAHN and may, therefore, be at risk for procedure-related complications, such as rotator cuff violation, fixation failure, and potential malreduction. In view of this finding, we recommend to routinely analyze multiplanar CT reformations of the uninjured contralateral side prior to surgery to improve selection of patients for SAHN and to minimize foreseeable complications. For "critical type" humeri, an alternative surgical procedure should be considered.