Archives of orthopaedic and trauma surgery
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Arch Orthop Trauma Surg · Dec 2018
Relationships between Hoffa fragment size and surgical approach selection: a cadaveric study.
Fixation of a small Hoffa fragment requires a selection of the proper surgical approach for reduction and posterior to anterior screws fixation. However, currently there are no guidelines regarding how to select the best approach for small posterior Hoffa fractures. ⋯ When the Hoffa fragment is less than 18.3% of the AP diameter of medial condyle or 10.1% of lateral condyle, the fracture is invisible with the PPA. When the Hoffa fragment is more than 28.7% of the medial condyle or 19.9% of the lateral condyle, the PPA should be selected. If the Hoffa fragment is less than 28.7% of the medial condyle or 19.9% of the lateral condyle, the DMA or PLA with posterior-to-anterior screws is recommended. Combined approaches should be considered in some complex cases with articular comminution.
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Arch Orthop Trauma Surg · Dec 2018
Meta AnalysisArthroscopic meniscal surgery versus conservative management in patients aged 40 years and older: a meta-analysis.
The efficacy of arthroscopic meniscus surgery in old aged patients remains controversial. The purpose of the present study was to review published studies comparing arthroscopic meniscal surgery with conservative management to treat meniscal injuries in patients 40 years of age and older. ⋯ The efficacy of arthroscopic surgery was not superior to conservative management in this type of patients. Therefore, arthroscopic meniscal surgery should not be recommended as a first choice of treatment for degenerative meniscal tears. In patients over 40 years of age, arthroscopic surgery should be cautiously considered for degenerative meniscal tears and only when there has not been a satisfactory response to conservative management.
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Arch Orthop Trauma Surg · Dec 2018
ReviewThe value of radiography in the follow-up of extremity fractures: a systematic review.
The added value of routine radiography in the follow-up of extremity fractures is unclear. The aim of this systematic review was to create an overview of radiography use in extremity fracture care and the consequences of these radiographs for the treatment of patients with these fractures. ⋯ Based on current literature, the added value of routine radiography in the follow-up of extremity fractures seems limited. Results, however, should be interpreted with care, considering that available evidence is of a low level.
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Arch Orthop Trauma Surg · Dec 2018
Bone density correlates with clinical outcomes after ankle fracture fixation.
Osteoporosis and decreased bone density are known to increase fracture incidence and severity. Although much is known regarding the effects of bone density on fracture risk and the treatment options for prevention of fragility fractures, whether bone quality alters clinical outcomes after fracture fixation is unknown. The purpose of this study was to determine whether bone quality correlates with clinical outcomes after fracture fixation. ⋯ Our results suggest that decreased bone quality, as measured using preoperative CT, significantly correlates with inferior short-term clinical outcomes. These results have significant implications for integrating bone quality into treatment algorithms for fracture patients.
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Arch Orthop Trauma Surg · Dec 2018
Comparative StudyDoes discoid lateral meniscus have inborn peripheral rim instability? Comparison between intact discoid lateral meniscus and normal lateral meniscus.
Little is known about peripheral rim instability (PRI) of adult discoid lateral meniscus (DLM). We compared PRI of the intact DLM (iDLM) to those of intact normal lateral meniscus (LM) in adult patients and also investigated whether there was any association between PRI and DLM tears. ⋯ Level 3, comparative study of anatomical instability of living subjects.