Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Apr 2017
Comparative StudyDorsal versus lateral plate fixation of finger proximal phalangeal fractures: a retrospective study.
Unstable proximal phalanx fractures are relatively common injuries but consensus of standard treatment is lacking. Outcomes following plate fixation are highly variable, and it remains unclear which factors are predictive for poorer results. The purpose of this study was to compare dorsal and lateral plate fixation of finger proximal phalangeal fractures with regard to factors that influence the outcome. ⋯ Therapeutic, retrospective comparative, level III.
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Arch Orthop Trauma Surg · Apr 2017
Surgical dislocation for pediatric and adolescent hip deformity: clinical and radiographical results at 3 years follow-up.
The aim of this study is to evaluate the clinical, radiographic short-term results and complications after surgical hip dislocation in young patients (≤18 years). ⋯ Level IV, retrospective study, case series.
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Arch Orthop Trauma Surg · Apr 2017
Treatment of acetabular fractures in older patients-introduction of a new implant for primary total hip arthroplasty.
Fractures of the acetabulum in younger patients are commonly treated by open reduction and internal fixation. For elderly patients, stable primary total hip arthroplasty with the advantage of immediate postoperative mobilization might be the adequate treatment. For this purpose, a sufficiently stable fixation of the acetabular component is required. ⋯ The presented cage provides the possibility of early mobilization with full weight bearing which represents a valuable addition to the treatment spectrum in this challenging patient group.
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Arch Orthop Trauma Surg · Apr 2017
Rotational acetabular osteotomy for acetabular dysplasia and osteoarthritis: a mean follow-up of 20 years.
Rotational acetabular osteotomy (RAO), a joint-conserving surgery in which the femoral head coverage by autologous cartilage is improved to achieve joint stability, is one of the most common joint-conserving surgeries for acetabular dysplasia of the hip in adult patients. Favorable outcome of RAO for pre- and initial coxarthrosis has been reported with middle- to long-term observation; however, surgery should be selected for advanced coxarthrosis. The objective of this study was to investigate the long-term clinical outcomes and radiological arthritis changes in patients who were treated with RAO and could be followed for 15 years or longer, and to investigate the joint conservation rate by preoperative arthritis stage. ⋯ The outcome of rotational acetabular osteotomy in most hips with pre- or initial coxarthrosis was satisfactory. Rotational acetabular osteotomy is an effective surgery for treating symptomatic developmental dysplasia of the hip in selected patients.
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Arch Orthop Trauma Surg · Apr 2017
Complications during hospitalization and risk factors in elderly patients with hip fracture following integrated orthogeriatric treatment.
This study aimed to evaluate the incidence of complications in elderly patients with a hip fracture following integrated orthogeriatric treatment. To discover factors that might be adjusted, in order to improve outcome in those patients, we examined the association between baseline patient characteristics and a complicated course. ⋯ After integrated orthogeriatric treatment, a complicated course was seen in 49.6% of the patients with a hip fracture. The in-hospital mortality rate was 3.8%. Important risk factors for a complicated course were increasing age, poor medical condition and delirium risk VMS Frailty score. Awareness of risk factors that affect the course during admission can be useful in optimizing care and outcomes. In the search for possible areas for improvement in care, targeted preventive measures to mitigate delirium, and healthcare-associated infections (HAIs), such as CAUTIs and pneumonia are important.